Personality Disorders- Cluster A Flashcards
What personality disorders are in cluster A?
- Paranoid
- Schizoid
- Schizotypal
How might individuals in cluster A appear?
Odd and eccentric
What is the personality style of Paranoid PD?
independent/vigilant
What is the predominant theme of Paranoid PD?
Distrust and suspiciousness of others such that their motives are interpreted as malevolent
- frequently get defensive during interactions w/ others
- refuse responsibility for their feelings and assign responsibility to others
- suspicious
- constantly on guard
Paranoid PD
- Major depressive disorder (MDD)
- Substance abuse
- Agoraphobia
- OCD
- Borderline PD
- Narcissistic PD
Comorbid disorders associated with Paranoid PD
What is the treatment of choice for Paranoid PD?
Psychotherapy- individual client centered therapy focused on building rapport/counter negative thinking
- •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
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
Paranoid PD
What is pharmacotherapy for Paranoid PD mainly used for?
agitation or anxiety (Rx anti-anxiety agents like Buspirone, hydroxyzine, clonazepam)
Pharmacotherapy also targeted at comorbid disorders
What can be used in Paranoid PD if pt decompensates into severe agitation or delusional thinking?
Haloperidol (Haldol)
What are some provider strategies for interacting with patients who have paranoid PD?
- 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
What is the personality style of Schizoid PD?
Solitary
What is the predominant theme of Schizoid PD?
Detachment from social relationships and restricted range of expression of emotions in interpersonal settings, beginning in early adulthood
React passively to adverse circumstance
Schizoid PD
- Major depressive disorder (MDD), anxiety disorders, schizophrenia, delusional disorders
- Paranoid PD, schizotypal PD, avoidant PD
Schizoid PD
- Doesn’t want/enjoy close relationships
- Chooses solitary activities.
- Has little interest in having sexual experiences with another person.
Some diagnostic criteria (DSM 5) for Schizoid PD
- 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.
Some diagnostic criteria (DSM 5) for Schizoid PD
Dpesn’t occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features
Diagnostic Criteria (DSM5) for Schizoid PD
- 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
Schizoid PD- Proverb interpretation
Proverb interpretation is abstract
Treatment of choice for Schizoid PD
psychotherapy
When are people with schizoid PD likely to seek treament
only if they are under increased stress or pressure in their life
Tx short term, pt will likely terminate
What is pharmacotherapy targeted at in a person with schizoid PD
at comorbid disorders
Provider strategies for Schizoid PD
- pt privacy
- low key
- focus on technical elements of tx
What is the personality style of Schizotypal PD?
idiosyncratic
•social and interpersonal deficits marked by acute discomfort and reduced capacity for close relationships as well as:
- cognitive or perceptual distortions
- eccentric behavior
Predominant theme of Schizotypal PD
- Involves odd beliefs, behavior, appearance, and interpersonal style
- Not able to negotiate the full range of affects and interpersonal cuing required for successful relationships
Schizotypal PD
- 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
Comorbid disorders of Schizotypal PD
Treatment for schizotypal PD
- Low dose antipsychotics (Risperidone, Olanzapine)
- Long-acting anxiolytics for social anxiety (Clonazepam aka Klonopin)
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
Schizotypal PD
over 50% admitted to clinical setting have a concurrent major depressive disorder
Schizotypal PD
