Personality Disorders, Obsessive-Compulsive and Related Disorders Flashcards
pervasive, enduring patterns of thinking, perceiving, reacting, and relating that cause significant distress or functional impairment
personality disorders
there are _ types of personality disorders,
grouped into _ clusters
10 types
3 clusters
-what personality disorders are included in cluster A
-what are the 2 characteristics of cluster A
disorders:
paranoid
schizoid
schizotypal
characteristics:
odd
eccentric
-what are the cluster B personality disorders
-what are the 3 characteristics of cluster B
disorders:
antisocial
borderline
histrionic
narcicisstic
characteristics:
dramatic
emotional
erratic
-what are the cluster C personality disorders
-what are the 2 characteristics of cluster C
disorders:
avoidant
dependent
obsessive compulsive
characteristics:
anxious
fearful
what 4 personality disorders are not included in the A/B/C clusters
-general personality disorder
-personality change due to other medical condition
-other specified personality disorder
-unspecified personality disorder
enduring pattern of inner experience and behavior that deviates markedly from teh expectations of the individual’s culture
general personality disorder
general personality disorder is manifested in at least _ of what 4 categories
at least 2 of the following:
cognition
affectivity
interpersonal functioning
impulse control
ways of perceiving and interpreting self, other people, and events
cognition
the range, intensity, lability, and appropriateness of emotional response
affectivity
generalized personality disorder behaviors must meet what criteria (5)
-inflexible and pervasive across a broad range of personal/social situations
-cause clincally significant distress/impairment in functioning
-stable and of long duration - traced back to at least adolescence or childhood
-not better explained by other mental disorder
-no attributable to substances or another medical condition
persistent feelings of suspiciousness and mistrust of other ppl
paranoid personality d.o
paranoid personality d.o has higher incidence in families with what condition
schizophrenia
emotional aloofness, indifferent to praise or criticism w.o bizarre or idiosyncratic thinking
shizoid personality d.o
3 key characteristics of schizoid personality d.o
-voluntary social withdrawal
-content w. social isolation
-limited emotional expression
t/f: schizoid personality d.o is associated w. schizophrenia
f!
3 key characteristics of schizotypal personality d.o
-odd eccentric behavior
-discomfort w. social relationships/social and interpersonal deficits
-acute discomfort w., and reduced capacity for, close relationships
4 common characteristics of schizotypal personality d.o
-eccentric behavior
-magical thoughts
-odd beliefs
-perceptual distortion
t/f: pt’s w. schizotypal personality d.o are usually unable to function in society
f!
they can, but struggle w. relationships
t/f: schizotypal personality d.o is associated w. development of schizophrenia
t!
3 key characteristics of antisocial personality d.o
-lack of remorse and no concern for others
-disregard for, and violation of the rights of others
-associated w. criminality
does antisocial personality d.o have higher incidence in m or w
men!
duh
what do you diagnose your 16 yo patient with who meets dsm 5 criteria for antisocial personality d.o
conduct d.o
what should you r.o before diagnosing your pt w. conduct d.o (2)
-SUD
-sexual abuse
classic triad of conduct d.o/antisocial personality d.o
fire setting
animal torture
bedwetting
what personality d.o do you think of when you see “sociopath”
antisocial personality d.o
3 key characteristics of borderline personality d.o
-emotional instability
-unstable relationships
-self-harming behavior
is borderline personality d.o mc in m or w
w :(
what does “splittng” make you think of
defense mechanism for borderline personality d.o
what is “splitting”
black and white thinking
ex. relationships are either all good or all bad - “my bf is a perfect angel” or “my bf is evil and i hate him
6 key characterstics of histrionic personality d.o
-attention seeking dramatic seductive behaviors
-center of attention
-dramatic
-shallow
-seductive/flirtatious
-large concern w. appearance
5 key characteristics of narcissistic personality d.o
-need for admiration
-grandiose thoughts
-concerned what others think
-lack empathy BUT lack empathy
-sense of entitlement
how might a pt w. narcissistic personality d.o react to criticism
rage!
key characteristics of avoidant personality d.o
-social inhibition
-feelings of inadequacy
-hypersensitivity to negative evaluation
behaviors of avoidant personality d.o must be apparent by _
and present _
-early adulthood
-in a variety of contexts
key difference btw avoidant personality d.o and schizoid personality d.o
-avoidant desires relationships
-schizoid prefers to be alone
4 key characteristics of dependent personality d.o
-submissive
-clingy
-need to be taken care of
-low self-esteem
3 key characteristics of obsessive compulsive personality d.o
-preoccupation w. order
-perfectionism
-control
key difference btw obsessive compulsive personality d.o and OCD
-obsessive compulsive personality d.o is ego-syntonic
-OCD is egodystonic
what is egosyntonic
-pt not aware behavior is causing issues
-behaviors are acceptable to self
what is ego dystonic
-pt aware that behavior is causing issues
-behaviors are unacceptable to self
what are the 2 obsessive compulsive disorders included in the PAEA EOR topic list
-OCD
-body dysmorphic d.o
(there are 7 others not included in the blue print - thanks PAEA!)
