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Psychiatry > Personality Disorders > Flashcards

Personality Disorders Flashcards

1
Q

Define personality

A

A cluster of relatively predictable patterns of thinking, feeling, and behaving that is generally consistent across time, space, and context

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2
Q

Personality Trait Vs Disorder

A

A problematic trait can only be called a disorder if it is pervasive AND causes distress/impairement of functioning in most areas.

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3
Q

What is a personality disorder

A

Pattern of behaviour that deviated markedly from the normal, not due to brain injury or other psychiatric disorders.

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4
Q

Features of personality disorders

A

Pervasive and inflexible across a broad range of situations

Clinically significant distress or impairment in 2 or more areas of functioning

Onset can be traced back atleast to adolescence

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5
Q

List the areas in which personality disorders manifest

A
  1. cognition - interpretation of self, other people, events
  2. Affectivity
  3. Interpersonal functioning
  4. Impulse control
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6
Q

DSM 5 classification of personality disorders

A

CLUSTER A: paranoid, schizoid
CLUSTER B: antisocial, borderline, histrionic
CLUSTER C: avoidant, dependant, obsessive-compulsive/Ankanastic

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7
Q

What is paranoid personality disorder?

A

A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent

Beginning by early adulthood

Present in a variety of contexts

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8
Q

Features of paranoid personality disorder

A

Suspicious - without sufficient basis that others are exploiting, harming or deceiving

Mistrustful - unwarranted fear that information will be used maliciously against them

Jealous

Sensitive - take offence easily, see criticism where none was intended

Resentful

Bears grudges

Self importance

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9
Q

Aetiology of paranoid personality disorders

A

Unclear

Suspect genetic influence

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10
Q

Features of Schizoid PD

A

Emotionally cold

Detached - chooses solitary activities

Aloof

Lacking enjoyment

Introspective

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11
Q

Aetiology of schizoid PD

A

Unclear

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12
Q

What is antisocial PD?

A

A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years

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13
Q

Features of antisocial PD

A

Callous lack of concern for others - may be violent or cruel

Transient relationships

Irresponsible- do not obey rules, often break the law

Impulsive and irritable - do not plan ahead, risk safety of themselves and others

Lacking guilt and remorse

Failure to accept responsibility - blame others, rationalise their own failures

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14
Q

Aetiology of antisocial PD

A

Genetic
Cerebral pathology and maturation
Abnormal 5-HT transmission
Childhood behaviour and family problems

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15
Q

What is borderline/emotionally unstable (ICD-10) PD?

A

pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood

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16
Q

Features of borderline PD

A

Strong and fluctuating emotions - overwhelming

Identity disturbance- markedly and persistently unstable self-image or sense of self.

Impulsivity in at least 2 areas that are self damaging

Self harm/suicidal ideation

Alcohol and drug abuse

Difficulty controlling anger

Frantic efforts to avoid abandonment (real or imagined)

17
Q

What is histrionic PD?

A

excessive emotionality and attention seeking, beginning by early adulthood

18
Q

Features of histrionic PD

A

Self dramatization - emotional blackmail, angry scenes, demonstrative suicide attempts

Inappropriately seductive

Seek attention and excitement

Suggestible - easily influenced by others or circumstances

Over concerned with physical appearance

self centred

Shallow labile effect

Self deception - convinced by their own fabrications

19
Q

What is avoidant (anxious) PD?

A

pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood

20
Q

Features of avoidant PD

A 
Feels socially inferior 
Preoccupied with rejection
Avoids involvement
Avoids risk
Avoids social activity
Restraint in intimate relationships due to fear of being shamed or ridiculed
21
Q

What is dependent PD?

A

excessive need to be taken care of that leads to submissive and clinging behaviour and fears of separation, beginning by early adulthood

22
Q

Features of dependent PD

A

Allows others to take responsibility
Difficulty making everyday decisions without advice and reassurance from others
Difficulty initiating projects
Goes to excessive lengths to obtain support
Urgently seeks supportive relationship
Unduly compliant
Feels unable to care for himself or herself

23
Q

What is obssessive compulsive/anankastic PD

A

preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood

24
Q

Features of Obsessive compulsive/anankastic PD

A

Preoccupied with details/rules etc.

Inhibited by perfectionism

Over conscentious and scrupulous in ethics and morals

Excess concern with work and productivity

Unable to disregard worthless objects

25
Q

Antisocial PD vs psychopathy

A

Antisocial PD ≠ psychopathy
Antisocial PD is largely based on behaviour, whilst psychopathy describes a set of ‘deficits’ in emotional and cognitive functioning

26
Q

Name the only forms of PD that respond to treatment

A

Avoidant PD
Antisocial PD
Borderline PD

27
Q

Treatment for avoidant PD

A

Social skills training - increase self efficacy and functioning
Some evidence for antidepressants

28
Q

Treatment for emotionally unstsable/borderline PD

A

Mainstay treatment - Dialectical Behavioural Therapy (DBT)

Mentalisation

Pharmacotherapy

29
Q

Features of DBT

A

To reduce harmful behaviours - suicide, substance abuse, self harm

Increase emotional and cognitive regulation - awareness of triggers and assessing coping skills

30
Q

Features of mentalisation

A

Helping the patient become more aware their thoughts and feelings rather than acting on them without reflection.

31
Q

Pharmacologic treatment of borderline PD

A

Use of medications to treat co-morbid conditions only rather than the individual symptoms or behaviours associated with the disorder.

Can administer in the case of a crisis, however should not be given for > 1 week

Psychiatry (15 decks)

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