Personality Disorders - Vertrees/Berges Flashcards
personality disorder
pattern of inner experience - deviates from expectations from culture
diagnosis of personality disorder
2 or more areas
cognition
affectivity - emotion
interpersonal function
impulse control
impair social functionaling
begins adolescence/early adult
not caused other condition
med causes causing personality change
hyperPTH HIV neurosyphilis sleep apnea brain tumor head injury MS huntingtons
personality disorder clusters
A - odd and eccentric
B - dramatic, emotional, erratic
C - anxious, fearful
cluster A PD
odd and eccentric
paranoid
schizoid
schizotypal
cluster B PD
dramatic, emotional, erratic
borderline
narcissistic
histrionic
antisocial
cluster C PD
anxious and fearful
anxious
dependent
obsessive compulsive
paranoid personality
Pervasive distrust and suspiciousness of others such that their motives are very often interpreted as malevolent
dx of paranoid personality
4 of following
- other lie, harm them
- doubt others loyalty
- fear of confiding in others
- cannot forgive
- see character attacks
- recurrent suspicious of infidelity
defenses paranoid personality
splitting
projection
tx paranoid personality
supportive psychotherapy
low dose antipsychotics
trust is main concern
schizoid personality
pervasive detachment from social relationships
-restricted range of emotional expression
diagnosis of schizoid personality
4 or more of following
- neither desire/enjoy close relation
- choose solitary activity
- little interest in having sex
- pleasure in few activities
- lacks close friends - other than 1st degree relatives
- indifferent to praise
- emotional cold, detachment, flat affect
tx schizoid personality
supportive psychotherapy
schizotypal personality
magical thinking
-appearance and behavior odd, eccentric, peculiar
diagnosis of schizotypal personality
5 of following
- ideas of reference
- magical thinking
- unusual perceptual experience
- odd form thought
- suspicious of paranoid aspect
- odd affect
- odd behavior
- no close social ties
tx schizotypal personality
defense - denial, distortion, projection, schizoid fantasy
support reality based therapy
-low dose antipsychotics
antisocial personality
pattern of exploiting others
-disregard rights of others and society
does not learn from past evidence before 15 irritable and aggressive lack of remorse reckless disregard for safety of self
more in males
substance abuse, depression, suicide
difficult to tx
diagnosis antisocial PD
3 of following
- failure conform social norms
- deceitful
- impulsive, short term thinking
- irritable and aggressive
- disregard safety of others
- fail assume responsibility self
- lack of remorse
age >18yo
MC comorbid with antisocial
substance abuse
tx of antisocial
individual/group therapy
tx of antisocial
individual/group therapy
magical thinking
belief thoughts can cause something to happen
psychopath
lots of planning
conduct disorder
behavior in:
- theft
- violation of age appropriate rules
- physical aggression
on way to antisocial - but not 15
triad - bed wetting, fire setting, cruelty to animals
bed wetting, fire setting, cruelty to animals
conduct disorder
high prevalence in family of schizophrenia
schizotypal PD
cluster B
dramatic personalities
antisocial
borderline
histrionic
narcissistic
cluster C
shy and needy
avoidant
dependent
obsessive compulsive
want friends, but don’t know how to do it
everything needs to be perfect
obsessive compulsive PD
tattoo
alcohol use
drug use
antisocial
mixed personality disorder
PD not otherwise specified
no longer diagnostic - but focus of tx
borderline PD
world of turmoil and intensity
-everything intense
major internal stress
significant use of physicians and therapy
non-adherent to tx
borderline PD sex
more in females
perceive others as all good or all bad
borderline PD
splitting
borderline
between schizophrenia and depression
10% borderline
commit suicide
arrested oedipal development between patient and mother
borderline PD
frequently - mother absent
-between 18mo-3yo
marked mood lability and instability
borderline PD
histrionic PD
overly dramatic
2% of population
everything bigger, better, and more impressive
tx - CBT, group therapy
flamboyant in appearance and unaware of how appear to others
histrionic PD
narcissistic PD
I am the greatest
inflated sense self importance
entitlement
relationships superficial, cold, serving
lawyers, doctors, executives
prevalence narcissistic PD
6%
may enter therapy for tx of anger/depression
hard to tx
avoidant PD
shy personality
desire to have relationships - but don’t know how to do it
schizoid
don’t need other people
tx avoidant
SSRI and benzos
tx avoidant
SSRI and benzos
OC PD
see traits as perfectionism
OCD
see traits as pathologic