focus on obsessions and repititions of compulsive behavior
OCD
recurring intrusive thoughts that cause severe distress and impairment
obsessions
performance of repetitive actions (rituals) in an attempt to neutralize obsessions
compulsions
OCD is ego__
dystonic
it distresses the pt - inconsistent w. pt’s beliefs and attitudes
hand washing is a common example of a
compulsion
primary goal of compulsions
to not lose control
what condition is associated w. OCD
tourette’s disorder
what do you think when you see a beautiful woman who complains that her hands are too big, yet they appear well formed and appropriate (weird example Smarty PANCE)
body dysmorphic d.o
-preoccupation w. an imagined defect in physical appearance/exaggerated distortion of a minor flaw
-obsession w. fixing a specific feature of appearance that is w.o major flaws
body dysmorphic d.o
5 common concerns associated w. body dysmorphic behavior
face
hair
skin
breasts
genitalia
body dysmorphic d.o has high comorbidity w. what 2 conditions
psychotic d.o
OCD
_ may play a role in the development of body dysmorphic d.o
stereotypes of beauty
mc personality d.o in prison pops
antisocial
up to 75%
2 socioeconomic factors related to antisocial personality d.o
large families
poor urban areas
pt w. antisocial d.o may appear _ which can mask symptoms
charming
4 behaviors associated w. antisocial pd that SMARTY PANCE stresses
substance abuse
theft
lying
agression
2 characteristics of antisocial pd that SMARTY PANCE stresses
-failure to conform to social norms
-lack of remorse for actions
what do you think when you see a pt who refuses to attend her holiday work party bc she is afraid her coworkers will not like her - she would like to meet ppl but is too shy to initiate convo
avoidant pd
what do you think when you see: hypersensitivity to rejection and a desire for social interaction
avoidant pd
gs management of avoidant pd
CBT
pharm treatment of body dysmorphic d.o
SSRI
what do you think when you see a pt who states office staff are incompetent and that you are the only medical provider who has ever understood her (even tho you have only had 1 previous encounter) - when you tell her you can not prescribe her pain meds, she says you are incompetent and storms out
borderline pd
what do you think when you see a pt who presents w. a suicide attempt and emotional lability
borderline pd
describe the relationships of a pt w. borderline pd (2)
intense
unstable
a pt who thanks a doctor profusely and then rages when they don’t get what they want, is an example of
splitting -> borderline pd
gs tx for borderline pd
long-term dialectical behavioral therapy
what is dialectical behavior therapy
type of talk therapy for pt’s who experience emotions very intensely
characteristic of dependent pd that SMARTY PANCE stresses
submissive and clinging behavior
to pt’s w. dependent pd, other people appear (3)
powerful
competent
capable of providing security/support
what do you think when you see a pt who: arrives in short skirt, flirts w. you, asks if you like her dress, yells into her cell phone and then cries, and describes her flu sx as if she’s dying
histrionic pd
3 tactics commonly used by histrionic pd patients
-impressionistic speech
-tantrums
-accusations
what is impressionistic speech
-speaking in a general manner that lacks detail
-instead of focusing on describing what happened, pt talks about how they felt during experience
how might a histrionic pd pt view their relationships (2)
-deeper and more solid than they are
-serious after limited interaction
what do you think when you see a pt who is being worked up for lbp who demands to see the chief neurosurgeon and won’t let anyone else in the room - he says he knows VIPs and you will be in trouble if he waits longer than 5 min
narcissistic pd
2 characteristics of narcissistic pd that SMARTY PANCE stresses
-lack of empathy
-sense of entitlement
what do you think when you see: willingness to exploit others and preoccupation w. success
narcissistic pd
what do you think when you see the following pt: very successful PA student who has become increasingly preoccupied w. failing - wakes up 10-15 x/night to check textbooks for factual recall - has tried unsuccessfully to suppress these thoughts and actions - is now anxious and sleep deprived
OCD
17 yo boy feels compelled to walk around the house 12 times before leaving to keep his family safe - what other psych phenomenon might be seen in this pt
vocal tics
tx for OCD (2)
CBT
SSRI’s
(or combo)
what do you think when you see: PA student struggling w. studies bc she must read every reading assignment 2-3 times - she takes meticulous notes which she color codes and she works poorly in groups bc she can not delegate tasks
obsessive compulsive pd
characteristics of obsessive compulsive pd that SMARTY PANCE stresses (4)
preoccupation w. order and control
need for perfection
over-attention to detail
insistence on rule following
what do you think when you see pt who believes coworkers are planning to have her fired and says they talk shit about her when she is not around - she wants to pursue legal action bc they have an intention to harm her
paranoid pd
what do you think when you see pt who lives alone in a cabin on several acres of land - he rarely interacts w. family or community - he does not feel lonely
shizoid pd
tx for schizoid pd
no tx required
how do shizoid pd patients commonly appear to others
cold
unfeeling
how do shizoid pd pt’s respond to praise or criticism
indifferent
what do you think when you see pt who recently quit her job to start a small business bc spirits told her to sell trinkets, each of which has a unique power - she dresses strangely and has hard time making friends bc of strange behavior
schizotypal pd
key differentiating factors btw schizotypal pd and schizophrenia
-shizoid can fxn in society and care for self
-schizoid does not respond to internal stimuli
-schizoid do not experience visual/auditory hallucinations
t/f: schizotypal pd patients struggle with relationships
t!
