Personality disorders Flashcards

1
Q

3 ps of behavior

A

persistent (over time)
pervasive (over people and situations)
pathological (clearly abnormal)

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2
Q

Cluster A

A

people who are perceived as odd or eccentric ie. paranoid, schizoid, and schizotypal

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3
Q

Cluster B

A

“drama queens” - people whose behavior is overly dramatic, emotional, or erratic ie. antisocial, borderline, histrionic, and narcissistic

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4
Q

Cluster C

A

Anxious or fearful individuals ie avoidant,

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5
Q

Paranoid personality disorder

A

4+:
-suspects others are exploiting, harming, or deceiving him/her
-preoccupied w/ unjustified doubts about loyalty
-reluctant to confide in others
-reads hidden mdemaning or threatening meanings into benign remarks or events
-persistently bears grudges
-perceives attacks on character
-
–> not exclusively during schizophrenia, bipolar or depressive dx w/ psychotic features, or another psychotic disorder

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6
Q

Individuals w PPD may develop…

A

MDD, agoraphobia, OCD, substance-use disorders

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7
Q

Schizoid personality disorder

A

Pervasive pattern of detachment from social relationships
-begins by early adulthood
4+:
-no desire or joy in close relationships
-almost ALWAYS chooses solitary activities (not disturbed by this)
-little to no interest in sexual experiences w another person
….

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8
Q

Schizoid personality disorder Commorbidity

A

may appear as premorbid antecedent of delusional disorder or schizophrenia

  • may develop MDD
  • co-occurs most often w schizotypal, paranoid, and avoidant personality disorders
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9
Q

Schizoid personality disorder prevalence

A

uncommon in clinical settings

3-5%

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10
Q

Schizoid Personality Disorder differential dx

A
  • other mental disorders w psychotic symptoms

- autism spectrum disorder

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11
Q

Schizotypal Personality Disorder

A

-pervasive pattern of social dn interpersonal deficits
-acute DISCOMFORT W and reduced capacity for close relationships
5+:
-ideas of reference (excluding delusions of reference)
-odd beliefs or magical thinking
-unusual perceptual experiences, including bodily illusions (misinterpretation of something, just short of hallucination)
-odd thinking and speech
-suspicioussness or paranoid ideation
-inappropriate or constricted affect
-behavior or appearance that is odd, eccentric, or peculiar
-lacks close friends or confidants
-excessive social anxiety

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12
Q

schizotypal personality disorder comorbidity

A
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13
Q

Antisocial personality disorder

A

-pervasive pattern of disregard for, and violation of, the rights of others
-at least 18 yo
-there is evidence of conduct disorder w onset before age 15 years
-not exclusively during the course of schizophrenia or bipolar disorder
(often in lay terms referred as ‘psychopath’ or ‘sociopath’)

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14
Q

Antisocial personality disorder reqs

A

3+

  • failure to conform to social norms re lawful bus
  • deceitfulness, as indicated by repeated lying
  • impulsivity or failure to plan ahead
  • irritability and aggressiveness
  • reckless disregard for safety of self or others
  • consistent irresponsibility
  • lack of remorse
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15
Q

Antisocial personality disorder associated features

A

risk of developing this dx as an adult is increased if hx …

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16
Q

Genetic Risk

A

Risk to biological relatives of females with dx tends to be higher than to biological

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17
Q

Borderlien Personality Disorder

A
  • tend to undermine themselves at the moment a goal is about to be realized
  • pervasive pattern of instability of interpersonal relationships, self-image, and affects
  • marked impulsivity
  • beginning by early adulthood
  • present in a variety of contexts
  • higher risk of suicidality
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18
Q

Borderline Personality Disorder reqs

A

5+:

  • frantic efforts to avoid real or imagined abandonment
  • pattern of unstable and intense interpersonal relationships characterized by alternating bw extremes of idealization and devaluation
  • identity disturbance (unstable self-image)
  • 2+ areas of impulsivity
  • recurrent suicidal bx, gestures, threats, or SIBs/SABs
  • labile affect
  • chronic feelings of emptiness
  • inappropriate, intense anger
  • transient stress-related paranoia or severe dissociative sxs
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19
Q

Borderline Personality Disorder comorbidity

A

common ie depressive and bipolar disorders, substance use disorders, eating disorders, ptsd, add

  • freq occurs w other personality dxs
  • physical/sexual abuse, neglect, hostile conflict, and early parental loss common in the childhood histories of those w borderline personality dx
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20
Q

borderline personality disorder prevalence

A

1.6-5.9%
6% in primary care settings
10% in outpatient mental health clinics

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21
Q

Borderline personality disorder genetic risk

A

5x more common among 1st degree biological relatives of those w the disorder

22
Q

Histrionic Personality Disorder

A
  • excessive emotionality and attention seeking
  • beginning early adulthood
  • present in variety of contexts
23
Q

Histrionic Personality Disorder reqs

A

5+:

