Personality Disorders and Mood Disorders Flashcards
A fixed way of interacting with the environment that causes distress or impaired function
Personality disorder
What are the 3 Cluster A (Weird) personality disorders?
Paranoid, Schizoid, Schizotypal
What are the 4 cluster B (Wild) personality disorders?
-Dramatic erratic behavior
Antisocial, Borderline, Histrionic, and Narcissistic
What are the 3 Cluster C (whacky) PD’s?
-Anxious, fearful behavior
Avoidant, Obsessive-compulsive, and dependent
Characterized as being distrustful of others, even friends/family
Paranoid PD
The hallmark ego defense of Paranoid PD is?
-Attributing unacceptable thoughts to others
Projection
Chooses social isolation
-More comfortable alone
Schizoid PD
Does not enjoy close relationships and has little/no interest in sexual experiences
Schizoid PD
Another characteristic of Schizoid PD is
Flat affect
Fear of social interactions and few close friends. Characterized by odd beliefs or magical thinking
-Superstitious
Schizotypal PD
Tend to believe that events and happenings are somehow related to them
Schizotypal PD
A key feature that distinguishes Schizotypal PD from schizophrenia and delusions is that Schizotypals are
Open to challenges to beliefs
Disregard for the rights of others
- More common in men
- Often break the law
Antisocial PD
If the child is under 18 years old, than we don’t call it antisocial PD, but rather
Conduct disorder
Characterized by unstable relationships and is more common in women than men
Borderline PD
Believe that all people are either very good or very bad
- Can change daily
- Fear of abandonment
Borderline PD
The major defense mechanism in borderline PD is
Splitting
Form of cognitive behavioral therapy that is the gold standard for borderline PD
Dialectical Behavioral Therapy
Wants to be the center of attention
-Talks loudly, tells wild stories, and uses hand gestures
Histrionic PD
Often wears provocative clothing and engages in inappropriate sexually provocative behavior
-Very concerned with physical appearance
Histrionic PD
Has an inflated sense of self
- Lacks empathy for others
- Wants to hear they are great
- Overreacts to criticism w/ anger/rage
Narcissistic PD
Avoids social interactions because they feel inadequate
Avoidant PD
Afraid that people won’t like them and struggle with intimate relationships
Avoidant PD
Different from schizoid because they want to socialize but can’t
Avoidant PD
Pre-occupied with order and control
-Inflexible at work or in relationships
Obsessive-Compulsive PD
Behaviors help to achieve goals
Obsessive-compulsive PD
OCPD patients obsessions/compulsions are used to achieve foals. This is classified as being
Egosyntonic
OCD patients on the other hand have obsessions/compulsions that are barriers to goals. This is called
Egodystonic
Characterized by clinginess and low self-confidence
-Struggle to care for themselves
Dependent Personality Disorder
Patients with Dependent Personality Disorder (DPD) have difficulty expressing an
Opinion
Characterized by abnormal emotional state such as sadness (depression) or extreme happiness (mania)
Mood disorders
What are three cardinal symptoms of Major Depressive Disorder (MDD) besides the classic depressed mood, lost of interest, and feeling worthless?
Appetite changes, weight loss/gain, and sleep disturbances
Can present with altered sleep rhythms. REM starts quicker after sleep onset
MDD
What is the effect of REM starting quicker after sleep onset in MDD?
Decreased REM Latency
Have increased total REM sleep but decreased slow-wave sleep
MDD
From a psychomotor standpoint, MDD can present with either
Psychomotor agitation or psychomotor retardation
Excessive motor activity, often repetitious
-Feeling of inner tension
Psychomotor agitation
Slowing of movements, thinking, or speech
-Slower to answer questions
Psychomotor depression
Patients must meet at least 5 symptoms of SIG E CAPS to be diagnosed with
MDD
Characterized by the core unique feature that patients are able to react to pleasurable stimuli, I.e. they feel better when good things happen
Atypical Depression
Are classified as eating and sleeping all the time
- Increased appetite or weight gain
- Increased sleep
Atypical Depression
Atypical depression is usually treated with
SSRI’s (but could also see MAOI use)
Abnormally elevated mood and energy level
- Talking fast w/ pressured speech
- Decreased need for sleep
Manic Episode
Two key buzzwords for mania are
Disinhibition and Grandiosity
Typical case is: change in mood to elevated state, not sleeping, altered behavior, and disruption of social functioning
Mania
What is the acronym for mania
DIG FAST
Distractibility Irresponsibility Grandiosity Flight of Ideas Agitation Less Sleep Talking too much/pressured speech
Have symptoms similar to those of mania but less severe
Hypomania
A key feature of hypomania is little/no impairment in
Functioning
Shows inflated self esteem, but no delusions of grandeur
Hypomania
Hypomania lasts for at least
4 days
Hypomania shows no
Psychotic symptoms
Presents with the typical case of: change in mood to elevated state, continued social functioning, and resolves in a few weeks
Hypomanic Episode
Manic episodes =
Bipolar 1
Hypomania and depression w/ no manic episodes =
Bipolar 2
Most of the mood stabilizers for bipolar disorder are
Anticonvulsants (valproic acid, carbamazepine, or lamotrigine)
Always occur TOGETHER with mood symptoms in bipolar disorder
Psychotic features
Psychosis without mood symptoms =
Schizoaffective Disorder
Characterized by mild mania and mild depressive symptoms that does not meet criteria for hypomania or MDD
Cyclothymic disorder
With cyclothymic disorder, the symptoms come and go over at least
2 years
Low grade form of depression that is less severe but more chronic
-Lasts for at least 2 years
Persistent Depressive Disorder
Seen in depression and bipolar disorder
-95% of successful attempts have psychiatric diagnosis
Suicide
Have more suicide attempts but are less successful
Women
Have fewer suicide attempts but are more successful
Men
The most common method of suicide is
Firearms
Normal response to loss of a loved one
-There are 5 stages
Acute grief
Grief that lasts longer than 6 months, interferes w/ functioning, and may lead to MDD
Persistent Grief
Depressed mood, insomnia, fatigue, and poor concentration that starts 2-3 days after delivery
Postpartum Blues (up to 85% of women post delivery)
The post partum blues resolves within
2 weeks
Around 15% of women that give birth will experience
- Lasts longer than two weeks
- Treat with CBT and SSRIs
Postpartum Depression
Performed under general anesthesia
- Essentially an electrically administered seizure
- May cause amnesia
Electroconvulsive therapy