Personality Disorders Flashcards
Inflexible, maladaptive, and rigidly pervasive pattern of behavior causing subjective distress and/or impaired functioning; person is usually not aware of problem; usually presents by early adulthood
Personality disorder
Prevalence of personality disorders
Affect 10-15% of adult US population
[most common ones are schizotypical, antisocial (men), and histrionic which reach up to 3% prevalence]
DSM criteria for personality disorders
Enduring pattern on inner experience and behavior that deviates markedly from expectations of individual’s culture — manifesting in 2 or more of: cognition, affect, interpersonal functionin, and/or impulse control
Enduring pattern is inflexible and pervasive across a broad range of personal and social situations
Leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning
Pattern is stable and of long duration and onset can be traced back to adolescence/early adulthood
Pattern is not better accounted for by another mental d/o
Not due to direct physiological effects of substance or head injury, etc
T/F: personality disorders are usually diagnosed prior to age 18
False — People under 18 who fit criteria of personality disorder are usually not diagnosed with one, although they may be dx with a related d/o. In order to diagnose an individual under 18 with a PD, symptoms must be present for at least 1 year
List the personality disorders included in “Cluster A”
Paranoid personality disorder
Schizoid personality disorder
Schizotypal personality disorder
[Cluster A is considered the “weird, odd, eccentric” disorders]
Personality disorder characterized by irrational suspicions and mistrust of others
Paranoid personality disorder
[may think that others are exploiting or deceiving them, friends and associates are untrustworthy, info confided in others will be used maliciously, hidden meaning in remarks/events others perceive as benign, spouse or partner is unfaithful; at increased risk for agoraphobia, major depression, OCD, and substance abuse]
Personality disorder characterized by lack of interest in social relationships, seeing no point in sharing time with others; appear indifferent to the praise or criticism of others and often seem cold or aloof; lacks close friends or confidants other than first degree relatives. Marked by little pleasure or interest in activities
Schizoid personality disorder
Personality disorder characterized by odd behavior or thinking, ideas of reference, odd beliefs or magical thinking, vague/circumstantial/stereotyped speech, excess social anxiety that does not diminish with familiarity, idiosyncratic perceptual experiences or bodily illusion
Schizotypal personality disorder
List the 4 personality disorders included in “Cluster B”
Antisocial PD
Boderline PD
Histrionic PD
Narcissitic PD
[Cluster B includes the dramatic, emotional, or erratic disorders]
Personality disorder characterized by pervasive disregard for the law and rights of others; may include repeated violations of the law, pervasive lying and deception, physical aggressiveness, reckless disregard for safety of self or others, consistent irresponsibility in work and family environments, and/or lack of remorse
Antisocial personality disorder
Personality disorder characterized by extreme “black and white” thinking, instability in relationship, self-image, identity and behavior; may involve frantic efforts to avoid expected abandonment, unstable and intense interpersonal relationships, impulsivity in at least 2 areas that are potentially self-damaging, recurrent suicidal behaviors or threats of self-mutilation, affective instability, chronic feelings of emptiness, inappropriate and intense anger, transient paranoia or dissociation
Borderline PD
Personality disorder characterized by pervasive attention seeking behavior including inappropriate sexual seductiveness and shallow or exaggerated emotions
Histrionic PD
Personality disorder characterized by pervasive pattern of grandiosity, need for admiration, and lack of empathy
Narcissitic PD
T/F: Antisocial personality disorder is 3x more common in women and involves learned behaviors
False — Antisocial PD is 3x more prevalent in men and has a genetic basis
Borderline PD is 3x more common in _______ (women/men)
Women
What personality disorder:
Very manipulative by nature, immature personality traits (“teddy bear sign”), requires a need to set rigid boundaries when treating them; are often victims of sexual or emotional abuse, and have a high rate of comorbid depression
Borderline PD
What personality disorder is associated with tendency to vague and impressionistic speech, and a seemingly indifferent detachment while describing dramatic physical symptoms as well as particular association with somatoform d/o?
Histrionic personality disorder
What personality disorders are included in “cluster C”?
Avoidant PD
Dependent PD
OCPD
[these are the anxious or fearful disorders]
Personality disorder characterized by difficulty making decisions without guidance and reassurance, difficulty expressing disagreement with others, discomfort or helplessness when alone, and unrealistic preoccupation with fears of being left to fend for themselves?
Dependent PD
Personality disorder characterized by social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation, and avoidance of social interaction?
Avoidant personality disorder
Personality disorder characterized by rigid conformity to rules, moral codes, and excessive orderliness, but preoccupations interfere with their efficiency despite their focus on tasks; often stingy as well as stubborn
OCPD
How is avoidant personality disorder different from schizoid PD?
In avoidant PD, they desire relationships with others
OCDP is more common in _____ (women/men)
Men
Personality disorder characterized by the presence of 2+ distinct identities or personality states; more common in women and associated with hx of sexual abuse
Dissociative identity disorder
Nonpharmacologic treatment options for personality disorders
Psychodynamic psychotherapy
Cognitive Behavioral Therapy
Group pscyhotherapy
Dialectical Behavioral Therapy
Pt and family education
What is the treatment of choice for borderline personality disorder?
Dialectical behavior therapy
[Manual-based therapy is on the development of coping skills to improve affective stability and impulse control and on reducing self-harm]
What class(es) of medications are typically avoided when treating pts with personality disorders?
TCAs
MAOIs
Benzodiazepines
Narcotics
What medications may provide some relief to pts with manifestations of personality disorders?
SSRIs
Anticonvulsants like valproic acid — impulse control
Atpyical antipsychotics for pts experiencing transient psychotic periods
Homicide is a potential complication in personality disorders, particularly _____ and ______
Paranoid; antisocial
Cluster ___ and ____ personality disorders tend to become less severe and intense in middle age and late life, while cluster ____ characteristics tend to become exaggerated in later life
A; B; C
Which cluster of personality disorders tends to have the worst prognosis, highest susceptibility to problems of substance abuse, impulse control issues, and suicidal behavior?
Cluster B
