Personality Disorders - Cluster A Flashcards

1
Q

What are the 3 personality disorders in cluster A (MAD)?

A

paranoid
schizoid
schizotypal

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2
Q

what is the pattern that describes paranoid personality disorder?

A

a pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent
“long standing suspiciousness & mistrust”

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3
Q

what is the pneumonic for paranoid personality?

A

GET FACT

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4
Q

how many of the DSM-IV criteria (out of 7) are needed for paranoid personality disorder?

A

at least 4 out of the 7

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5
Q

what are the criteria extracted from the GET FACT pneumonic for paranoid personality?

A

GRUDGES for long periods (is unforgiving of insults, injuries, or slights)
EXPLOITATION expected (without sufficient basis)
TRUSTWORTHINESS of others doubted
FIDELITY of sexual partner questioned
ATTACKS on character are perceived
CONFIDES in others rarely (if at all)
THREATENING meanings read into events (reads hidden meaning)

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6
Q

Scenario: a 50 yo office worker tells you that he has never been promoted bc his coworkers frequently claim his ideas as their own. when he is fired for poor performance, he files a lawsuit against the company.

what type of patient does this describe?

A

a typical paranoid patient

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7
Q

what are the characteristics of a paranoid patient?

A

suspicious, mistrustful, litigious, attributes responsibility for problems to others.

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8
Q

what are 2 major psychodynamic defense mechanisms used in paranoid patients?

A

projection and denial

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9
Q

what does paranoid personality disorder lack?

A

a fixed delusion or a true thought disorder

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10
Q

how does paranoid personality differ from schizophrenia? hint: there are 2 out of 5 things that you need to have for schizophrenia…

A
  1. delusions
  2. hallucinations
  3. disorganized speech
  4. grossly disorganized or catatonic behavior
  5. negative symptoms
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11
Q

what populations are commonly seen in paranoid personality disorder?

A

minorities, immigrants, deaf

M>F

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12
Q

what is the typical course of paranoid personality disorder?

A
  1. no change (c/w personality disorder)
  2. harbinger to schizophrenia
  3. reaction formation
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13
Q

what is reaction formation (seen in paranoid personality disorder)?

A

taking up the opposite position/emotion to hide how you really feel
Ex: rejecting relationships when in reality, it is what you desire the most.

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14
Q

contact tips for the paranoid patient:

A
  1. difficulty with trust and tolerating intimate relationships
  2. be professional (not overly warm/touchy)
  3. trying to interpret behavior in front of patient can result in mistrust.
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15
Q

treatment of choice for the paranoid patient?

A

psychotherapy.

they don’t do well with group therapy though, since they don’t trust others

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16
Q

pharmacotherapy for the paranoid patient?

A

antianxiety agents
OR
antipsychotics and/or haldol for severe agitation or delusions.

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17
Q

how would you describe a patient with schizoid personality disorder?

A

pattern of detachment from social relationships and a restricted range of emotional expressions

18
Q

how might others view a patient with schizoid personality?

A

asceccentric, isolated, lonely, detatched, would rather be alone, doesnt make eye contact, no concern for others

19
Q

what is the affect of a schizoid?

A

bland constricted affect

20
Q

what types of jobs to schizoids usually have?

A

night shift; computer jobs; little contact with others

21
Q

what is the pneumonic for schizoid personality disorder?

A

SIR SAFE

22
Q

what does the pneumonic SIR SAFE stand for (schizoid personality)

A
SOLITARY lifestyle
INDIFFERENT to praise or criticism
RELATIONSHIPS of no interest
SEXUAL experiences not of interest
ACTIVITIES not enjoyed
FRIENDS lacking
EMOTIONALLY cold and detached
23
Q

out of the SIR SAFE pneumonic, how many of them does a patient need to qualify as having schizoid personality?

A

at least 4 out of the 8 (DSM criteria also includes “solitary jobs, works at night”

24
Q

scenario: a 48 year old man is content living alone in an isolated cabin, growing his own food, and rarely having contact with others.

what personality disorder is this consistent with?

A

schizoid personality

25
Q

what’s the tagline of schizoid personality disorder?

A

lifelong pattern of voluntary social withdrawl

26
Q

how would you describe a patient with schizotypal personality disorder?

A

pattern of acute discomfort in close relationship, cognitive perceptual distortions, and eccentricities of behavior; strikingly odd or strange (magical) thinking.

27
Q

what are ideas of reference?

A

speaking in words only the person understands

28
Q

to people with schizotypal personality believe they have special powers?

A

yes. yes they do

29
Q

what is the pneumonic for schizotypal personality disorder?

A

UFO AIDER

30
Q

what does UFO AIDER stand for (schizotypal personality)

A
UNUSUAL perceptions
FRIENDLESS except for family
ODD beliefs, thinking, speech
AFFECT - inappropriate, constricted
IDEAS of reference
DOUBTS others - suspicious
ECCENTRIC (appearance, behavior)
RELUCTANT in social situations, excessive social anxiety
31
Q

how many of the UFO AIDER criteria does one need to classify as having a schizotypal personality?

A

at least 5 of the 8

32
Q

do schizotypal patients have a frank thought disorder?

A

no. they lack a frank thought disorder

33
Q

schizotypal personality may be premorbid personality of patients with schizophrenia. if they do not develop psychotic features before age 30, are they likely to progress?

A

no.

34
Q

what is the difference between schizophrenia and schizotypal personality?

A

schizotypal retain some self awareness that their beliefs/speech are odd/eccentric. schizophrenia lacks this insight into self.

35
Q

can the schizotypal patient successfully trust a provider or another person?

A

yes, they can. they naturally tend toward introspection, but usually they just don’t put forth the effort to have a relationship with someone.

36
Q

meds that include which neurotransmitter have been shown to help schizotypal patients be less sensitive to rejection?

A

serotonin. (typical and atypical antipsychotics)

37
Q

which meds can help schizotypal patients with interpersonal anxiety?

A

benzo’s

38
Q

scenario: a 35 yo male tells you that he never steps on the cracks in the sidewalk to avoid “breaking his mother’s back” (magical thinking). . he seems odd and says that he never feels comfortable in social situations. he has few friends.

what personality disorder is consistent with this scenario?

A

schizotypal personality disorder

39
Q

up to 50% of schizotypal patients have what other psych diagnosis?

A

depression

40
Q

what are the two defense mechanisms of schizotypal personality disorder? hint: same as paranoid personality.

A

projection and denial