Personality Disorders-Kohlenberg Flashcards
How many personality disorders are there?
10 w/ A, B & C clusters
How do you evaluate personality disorders?
instead of strict criteria, you more see that a patient fits into a cluster
ex: may see that they trust no one & have a paranoid type of personality disorder
What is parasuicide?
ex: cuts
not meant to kill yourself, but has that vibe
What is the #1 thing used to reduce parasuicidal behavior?
Dialectical Behavior therapy
Chip, a 24 year old new patient, sees his primary care doctor for a bad cough. He is dressed eccentrically and he asks about the doctor's astrological sign. He is in a rush to get the prescription for antibiotics because he believes they will work best if taken exactly on the hour. Eye contact is poor. Which personality disorder is the most appropriate diagnosis? a. Schizoid Personality Disorder b. Schizotypal Personality Disorder c. Paranoid Personality Disorder d. Antisocial Personality Disorder e. Borderline Personality Disorder
B. Schizotypal.
How does it feel to have a personality disorder?
ego-syntonic
miserable: relationship failures, depression, suicide
What is ego syntonic & dystonic?
ego dystonic: I have an issue w/ depression. This isn’t who I am & I want to be better.
ego syntonic: I’m alright–everyone else is messed up.
Who is Tony Soprano an example of?
someone w/ antisocial personality disorder
only presents to the psychiatrist for an anxiety disorder
What is a personality?
a common way that a person feels & behaves across situations.
How does personality or “self” develop?
develops through interactions with others
ex: caregiver relationship is very important. If they constantly abuse you-you may not have a sense of your needs or personality.
What is the relationship w/ childhood neglect & developing a personality disorder?
children who have been abused 4X more likely to be diagnosed w/ a PD.
73% of PD patients were abused as children.
What are the 6 key elements of personality disorders?
- enduring pattern of inner experience & behavior
- this enduring pattern is inflexible & pervasive
- pattern leads to clinically significant distress or impairment in social or occupational areas of functioning
- The pattern is of long duration, onset in adolescence or early adulthood.
- Not better explained as a manifestation or consequence of another mental disorder.
- Not due to physiological effects of a substance or medical condition.
Describe the onset of a personality disorder.
**never new onset
evaluate long term functioning
evident in early adulthood
rarely diagnosed in kids
TF Personality disorders are a subtype of situation/mood disorders, anxiety disorders, substance abuse.
False.
What is Cluster A of personality disorders?
Odd or eccentric (paranoid, schizoid, schizotypal)
What is Cluster B of personality disorders?
Dramatic, emotional, erratic (antisocial, borderline, histrionic, narcissistic)
What is Cluster C of personality disorders?
Anxious, fearful (avoidant, dependent, obsessive compulsive personality disorder)
What is paranoid personality disorder?
A pattern of pervasive distrust and suspiciousness of others such that their motives are considered malevolent. Begins in early adulthood, across a variety of contexts.
is reluctant to confide in others because of fears that the information will be used against him or her
reading insults into benign remarks
persistently bears grudges, is unforgiving of insults, injuries, or slights
perceives attacks on his or her character or reputation that are not apparent to others and is quick to react or to counterattack
has recurrent suspicions, w/o justification, regarding fidelity of spouse or sexual partner
How does paranoid personality disorder differ from paranoid schizophrenia?
paranoid schizophrenia has clear cut delusions that are specific & not pervasive across different contexts.
these delusions may come & go.
What is schizoid personality disorder?
A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions–beginning by early adulthood.
does not desire or enjoy close relationships, including being part of a family
Neither desires nor enjoys close relationships, including being part of a family.
Has little interest, if any, in sexual experiences with another person
takes pleasure in few, if any, activities
lacks close friends or confidants other than first-degree relatives
appears indifferent to the praise or criticism of others
shows emotional coldness, detachment, or flattened affectivity
T/F Schizoid personality disorder is a part of schizophrenia?
False. Does not occur during the course of Schizophrenia, Mood Disorder w/Psychotic features…
Is schizoid personality disorder an avoidant personality disorder?
no, b/c they have a preference for being alone
What is schizotypal personality disorder?
A pervasive pattern of social and interpersonal deficits marked by discomfort with, and reduced capacity for, close relationships as well as by cog. or perceptual distortions and eccentricities of behavior.
odd beliefs or magical thinking
unusual perceptual experiences–including bodily illusions
odd thinking and speech peculiar behavior or appearance
suspiciousness or paranoia
inappropriate or constricted affect
T/F Schizotypal personality disorder is a part of schizophrenia.
False.
Once again, what are types of cluster A personality disorder?
paranoid personality disorder
schizoid personality disorder
schizotypal personality disorder
What is antisocial personality disorder?
A pervasive pattern of disregard for, and violation of, the rights of others that occurs that began in childhood or early adolescence and continues into adulthood.
Must be at least 18 to receive this dx.
What is the DSM5 criteria for antisocial personality disorder? Personality functioning
impairments in personality disorder
pathologic personality traits
A. personality functioning–
1. impairments in self functioning
**identity: ego centrism, self esteem derived for personal gain, power or pleasure
**self-direction:goal setting for personal gain, absence of prosocial internal standards
2. impairments in interpersonal functioning
**empathy:lack of concern for other’s feelings, needs, sufferings, lack of remorse for hurting others
**intimacy:can’t have mutually intimate relationships, exploit people, use dominance, deceit
What is DSM5 criteria for antisocial personality disorder?
