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Psychiatry > Personality Disorders > Flashcards

Personality Disorders Flashcards

1
Q

What are the three groups of personality disorders?

A

Cluster A
Cluster B
Cluster C

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2
Q

What are cluster A PDs to do with?

A

Prominent problems are with the perceived safety of interpersonal relationships

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3
Q

What are the three cluster A PDs?

A

Schizoid PD
Schizotypal PD
Paranoid PD

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4
Q

What is the diagnostic criteria for paranoid PD?

A

Pervasive distrust & suspiciousness of others such that their motives are interpreted as malevolent, beginning in early adulthood & present in a variety of contexts as indicated by 4+ of:

  • Suspects, without sufficient basis, that others are exploiting, harming or deceiving him or her
  • Is preoccupied with unjustified doubts about the loyalty or trustworthiness or friends/associates
  • Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her
  • Reads hidden demeaning/threatening meanings into benign remarks/events
  • Persistently bears grudges
  • Perceives attacks on his or her character or reputation that are not apparent to others and quick to react angrily or to counteract
  • Has recurrent suspicious, without justification, regarding fidelity of spouse or sexual partner

Does not occur exclusively during course of schizophrenia, bipolar or depressive disorder with psychotic features, or another psychotic disorder or physiological effects of another medical condition

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5
Q

What is the diagnostic criteria for schizoid PD?

A

Pervasive pattern of detachment from social relationships and a restricted range of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, including 4+ of:

  • Neither desires nor enjoys close relationships, including being part of a family
  • Almost always chooses solitary activities
  • Has little, if any interest in having sexual experiences with another person
  • Takes pleasure in few, if any, activities
  • Lacks close friends or confidants other than first degree relatives
  • Appears indifferent to the criticism or praise of others
  • Shows emotional coldness, detachment or flattened activity

Does not occur exclusively during course of schizophrenia, bipolar or depressive disorder with psychotic features, or another psychotic disorder, ASD or physiological effects of another medical condition

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6
Q

What is the diagnostic criteria for schizotypal PD?

A

A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behaviour, beginning in early adulthood and present in a variety of contexts, including 5+ of:

  1. Ideas of reference
  2. Odd beliefs or magical thinking that influences behaviour and is inconsistent with cultural norms (e.g. superstitutiousness, belief in clairvoyance, telepathy etc.)
  3. Unusual perceptional experiences, including bodily illusions
  4. Odd thinking and speech (e.g. vague, circumstantial, metaphorical etc.)
  5. Suspicious or paranoid ideation
  6. Inappropriate or constricted effect
  7. Behaviour or appearance that is odd, eccentric or peculiar
  8. Lack of close friends/confidants other than first degree relatives
  9. Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than judgements about self

Does not occur exclusively during course of schizophrenia, bipolar or depressive disorder with psychotic features, or ASD

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7
Q

What do cluster B PDs centre around?

A

Problems keeping feelings tolerable without acting

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8
Q

What are the 4 cluster B PDs?

A

Narcissistic PD
Borderline PD
Antisocial PD
Histrionic PD

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9
Q

What is the diagnostic criteria for antisocial PD?

A

A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years, as indicated by 3+ of:

  1. Failure to conform to social norms with respect to lawful behaviours, as indicated by repeatedly performing acts that are grounds for arrest
  2. Deceitfulness, as indicated by repeated lying, uses of allases, or conning others for personal profit or pleasure
  3. Impulsivity or failure to plan ahead
  4. Irritability and aggressiveness as indicated by repeated physical fights or assaults
  5. Reckless disregard for safety of others or self
  6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behaviour or honour financial obligations
  7. Lack of remorse, as indicated by being indifferent to or rationalising having hurt, mistreated or stolen from another

Individual is at least 18yo
There is evidence of conduct disorder onset before age 15y
The occurrence of antisocial behaviour is not exclusively during the course of schizophrenia or bipolar disorder

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10
Q

What is psychopathy?

A

Severe form of antisocial PD

Characterised by antisocial behaviour, callous disregard and lack of empathy

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11
Q

How can you diagnose psychopathy?

A

PCL-R

Psychopathy checklist - revised

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12
Q

What is the diagnostic criteria for borderline PD?

