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Psychiatry > Personality Disorders > Flashcards

Personality Disorders Flashcards

1
Q

What is a personality trait?

A

Longstanding pattern of perceiving, relating to, and thinking about the world

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2
Q

What is a personality disorder?

A

When these personal traits and behavior patterns are inflexible and maladaptive, so that they cause impairment

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3
Q

What does it mean when we say all personality disorders have character deficits which are ego-syntonic?

A

The person has poor insight into their own problems -> behaviors are consist overtime and difficult to modify for this reason

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4
Q

During what time is it most difficult to diagnose a personality disorder? When do these symptoms first appear?

A

Most difficult during times of crisis or illness

Symptoms first appear in early adulthood or teen years and must’ve been present for over the past year

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5
Q

What are the three clusters of personality disorders?

A

Cluster A - Weird
Cluster B - Wild
Cluster C - Worried

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6
Q

What is the mnemonic for Cluster A disorders?

A

Cluster A - Weird - Three A’s

Accusatory - Paranoid
Aloof - Schizoid
Awkward - Schizotypal

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7
Q

What is the mnemonic for Cluster B disorders?

A

Cluster B - Wild - Four B’s

Bad - Antisocial
Borderline - Borderline
flamBoyant - Histrionic
and
the Best - Narcissitic
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8
Q

What is the mnemonic for Cluster C disorders?

A

Cluster C - Worried - 3 C’s

Cowardly - Avoidant
Obsessive-Compulsive
Clingy - Dependent

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9
Q

What defense mechanism is often used by those with paranoid personality disorder?

A

Projection -> project their distrust and suspicion onto you

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10
Q

What are the common features of paranoid personality disorder?

A

Person has a pervasive distrust and suspiciousness of others, interpreting motives as malevolent
-> without basis or justification

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11
Q

What characterizes the Schizoid personality disorder? How does it differ from Avoidant?

A

Detachment from social relationships and restricted range of expression of emotions in an interpersonal setting (emotions)

-> In schizoid, they actually just don’t want these relationships at all

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12
Q

How should you manage a patient with schizoid personality disorder?

A

Appreciate their need for privacy, focus on the technical aspects of treatment, and try to avoid a personal / close relationship

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13
Q

What characterizes Schizotypal personal disorder?

A

Awkward -

Basically Schizoid personality disorder + cognitive / perceptual distortions and eccentricities of behavior

  • > difference is, this person will want normal relationships a little more but feel uncomfortable with close relationships (excessive social anxiety)
  • > strange thinking / paranoia, odd behavior / appearance, lack of close friends or confidants
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14
Q

How should you manage schizotypal personality disorder?

A

Avoid judgmental attitude about patient’s beliefs, and try not to get too close (like Schizoid)

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15
Q

Who is most likely to have antisocial personality disorder, and what must they have a history of?

A

Males are more likely than females, and they must have evidence of conduct disorder before age 15 years

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16
Q

What characterizes antisocial personality disorder?

A

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

  • > fails to conform to social normals with respect to law
  • > deceitful, impulsive, irresponsible, reckless, remorseless
17
Q

How should doctors manage patients with antisocial personality disorder?

A

Expect to feel manipulated, and know that the patient may feign physical symptoms. Set firm limits with no nonsense, but do not try to punish them

18
Q

What defense mechanism is used by people with borderline personality disorder and who does it typically affect?

A

Splitting, affects females more than males

19
Q

What characterizes borderline personality disorder?

A

Instability of interpersonal relationships, self-image, affect, and marked impulsivity.

Person will chronically feel empty and fear abandonment.

Splitting makes their interpersonal relationships very intense.

20
Q

Why can it be difficult to manage a patient with borderline personality disorder?

A

Patient may split staff (some like and some don’t), you must constantly monitor your countertransference, and you need consistent treatment so patient doesn’t fear abandonment

21
Q

How should most personality disorders be treated?

A

Most are treated with psychotherapy, but treat comorbid conditions / symptoms

Personality disorders often present with anxiety and depression, so treat that with pharmacotherapy.

In borderline personality disorder, all classes of psychotropics are used to manage symptoms

22
Q

What characterizes histrionic personality disorder?

A

FlamBoyant

  • > excessive emotionality / attention seeking, patient is uncomfortable when not the center of attention, often seductive / provocative.
  • > speech will lack detail and be impressionistic, exaggerated emotional expression, easily influenced by others and relationships are interpreted as more intimate than they actually are
23
Q

How should a patient with histrionic personality disorder be managed?

A

Prepare for overly-dramatic complaints, and set clear boundaries.

Like Schizotypal and Schizoid -> avoid close relationship, may be misinterpreted as sexual.

24
Q

What characterizes narcissistic personality disorder?

A

The Best

  • > Pattern of grandiosity, need for admiration, and lack of empathy (True entitlement)
  • > Feel very self-important / powerful, think they can only be understood by high status people, require admiration and lack empathy, envious of others, very arrogant and exploitive in nature
25
Q

How do you manage someone with narcissistic personality disorder?

A

Acknowledge that you are the doctor, but try to include the patient into their decision-making more. Anticipate that they may degrade the junior members of your team.

26
Q

What characterizes avoidant personality disorder?

A

Cowardly

Pervasive social inhibition due to feelings of inadequacy / hypersensitivity to rejection

Vs Schizoid, they really want interpersonal relationships but are afraid to risk going for them for fear of embarrassment

27
Q

How should you manage a patient with avoidant personality disorder?

A

Take initiative in discussing medical care -> they will likely be timid to disclose personal details.

Try to build trust and emphasize availability, respecting their wishes as best

28
Q

What characterizes dependent personality disorder?

A

Clingy

Excessive need to be taken care of that leads to submission / clinging behavior, and fears of separation

-> Decisions take extra advice / reassurance, makes others assume responsibility, feels uncomfortable when along, difficulty doing things on their own

29
Q

How should you manage a patient with dependent personality disorder?

A

Schedule more frequent, brief appointments, recognizing the patient gains from your attention.

Set firm limits and watch for your own burnout, and realize that they may be overly-eager to accept treatment and this makes them susceptible

30
Q

What characterizes obsessive-compulsive personality disorder?

A

Preoccupation with orderliness, perfectionism, and mental / interpersonal control which is at the expense of flexibility, openness, and efficiency

  • > major point of activity is lost due to all of the rules which must be adhered too
  • > perfectionism interferes with task completion
  • > miserly spending style, rigid / stubborn
  • > no time for leisure / friendships often
31
Q

How should you manage a patient with obsessive-compulsive personality disorder? What type of physician treats them best?

A

Recognize the patient doesn’t like being sick -> loss of control
Treated best by a “scientific” physician -> detailed explanations and includes patients in decision making
Even more than narcissistic, give patient control in treatment as much as possible

Psychiatry (22 decks)

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