Personality Disorders

Question 1

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

Answer 1

Personality disorder

Question 2

Prevalence of personality disorders

Answer 2

Affect 10-15% of adult US population

[most common ones are schizotypical, antisocial (men), and histrionic which reach up to 3% prevalence]

Question 3

DSM criteria for personality disorders

Answer 3

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

Question 4

T/F: personality disorders are usually diagnosed prior to age 18

Answer 4

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

Question 5

List the personality disorders included in “Cluster A”

Answer 5

Paranoid personality disorder

Schizoid personality disorder

Schizotypal personality disorder

[Cluster A is considered the “weird, odd, eccentric” disorders]

Question 6

Personality disorder characterized by irrational suspicions and mistrust of others

Answer 6

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]

Question 7

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

Answer 7

Schizoid personality disorder

Question 8

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

Answer 8

Schizotypal personality disorder

Question 9

List the 4 personality disorders included in “Cluster B”

Answer 9

Antisocial PD

Boderline PD

Histrionic PD

Narcissitic PD

[Cluster B includes the dramatic, emotional, or erratic disorders]

Question 10

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

Answer 10

Antisocial personality disorder

Question 11

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

Answer 11

Borderline PD

Question 12

Personality disorder characterized by pervasive attention seeking behavior including inappropriate sexual seductiveness and shallow or exaggerated emotions

Answer 12

Histrionic PD

Question 13

Personality disorder characterized by pervasive pattern of grandiosity, need for admiration, and lack of empathy

Answer 13

Narcissitic PD

Question 14

T/F: Antisocial personality disorder is 3x more common in women and involves learned behaviors

Answer 14

False — Antisocial PD is 3x more prevalent in men and has a genetic basis

Question 15

Borderline PD is 3x more common in _______ (women/men)

Answer 15

Women

Question 16

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

Answer 16

Borderline PD

Question 17

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?

Answer 17

Histrionic personality disorder

Question 18

What personality disorders are included in “cluster C”?

Answer 18

Avoidant PD

Dependent PD

OCPD

[these are the anxious or fearful disorders]

Question 19

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?

Answer 19

Dependent PD

Question 20

Personality disorder characterized by social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation, and avoidance of social interaction?

Answer 20

Avoidant personality disorder

Question 21

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

Answer 21

OCPD

Question 22

How is avoidant personality disorder different from schizoid PD?

Answer 22

In avoidant PD, they desire relationships with others

Question 23

OCDP is more common in _____ (women/men)

Answer 23

Men

Question 24

Personality disorder characterized by the presence of 2+ distinct identities or personality states; more common in women and associated with hx of sexual abuse

Answer 24

Dissociative identity disorder

Question 25

Nonpharmacologic treatment options for personality disorders

Answer 25

Psychodynamic psychotherapy

Cognitive Behavioral Therapy

Group pscyhotherapy

Dialectical Behavioral Therapy

Pt and family education

Question 26

What is the treatment of choice for borderline personality disorder?

Answer 26

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]

Question 27

What class(es) of medications are typically avoided when treating pts with personality disorders?

Answer 27

TCAs
MAOIs
Benzodiazepines
Narcotics

Question 28

What medications may provide some relief to pts with manifestations of personality disorders?

Answer 28

SSRIs

Anticonvulsants like valproic acid — impulse control

Atpyical antipsychotics for pts experiencing transient psychotic periods

Question 29

Homicide is a potential complication in personality disorders, particularly _____ and ______

Answer 29

Paranoid; antisocial

Question 30

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

Answer 30

A; B; C

Question 31

Which cluster of personality disorders tends to have the worst prognosis, highest susceptibility to problems of substance abuse, impulse control issues, and suicidal behavior?

Answer 31

Cluster B