Personality disorders Flashcards
What is the DSM-5 criteria for Borderline personality disorder?
CODE:301.83
5 or more of the following:
1. Frantic efforts to avoid real or imagined abandonment (exc. suicidal or self-mutilating behaviour)
2. A pattern of unstable and intense interpersonal relationships characterised by alternating between extremes of Idealisation and devaluation.
3. Identity disturbances: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging (eg. spending, sex, substance abuse, reckless driving, binge eating)
5. Recurrent suicidal behaviour gestures, or threats, or self-mutilating behaviour.
6. Affective instability due to a marked reactivity of mood (eg. intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (eg. frequent displays of temper, constant anger, recurrent physical fights)
9. Transient, stress related paranoid ideation or severe dissociative symptoms
What is this personality disorder?
CODE:301.83
5 or more of the following:
1. Frantic efforts to avoid real or imagined abandonment (exc. suicidal or self-mutilating behaviour)
2. A pattern of unstable and intense interpersonal relationships characterised by alternating between extremes of Idealisation and devaluation.
3. Identity disturbances: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging (eg. spending, sex, substance abuse, reckless driving, binge eating)
5. Recurrent suicidal behaviour gestures, or threats, or self-mutilating behaviour.
6. Affective instability due to a marked reactivity of mood (eg. intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (eg. frequent displays of temper, constant anger, recurrent physical fights)
9. Transient, stress related paranoid ideation or severe dissociative symptoms
Borderline personality disorder
What is the study that provides significant justification for the treatability of borderline personality disorder
Zanarini et al. (2010) conducted a study which followed 300 people diagnosed with BPD for 10 years. They found that over 50% of participants achieved full recovery (no longer fit the diagnostic criteria for BPD) and achieved reasonable social and occupational functioning.
What is the typical triggering event for borderline personality disorder?
Frantic efforts to avoid real or imagined abandonment
What personality disorder is the following triggering event related to?
Frantic efforts to avoid real or imagined abandonment
Borderline personality disorder
What is the interpersonal style characteristic of borderline personality disorder?
Paradoxical instability. Quick fluctuation between idealising and clinging to another person, and then devaluing and opposing that person.
They go to great lengths to avoid being alone (inc. indiscriminate sexual affairs, late night phone calls, and visits to hospitals with vague complaints).
What personality disorder is this interpersonal style characteristic of?
Paradoxical instability. Quick fluctuation between idealising and clinging to another person, and then devaluing and opposing that person.
They go to great lengths to avoid being alone (inc. indiscriminate sexual affairs, late night phone calls, and visits to hospitals with vague complaints).
Borderline personality disorder
What is the cognitive style which is characteristic of borderline personality disorder
Inflexible and impulsive.
Reasoning based on analogy from past experience and have difficulty reasoning logically
What personality disorder is this cognitive style characteristic of?
Inflexible and impulsive.
Reasoning based on analogy from past experience and have difficulty reasoning logically
Borderline personality disorder
What is the locus of control in borderline personality disorder
External
What is the affective style which is characteristic of borderline personality disorder?
Marked shifts between euthymic to dysphoric mood.
Easy triggering of intense rage
Feelings of emptiness or boredom
What personality disorder is this affective style characteristic of?
Marked shifts between euthymic to dysphoric mood.
Easy triggering of intense rage
Feelings of emptiness or boredom
Borderline personality disorder
What is the attachment style which is characteristic of borderline personality disorder?
Disorganised attachment style which is associated with dissociative symptomology.
What is the primary suggested aetiology for borderline personality disorder?
Childhood abuse.
What is the prototypic description of borderline personality disorder?
These individuals have intense and frustrating relationships which predictably degenerate into conflict.
Fear of abandonment leads them to impose unrealistic demands on others.
Fragile sense of self
Impulsive sexual and aggressive behaviour
The following is a prototypic description of which personality disorder?
These individuals have intense and frustrating relationships which predictably degenerate into conflict.
Fear of abandonment leads them to impose unrealistic demands on others.
Fragile sense of self
Impulsive sexual and aggressive behaviour
Borderline personality disorder
What is the psychodynamic case conceptualisation of borderline personality disorder
Stems from Kernberg (1975), Masterson (1976) and Masterson and Klein (1989).
Error in rapprochement sub-phase of separation-individuation theory which prevents development of an internalised image of the mother due to mothers emotional unavailability.
Also atypical relationship with mother, with mother not wanting the child to grow up ‘if you grow up something will happen to me’
What is the mentalisation approach case definition of borderline personality disorder
Bateman and Fonargy (2007)
Problem with mentalising (the process through which individuals interpret their own subjective cognitions, behaviours, and emotions, as well as those of others.
