PERSONALITY DISORDERS Flashcards

1
Q

what are personality disorders?

A
  • disorders marked by persistent, inflexible, maladaptive patterns of thought and behaviour
  • develops in early adulthood/adolescence
  • impairs ability to function
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2
Q

trait domains PD is based on

A
negative affectivity
detachment
antagonism
disinhibition
psychotism
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3
Q

individual PD - DSM-5

A
  • shcizotypal PD
  • antisocial PD
  • BPD
  • narcissistic PD
  • obsessive compulsive PD
  • avoidant PD
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4
Q

prevalence of PD

A
  • most common –> schizoid, avoidant and paranoid

- worldwide estimates - 4-15%

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5
Q

history of diagnosis of PD

A
  • diagnosis of exclusion

- label used for those difficult to help

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6
Q

difficulties with diagnosis of PD

A
  • clinicians bypass general diagnostic requirements

- types = subjective

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7
Q

criteria for general PD

A
ongoing rigid pattern of though and behaviour with 2 or more:
- cognition
- affectivity
- interpersonal functioning
- impulse control
consistent and long lasting pattern
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8
Q

cluster A of PD

A
  • schizotypal PD
  • schizoid PD
  • dilutional disorder
  • schizoaffective disorder
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9
Q

cluster B of PD

A

anti social PD

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10
Q

cluster C of PD

A

obsessive compulsive PD

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11
Q

cluster A aetiology

A
  • genetic link

- neurobiological evidence - similarity in abnormal brain development and physiological evidence

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12
Q

Cluster B aetiology

A
  • MZ > DZ

- genetics likely to interact with environment

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13
Q

physiological evidence for cluster B

A
  • lower reactivity levels of skin conductance
  • no startle response
  • slow automatic arousal to emotional/distressting stimuli
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14
Q

cluster C aetiology

A
  • low comorbidity with OCD (22%)
  • linked to manipulation/guilt induction parenting style (Aycicegi et al., 2002)
  • not a lot of research
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15
Q

maintenance factors of PD

A
  • emotion dysregulation - mediated associationg between BPD symptom severity at baseline and affective instability and identity disturbance at 12 month follow up, consistent with emotional dysregulation as maintenance factor
  • not seeking support/help (Lenzenweger, 2006)
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16
Q

pharmocotherapy intervention

A
  • mood stabilisers - help mood swings
  • anti psychotics - alleviate psychotic symptoms
  • only used in cases of comorbidity with mood disorders
17
Q

psychosocial interventions

A
  • behaviour therapy
  • traditional psychoanalytic
  • individual or group treatment
  • guidelines suggest these should be paired with other support (e.g. social or employment)
18
Q

aims of interventions

A
  • reduce life threatening symptoms
  • improve distressing mental state symptoms
  • aid in advocacy issues (e.g. employment)
  • improve life outcomes
  • acute symptoms generally met but more complex needs are not (Bateman et al., 2015).
19
Q

cluster A interventions: psychosocial

A
  • cognitive therapy - effects change in cognitive/social disabilities
  • nature of paranoid PD –> suspicion means interventions are difficult to implement
20
Q

cluster A interventions: pharmacological

A
  • antipsychotics - improvement in symptom severity/risk to benefit ratio unclear
  • no RCT —> lack of evidence
21
Q

cluster B interventions - psychosocial

A
  • CBT - schema specific
  • transference focused psychotherapy
  • mentalisation based therapy
  • systems training emotional predictability therapy
  • cognitive analytical therapy
  • social skills training
22
Q

cluster B interventions: pharmacological

A
  • SSRIs
  • low dose antipsychotics
  • mood stabilisers
23
Q

cluster C interventions: psychosocial

A
  • cognitive therapy
  • CBT
  • schema focused therapy
24
Q

clsuter C interventions: pharmacological

A

antidepressants

25
Q

NHS treatments

A
  • care programme approach
  • psychotherapy
  • mentalisation-based therapy (MBT)
  • therapeutic communities (TCs)
  • arts therapies
  • medication