Personality Disorders- Cluster A

Question 1

What personality disorders are in cluster A?

Answer 1

1. Paranoid
2. Schizoid
3. Schizotypal

Question 2

How might individuals in cluster A appear?

Answer 2

Odd and eccentric

Question 3

What is the personality style of Paranoid PD?

Answer 3

independent/vigilant

Question 4

What is the predominant theme of Paranoid PD?

Answer 4

Distrust and suspiciousness of others such that their motives are interpreted as malevolent

Question 5

• frequently get defensive during interactions w/ others
• refuse responsibility for their feelings and assign responsibility to others
• suspicious
• constantly on guard

Answer 5

Paranoid PD

Question 6

• Major depressive disorder (MDD)
• Substance abuse
• Agoraphobia
• OCD
• Borderline PD
• Narcissistic PD

Answer 6

Comorbid disorders associated with Paranoid PD

Question 7

What is the treatment of choice for Paranoid PD?

Answer 7

Psychotherapy- individual client centered therapy focused on building rapport/counter negative thinking

Question 8

• •Often hostile, angry, and irritable
• •Inability to relax
• need to scan the environment for clues
• •Manner is humorless and serious
• •Speech is goal directed and logical in their arguments

Question 9

S – spouse is cheating suspected

U – unforgiving / bears grudges

S – suspicious of others

P – perceives attacks and reacts quickly

E – enemy in everyone → suspects associates, friends

C – confiding in others feared

T – threats seen in very benign events

Answer 9

Paranoid PD

Question 11

What is pharmacotherapy for Paranoid PD mainly used for?

Answer 11

agitation or anxiety (Rx anti-anxiety agents like Buspirone, hydroxyzine, clonazepam)

Pharmacotherapy also targeted at comorbid disorders

Question 12

What can be used in Paranoid PD if pt decompensates into severe agitation or delusional thinking?

Answer 12

Haloperidol (Haldol)

Question 13

What are some provider strategies for interacting with patients who have paranoid PD?

Answer 13

• be empathetic towards fears
• Give detailed care plan. Give info about risks of tx
• Maintain patient’s independence when possible, optimize the patient’s control
• Utilize a professional, objective stance

Question 14

What is the personality style of Schizoid PD?

Answer 14

Solitary

Question 15

What is the predominant theme of Schizoid PD?

Answer 15

Detachment from social relationships and restricted range of expression of emotions in interpersonal settings, beginning in early adulthood

Question 16

React passively to adverse circumstance

Answer 16

Schizoid PD

Question 17

• Major depressive disorder (MDD), anxiety disorders, schizophrenia, delusional disorders
• Paranoid PD, schizotypal PD, avoidant PD

Answer 17

Schizoid PD

Question 18

• Doesn’t want/enjoy close relationships
• Chooses solitary activities.
• Has little interest in having sexual experiences with another person.

Answer 18

Some diagnostic criteria (DSM 5) for Schizoid PD

Question 19

• Takes pleasure in few activities.
• Lacks close friends other than first-degree relatives.
• indifferent to the praise or criticism of others.
• Shows emotional coldness, detachment, or flattened affectivity.

Answer 19

Some diagnostic criteria (DSM 5) for Schizoid PD

Question 21

Dpesn’t occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features

Answer 21

Diagnostic Criteria (DSM5) for Schizoid PD

Question 22

• Rarely tolerates eye contact
• Speech is goal-directed

-Difficulty expressing anger–> makes it seem like they lack emotion

•Brief psychotic episodes in time of stress

Question 23

Schizoid PD- Proverb interpretation

Answer 23

Proverb interpretation is abstract

Question 24

Treatment of choice for Schizoid PD

Answer 24

psychotherapy

Question 25

When are people with schizoid PD likely to seek treament

Answer 25

only if they are under increased stress or pressure in their life

Tx short term, pt will likely terminate

Question 26

What is pharmacotherapy targeted at in a person with schizoid PD

Answer 26

at comorbid disorders

Question 27

Provider strategies for Schizoid PD

Answer 27

• pt privacy
• low key
• focus on technical elements of tx

Question 28

What is the personality style of Schizotypal PD?

Answer 28

idiosyncratic

Question 29

•social and interpersonal deficits marked by acute discomfort and reduced capacity for close relationships as well as:

• cognitive or perceptual distortions
• eccentric behavior

Answer 29

Predominant theme of Schizotypal PD

Question 30

• Involves odd beliefs, behavior, appearance, and interpersonal style
• Not able to negotiate the full range of affects and interpersonal cuing required for successful relationships

Answer 30

Schizotypal PD

Question 31

• Schizotypal PD → premorbid personality of patient with schizophrenia
• Major depressive disorder (MDD), bipolar I and II disorders, social and specific phobias, post-traumatic stress disorder
• Schizoid PD, borderline PD

Answer 31

Comorbid disorders of Schizotypal PD

Question 32

Treatment for schizotypal PD

Answer 32

• Low dose antipsychotics (Risperidone, Olanzapine)
• Long-acting anxiolytics for social anxiety (Clonazepam aka Klonopin)

Question 33

M – magical thinking that influences behavior, superstitiousness or the paranormal

E – eccentric behavior or appearance

P – paranoid ideation

E – experiences unusual perceptions

C – constricted affect

U – unusual thinking & speech

L – lacks friends

I – ideas of reference

A – anxiety (socially)- doesn’t diminish w/ familiarity associated w/ paranoid fears

R – rule out psychotic disorders

Answer 33

Schizotypal PD

Question 34

over 50% admitted to clinical setting have a concurrent major depressive disorder

Answer 34

Schizotypal PD