Personality Disorders

Question 1

Define personality disorders?

Answer 1

Enduring patterns of behaviour that manifest themselves as inflexible responses to a broad range of personal and social situations

Question 2

For someone to have a personality disorders the personality traits must be ______ and must cause _________

Answer 2

pervasive
ie present in all scenarios not just in certain situations

must cause personal distress and/ or have an adverse impact on the social environment

Question 3

Describe when personality disorders arise?

Answer 3

They are developmental conditions that appear in childhood or adolescence and continue into adult life

Question 4

Describe personality disorders and other adult mental disorders?

Answer 4

Personality disorders cannot be explained as a manifestation or consequence of other adult mental disorders as then they are not personality disorders!

However personality disorders are more common in those with other mental health disorders.

Question 5

Cluster A personality disorders are known as the _______

Answer 5

odd and eccentric

Question 6

Cluster B personality disorders are known as the ______

Answer 6

dramatic and emotional

Question 7

Cluster C personality disorders are known as ______

Answer 7

anxious and avoidant

Question 8

List the cluster A personality disorders?

Answer 8

paranoid
schizoid
schizotypal

Question 9

List the cluster B personality disorders?

Answer 9

dissocial 
emotionally unstable impulsive
emotionally unstable borderline 
histrionic 
narcissistic

Question 10

List the cluster C personality disorders?

Answer 10

anankastic
anxious
dependent

Question 11

Which personality disorder has an overlap with autism symptoms?

Answer 11

schizoid

Question 12

Overview of treatment of PDs?

Answer 12

generally there is not good evidence to guide treatment for most PD
treatment of co-morbidities e.g. depression and anxiety is effective
in general pharmacological treatment is not recommended by NICE but can be used for individual symptoms

Question 13

When may antipsychotics be used in PD?

Answer 13

to help with suspiciousness of cluster A, may also help with borderline if paranoid or hearing voices

e.g. quetiapine, olanzapine, haloperidol

Question 14

When may antidepressants be used in PD?

Answer 14

to help with mood and emotional difficulties in cluster B PDs
to reduce anxiety in cluster C

Question 15

What can SSRIs help with in PD?

Answer 15

help people be less impulsive and aggressive in borderline and dissocial disorders

Question 16

When may mood stabilisers be used in PD?

Answer 16

to help with unstable mood and impulsivity that people with emotionally unstable borderline may experience e.g. lamotrigine

Question 17

When may benzodiazepams and hypnotics be used in PD?

Answer 17

used short term as sedatives as part of a larger care plan during a crisis

Question 18

Paranoid Personality Disorder Criteria? (7 points total)

Answer 18

4 of:
• Excessive sensitivity to setbacks
• Tendency to bear grudges
• Suspiciousness and tendency to misconstrue the neutral/ friendly actions of others as hostile/ contemptuous
• A combative and tenacious sense of personal rights out of keeping with the actual situation
• Recurrent suspicions without justification regarding sexual fidelity of partner
• Persistent self-referential attitude, associated particularly with excessive self-importance
• Preoccupation with unsubstantiated “conspiratorial” explanations of events in the world at large

Question 19

Schizoid Personality Disorder Criteria? (9 points total)

Answer 19

4 of:
• Few, if any activities provide pleasure
• Emotional coldness, detachment, or flattened affectivity
• Limited capacity to express warm feelings for others as well as anger
• Indifferent to either praise or criticism of others
• Little interest in having sexual experiences with another person
• Almost always chooses solitary activities
• Excessive preoccupation with fantasy/ introspection
• Neither desires nor has any close friends or confiding relationships (or only one)
Marked insensitivity to prevailing social norms/ conventions

Question 20

Schizotypal Personality Disorder Criteria? (9 points total)

Answer 20

5 or more of:
• Ideas of reference (excluding delusions of reference)
• Odd beliefs or magical thinking, inconsistent with subcultural norms (e.g. superstitious, belief in clairvoyance, telepathy or “sixth sense”)
• Unusual perceptual experiences, including bodily illusions
• Odd thinking and speech (e.g. vague, circumstantial, metaphorical, elaborate or stereotyped)
• Suspicious or paranoid ideation
• Inappropriate or constricted affect
• Behaviour or appearance that is off, eccentric or peculiar
• Lack of close friends or confidants other than first degree relatives
• Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgements about self