A

A pervasive pattern of instability of interpersonal relationships, self-image and affects and remarked impulsivity, beginning in early adulthood and present in a variety of contexts as indicated by 5+ of:

  1. Frantic efforts to avoid real or imagined abandonment
  2. A pattern of unstable and intense interpersonal relationships charactersised by alternating between extremes of idealisation and devaluation
  3. Identify disturbance: marked and persistently unstable self image or sense of self
  4. Impulsivity in at least 2 areas that are potentially self-damaging (e.g. spending, sex, substance abuses, reckless driving, binge eating)
  5. Recurrent suicidal behaviour, gestures, threats or self-mutilating behaviour
  6. Affective instability due to a marked reactivity of mood
  7. Chronic feeling of emptiness
  8. Inappropriate, intense anger or difficulty controlling anger
  9. Transient, stress related paranoid ideation or severe dissociative symptoms
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13
Q

What is the narcissistic PD diagnostic criteria?

A

A pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration and lack of empathy, beginning in early adulthood and present in a variety of contexts, including 5+ of:

  1. Has grandiose sense of self-importance (e.g. exaggerates achievements and talents)
  2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love
  3. Believes that he or she is special and unique and can only be understood by, or should associate with high status/special people
  4. Requires excessive admiration
  5. Has a sense of entitlement
  6. Is interpersonally exploitive
  7. Lacks empathy, is unwilling to recognise or identify with the feelings and needs of others
  8. Is often envious of others and believes others are envious of him or her
  9. Shoes arrogant, haughty behaviours or attitudes
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14
Q

What is the diagnostic criteria for histrionic PD?

A

A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, including 5+ of:

  1. Is uncomfortable in situations in which he or she is not the centre of attention
  2. Interaction with others is often characterised by inappropriate sexually seductive or provocative behaviour
  3. Displays rapidly shifting and shallow expression of emotions
  4. Consistently uses physical appearance to draw attention to self
  5. Has a style of speech that is excessively impressionistic and lacking in detail
  6. Shows self-dramatization, theatrically, and exaggerated expression of emotion
  7. Is suggestible
  8. Considers relationships to be more intimate than they are
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15
Q

What is the main problem in cluster C personality disorders?

A

Problems relating to anxiety and how is it managed in relationships

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16
Q

What are the 3 cluster C PDs?

A 
Dependent PD
Obsessive compulsive (Anankastic) PD
Avoidant PD
17
Q

What is the diagnostic criteria for dependent PD?

A

A pervasive and excessive need to be taken care of that leads to submissive and clinging behaviour and fears of separation, beginning in early adulthood and present in a variety of contexts, including 5+ of:

  1. Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others
  2. Needs others to assume responsibility for most major areas of his or her life
  3. Has difficulty expressing disagreement with others because of fear of loss of support or approval
  4. Has difficulty initiating problems or doing things on his or her own (due to lack of self-confidence in judgement or abilities rather than lack of motivation/energy)
  5. Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant
  6. Feels uncomfortable/helpless when alone because of exaggerated fears of being unable to care for themselves
  7. Urgently seeks another relationship as a source of care and support with a close relationship ends
  8. Is unrealistically preoccupied with fears of being left to take care of him or herself
18
Q

What is the diagnostic criteria for obsessive compulsive PD?

A

A pervasive pattern of preoccupation with orderliness, perfectionism and mental and interpersonal control at the expense of flexibility, openness and efficiency, beginning in early adulthood and present in a variety of context, including at lest 4 of:

  1. Is preoccupied with details, rules, lists, orders, organisation or schedules to the extent that the major point of the activity is lost
  2. Shows perfectionism that interferes with ability to complete task
  3. Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships
  4. Is overconscientious, scrupulous and inflexible about matters of morality, ethics or values
  5. Is unable to discard work out or worthless objects even if they have no sentimental value
  6. Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things
  7. Adopts a miserly spending style towards both self and others, money is viewed as something to be hoarded for future catastrophes
  8. Shows rigidity and stubbornness
19
Q

What is the diagnostic criteria for avoidant personality disorder?

A

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning in early adulthood and present in a variety of contexts, including 4+ of:

  1. Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection
  2. Is unwilling to get involved with people unless certain of being liked
  3. Shows restraint within intimate relationships because of fear of being shamed or ridiculed
  4. Is preoccupied with being criticised or rejected in social situations
  5. Is inhibited in new interpersonal situations because of feelings of inadequacy
  6. Views self as socially inept, personally unappealing or inferior to others
  7. Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing
20
Q

What are the therapeutic options for PDs?

A 
Pharmacotherapy
Psychotherapy 
Specialist CBT 
Behavioural therapy 
Mentalisation based therapy
21
Q

What is mentalising?

A

The process by which we make sense of each other and ourselves, implicitly and explicitly, in terms of subjective states and intentional varied mental processes

Psychiatry (26 decks)

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