Proposes that this arises due to poor quality object relationships early in life, subsequent to neglect, abuse, or poor parental relationships.
What is the biopsychosocial case conceptualisation of of borderline personality disorder?
Millon and Davis (1996)
Lack of clear and coherent sense of identity is central to the pathogenesis of BPD. Identity confusion is the result of biopsychosocial factors that combine to impair a coherent sense of identity.
What is a description of a borderline-dependent person?
Passive infantile pattern of behaviour.
Strong attachment and dependency to a single caregiver.
What is a description of a borderline-histrionic person?
Hyperresponsiveness to stimulation.
Feels accepted only where their behaviour is explicitly approved by others.
‘performs’ to secure support and attention.
What is a description of a borderline-passive aggressive person?
‘difficult child’ temperaments
Erratic behaviour, highly vacillating.
Aggressive and passive aggressive
What is the self view of someone with borderline personality disorder?
Identity problems involving gender, career, loyalties, and values.
Self esteem fluctuates with current emotions
What is the world view of someone with borderline personality disorder?
Paradoxical and vacillating
What are the maladaptive schemas associated with borderline personality disorder?
Fear of abandonment Emotional deprivation Mistrust Social isolation Self control (Insufficient self control)
What are the primary treatments for borderline personality disorder?
Dialectical behavioural therapy is the mainstay.
Medications are usually for control of affective instability, aggression, transient psychotic episodes, and self-harm
Affective instability = Lithium and carbamazepine
Aggression = Serotonergic agents (fluoxetine and sertraline. MAOI only if other treatments unsuccessful)
Transient psychosis = atypical antipsychotics
Self-harm = SSRI (if not succsesful, add naltrexone)
Seroquel is prescribed generally for anxiety reduction.
What are the three stages of dialectical behavioural therapy in borderline personality disorder?
- Focus on reducing parasuicidal and suicidal behaviours, therapy interfering behaviours, and behaviours that reduce quality of life.
- Focus on difficult problems like PTSD and prior abuse.
- Focus on building self esteem and individual treatment goals.
What is the DMS-5 criteria for paranoid personality disorder
CODE: 301.0
Four or more of the following:
1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him / her.
2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
4. Reads hidden demeaning or threatening meanings into benign remarks or events.
5. Persistently bears grudges
6. Perceives attacks on his or her character or reputation that are not apparent the others and is quick to react angrily or counter attack.
7. Has recurrent suspicions, without justification, regarding the fidelity of spouse or sexual partner.
What is a general description of paranoid personality disorder?
A pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent
What is the DSM-5 criteria for schizoid personality disorder?
CODE: 301.20
Four or more of the following:
1. Neither desires nor enjoys close relationships including being part of a family.
2. Almost always chooses solitary activities.
3. Has little, if any, interest in having sexual experiences with another person.
4. Takes pleasure in few, if any, activities.
5. Lacks close friends or confidants other than first degree relatives.
6. Appears indifferent to the praise of criticism of others.
7. Shows emotional coldness, detachment, or flattened affect.
What is a general description of schizoid personality disorder?
A pattern of detachment from social relationships and a restricted range of emotional expression.
What is the DSM-5 criteria for schizotypal personality disorder?
CODE: 301.22
Five or more of the following:
1. Ideas of reference (excluding delusions of reference)
2. Odd beliefs or magical thinking that influences behaviour and is inconsistent with subcultural norms.
3. Unusual perceptual experiences, including bodily illusions
4. Odd thinking and speech (vague, circumstantial, metaphorical, over-elaborate, stereotyped).
5. Superstitious or paranoid ideation.
6. Inappropriate or constricted affect.
7. Behaviour or appearance that is odd, eccentric, or peculiar.
8. Lack of close friends or confidants other than first degree relatives.
9. Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgements about self.
What is a general description of schizotypal personality disorder?
A pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behaviour.
What is the DSM-5 criteria for antisocial personality disorder?
CODE: 301.7
Three or more of the following:
1. Failure to conform to social norms with respect to lawful behaviours, as indicated by repeatedly performing acts that are grounds for arrest.
2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.
3. Impulsivity or failure to plan ahead.
4.Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
5. Reckless disregard for safety for self and others
6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behaviour or honour financial obligations.
7. Lack of remorse, as indicated by being indifferent to or rationalising having hurt, mistreated, or stolen from someone.
+ Over 18
+ evidence of conduct disorder onset before 15