Question 21

Dissocial Personality Disorder Criteria? (6 points total)

Answer 21

3 of:
• Callous unconcern for feelings of others
• Irresponsible and disregard for social norms/rules/ obligations
• Incapacity to maintain enduring relationships, though no difficulty in establishing them
• Very low tolerance to frustration and low threshold for aggression/ violence
• Incapacity to experience guilt, or to profit from adverse experience, particulalry punishment
Marked proneness to blame others

Question 22

Histrionic Personality Disorder Criteria? (6 points total)

Answer 22

4 of:
• Self dramatization, theatricality, or exaggerated expression of emotions
• Suggestible
• Shallow/ labile affectivity
• Continually seeks excitement and activities in which the subject is the centre of attention
• Inappropriately seductive in appearance or behaviour
Overly concerned with physical attractiveness

Question 23

Emotionally unstable impulsive personality disorder criteria? (5 points total)

Answer 23

3 of:
• Tendency to act unexpectedly, without consideration of consequences
• Quarrelsome behaviour and conflicts with others, especially when impulsive acts are thwarted/criticized
• Liability to outbursts of anger or violence
• Difficult in maintaining any course of action that offers no immediate reward
• Unstable mood

Question 24

Emotionally unstable borderline personality disorder criteria? (5 points total)

Answer 24

Need to have 2 from the impulsive subtype category plus 2 of:
• Disturbances in and uncertainty about self-image aims, and internal preferences (including sexual)
• Intense and unstable relationships, often leading to emotional crises (form relationships quickly but relationships also breakdown of relationships)
• Excessive efforts to avoid abandonment
• Recurrent threats or acts of self harm
• Chronic feelings of emptiness

Question 25

Narcissistic PD criteria? (9 points total)

Answer 25

5 of:
• A grandiose logic of self importance
• A fixation with fantasies of infinite success, control, brilliance, beauty or idyllic love
• A credence that he or she is extraordinary and exceptional and can only be understood by, or should connect with, other extraordinary or important people or institutions
• A desire for unwarranted admiration
• A sense of entitlement
• Interpersonally oppressive behaviour (oppressive behaviour towards others)
• No form of empathy
• Resentment of others or a conviction that others are resentful of him or her
A display of egotistical and conceited behaviours or attitudes

Question 26

Anankastic PD criteria? (8 points total)

Answer 26

4 of:
• Excessive doubt and caution
• Preoccupation with details, rules, lists, order, organisation or schedule
• Perfectionism that interferes with task completion
• Excessive conscientiousness
• Undue preoccupation with productivity to the exclusion of pleasure/ interpersonal relationships
• Pedantic, excessive adherence to social conventions
• Rigidity and stubbornness
Unreasonable insistence that other submit exactly to his or her way of doing things, or unreasonable reluctance to allow others to do things

Question 27

Anxious PD criteria? (6 points total)

Answer 27

4 of:
• Persistent pervasive feelings of tension/ apprehension
• Belief that oneself is socially inept/ inferior to others
• Excessive preoccupation about being criticized/ rejected in social situations
• Unwillingness to get involved with people unless certain of being liked
• Restrictions in lifestyle because of need of security
Avoidance of social or occupational activities that involve significant interpersonal contact, because of fear of criticism, disapproval or rejection

Question 28

Dependent PD criteria? (6 points total)

Answer 28

4 of:
• Encouraging or allowing others to make most of one’s important life decisions
• Subordination of one’s own needs to those of others on whom one is dependent, and undue compliance with their wishes
• Unwillingness to make even reasonable demands on the people one depends on
• Feeling uncomfortable or helpless when alone because of exaggerated fears of inability to care for oneself
• Preoccupation with fears of being left to take care of oneself
Limited capacity to make everyday decisions without an excessive amount of advice/ reassurance