Personality Disorders Flashcards

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1
Q

What is a personality disorder?

A

When personality traits are persistently disabling/distressing

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2
Q

How do you qualify something as a PD?

A

3Ps

PERSISTENT - emerge in childhood/adolescence into adulthood

PERVASISVE - occur in most / all areas of life

PATHOLOGICAL - cause distress, affect relationships, impair occupational/social functioning

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3
Q

What are the three types of personality traits?

A

A
B
C

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4
Q

Describe type A

A

Odd / eccentric

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5
Q

Describe type B

A

Dramatic/emotional

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6
Q

Describe type C

A

Anxious (avoidant), dependsnt, anankastic

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7
Q

What are psychological theories behind PD?

A
Attachment theory
Defense mechanisms (acting out, splitting, projection, passive aggression)
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8
Q

What are psych interventions for PD?

A

CBT
Dialectical behavioural therapy (DBT)
Cognitive analyticall therapy (CAT)
metallisation based therapy (MBT)

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9
Q

What are examples of trait A PD?

A

Paranoid
Schizoid
Schizotypal

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10
Q

What are examples of trait B PD

A

Histrionic
EUPD
Dissocial

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11
Q

What are the general traits of EUPD?

A

AEIOU

Affective instability
Explosive behaviour 
Impulsiveness
Outburst of anger
Unable to plan or consider consequences
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12
Q

What are the two types of EUPD?

A

Impulsive

Borderline

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13
Q

What are the features of impulsive EUPD?

A

LOSE IT

Lacks impulse control
Outbursts/treats of violence
Sensitive to criticism
Emotional instability. (mood swing)

Inability to plan
Thoughtless of consequence

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14
Q

What are features of borderline PD?

A

SCARS

Self image unclear (and sexuality confused)
Chronic feeling of emptiness  
Abandonment fear
Relationships intense, unstable 
Suicidal behaviour/self harm
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15
Q

How do we make PD dx?

A

MULTIPLE follow up interviews with patients
Questionnaires (e.g. SAPAS)
OR semi-structured interviews

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16
Q

What are medical treatments for PD?

A

Generally not recommended

  • antidepressants to treat depression secondary to PD
  • Atypical antipsychotic QUETIAPINE may be prescribed
  • Mood stabiliser may help with fluctuation
  • Sedative during crisis
17
Q

What is important to set with a PD patient?

A

BOUNDARIES

18
Q

What should you not believe if a PD patient tells you?

A

COMPLIMENTS
They will be exaggerated, and push you to give them preferential tx
This means once you do something they don’t like they will treat you like CRAP

19
Q

How should you treat a PD patient?

A

The SAME as EVERYONE else

20
Q

Should you admit PD patient onto MHU?

A

If possible, NO

If risk assessment shows risk is high, admit for SHORT PERIOD ONLY

21
Q

What is the appropriate therapy for the PD patient in long-term?

A

PSYCHOLOGICAL THERAPY IN THE COMMUNITY

22
Q

What are fts of HISTRIONIC personality disorder

A

Actors

attention seeking 
concerned with appearance 
theatrical 
open to suggestions 
racy, seductive 
shallow affect
23
Q

What are fts of DISSOCIAL/ANTISOCIAL PD

A

Serial killer

FIGHTS

Forms but cannot maintain relationship 
Irresponsible 
Guiltless, lact of remorse 
Heartless (callous about feelings of others) 
Temper lost easily 
SOmeone elses fault
24
Q

What are Type C personality disorders

A

Anakastic
Anxious
Dependent

25
Q

Anakastic

A
DETAILED 
Doubtful 
Excessive detail 
Tasks not completed 
Adheres to rules 
Inflexible 
LLikes own way 
Excludes pleasures and relationshiops 
Dominated by intrusive thoughts
26
Q

What are features of anxious PD

A

AFRAID

Avoids social contact
Fears Rejections / criticism 
Restricted lifestyle 
Apprehensive 
Inferiority 
DOes't get involved unless sure of acceptance
27
Q

What are features of dependent PD

A

SUFFER

Subordinate 
Undemanding 
Feels helpless 
Fears abondonment 
Encourages others to make decisions 
Reassurance needed
28
Q

How do you manage PD

A

Psychotherapy:

  • Dialectical behavioural therapy DBT
  • Cognitive analytical therapy CAT
  • mentalisation

+ ART THERAPY

29
Q

How does DBT work

A

Type of CBT for people who experience intense emotion
Treats EUPD
Focuses on changing unhelpful behaviours and accepting who you are

30
Q

How does mentalisation based therapy work

A

Teaches to think about thinking

  • take a step back and scrutinise your own thoughts and impulses
  • Recognise other poeples thought patterns and recognise that your interpretation may not be correct
31
Q

how do you give contacts to crisis manage a PD pt

A
  • community mental healrth nurse
  • out of hours social worker
  • crisis resolution team
32
Q

What is insomnia

A

difficulty getting to sleep / maintaining sleep for 3 or more nights of the week for 3 or more months

33
Q

How do you investigate insomnia

A

sleep diary /actigraph

Exclude potential causes (depression/anxiety)

34
Q

How do you manage insomnia

A

Advise sleep hygiene, don’t drive when tired
CBT-I for insombnia
Consider short acting benzo (e.g. lorazepam) or Z drug (zopiclone) - lowest possible dose and shortest time possible

35
Q

How does dialectical based therapy work

A

based on CBT

understand and accept your difficult feelings. learn skills to manage them.

36
Q

describe scarlet fever rash

A

There is a blanching punctate rash SPARING the face

37
Q

what is initial management of hirschprung’s

A

bowel irrigation - to allow passage of meconium

once diagnosis is confirmed - anorectal pullthrough