Personality traits
B. Pathologic Personality Traits:
- Antagonism
a. manipulativeness
b. deceitfulness
c. callousness
d. hostility - Disinhibition
a. irresponsibility
b. impulsivity
c. risk taking
What are other DSM 5 criteria for antisocial personality disorder?
C. Impairments in personality functioning & the individual’s personality trait expression are relatively stable across time & consistent across situations
D. not better understood as normative to culture or developmental stage
E. not solely due to physiological effects of a substance or medical condition
F. individual at least 18 yo
People with antisocial personality disorder are usu treated voluntarily?
No, usu involuntary in jail or something
What does psychopathy screen for?
personality disorder-antisocial glib & superficial charm grandiose self worth need for stimulation or proneness to boredom pathological lying lack of remorse or guilt shallow affect callousness & lack of empathy parasitic lifestyle poor behavioral controls promiscuous sexual behavior early behavior problems lack of realistic long term goals impulsivity irresponsible failure to accept responsibility for actions many short term marital relationships juvenile delinquency revocation of condition release criminal versatility
What is borderline personality disorder?
Pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity that begins in early adulthood and is present in a variety of contexts.
frantic efforts to avoid real or imagined abandonment
idealized and devalued interpersonal relationships
identity disturbance–unstable sense of self
impulsive behavior–$, sex, substance abuse, reckless driving, etc……
affective instability–reactivity of mood
chronic feelings of emptiness
recurrent suicidal behavior or self-mutilation
inappropriate anger
stress related paranoid ideation or dissociative symptoms
What is a good treatment for borderline personality disorder?
dialectical behavior disorder-reduces symptoms by 80%
T/F Borderline personality disorder is as common as schizophrenia or bipolar disorder.
True.
What is the biological aspect of borderline personality disorder?
much more emotional dysregulation higher sensitivity higher reactivity longer lasting arousal mood instability
T/F A perfectly nice mom can abuse a child with borderline personality disorder without even thinking about it.
True. b/c perfectly fine things can traumatize a kid w/ BPD.
What are the functions of self-injurious behavior?
Almost all (80-94%) self-mutilators report a decrease in negative emotion and shame after cutting. Self-mutilators often report that self-injury helps them feel as if they exist during periods of profound emptiness or dissociation.
Give more info about DBT that helps treat BPD.
Linehan’s work
Skills focused on inner experience
emotional dysregulation, mindfulness, wise mind
Skills focused on effectiveness in the world (chain analysis, problem solving, affirmation, the dialectic)
**gives BPD patients a tool kit to handle their emotions & analyze why they are feeling what they are feeling.
What is wise mind?
the intersection of rational/logical mind & emotional mind
What is histrionic personality disorder?
Pervasive and excessive emotionality and attention-seeking behavior
begins in early adulthood
Colorful, dramatic, extroverted, excitable and emotional. Males can act tough and macho. And a deep seated inability to maintain strong, reciprocal, and long-lasting friendships.
Love attention, unable to be ignored, shallow.
What is narcissistic personality disorder?
A pervasive pattern of grandiosity, need for admiration, and lack of empathy that begins in early adulthood
grandiose sense of self importance
preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love
believes he or she is special or unique
requires excessive admiration sense of entitlement interpersonally exploitative lacks empathy envious of others and thinks others envy him or her arrogant and haughty
no ability to be empathic
common in adolescents–not predictive of adult NPD
2-16% in the clinical population, 1% in gen. population
no heritability
What is cluster b personality disorders?
antisocial PD
borderline
histrionic
What are cluster c personality disorders?
**tend to be anxious & fearful.
avoidant
dependent
obsessive compulsive personality disorder
What is avoidant personality disorder?
a pervasive pattern of social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation
avoids jobs that involve interpersonal contact, due to fears of disapproval or rejection
unwilling to get involved with people unless certain of being liked
shows restraint within intimate relationships because of fear of being shamed or ridiculed
is preoccupied with being criticized or rejected in social situations
How can you tell avoidant PD from schizoid PD?
avoidant: want social interactions etc but fear & anxiety prohibit them
schizoid: disinterested
Which personality disorder does Glenn Close have when she boils the bunny?
borderline personality disorder
What is the difference b/w social anxiety disorder & avoidant personality disorder?
social anxiety but treatable, not to the level of –I don’t want to go to the bank b/c I will do something wrong & they will make fun of me. More like: I’m nervous about going on a date.
What is dependent personality disorder?
pervasive need to be taken care of that leads to submissive and clinging behavior and fears of separation
has difficulty making everyday decisions without advice from others
needs others to assume responsibility for most major areas in life
has difficulty disagreeing with others
What is obsessive compulsive personality disorder?
A preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency.
preoccupied with details, rules, order–to the extent that the major point of an activity is lost
shows perfectionism-interferes with task completion
is excessively devoted to work and productivity, excludes leisure activity and friendships
is overconscientious, and inflexible about matters of morality, ethics or values
is unable to discard worn-out of worthless objects even with no sentimental value
is reluctant to delegate tasks (w/o assurance)
What is the difference b/w obsessive compulsive disorder & obsessive compulsive personality disorder?
OCD: huge amount of suffering, want more. compulsive thoughts/behaviors.
OCPD: personality style, not in misery.