Personality Disorders I

Question 1

describe cluster A, B and C in personality disorders

Answer 1

• cluster A, odd-eccentric:
  
  • paranoid
  • schizoid
  • schizotypal
• cluster B, dramatic/emotional/erratic
  
  • histrionic
  • borderline
  • narcissistic
  • antisocial
• cluster C, anxious/fearful:
  
  • avoidant
  • depressive
  • obsessive-compulsive

Question 2

describe personality disorders and their onset and course

Answer 2

• pattern of perceiving, relating and thinking about the environment and oneself that is:
  
  • chronic and pervasive
  • culturally deviant
  • maladaptive or distressful
• onset and course: in childhood-adolescence with behaviors solidifying with age (typically not diagnosed until adult)

Question 3

describe the treatment and prognosis of personality disorders

Answer 3

• cognitive-behavioral psychotherapy is typically used as the primary form of treatment
• medications could be used as adjunctive treatment
• in general, treatment is difficult due to:
  
  • patient disinterest in treatment
  • the inherent difficulty in unlearning entrenched behaviors

Question 4

describe paranoid personality disorder (PDD)

Answer 4

• example symptoms
  
  • suspicion that others are being exploitative or deceptive
  • unjustified doubts about loyalty/trustworthiness
  • reluctance to confide
  • reads hidden threatening meanings into remarks
  • reacts angrily to perceived insults
• theme: distrust and suspicion

Question 5

describe a PPD differential

Answer 5

• differential: delusional disorder (DD), persecutory type
  
  • in DD, the paranoid thought is “believed with certainty” while in PDD, the paranoid thought is merely “suspected”
  • in DD, the onset is sudden and typically in middle age with a focus on a single paranoid theme; in PPD, symptom onset is gradual and typically in childhood with pervasive paranoia

Question 6

describe schizoid personality disorder

Answer 6

• example symptoms:
  
  • lacks desire for close relationships/intimacy
  • lacks close friends
  • prefers solitary activities
  • derives pleasure in few activities
  • indifference to praise/criticism
  • emotional coldness, detachment or flat affect
• theme: interpersonal detachment

Question 7

describe schizotypal personality disorder

Answer 7

• example symptoms:
  
  • ideas of reference
  • odd beliefs or magical thinking
  • unusual perceptual experiences
  • odd thinking and speech
  • odd appearance
  • problematic social relatedness (lack of close friends)
• theme: eccentric

Question 8

schizotypal disorder is listed in both, the ____ disorders and _____

Answer 8

schizotypal disorder is listed in both, the personality disorders and schizophrenia spectrum

• schizotypals don’t have psychotic symptoms (delusions, hallucinations)
  
  • some schizotypal MAY eventually develop psychotic symptoms (thus, schizotypal personality may be the premorbid personality of schizophrenia)

Question 9

describe histrionic personality disorder

Answer 9

• example symptoms
  
  • needs to be center of attention
  • uses physical appearance for attention
  • inappropriately provocative behavior
  • shallow and rapidly shifting emotions
  • exaggerated emotional expression
  • considers relationships intimate
• theme: excessive emotionality

Question 10

describe borderline personality disorder

Answer 10

• example symptoms
  
  • relationships
    
    • unstable intense relationships with alternating idealization and devaluation (“splitting”)
    • frantically avoids abandonment
  • emotions
    
    • intense uncontrolled anger
    • marked reactivity of mood
    • chronic feelings of emptiness
  • self
    
    • unstable self-image
  • behaviors
    
    • self-damaging impulsivity
    • suicidal gestures/self-mutilation
    • transient stress-related
    • dissociative/paranoid symptoms
• theme: instability

Question 11

describe narcissistic personality disorder (NPD)

Answer 11

• example symptoms
  
  • grandiose sense of self-importance
  • preoccupied with success
  • requires admiration
  • sense of entitlement
  • interpersonally exploitative
  • lacks empathy with haughty attitudes
• theme: grandiosity
• a narcissistic injury (blow or threat to self-esteem) may result in a rage reaction

Question 12

describe antisocial personality disorder (ASPD)

Answer 12

• example symptoms
  
  • repeated unlawfaul acts
  • deceitfulness
  • irritability and aggressiveness
  • reckless disregard for safety of self or others
  • irresponsibility (employment or financial)
  • lack of remorse
• theme: pervasive disregard for other’s rights

Question 13

describe diagnosis of ASPD

Answer 13

• person must be at least 18 for ASPD diagnosis
• there must be evidence of conduct disorder with onset before age 15

Question 14

ASPD is associated with lack of _______ which may caused by _____ dysfunction

Answer 14

ASPD is associated with lack of physiological reactivity to stressors which may caused by amygdala dysfunction