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Year 4 Psych > Personality Disorders and LD > Flashcards

Personality Disorders and LD Flashcards

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1
Q

What is personality?

A

Collection of characteristics or traits that develop as you grow up and that makes each of us individual

Governs the way we think, feel and behave

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2
Q

What age is it generally accepted our personality is developed?

A

Late teens / early 20s

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3
Q

What shapes our personality?

A

1) Genetics - we share personality traits with out parents and close family members
2) Neurophysiology
3) Childhood experiences - trauma, violence and attachment issues

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4
Q

What is the ICD-10 definition of a disorder?

A

“A severe disturbance in the characterological constitution and behavioural tendencies of the individual usually involving several areas of the personailty. Nearly always associated with considerable social and personal disruption”

Usually it is said that it is not resulting from organic change to the brain or resulting from another medical health disorder

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5
Q

What is a personailty disorder?

A

Abnormal, persistent and extreme variation from the normal range of one or more personality traits causing the individual and/or society to suffer

  • Associated with considerable personal distress and social disruption
  • Usually manifest since childhood or adolescence
  • Not resulting from disease or damage to the brain
  • Increases vulnerability to metal illness and worsens the prognosis
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6
Q

From what age can a personality disorder be diagnosed?

A

Over 18yrs

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7
Q

List some types of personality disorder listed in ICD-10 and DSM-5 (10)

A

1) Paranoid
2) Schizoid
3) Schizotypal
4) Dissocial (ICD) vs antisocial (DSM)
5) Emotionally unstable (ICD) vs borderline (DSM)
6) Histrionic
7) Narcissistic (DSM)
8) Anankastic (ICD) vs obsessive-compulsive (DSM)
9) Anxious (ICD) vs avoidant (DSM)
10) Dependent

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8
Q

Outline the features of a schizoid personality disorder

A

Preferring to be alone
Don’t like relationships
Low libido

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9
Q

How common are personality disorders?

A

Approx 10% population and 50% of psychiatric pt

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10
Q

How may personality disorders present?

A

Diverse presentation but some features shared:

1) Impulsive
- Self harm, promiscuity, stress intolerance and problems with relationships
2) Unstable mood
3) Intense anger and violent outbursts
4) Disturbance of self image and chronic feelings of emptiness
5) Intense and unstable relationships
6) Suicidal threats and self harm
7) Paranoia
8) Antisocial behaviours
- Irritable, callous, failure to accept responsibility
9) Obsessions and compulsions
- Rigid, stubborn, pedantic

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11
Q

What is the most most common personality disorder diagnosis?

A

Emotionally unstable personality disorder (EUPD)

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12
Q

What is thought to be the aetiology of EUPD?

A

Genetic predisposition and a bad experience during childhood

This leads to an underlying mood dysregulation which can cause problems with:

  • Difficulty tolerating stress (which can lead to DSH)
  • Problems with inter-personal relationships
  • Problems regulating mood
  • Problems with sense of self
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13
Q

Personality disorders can be split into clusters A, B and C. Which are included in cluster A?

A

Temperament = odd, eccentric, aloof, suspicious

1) Paranoid
2) Schizoid
3) Schizotypal

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14
Q

Describe a paranoid personality disorder

A

Suspicion and distrust
Sensitivity to criticism, bears grudges
Self-importance

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15
Q

Describe a schizotypal personality disorder

A

Emotionally cold and detached
Social isolation
Lack of “life enjoyment”

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16
Q

What personality disorders are included cluster B?

A

Temperament = dramatic, emotional, erratic

1) Borderline
2) Narcissistic
3) Histrionic
4) Antisocial

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17
Q

Describe an antisocial personality disorder

A 
Callous, unstable relationships
Easily frustrated
Impulsive
Failure to learn or accept responsibility
Lack of guilt
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18
Q

Describe a borderline / emotionally unstable personality disorder

A

Multiple, turbulent relationships, easily frustrated
Impulsive
Intense mood
Esp seen in young women

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19
Q

Describe a histrionic personality disorder

A 
Exaggerated, theatrical expression
Attention seeking
Vain
Shallow, labile mood
Brief crushes
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20
Q

Describe a narcissistic personality disorder

A

Grandiose self-importance
Exaggerates abilities
Exploits others, arrogant
Expects praise and respect

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21
Q

What personality disorders are included in cluster C?

A

Temperament = anxious, fearful

1) Anxious
2) Dependent
3) Anakastic / obsessional

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22
Q

Describe an anxious personality disorder

A

Tension and apprehension
Avoid personal contact
Fear of rejection

23
Q

Describe an anakastic / obsessional personality disorder

A

Preoccupation with detail
Inflexible
Humourless

24
Q

Describe a depended personality disorder

A

Encourages others to make decisions

Excessive need to be cared for

25
Q

What is assessments help to confirm the diagnosis of a personality disorder

A

Collateral history
Alcohol / drug history
Childhood history - determine whether the problem has been longstanding (required for diagnosis)
Psych history - screen for depression / anxiety (commonly co-exist)

26
Q

What is the management of personality disorders?

