Personality Disorders, Obsessive-Compulsive and Related Disorders Flashcards
What are the Cluster A personality disorders?
paranoid, schizoid, & schizotypal → ODD or ECCENTRIC
What are symptoms of paranoid personality disorder?
- Suspects w/o evidence that others are exploiting, harming, or deceiving them
- Preoccupied w/ unjustified doubts about the loyalty or trustworthiness of friends/associates
- Reluctant to confide in others b/c of unwarranted fear that the info will be used maliciously against them
- Reads hidden demeaning or threatening meanings into benign remarks or events
- Persistently holds grudges (is unforgiving of insults, injuries, or slights).
- Perceives attacks on their character that are not apparent to others & is quick to counterattack
- Recurrent suspicions, w/o justification, regarding fidelity of spouse or sexual partner
What is the diagnostic criteria for paranoid personality disorder?
Persistent suspiciousness & mistrust of others in early adulthood & present in a variety of contexts, as indicated by ≥4 sxs
How is paranoid personality disorder treated?
Psychotherapy (avoid group therapy!)
What is schizoid personality disorder?
Lifelong pattern of voluntary social withdrawl and anhedonic introversion
What are symptoms of schizoid personality disorder?
Schizoids AVOID perople
* Anhedonic: little pleasure in activities or relationships
* Voluntary social withdrawl: prefers to be alone, no desire for close or sexual relationships
* Odd-appearing or eccentric but lacks the bizarre thinking seen with schizotypical or schizophrenia
* Introvert loner, “hermit-like” behavior
* Indiffernt to the premises and critics of others
* Detached, falt, cold, constricted affect
What is the diagnostic criteria for schizoid personality disorder?
Social withdrawal & restricted emotional expression in early adulthood & present in a variety of contexts, as indicated by ≥4 sxs
How is schizoid personality disorder treated?
psychotherapy
What is schizotypical personaltiy disorder?
Presents w/ eccentric behavior, magical thoughts, odd beliefs & perceptual distortion
* Pts are able to function in society, though struggle to maintain social relationships
What are symptoms of schizotypical personality disorder?
- Ideas of reference (excluding delusions of reference)
- Odd beliefs or magical thinking, inconsistent w/ cultural norms (superstitious, clairvoyance, telepathy,“sixth sense”)
- Unusual perceptual experiences, including bodily illusions
- Suspiciousness/paranoid ideation
- Inappropriate or restricted affect
- Odd, eccentric, or peculiar behavior/appearance
- Odd thinking & speech (vague, circumstantial, metaphorical, overelaborate, stereotyped)
- Lack close friends/confidants
- Excessive social anxiety often a/w paranoid fears (does not diminish w/ familiarity)
What is the diagnostic criteria for schizotypical personality disorder?
Pattern of social deficits marked by eccentric behavior, cognitive/perceptual distortions, & discomfort w/ close relationships, beginning by early adulthood & present in a variety of contexts, as indicated by ≥5 sxs
What is the treatment for schizotypical personality disorder?
Psychotherapy +/- short course of low-dose antipsychotics
What are Cluster B personality disorders?
antisocial, borderline, histrionic, & narcissistic → DRAMATIC, EMOTIONAL, OR ERRATIC
What is antisocial personality disorder?
A disregard for & violation of the rights of others w/ a lack of remorse which commonly results in criminality
* Sociopath: a lack of remorse & no concern for others
* Conduct disorder if < 18 years
What are symptoms of antisocial personality disorder?
Antisocial PD CORRUPTS
* Conduct disorder by 15 y/o & atleast 18 y/o
Atleast 3 of the following:
* Obligations are not honored
* Reckless & disregards the safety of others
* Remoreseless
* Uses other & Un-truthful
* Planning not meditated: impulsive
* Temper: irritable or aggressive towards others
* Society laws violated, Social norms disregarded & violation of the rights of others or committing unlawful acts
What is the diagnostic criteria for antisocial personality disorder?
Pattern of disregard & violation of the rights of others, since 15 y/o, as indicated by ≥3 sxs
* Must be ≥18 y/o w/ hx of childhood/adolescent behavior consistent w/ conduct disorder
How is antisocial personality disorder treated?
Psychotherapy → AVOID medications w/ high potential for abuse
What is borderline personality disorder?
- Emotional instability, unstable relationships, & self-harming behavior
- Black & white perception, splitting is a major defense mechanism (relationships are either all good or all bad)
- MC Females > Males
What are symptoms of borderline personality disorder?
B’s of Borderline PD
* Cluster B disorder: dramatic, wild, erratic, impulsive & emotional
* Bat: mood swings
* Black & white thinking: thinks in extremes, all good or bad (splitting)
* Blown up (intense) reaction diproportionate to the event
* Broken: unstable relationships & fear of abandonment (breaking up)
* Bad behavior: impulsivity in self-damaging behaviors
* Bad sense of self
What is the diagnostic criteria for borderline personality disorder?
Unstable relationships, self-image, affect, & impulsivity by early adulthood & in a variety of contexts, as indicated by ≥5 sxs
* Impulsivity in ≥2 potentially harmful ways
How is borderline personality disorder treated?
dialectal behavioral therapy (DBT)
What is histrionic personality disorder?
Attention seeking, dramatic, seductive behaviors, large concern w/ appearance
What are the symptoms of histrionic PD?
