personality disorders Flashcards
define personality disorders
depply ingrained and enduring pattern of inner experience and behaviour that deviates markedly from expectation in the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood is stable over time and leads to distress or impairment
RFs for personality disorders
Society
- low socioeconomic status
- social reinforcement of abnormal behaviour
Genetics
- Positive FH of PD
Dysfunctional fmaily
- Poor parenting
- parental deprivation
Abuse during childhood - physical sexual - linked to emotionally unstable PD - emotional abuse - neglect
Psychodynamic theories – discusses the use of maladaptive or primitive defence mechanisms
Cognitive behavioural theories – relates to the development of maladaptive schemata/core beliefs derived from early experiences
Cluster WWW
A
B
C
Cluster A WEIRD (odd/eccentric)
- paranoid
- schizoid
Cluster B WILD (Dramatic/Emotional)
- emotionally unstable
- dissocial
- historionic
Cluster C WORRIERS (Anxious/fearful)
- dependent
- avoidant (anxious)
- anankastic (obsessional)
features of paranoid
“SUSPECTS”
Suspicious of others Unforgiving (bears grudges) Spouse fidelity questioned Percevies attack Envious (jealous) Criticism not liked/Cold affect Trust in others reduced Self-reference
features of Schizoid “DISTANT”
Detached (flattened) affect Indifferent to praise or criticism Sexual drive reduced Tasks done alone Absence of close friends No emotion (cold) Takes pleasure in few activities
features of emotionally unstable (borderline) “AM SUICIDE”
Abandonment feared Mood instabilty Suicidal behaviour Unstable relationships Intense relationships Control of anger poor Impulsivity Disturbed sense of self (identity) Emptiness (chronic)
features of antisocial
“CORRUPT”
Callous Others Blamed Reckless disregard for safety Remorseless (lack of guilt) Underhanded (deceitful) Poor planing Temper/Tendency to violence - repeated physical fights or assaults
deceptice
more common in men
features of histrionic “PRAISE”
Provocative behaviour Real concern for physical attractiveness Attention seeking Influenced easily Shallow/seductive inappropriately Egocentric (vain)/ exaggerated emotions
features of dependent “RELIANCE”
Reassurance required Expressing disagreement is difficult Lack of self-confidence Initiating projects is difficult Abandonment feared Needs others to assume responsibility Companionship sought Exaggerated fears
- Difficulty making everyday decisions without excessive reassurance from others
- Need for others to assume responsibility for major areas of their life
- Difficulty in expressing disagreement with others due to fears of losing support
- Lack of initiative
- Unrealistic fears of being left to care for themselves
- Urgent search for another relationship as a source of care and support when a close relationship ends
- Extensive efforts to obtain support from others
- Unrealistic feelings that they cannot care for themselves
features of anxious (avoidant) “CRIES”
Certainty of being liked needed before becoming involved with people
Restriction to lifestyle in order to maintain security
Inadequacy felt
Embarrassment potential prevents involvement in new activities
Social inhibition
- Preoccupied with ideas that they are being criticised or rejected in social situations
- Restraint in intimate relationships due to the fear of being ridiculed
- views self as inept adn inferior to others
features of anakastic (obsessional) “LAW FIRMS”
Loses point of activity (due to preoccupation with detail)
Ability to complete tasks compromised (due to perfectionism)
Workaholic at the expense of leisure
Fussy (excessively concerned with minor details)
Inflexible
Rigidity
Meticulous attention to detail
Stubborn
Ix for personality disorders
questionnaires: ie. Personality Diagnostic Questionnaire, Eysenck Personality Questionnaire
Psychological testing: MInnesota multiphasic personality inventory (MMPI)
CT/MRI
DDx for personality disorders
mood disorders: mania, depression
Psychotic disorders: schizophrenia, schizoaffective disorder
Substance misuse
Mx of antisocial PD
group-based cognitive and behavioural interventions
if they have offending behaviour focus on ‘reasoning and rehabilitation’
Treat comorbid disorders in particular depression and anxiety
Mx for emotionally unstable/borderline PD
psychotherapy - Therapeutic community - Dialectical behavioural therapy DBT - Cognitive analytic therapy CAT Psychodynamic therapy
mood stabilisers to manage the Sx such as mood instability and aggression
