Personality Disorders Flashcards
Personality
Definition
An enduring pattern of perceiving, relating, and thinking about the environment and oneself that is seen in a wide range of social and personal situations.
- Stable
- Predictable
- Flexible
- Adaptable
Personality Disorder
Definition
-
Enduring pattern of inner experiences and behavior that deviate from cultural standards.
This is manifested as:- Cognition (Way of perceiving self, other people and events)
- Affect (Lability, appropriateness…)
- Interpersonal functioning
- Impulse control
-
The pattern is rigidly pervasive
- Have an onset in adolescence and the behavior pattern is stable and of long duration
- There is significant distress and / or impairment in social, occupational functioning
- Not due to another mental illness, or substance abuse
Personality Disorders
Subtypes
DSM 5 groups them into three clusters:
A. CLUSTER A: Odd (paranoid, schizoid, and schizotypal)
B. CLUSTER B: Sad (antisocial, borderline, histrionic, and narcissistic)
C. CLUSTER C: Anxious (avoidant, dependent and obsessive‐ compulsive)
Other Specified and Unspecified Personality Disorder
Paranoid Personality Disorder
Key Features
- Suspects that he/she is being exploited or deceived
- Doubts loyalty or trustworthiness of friends
- Reluctant to confide
- Reads hidden meaning
- Bears grudges
- Perceives attacks on his / her reputation and is quick to react and counterattack
- Argumentative
- Difficult to get along
- Suspicious about spouses fidelity
Paranoid Personality Disorder
Epidemiology
- 0.5‐2.5% of general population. (DSM5: 2.3% ‐ 4.4%)
- More in males
- More in minorities, immigrants and ? in the deaf
- Higher incidence in patients with schizophrenia
Paranoid Personality Disorder
Differential Diagnosis
- Schizophrenia
- Delusional Disorder
Paranoid Personality Disorder
Course and Management
- Course & Prognosis: Lifelong disorder. May go on to have a schizophrenic breakdown
- Treatment:
- Psychotherapy is the treatment of choice
- These patients do not do well in groups
-
Pharmacotherapy has limited role.
- Anti-anxiety drugs and neuroleptics have been used
Schizoid Personality Disorder
Key features
- Neither desires nor enjoys close relationships
- Always chooses solitary activities
- No interest in having a sexual relationship
- No close fiends
- Indifferent to praise or criticism
- Emotional detachment
Schizoid PD
Epidemiology
- DSM5: around 5% of general population
- Male > Female
- Onset is in early childhood
- Lifelong course
Schizoid PD
Differential diagnosis
- Paranoid PD
- Schizotypal PD
- Schizophrenia
Schizoid PD
Treatment
- Psychotherapy
- Neuroleptics
- Benzodiazepines
- SSRI’s
Schizotypal PD
Definition
A pattern of social interpersonal deficits with reduced capacity for close relationships AND cognitive and perceptual distortions:
- Ideas of reference
- Odd beliefs
- Unusual perceptual experiences
- Odd thinking
- Suspicious
- Inappropriate or constricted affect
- Behavior or appearance that is odd
- Brief psychotic episodes*
Schizotypal PD
Epidemiology
- 3% of the population
- Sex ratio?
- More likely in relatives of Schizophrenia
- MZ > DZ twins
Schizotypal PD
Differential Diagnosis
- Schizophrenia
- Paranoid personality disorder
- Borderline personality disorder
Schizotypal PD
Course and Management
- Course and Prognosis:
- 10% risk of suicide
- Schizophrenic breakdown
- Treatment:
- Pharmacotherapy: Neuroleptics
- Psychotherapy
