Personality disorders

Question 1

How is personality disorder defined?

Answer 1

An enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture
Pattern is inflexible and pervasive
Leads to clinically significant distress or impairment in a range of functioning
Pattern is stable and can be traced back to early adulthood
Not better explained by another diagnosis
Not attributable to physiological change

Question 2

What disorders fall into cluster A personality disorders?

Answer 2

Paranoid personality disorders
Schizoid personality disorder
Schizotypal personality disorder

Question 3

What is the main feature of cluster A personality disorders?

Answer 3

Prominent problems are with perceived safety of interpersonal relationships

Question 4

What are diagnostic criteria for paranoid personality disorder?

Answer 4

Pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood annd present in a variety of contexts indicated by 4 or more criteria (these will be in another card)
Does not occur exclusively during course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to the physiological effects of another medical condition

Question 5

What are the diagnostic criteria in paranoid personality disorder for distrust of others?

Answer 5

4 or more of:
Suspects that others are exploiting, harming, or deceiving them without sufficient basis
Is preoccupied with unjustified doubts about trustworthiness of friends and associates
Reluctant to confide in others because of unwarranted fear info will be used maliciously
Reads hidden demeaning or threatening meanings into benign remarks or events
Persistently bears grudges
Perceives attacks on their character that arent apparent to others
Recurrent suspiciouns regarding faithfulness of spouse

Question 6

What is schizoid personality disorder?

Answer 6

Pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood

Question 7

What are criteria for schizoid personality disorder?

Answer 7

4 or more of:
Neither desires nor enjoys close relationships, including family
Almost always chooses solitary activities
Little interest in sex
Takes pleasure in few activities
Lacks close friends or confidants other than first degree relatives
Appears indifferent to praise or criticism of others
Emotional coldness

Question 8

What is schizotypal personality disorder?

Answer 8

Pervasive pattern of social and interpersonal deficits marked by acute discomfort with close relationships as well as by cognitive or perceptual distortions and eccentricities of behaviour

Question 9

What are diagnostic criteria for schizotypal personality disorder?

Answer 9

5 or more of:
Ideas of reference
Odd beliefs or magical thinking that influences behaviour and is inconsistent with subcultural norms
Unusual perceptual experiences
Odd thinking and speech
Suspiciousness or paranoid ideation
Inappropriate or constricted affect
Behaviour or appearance that is odd, eccentric, peculiar
Lack of close friends or confidants other than first degree relatives
Excessive social anxiety associated with paranoid fears rather than self esteem

Question 10

What disorders fall under cluster B personality disorders?

Answer 10

Antisocial personality disorder
Narcissistic personality disorder
Borderline personality disorder
Histrionic personality disorder

Question 11

What is the main feature of cluster B personality disorders?

Answer 11

Prominent problems are with keeping feelings tolerable without acting

Question 12

What is antisocial personality disorder?

Answer 12

Pervasive pattern of disregard for and violation of the rights of others, occurring since age 15

Question 13

What are diagnostic criteria for antisocial personality disorder?

Answer 13

Failure to conform to social norms with respect to lawful behaviours - repeatedly committing crimes
Deceitfulness - repeated lying, conning others for personal profit
Impulsivity or failure to plan ahead
Irritability and aggressiveness - repeated physical fights or assaults
Reckless disregard for safety of self or others
Consistent irresponsibility
Lack of remorse

Question 14

What is borderline personality disorder?

Answer 14

Pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity

Question 15

What are diagnostic criteria for borderline personality disorder?

Answer 15

5 or more of:
Frantic efforts to avoid real or imagined abandonment
Unstable and intense interpersonal relationships - extremes of idealisation and devaluation
Identity disturbance - unstable self-image
Impulsivity in at least 2 areas that are potentially self damaging - spending, sex, substance abuse, reckless driving, binge eating
Recurrent suicidal behaviour and self harm
Affective instability
Chronic feelings of emptiness
Inappropriate intense anger or difficulty controlling anger
Transient stress related paranoid ideation or severe dissociative symptoms

Question 16

What is narcissistic personality disorder?

Answer 16

Pervasive pattern of grandiosity, need for admiration, and lack of empathy

Question 17

What are diagnostic criteria for narcissistic personality disorder?

Answer 17

Grandiose sense of self-importance
Preoccupied with fantasies of unlimited success, power, brilliance, beauty, ideal love
Believes they are special and can only be understood by people in high positions
Requires excessive admiration
Sense of entitlement
Interpersonally exploitative
Lacks empathy
Often envious of others or believes others are envious of them
Shows arrogant haughty behaviours or attitudes

Question 18

What is histrionic personality disorder?

Answer 18

Pervasive pattern of excessive emotionality and attention seeking

Question 19

What is diagnostic criteria for histrionic personality disorder?`

Answer 19

5 or more of:
Uncomfortable in situations where they are not the centre of attention
Interaction with others characterised by inappropriate sexually seductive or provocative behaviour
Rapid shifting and shallow expression of emotions
Consistently use physical appearance to draw attention to self
Excessively impressionistic speech
Self-dramatisation, theatricality, and exaggerated expression of emotion
Is suggestible
Considers relationships to be more intimate than they actually are

Question 20

What disorders fall under cluster C personality disorders?

Answer 20

Obsessive compulsive personality disorder
Avoidant personality disorder
Dependent personality disorder

Question 21

What is dependent personality disorder?

Answer 21

Pervasive and excessive need to be taken care of that leads to submissive and clinging behaviour and fears of seperation

Question 22

What are criteria for dependent personality disorder?

Answer 22

5 or more of:
Difficulty making everyday decisions without excessive advice and reassurance
Needs others to assume responsibility for most major areas of life
Difficulty expressing disagreement with others because of fear of loss of support
Difficulty initiating projects or doing things on their own
Goes to excessive lengths to obtain nurturance and support from others to the point of volunteering to do things that are unpleasant
Feels uncomfortable or helpless when alone because of fear of being unable to care for themself
Urgently seeks new relationship when one ends
Unrealistically preoccupied with fears of being left alone

Question 23

What is obsessive compulsive personality disorder?

Answer 23

Pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency

Question 24

What are diagnostic criteria for OCD?

Answer 24

Preoccupied with details, rules, lists, etc to the extent the main point of the activity is lost
Perfectionism that interferes with task completion
Excessively devoted to work and productivity to the exclusion of leisure activities
Overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values
Unable to discard worn-out or worthless objects even when they have no sentimental value
Reluctant to delegate tasks to others unless they do things exactly as they do
Adopts miserly spending style
Rigidity and stuborness

Question 25

What is avoidant personality disorder?

Answer 25

A pervasive pattern of social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation

Question 26

What are diagnostic criteria for avoidant personalit disorder?

Answer 26

4 or more of:
Avoid occupational activities that involve significant interpersonal contact
Unwilling to get involved with people unless certain of being liked
Restraint within intimate relationships due to fear of being shamed
Preoccupied with being criticised in social situations
Inhibited in new interpersonal situations because of feelings of inadequacy
Views self as socially inept, personally unappealing, etc
Unusually reluctant to take personal risk or engage in new activities in case of embarrassment

Question 27

How is bipolar personality disorder treated?

Answer 27

Dialectic behavioural therapy
Mentalisation-based treatment
Symptomatic prescribing
Co-ocurring mental illness