H’s for Histrionic PD
* Hey look at me: attention seeking, overly emotional, dramatic, seductive
* Hissy fits: self-absorbed, “temper tantrums” in an effort to draw themselves with the need to be the center of attention
* Hysterical: theatrical & dramatic
* Come Hither: oftern inappropriate, sexually provacative, seductive
* Hyper me up: seeks reassurance & praise often
How is histrionic personality treated?
psychotherapy
What is narcissistic personality disorder?
Need for admiration, grandiose thoughts, concerned about what others think yet lack empathy
* Sense of entitlement lacks empathy, reacts to criticism w/ rage
What are symptoms of narcissistic personality disorder?
- Exaggerated sense of self-importance (grandiosity)
- Preoccupation w/ fantasies of unlimited money, success, brilliance, beauty, power, etc.
- Believes they’re “special” or unique & can associate only w/ other high-status persons
- Requires excessive admiration
- Sense of entitlement (special treatment, automatic compliance w/ expectations)
- Takes advantage of others for self-gain (interpersonally exploitive)
- Lacks empathy (unwilling to recognize/identify w/ feelings/needs of others)
- Envious of others or believes others are envious of them
- Arrogant or haughty behaviors/attitudes
How is narcissistic personality disorder treated?
Psychotherapy → AVOID medications w/ high potential for abuse
What are Cluster C personality disorders?
avoidant, dependent, & obsessive-compulsive personality disorders → ANXIOUS OR FEARFUL
What is avoidant personality disorder?
social inhibition due to an intense fear of rejection with a longing to relate to others
What are symptoms of avoidant personality disorder?
Avoidant patients are AFRAID
* A voids occupational activities that involve significant interpersonal contact
* Fears being critizied or rejected in social situations
* Reluctant to take personal risks or engage in new activities
* Afraid to get involved with others
* Inhibited in new interpersonal situations
* Deficient sence of self makes them view themselves as inferior to others
* Shows caution or restraint within intimate relationships
What is the diagnostic criteria for avoidant personality disorder?
social inhibition, feelings of inadequacy, & hypersensitivity by early adulthood & in a variety of contexts, as indicated by ≥ 4 sxs
How is avoidant personality disorder treated?
psychotherapy
What are symptoms of dependent personality disorder?
- Difficulty making everyday decisions w/o reassurance from others
- Need others to assume responsibility for most areas of their life
- Difficulty expressing disagreement b/c of fear of loss of approval/support
- Difficulty initiating projects/doing things on their own b/c of lack of self-confidence
- Goes to excessive lengths to obtain support from others (will volunteer to do things that are unpleasant)
- Feels helpless when alone d/t exaggerated fear of being unable to care for self
- Urgently seeks another relationship as source of care/support when one ends
- Preoccupied w/ fears of being left to care for themselves
What is the diagnostic criteria for dependent personality disorder?
Need to be taken care of → submissive/clingy behavior by early adulthood & in a variety of contexts, as indicated by ≥ 5 sxs
How is dependent personality disorder treated?
psychotherapy
What is obsessive-compulsive personality disorder?
Ego-syntonic: pt is not aware of their behavior causing issues
* WITHOUT obsessions or compulsions
What are symptoms of obsessive-compulsive personality disorder?
- Preoccupation w/ details, rules, lists, & organizations such that a major point of activity lost
- Perfectionism that interferes w/ task completion
- Excessive devotion to work/productivity (often excludes leisure activity/friendships)
- Excessive conscientiousness & scrupulousness about morals/ethics
- Will not delegate tasks unless the person submits exactly to their way of doing things
- Unable to discard worthless objects even if no sentimental value
- Miserly spending style (view money as something to hoard for future catastrophes)
- Rigid & stubborn
What is the diagnostic criteria for obsessive-compulsive personality disorder?
preoccupation w/ order, perfectionism, & control, at the cost of flexibility & efficiency, by early adulthood & in a variety of contexts, as indicated by ≥ 4 sxs
How is obsessive-compulsive personality disorder treated?
psychotherapy
What is obsessive-compulsive disorder?
Ego-dystonic: behavior inconsistent w/ one’s own beliefs & attitudes
What is the pathophysiology behind OCD?
Theorized due to abnormal communication between the basal ganglia, orbitofrontal cortex & the anterior cinguate gyrus
What is the diagnostic criteria for OCD?
presence of obsessions, compulsions, or both that are time-consuming (>1hr/day) or cause significant distress or dysfunction
What are the 4 major patterns of OCD?
- contamination: cleaning, handwashing
- pathologic doubt or harm: checking
- symmetry/precision: ordering or counting
- intrusive obsessive thoughts
How is OCD treated?
CBT (exposure & response prevention) + SSRIs (Fluoxetine, Sertraline)
* SSRIs: 12-16 wk trials → higher doses
* 2nd line: Clomipramine, tricyclic antidepressant
* Tx resistant: augment SSRIs w/ antipsychotics, transcranial magnetic stimulation (TMS)
What is body dysmorphic disorder?
Preoccupation w/ an imagined defect in physical appearance/exaggerated distortion of a minor flaw
* Common concerns: face/hair/skin/breasts/genitalia
* High a/w MDD, GAD, OCD
What is the diagnostic criteria of body dysmorphic disorder?
Preoccupation w/ ≥ 1 perceived defects or flaws in physical appearance that are not observable or appear slight to others
* Performes repetitive behaviors (mirror checking, excessive grooming, skin picking) or mental acts (comparing appearance) d/t concerns
How is body dysmorphic disorder treated?
SSRIs, clomipramine, CBT