A

Help individual find a lifestyle that suits them

Consistency of care

Education insight - prevent shifting of blame over to others

Psychological treatment - DBT

Medication

  • SSRIs for emotionally unstable group
  • Antipsychotics
27
Q

What is DBT?

A

Dialectical behavioural therapy

A form of CBT which helps people to recognise their triggers and reactive states and then helps them to implement strategies for coping with specific types of event

All about identifying two opposing opinions and trying synthesis and compromise between two ideas

28
Q

How long do people usually stay in DBT counselling?

A

2 years

29
Q

What are the key features of DBT? (DICE)

A

Distress intolerance
Interpersonal effectiveness
Cognitive mindfulness
Emotional regulation

30
Q

What is the criteria of learning / intellectual disability? (3)

A

1) IQ <70
2) Loss of adaptive social functioning
3) Onset before age of 18 (during development) - ie cannot acquire it later in life

31
Q

What is the IQ ranges of learning disabilities classified as:

1) Mild
2) Moderate
3) Severe
4) Profound

A

1) Mild = 50-69
2) Moderate = 35-49
3) Severe = 20-34
4) Profound = <20

32
Q

Broadly describe a mild LD

A

Sensory or motor deficits are slight and there is a reasonable level of independence

33
Q

Broadly describe a moderate LD

A

Generally people understand things well but they find it difficult to express themselves

(Better receptive than expressive language)

34
Q

Broadly describe a severe LD

What often accompanies this?

A

Increased sensory and motor deficits

50% have epilepsy

35
Q

Broadly describe a profound LD

What is their developmental age?

A

Increased need and vulnerability

Developmental age approx 12 months - need constant care

36
Q

What is the most common genetic cause of LD?

A

Downs syndrome

1 in 800 live births

37
Q

Other than LD, what other health risks are implicated in Down’s syndrome?

A 
AVSD
Cataracts
Hypothyroidism
Chest infection
Transient leukaemia
Epilepsy
Dementia
38
Q

What is the most common inherited cause of LD?

A

Fragile X syndrome

39
Q

What is the genetic basis of fragile X syndrome?

A

FMR1 mutation which causes too many repeats of CGG

40
Q

What peri-natal causes may lead to a LD?

A

Birth asphyxia

Maternal - placental insufficiency due to smoking / alcohol

Brith trauma - cord prolapse / compression, placental abruption

Difficulties due to premature birth

Infections in peri-natal period

41
Q

What is the leading preventable cause of LD?

A

Fetal alcohol syndrome

42
Q

What is fetal alcohol spectrum disorder?

A

An umbrella term for several diagnoses that are all related to prenatal exposure to alcohol

Not itself a clinical diagnosis but describes a full range of disabilities that may result from prenatal alcohol exposure

25-30% have LD

43
Q

What are the key features of fetal alcohol syndrome?

A

1) Growth retardation
2) Characteristic facial features
3) CNS abnormalities / dysfunction

44
Q

Describe the facial characteristic features of fetal alcohol syndrome

A 
Low nasal bridge
Indistinct philtrum
Micrognathia
Epicanthal folds
Short palpebral fissures
Flat midface and short nose
Thin upper lip
45
Q

Are these considered to be learning difficulties:

1) People who develop an impairment after the age of 18
2) People who suffer brain injury in accidents after the age of 18
3) People with complex medical conditions which develop after the age of 18 eg Huntington’s Chorea, AD?

A

All = no

46
Q

List some conditions which are linked with LD (ie not direct causes but are associated)

A

1) Cerebral palsy
2) Autistic spectrum disorder
3) Epilepsy
4) Prader-Willi syndrome
- Usually mild and IQ in range of 50-85
5) Tuberous sclerosis
- (Rare genetic disorder where non-cancerous tumours grow on the brain)
- 50% have LD

47
Q

What % of those with autism have a LD?

A

55%

48
Q

Outline some areas in which those with autism have difficulties (6)

A

1) Social interaction
2) Verbal and non-verbal communication
3) Restricted and repetitive behaviours
4) Unusual sensory perceptions
5) Physical clumsiness
6) Dietary restrictions

49
Q

What % of the total population develop a mental health problem in their lifetime?

And what % of those with a LD will develop a mental health problem in their lifetime?

A

16-25% of total population

24-40% of people with LD

50
Q

What mental health conditions most commonly seen in LD?

A

Depression
Anxiety
Dementia

51
Q

What biological factors increase vulnerabilities of those with LD?

A 
Genetic vulnerability
Brain damage
Infection
Physical disability
Sensory impairment
Tumours 
Medical / physical treatment
52
Q

What psychosocial factors increase vulnerabilities of those with LD?

A 
Small circle of friends
Limited opportunity for social outings
Reduced employment opportunities
Lack of finance
Lack of support
Exploitation (financial and sexual)
53
Q

What is a common cause of LD esp in those with trisomy 21?

A

Hypothyroidism

54
Q

Why may those with LD suffering from depression may be more difficult to treat?

A

May be difficult to encourage them to access talking therapies

Antidepressant medication takes longer to work

Year 4 Psych (10 decks)

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