Personality Disorders Flashcards
what is personality
cluster of predictable patterns of thinking, feeling and behaving that is generally consistent across time, space and context
what makes up the structure of personality
Openness Conscientiousness Extraversion Neuroticism Agreeableness
(OCEAN)
what is a personality disorder
a pattern of inner experience and behaviour that deviates markedly from expectations of the individuals culture
pattern leads to clinically significant distress or impairment in social, occupational or other areas of functioning
what areas do personality disorder patterns of experience manifest in
Cognition
Affectivity
Interpersonal functioning
Impulse control
criteria for the pattern of behaviour seen in personality disorders
Stable and long duration
Not better explained as a manifestation or consequence of another mental health disorder
is not attributable to the physiological effects of a substance
what is anakaastic/OCPD personality disorder
Excessive feelings of doubt and caution
Preoccupation with details, rules, lists, order, organisation
Perfectionism that interferes with task completion
Excessive conscientiousness and scrupulousness
Undue preoccupation with productivity to the exclusion of pleasure and relationships
Excessive pedantry and a adherence to social conventions
rigidity and stubbornness
unreasonable insistence that others submit to exactly their way of doing things
what makes it a personality disorder not a personality trait
It is a disorder if it is pervasive (not just in specific situations) and causes distress or impairment of functioning in most areas
How do you measure personality
Clinical assessment - multiple over time
Rating scales
- ZAN-BPD
- personality assessment schedule
- personality disorders questionnaire
- minnesota multi
what causes a personality disorder
genes
individual factors
environment
what percentage of the general population have a personality disorder
10.6%
1 in 10
what PDs are classified as cluster A in ICD-10
‘odd and eccentric’
Paranoid PD
Schizoid PD
What PDs are classified as cluster B in ICD-10
'dramatic and emotional' Antisocial Emotionally unstable Borderline Histrionic
what ODs are classified as cluster C in ICD-10
‘anxious and avoidant’
Anxious
Dependent
Anakastic (OCPD)
What is paranoid personality disorder
pervasive distrust and suspiciousness of others so their motives are interpreted as malevolent
what criteria must patients meet 4 of to have paranoid personality disorder
- Suspects other are exploiting, harming or deceiving them
- Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends/associates
- reluctant to confide in other for fear info will be used against them
- reads hidden demeaning or threatening messages into benign remarks or events
- persistently bears grudges
- perceives attacks on his or her character or reputation that are not apparent to others - quick to react angrily or to counter attack
- has recurrent suspicions without justification regarding cheating partners
what is schizoid PD
pattern of detachment from social relationships with restricted range of emotions in interpersonal settings
what criteria must patients have 4 or more of to have schizoid PD
- Neither desires no enjoys close relationships - including being in a family
- almost always chooses solitary activities
- little if any interest in having sexual experiences with another person
- takes pleasure in few if any activities
- lacks close friends/confidants
- appears indifferent to praise or criticism of others
- shows emotional coldness, detachment or flattened affect
What is Antisocial PD
Pattern of disregard for and violation of the rights of others. Occuring since 15 y/o
what criteria must a patient have 3 of to have antisocial personality disorder
- failure to conform to social norms with lawful behaviours eg. repeatedly performing acts that are grounds for arrest
- deceitfulness indicated by repeated lying, use of aliases or conning others for profit or pleasure
- impulsivity/failure to plan
- irritability and aggressiveness
- reckless disregard for safety of self or others
- consistent irresponsibility eg. repeated failure to sustain consistent work/meet financial obligations
- lack of remorse
what is borderline personality disorder (emotionally unstable)
pattern of instability of interpersonal relationships, self image and affects
marked impulsivity beginning in early adulthood
what criteria do you need to meet 5 or more of to be diagnosed with BPD
- frantic efforts to avoid real or imagined abandonment
- pattern of unstable and intense interpersonal relationships alternating between extremes of idealisation and devaluation
- identity disturbance, persistently unstable self image/sense of self
- impulsivity which is self damaging
- recurrent suicidal behaviour, gestures or threats or self mutilating behaviour
- Marked reactivity of mood
- chronic feelings of emptiness
- inappropriate intense anger
- transient, stress related paranoid ideation or severe dissociative symptoms
what is histrionic personality disorder
pattern of excessive emotionality and attention seeking
what criteria do you need 5 or more of to have histrionic PD
- uncomfortable in situations where they aren’t the centre of attention
- interaction with others inappropriate sexually seductive or provocative behaviour
- rapidly shifting and shallow emotions
- consistently uses physical appearance to draw attention to self
- has a style of speech that is excessively impressionistic and lacking detail
- shows self dramatisation, theatrically and exaggerated expression of emotion
- is easily influences
- considers relationships to be more intimate than they are
what is avoidant personality disorder
pattern of social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation
what criteria must patients meet 4 of to have avoidant PD
- avoids occupational activities involving interpersonal contact for fears of criticism/ disapproval
- unwilling to get involved with people unless certain of people liked
- shows restraint within intimate relationships due to fear of being shamed/ridiculed
- preoccupied with being criticised or rejected in social situations
-inhibited in new interpersonal situations due to feelings of
inadequacy
- views self as socially inept, personally unappealing or inferior
- reluctant to take personal risks or engage in new activities as they might be embarrassing
what is dependent personality disorder
excessive need to be taken care of leading to submissive and clinging behaviour with fears of separation
what criteria do patients with dependant PD need to meet 5 of
- difficulty making everyday decisions without excessive amount of reassurance
- needs other to assume responsibility for most major areas of their life
- difficulty expressive disagreement with other for fear of loss/approval
- difficulty initiating projects or doing things on his or her own
- goes to excessive lengths to obtain nurturance and support from others - to point of doing unpleasant things
- feels uncomfortable or helpless when along because of exaggerated fears of being unable to care for himself or herself
- urgently seeks another relationship as source of care and support when a relationship ends
- unrealistically preoccupied with fears of being left to take care of themselves
what is obsessive compulsive PD (not same as OCD)
pattern of preoccupation with orderliness, perfectionism and mental and interpersonal control
what is psychopathy
a set of ‘deficits’ in emotional and cognitive functioning
what is interpersonal factors in psychopathy
- superficial charm
- grandiose self worth
- pathological lying
- conning/manipulative
what is affective factors in psychopathy
- lack of remorse or guilt
- shallow affect
- callous/lack of empathy
- failure to accept responsibility for actions
what is lifestyle factors in psychopathy
- need for stimulation (prone to boredom)
- parasitic lifestyle
- lack of realistic long term goals
- impulsivity
- irresponsibility
what are antisocial factors in psychopathy
- poor behavioural controls
- early behavioural problems
- juvenile delinquency
- revocation of condition
- criminal versitility
How do you treat AVOIDANT PD
Teaching people social skills
Antidepressants
how do you treat BPD (emotionally unstable PD)
Dialectical Behavioural Therapy (DBT)
Drugs for co-morbid conditions
Antipsychotics
Mood stabilisers
what is DBT (dialectical behavioural therapy)
focuses in reduction of suicidal behaviour
combines behavioural approaches with buddhist concepts
hard work for patients and team
