Personality disorders Flashcards

Question

Features of **dependant personality** disorder (not mnemonic ones)

Answer 1

* underlying anxiety and a lack of confidence * person is needy, unable to make decisions, worries about upsetting other people * feel helpless and rely heavily on others for help

Answer 2

Someone who **SUFFERs** **S** Subordinate – always concedes to others wishes **U** Undemanding – would be unwilling to make demands of others **F** Feels helpless, especially when alone **F** Fears abandonment – is terrified by the thought of isolation **E** Encourages others to make decisions **R** Reassurance – needs lots of reassurance that they are ok

Answer 3

**The most important PD to know about** * There are 2 subtypes of this personality disorder – an **impulsive** type and a **borderline** type * This is the commonest PD seen in psychiatric settings and most inpatient wards and A + E departments will have regular contact with people with EUPD * a very complex personality disorder and people often experience hallucinations and have substance misuse problems

Answer 4

**List of Vowels** **A** Affective Instability (unstable mood) **E** Explosive behaviour (very quick changes in mood) **I** Impulsive (reckless – lack of planning) **O** Outburst of anger (often self-directed = deliberate self-harm) **U** Unable to plan or consider consequences

Answer 5

* overly dramatic * prone to exaggeration, telling white lies, acting in a very melodramatic and outspoken way * dressing provocatively, being flirtatious and/or confrontational Why?..... To gain attention. Attention seeking behaviour. People with this PD crave the limelight and being the centre of attention. This behaviour is probably a compensation for low self-esteem

Answer 6

People who are **ACTORS** **A** Attention Seeking **C** Concerned with their own appearance **T** Theatrical **O** Open to suggestion (easily influenced) **R** Racy and seductive (flirtatious) **S** Shallow affect (superficial concern for others)

Answer 7

Narcissism is: * vanity, arrogance, and self-obsession * despite initially being charming they are manipulative and very sensitive to criticism * they believe they are ‘special’ and should be recognised for this and find it impossible to accept any negative comments – and become hostile and aggressive if challenged or confronted

Answer 8

**MNEMONIC:** People who think **I LOVE ME** ## Footnote **I** - Is easily jealous **L –** Lacks empathy **O –** Over reacts to criticism **V –** Views themselves as ‘special’ **E –** Exaggerates own importance **M –** Manipulative of others **E –** Expectations are unrealistic

Answer 9

* self- obsessed, but in a negative way * they believe other people are conspiring against them * they are jealous, suspicious, guarded and sensitive * the nature of the belief is usually non-bizarre – so believing colleagues at work didn’t like you, or that your partner was being unfaithful * Paranoid PD isn’t psychosis, but the conviction with which the belief is held can be almost delusional

Answer 10

**People who SUSPECT others** **S** Sensitive **U** Unforgiving **S** Suspicious **P** Possessive (jealous of partners) **E** Excessive self-importance **C** Conspiracy Theories (person believes in conspiracies) **T** Tenacious sense of rights (They are ALWAYS right)

Answer 11

* arguably part of the autistic spectrum * emotionally detached * different from Avoidant PD as people who are Schizoid will mix with others, but just won’t connect socially * generally have no friends; no close partners and are often difficult to communicate with as they don’t seem to be able to communicate emotions clearly Think of an isolated, emotionally blunted social loner.

Answer 12

People who are **ALONE** **A** Anhedonia (no pleasure in lots of things) **L** Lacks (friends, sexual; interest, emotions) **O** Odd (emotionally blunted and detached) **N** Normal social conventions ignored **E** Excessive fantasy world

Answer 13

* odd beliefs, unusual perceptions etc * the nature and impact of these traits cause severe problems to the individual * most of society views them as a weirdo, oddball, freak

Answer 14

People who are **WEIRD** **W** Weird (some very odd ideas/strange beliefs) **E** Eccentric (strange clothing, unusual tastes and hobbies) **I** Ideas of reference (unusual beliefs – Aliens/Wizards etc) **R** Rule out psychosis (strange but not psychotic) **D** Difficulty with friendships

Answer 15

* ***The Hare PCL-R*** → for Dissocial PD (also known as psychopathy). * Hare PCL-R is **Hare P**sychopathy **C**heck**L**ist – **R**evised. 20 items are assessed: * No = 0 * maybe = 1 * yes = 2 * score of 30+ indicates Dissocial PD

Answer 16

Most forms of Personality Disorder are assessed using clinical judgement. However, Dissocial PD can be assessed using a checklist.

Answer 17

* Because personality is part of us – it is very hard to ‘treat’ * Most forms of medications and talking therapies have limited success with all forms of personality disorder – so interventions become symptom specific. * **Mood stabilisers** → may help people with impulsive traits – emotional unstable personality disorder/Dissocial * **Antipsychotics →** may help someone with Schizoid/Schizotypal/Paranoid PD * **SSRI’s** → may help people with associated mood and anxiety problems - so Anxious/Dependent/Anankastic/EUPD * Talking therapies may help depending on the level of insight the person has and type of personality disorder

Answer 18

**Psychotherapy** would most likely be unhelpful for Dissocial/Histrionic/Narcissistic PD → as it would probably just indulge the person in an opportunity to talk about themselves

Answer 19

* **EUPD** (emotional unstable personality disorder) responds best to a talking therapy called ***Dialectic Behaviour Therapy*** This is a form of talking therapy that mixes CBT with Mindfulness and other approaches → so it is a hybrid mix that centres on language (dialect) and the use of metaphors to help people make sense of their lives – hence the term dialectic

Answer 20

* Usually it is out-patient treatment delivered over a period of 1 year, although patients may join a DBT programme for a second year or stay in therapy for even longer * The main components for the patients are a weekly individual out-patient session, attendance at a weekly skills training group and possible out-of-hours telephone contact * Individual sessions typically last for 45–60 minutes and occur weekly. * The past week is reviewed using ‘diary cards’ that the patient has filled in. * There is a recommended structure to sessions that follows a hierarchy of topics. * Life-threatening behaviours should be discussed and dealt with first * Then come therapy-interfering behaviours, quality-of-life-interfering behaviours and attention to skills. * In practice, the detailed content of sessions may be influenced by the style of the individual therapist. * However, the whole process should be aimed at providing a setting that is validating for the patient.

Answer 21

REMEMBER….. People with personality disorders don’t choose to have them; they are people with a distressing mental disorder that causes them problems in life. So should be treated with kindness and compassion like everyone else!