Personality Disorders - Sher Flashcards
What axis are personality disorders on?
Axis II (Relationship disorders)
What are examples of mature, neurotic and primitive/immature defenses?
• Mature (healthy)
– humor
– suppression
– anticipation– altruism (hypersexual–>nun)
– sublimation (OCPD–>accountant)
• Neurotic (less
healthy)
– intellectualize
– rationalization
– repression
– controlling
• Primitive/Immature
(unhealthy)
– denial
– projection
– splitting
– distortion
– blocking
– acting out
– regression
– passive aggressive
– somatization
What are the three clusters of personality disorders?
Cluster A- Odd/eccentric
• Paranoid
• Schizoid
• Schizotypal
Cluster B- Dramatic/erratic
• Antisocial
• Borderline
• Histrionic
• Narcissistic
- Cluster C- Anxious/fearful
- Avoidant
- Dependent
- Obssesive-compulsive
What are the major characteristics of Paranoid PD?
Characterized by unwarranted
suspiciousness and a tendency to
misinterpret the actions of others as
threatening, or deliberately harmful (info being used against them).
Regular suspicions taken too far (not delusions), can possibly be pursuaded with reality intact.
May ask if being recorded.
0.5-2.5% prevalence, men>women, higher in minorities, immigrants and deaf people
What are the major characteristics of Schizoid PD?
Characterized by detachment from others,
a restricted range of emotional expression,
and a lack of interest in activities
Relate to the negative symptoms of
schizophrenia
“I have no need for other people”-doesn’t want any close relationships
2/1 M/F
What are the major charactersistics of schizotypal PD?
Ideas of reference (connect random events, not hallucinations)
Odd beliefs or magical thinking (sixth sense)
Bodily illusions (parts of body changed-exists but perceived differently)
Odd, eccentric or peculiar behavior
3% prevalence, high biological association
What are the major characteristics of Histrionic PD?
Characterized by excessive emotional expression and attention-seeking behavior- drama out of proportion, no actual intimacy
Overly seductive but with shallow emotion
Likes “making an entrance” (think Scarlett O’Hara)
2-3% prevalence, Mainly women, somatization and alcohol use associated
When do personality disorders develop? When can they be diagnosed?
Personality disorders exist “since birth” or from when the patient remembers themselves.
The only PD that can’t be given under age 18 is Antisocial PD (conduct disorder under 18 but can go away or become antisocial PD)
What are the major characteristics of Antisocial PD?
Pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years.
Failure to conform to social norms/laws.
Lack of remorse
Must be at least 18 and have evidence of conduct disorder before age 15.
3% in men, 1% in women, more common in poor, urban areas especially after abuse.
75% prevalence in prison
What are the major characteristics of dependent PD?
Individuals use their submissive and clinging behavior
toward others to elicit care, depending on them for
initiative, reassurance, decision making, and advice .
Characterized by submissive behavior
and excessive needs for emotional support
Happily remains the well-used doormat
(think Edith Bunker)=- “whatever you say is fine”
Particularly evident in borderline, avoidant,
and histrionic personalities as well as in
mood and anxiety disorders
The “sidekick” in movies and TV
Women > men (vulnerable to abuse), more common in people with chronic physical illness in childhood
What are the major characteristics of Avoidant PD?
Characterized by inhibition, introversion, and anxiety in social situations.
Considerable overlap with Dependent Personality Disorder
Was previously described as “inadequate” personality disorder. Opposite of narcissistic PD.
Wants contact but is afraid and so avoids them.
1-10% prevalence.
What are the major characteristics of Obsessive-compulsive personality disorder?
Individuals sacrifice openness, spontaneity, and flexibility to pursue orderliness, control, and perfectionism.
Ridig, detail oriented, see the tress and not the forest.
Often goes with anorexia.
Perfection interferes with task completion. Hoarding common.
Men more common than women.
Background often characterized by harsh discipline.
What are the major characteristics of Borderline PD?
Affective instability with marked reactivity of mood changing from minute to minute connected to an event (but extreme)- quick to heat up and slow to cool down causing impulsivity and dysregulation.
Alternating extremes of idealization and devaluation .
Self-mutilation or suicidal behavior, self-damaging behaviors (spending, sex, substance abuse, reckless driving, binge eating)- 70% attempt suicide (usually repeatedly)
Inappropriate, intense anger difficult to control.
Transient, stress-related paranoid ideation or severe dissociative symptoms (can be talked out)
Frantic efforts to avoid real or imagined abandonment.
70% have history of physical or sexual abuse
10% of diagnosed die by suicide
Biosocial theory: combined emotional dysfunctional with invalidating environment (chaotic, unavailable family).
Treated by DBT (dialectical behavior therapy) and mood stabilizers
