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Psychiatry > Personality disorders > Flashcards

Personality disorders Flashcards

1
Q

What are the types of specific personality disorders?

A

Cluster A
Cluster B
Cluster C

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2
Q

What is a personality disorder according to American Psychiatric Association?

A
  • Pattern of inner experience and behaviour that deviates markedly from expectations of individuals culture
  • Pattern is inflexible and pervasive
  • Leads to clinically significant distress or impairment in a range of important areas of functioning
  • Pattern is stable and can be traced back to at least early adulthood
  • Not better explained by another diagnosis
  • Not attributable to a physiological change
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3
Q

When talking about ‘patterns’ in personality disorder, what areas can the pattern affect?

A
  • Cognition
  • Affectivity
  • Interpersonal functioning
  • Impulse control
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4
Q

What are Cluster A personality disorders?

A

Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder

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5
Q

What are the diagnostic criteria for paranoid personality disorder?

A

Pervasive distrust and suspiciousness of others, such that motives are interpreted as malevolent, beginning in early adulthood and present as 4+ of following:

  • Suspects others are exploiting, harming or deceiving him or her
  • Doubts about loyalty or trustworthiness of friends
  • Reluctant to confide in others, that info will be used maliciously against them
  • Reads hidden demeaning/threatening messages into benign remarks/events
  • Bears grudges
  • Perceives attacks on their character or reputation that are not apparent to others - quick to react angrily/counterattack
  • Recurrent suspicions without justification, regarding fidelity

Does not occur exclusively during course of schizophrenia, bipolar disorder or depressive disorder with psychotic features

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6
Q

What are the diagnostic criteria for schizoid personality disorder?

A

Pervasive pattern of detachment from social relationships and restricted range of expression of emotions in interpersonal settings, beginning early adulthood and 4+ of following:

  • Neither desires nor enjoys close relationships, including family
  • Almost always chooses solitary activities
  • Has little interest in sexual experiences
  • Takes pleasure in few activities
  • Lacks close friends or confidants other than 1st degree relatives
  • Appears indifferent to praise/criticism of others
  • Shows emotional coldness, detachment or flattened affectivity

Does not occur exclusively during course of schizophrenia, bipolar disorder or depressive disorder with psychotic features, or autism spectrum disorder

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7
Q

What are the diagnostic criteria for schizotypal personality disorder?

A

Pervasive pattern of social and interpersonal deficits marked by acute discomfit with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behaviour, beginning in early adulthood and present as 5+ or following:

  • Ideas of reference
  • Odd beliefs or magical thinking that influences behaviour and is inconsistent with cultural norms (e.g. superstitiousness, telepathy, bizarre fantasies/preoccupations)
  • Unusual perceptional experiences e.g. bodily illusions
  • Odd thinking and speech (vague, metaphorical, overelaborate)
  • Suspiciousness or paranoid ideation
  • Inappropriate or constricted affect
  • Behaviour or appearance that is odd, eccentric or peculiar
  • Lack of close friends
  • Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears

Does not occur exclusively during course of schizophrenia, bipolar disorder or depressive disorder with psychotic features, or autism spectrum disorder

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8
Q

What is included in Cluster B personality disorders?

A

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

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9
Q

What are the diagnostic criteria for antisocial personality disorder?

A

Pervasive pattern of disregard for and violation of rights of others, occurring since age 15, 3+ of following:

  • Failure to conform to social norms with respect to lawful behaviours, repeatedly performing acts that are grounds for arrest
  • Deceitfulness, indicated by repeated lying, use of aliases, conning others for personal profit or pleasure
  • Impulsivity or failure to plan ahead
  • Irritability and aggressiveness, repeated physical fights or assaults
  • Reckless disregard for safety of self or others
  • Consistent irresponsibility, repeated failure to sustain consistent work, honor financial obligations
  • Lack of remorse, indifferent to or rationalising having hurt, mistreated or stolen from another
  • Individual is at least 18yo
  • Evidence of conduct disorder with onset before 15yo
  • Occurrence of antisocial behaviour not exclusively during course of schizophrenia or bipolar disease
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10
Q

What are the diagnostic criteria for narcissistic personality disorder?

A

Pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration, lack of empathy, beginning early adulthood and 5+ of following:

  • Grandiose sense of self-importance
  • Preoccupied with fantasies of unlimited success, power, brilliance, beauty, ideal love
  • Believe they are special and unique and should associate with other special/high-status people
  • Requires excessive admiration
  • Sense of entitlement
  • Interpersonality exploitative
  • Lacks empathy
  • Often envious of others/believes that others are envious of them
  • Shows arrogant, haughty behaviour or attitudes
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11
Q

What are the diagnostic criteria for borderline personality disorder?

