Personality Disorders Flashcards
Define personality
Personality = refers to set of consistent thoughts, feelings and behaviours shown across time in a variety of setting.
What differentiates a personality disorder from personality traits? (3Ps)
For it to be a disorder, it must conform to the 3Ps:
o Pervasive - occurs in all/most areas of life
o Persistent - evident in adolescence and continues through adulthood
o Pathological - causes distress to self or others, impairs function
Give the diagnostic criteria for personality disorders (ICD-10)
These are severe disturbances in the personality and behavioural tendencies of the individual; NOT directly resulting from disease, damage, or other insult to the brain, or from another psychiatric disorder; usually involving SEVERAL areas of the personality; nearly always associated with considerable PERSONAL distress and SOCIAL disruption; and usually manifest since CHILDHOOD or adolescence and continuing throughout adulthood
REPORT: o Relationships affected o Enduring o Pervasive o Onset in childhood/adolescence o Result in distress o Trouble in occupational/social performance
Give the five broad personality factors/traits (OCEAN)
o Openness to experience (curiosity, imagination, appreciation of art, adventure and emotion) o Conscientiousness (ability to plan and be self-disciplined to achieve goals) o Extraversion (predisposition to experience positive social events) o Agreeableness (tendency to be cooperative, trusting and kind) o Neuroticism (predisposition to negative emotions (e.g. anxiety, anger, depression))
Outline the 3 clusters of personality disorders (ICD-10)
o Cluster A - Odd or Eccentric • Paranoid • Schizoid o Cluster B - Dramatic, Erratic or Emotional • Histrionic • Emotionally unstable • Dissocial o Cluster C - Anxious and Fearful • Anankastic • Anxious (avoidant) • Dependent
Outline the aetiology of personality disorders using a bio-psycho-social model
Biological
- Genetics (determines 50% of personality)
- Family history of PD, depression or alcohol dependency
Psychological
- Childhood temperament (an infant’s pattern of activity, attention span, response to new situations and intensity of
emotional responses)
Social
- Childhood experience (e.g abuse, neglect, loss, trauma)
- Life event
- Poor support
Outline 3 theories of personality disorders
- Cognitive and psychoanalytical Theories
a. Quality of early relationships and the environment someone grows up in influences their expectations about
themselves and the world. E.g. behave cruelly if they were treated cruelly.
b. Behaviour is motivated by beliefs and desires- cognitive theories favour beliefs and psychoanalytic theories
emphasizing desires. Our expectations tend to be fulfilled and perpetuated. E.g. aggressive people tend to
spark hostility in others, proving their view that people are threatening and deserve an aggressive response. - Psychological Defences
a. Defence mechanisms are unconscious strategies used to manage uncomfortable feelings- often adaptive,
but can be harmful. In PD, can become rigid and overly reliant on these defences leading to conflict and
ignoring underlying emotions. Include: - Neurotransmitter Theories:
a. Lower serotonin levels in dissocial personality disorder. Serotonin implicated in regulation of impulsivity and
aggression.
b. Other monoamines may be involved e.g. dopamine for novelty seeking and noradrenaline for persistence and
dependency to rewards
Give examples of some psychological defence mechanisms
- Acting out - impulses are expressed through actions without conscious awareness of the underlying emotion (e.g. self-harm)
- Splitting - other people are thought of in polarised terms (either idealized or denigrated)
- Projection - uncomfortable feelings are put onto someone else and experienced as belonging to them
- Fantasizing: using imagination to escape from, painfulness of reality.
- Reaction formation: behaving in a way that is opposite to unacknowledged and unacceptable desires
Give examples of some personality disorders (8)
- Paranoid PD
- Schizoid PD
- Histrionic PD
- Emotionally unstable PD
- Dissocial (antisocial) PD
- Anankastic PD
- Anxious (avoidant) PD
- Dependent PD
Outline the clinical features of paranoid PD (SUSPECT) and its differentials
o Sensitive o Unforgiving o Suspicious o Possessive and jealous of partners o Excessive self-importance o Conspiracy theories o Tenacious sense of rights
DDx: schizophrenia, persistent delusional disorder
Outline the clinical features of schizoid PD (ALL ALONE) and its differentials
o Anhedonic o Limited emotional range o Little sexual interest o Apparent indifference to praise/criticism o Lacks close relationships o One-player activities o Normal social conventions are ignored o Excessive fantasy world
DDx: Asperger’s syndrome, agoraphobia, social phobia, psychosis, depression
Outline the clinical features of histrionic PD (ACTORS) and its differentials
o Attention seeking o Concerned with own appearance o Theatrical o Open to suggestion o Racy and seductive o Shallow affect
DDx: hypomanic/manic episode, substance misuse
Outline the different subtypes of emotionally unstable PD and give clinical features that are common to both (AEIOU)
Borderline type (borderling PD) & Impulsive type
o Affective instability
o Explosive behaviour
o Impulsive
o Outburst of anger
o Unable to plan or consider consequences
Outline the clinical features of borderline type PD (SCARS) and its differentials
o Self-image unclear o Chronic empty feelings o Abandonment fears o Relationships are intense and unstable o Suicide attempts and self-harm
DDx: adjustment disorder, depression, psychosis
Outline the clinical features of impulsive type PD (LOSE IT) and its differentials
o Lacks impulse control o Outbursts or threats of violence o Sensitivity to being thwarted or criticised o Emotional instability o Inability to plan ahead o Thoughtless of consequences
DDx: affective disorder, adjustment disorder, adult ADHD