  • uncomfortable in situations where not center of attention
  • often inappropriately sexually seductive or provocative
  • rapidly shifting and shallow emotional expressions
  • uses physical appearance to draw attention to self
  • speech style is excessively impressionistic and lacks detail
  • dramatization, theatricality, and exaggerated emotions
  • is suggestible (easily influenced)
  • considers relationships to be more intimate than in reality
24
Q

Histrionic person. disorder comorbidity

A
  • associated w higher rates of somatic symptom disorder, conversion disorder, and MDD
  • borderline, narcissistic, antisocial, and dependent personality disorders often co-occur
25
Narcissistic Personality Disorder
-pattern of grandiosity, need for admiration, and lack of empathy 5+: -grandiose sense of self-importance -fantasies of success, power, brilliance, beauty, ideal love -belief of being special and unique -requires excessive admiration -has sense of entitlement -in interpersonally exploitative -lacks empathy -often envious of others or believes others are envious -shows arrogant, caught behavior/attitudes
26
Narcissistic Personality Disorder comorbidity
- sustained self-criticism | - hypomanic mood, anorexia nervosa and substance use (esp cocaine)
27
Avoidant personality disorder
4+ - fears of criticism - unwilling to get involved unless sure to be liked - shows restraint within intimate relationships bc of fear of being shamed or ridiculed - preoccupied w being criticized - inhibited of.....
28
Avoidant personality disorder comorbidity
-commonly w depressive, bipolar, and anxiety disorders, especially with social anxiety disorder
29
Dependent Personality Disorder
-need to be cared for leading to submissive, clinging bx and fears of separation 5+ -difficult decision-making w/o excessive advice fo others -needs others to assume responsibility for most major areas of life -difficulty expressing disagreement w others -difficulty initiating projets or doing things on won -excessive lengths to get nurturance/support from others ...
30
Dependent personality disorder comorbidity
- other personality dxs - separation disorders - chronic physical illness or separation anxiety disorder in childhood or adolescence may predispose to this disorder
31
Prevalence
.5-.6% | -more females diagnosed
32
Obsessive-compulsive personality dx
``` 4+: -preoccupied w details, rules, lists, order, schedules -perfectionism that interferes w task -excessively devoted to work ... ```
33
Obsessive-compulsive personality disorder comorbidity
- social anxiety disorder, specific phobias, and odd - majority of individuals w odd do not have a pattern of behavior that meets criteria for ocpd - many of the features of ocpd overallp with 'type a' personality disorders
34
OcPD prevalence
MOST PREVALENT PERSONALITY DISORDER 2-8% of population -diagnosed 2x as often among males
35
ocpd differential diagnosis
- ocd is usually easily distinguished from ocpd by presence of true obsessions and compulsions in odd - when criteria are met for both ocpd and odd, dx both
36
Personality Change to another medical condition
personality disturbance that represents a change from individual's previous characteristic personality pattern -evidence that direct result of condition, medical diagnosis ...
37
Personality disorder assessment
-takes a long time (need solid baseline pattern, can be based on med records and notes from previous conclusion) -
38
Assessment instruments
MMPI-2 | -Coolidge Axis II Inventory (CATI)
39
Personality Disorders
Maladaptive, rigid bx pattern or personality traits Pervasive (over people and situations) and inflexible Deviates markedly from the individual's culture Onset in adolescence or early adulthood Stable over time Associated w states of personal distress or impairment
40
T/F: People w personality dx generally recognize a need to change themselves
False
41
Paranoid Personality Dx (generally)
Pattern of distrust and suspiciousness Motives of others are interpreted as malevolent Relationships suffer Not the more flagrant delusions typical of schizophrenia
42
Schizoid Personality Disorder (generally)
Little if any interest in social relationships Restricted range of emotional expression Appear distant and aloof
43
Schizotypal Personality Dx (generally)
Acute discomfort in close relationships | Appear odd or eccentric in thoughts, mannerisms, and bx, but not to degree found in schizophrenia
44
Antisocial personality dx (generally)
Persistently engage in bx that shows disregard for, and violates, social norms and the rights of others Tend to show no remorse for their misdeeds
45
Borderline Personality Dx (generally)
Pattern of instability in interpersonal relationships, self-image, and affect Often engage in impulsive, self-destructive acts
46
Histrionic Personality Disorder (generally)
Excessive emotionality and attention seeking Tend to be highly dramatic and emotional in their bx Demand to be center of attention
47
Narcissistic Personality Disorder (generally)
Grandiose, need for admiration, and lack of empathy | Demand to be center of attention
48
Avoidant Personality Dx (generally)
Pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation So terrified of rejection and criticism that they are generally unwilling to enter relationships w/o unusually strong reassurances of acceptance
49
Dependent Personality Disorder (gen)
Submissive and clinging bx related to an excessive need to be taken care of Have extreme difficulty acting independently or making even the smallest decisions on their own
50
Obsessive-Compulsive Personality Dx (gen)
Pattern of preoccupation w orderliness, perfectionism, and control W/o the true obsessions and compulsions associated with Obsessive-Compulsive Disorder
51
Personality Change due to another medical condition (gen)
Persistent personality disturbance judged to be due to the direct physiological effects of a medical condition