A

Pervasive pattern of instability of interpersonal relationships, self-image and affects, marked impulsivity, beginning by early adulthood, 5+ of following:

  • Frantic efforts to avoid real or imagined abandonment
  • Pattern of unusable and intense interpersonal relationships characterised by alternating between extremes of idealisation and devaluation
  • Identity disturbance, markedly and persistently unstable self-image/sense of self
  • Impulsivity in at least 2 areas that are potentially self-damaging e.g. spending, sex, substance abuse, reckless driving, binge eating
  • Recurrent suicidal behaviour, gestures, or threats, or self-mutiliating behaviours
  • Affective instability due to marked reactivity of mood
  • Chronic feelings of emptiness
  • Inappropriate, intense anger or difficulty controlling anger
  • Transient, stress-related paranoid ideation or severe dissociative symptoms
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12
Q

What are the diagnostic criteria for histrionic personality disorder?

A

Pervasive pattern of excessive emotionality and attention seeking, beginning in early adulthood and 5+ of following:

  • Uncomfortable in situations in which they are not the centre of attention
  • Interaction with others often characterised by inappropriate sexually seductive or provocative behaviour
  • Displays rapidly shifting and shallow expression of emotions
  • Consistently uses physical appearance to draw attention to self
  • Has style of speech that is excessively impressionistic and lacking in detail
  • Shows self-dramatisation, theatricality and exaggerated expression of emotion
  • Is suggestible
  • Considers relationships to be more intimate than they actually are
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13
Q

What comes before psychopathy?

A

Severe ASPD, antisocial personality disorder, antisocial behaviour

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14
Q

How are the personality disorder clusters sometimes referred to?

A

A - odd
B - dramatic
C - anxious

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15
Q

What is included in Cluster C personality disorders?

A

Obsessive-Compulsive (Anankastic) personality disorder
Avoidant personality disorder
Dependent personality disorder

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16
Q

What are the diagnostic criteria for obsessive-compulsive personality disorder?

A

Pervasive pattern of pre-occupation with orderliness, perfectionism, mental and interpersonal control, at expense of flexibility, openness and efficiency, beginning in early adulthood and 4+ of following:

  • Preoccupied with details, rules, lists, order, organization, schedules to extent that point of activity is lost
  • Shows perfectionism that interferes with task completion
  • Excessively devoted to work and productivity to exclusion of leisure activities and friendships
  • Overconscientious, scrupulous and inflexible about matters of morality, ethics or values
  • Unable to discard worn-out or worthless objects even with no sentimental value
  • Reluctant to delegate tasks or to work with others unless they submit exactly to their way of doing things
  • Adopts miserly spending style towards self and others
  • Shows righty and stubborness
17
Q

What are the diagnostic criteria for avoidant personality disorder?

A

Pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation, beginning early adulthood, 4+ of following:

  • Avoids occupational activities that involve significant interpersonal contact due to fears of criticism, disapproval or rejection
  • Unwilling to get involved with people unless certain of being liked
  • Shows restraint within intimate relationships because of fear of being shamed or ridiculed
  • Preoccupied with being criticised or rejected in social situations
  • Inhibited in new interpersonal situations because of feelings of inadequacy
  • Views of self as socially inept, personally unappealing or inferior to others
  • Unusually reluctant to take personal risks or engage in any new activities because may be embarrassing
18
Q

What are the diagnostic criteria for dependent personality disorder?

A

Pervasive and excessive need to be taken care of that leads to submissive and clinging behaviours, fear of separation, beginning of early adulthood and 5+ of following:

  • Difficulty making everyday decisions without excessive amount of advice and reassurance from others
  • Needs other to assume responsibility for most major areas of their life
  • Has difficulty expressing disagreement with others due to fear of loss or support/approval
  • Difficulty initiating projects or doing things on their own due to lack of self-confidence
  • Goes to excessive lengths to obtain nurturance and support from others, point of doing things unpleasant
  • Feels uncomfortable or helpless alone because of exaggerated fears of being unable to take care of themselves
  • Urgently seeks another relationship if one ends
  • Unrealistically preoccupied with fears of being left to take care of themselves
19
Q

What are treatment options for personality disorders?

A 
CBT
Group therapy
DBT
Psychotherapy
Antipsychotics
Monoamine Oxidase Inhibitors
Carbamazepine and lithium
20
Q

What is DBT?

A

Dialectical behavioural therapy: designed for BPD

Role of DBT: validation and dialectics - bring about positive changes in behaviour

21
Q

What is DBT usually treatment for?

A

Borderline personality disorder

22
Q

What personality disorders would antipsychotics be appropriate for?

A

Those with cognitive symptoms, impulsivity and intense angry affect

23
Q

What personality disorders would monoamine oxidase inhibitors be appropriate for?

A

Borderline PD to alleviate abnormal mood

24
Q

What personality disorders would carbamazepine and lithium be appropriate for?

A

Episodic behavioural dyscontrol and aggression

Psychiatry (15 decks)

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