Personality DOs Flashcards
4 personality disorder characteristics
1) . inflexible and maladaptive behaviors (pt doesn’t change)
2) . social - relationship probs
3) . subjective distress
4) . problems in functioning
men are more likely to be dx with _________, ________, and _____________ disorders
paranoid, OCD, and antisocial
women are more likely diagnosed with __________, ________, and _________ disorders
borderline, dependent, histrionic
how are PD’s patients with treatment?
difficulty complying and very resistant to change
symptoms of people with PD tend to be ___________
ego-syntonic- symptoms are built into the personality and feel like normal self (this won’t change)
what two things do you need to see in a person to diagnose them with a PD?
1) . personality traits need to be inflexible and maladaptive (current AND long term)
2) . significant impairment in functioning
symptoms for PD start when?
childhood or adolescence
6 guidelines for diagnosing PD
1) . Over time
2) . Collateral information
3) . Reactions in many different situations
4) . Differentiate from behavior under stress or under effects of substance
5) . Differentiate from other psych disorders
6) . Differentiate from personality changes caused by general medical conditions (head trauma, stroke – change in baseline behavior)
paranoid personality disorder criteria (two)
1) . distrust or suspiciousness of others with 4 or more (suspects others are deceiving/harming them, has unjustified doubts, reluctant to confide in others, interprets benign remarks into threatening ones, bears grudges, perceives attacks on his character, has recurrent suspicions with fidelity of spouse)
2) . does not occur during course of schizophrenia or another psychotic DO, not due to medical condition
treatment of paranoid PD
psychotherapy FIRST LINE, antianxiety meds or short course of antipsychotics
schizoid personality DO criteria (two)
1). detachment from social relationships and restricted range of expression of emotions (ANHEDONIA) with 4 or more: AVOID
A: Anhedonic
V: voluntary social withdrawal (prefers to be alone)
O: odd appearing or eccentric
I: Introvert- loner, hermit
D: Detached, constricted affect
2). does not occur during the course of another psychotic disorder
treatment for schizoid
Psychotherapy- FIRST LINE
-low dose short term antipsychotics, antidepressants
what are the 3 clusters of personality DOs?
a) . SOCIAL DETACHMENT = odd or eccentric
b) . dramatic, erratic, emotional
c) . anxious or fearful
3 disorders within odd or eccentric cluster
1) . paranoid PD
2) . schizoid PD
3) . schizotypal PD
gender prevalence for paranoid and schizoid DOs
higher among males
schizotypal disorder: higher risk of this among relatives of people with _________
schizophrenia
4 disorders within cluster B (dramatic, erratic, emotional)
histrionic PD, narcissistic PD, antisocial PD, and borderline PD
gender prevalence for histrionic, narcissistic, antisocial, borderline disorders
histrionic- females more
narcissistic- males more
antisocial- males 3x more
borderline- females 3x more
histrionic personality disorder criteria
excessive emotionality and attention seeking
5 H’s ***
1). HEY LOOK AT ME: uncomfortable in situations in which he/she is not the center of attention
2). Come HITHER:
sexually seductive or provocative behavior
3). HISSY FITS
4). HYPE ME UP: seeks reassurance and praise,
easily influenced by others
5). HYPERINFLATED: thinks relationships are more intimate than they are
what is Schizotypal personality disorder? criteria?
Odd, eccentric behavior and thought patterns suggestive of schizophrenia WITHOUT psychosis
Criteria: at least 5 1). ideas of reference 2). odd beliefs or magical thinking 3). unusual perceptual experiences 4). may talk to oneself in public 5). constricted affect 6). discomfort with close relationships: lack of close friends, social anxiety
**does not occur during the course of a psychotic disorder or pervasive developmental disorder
treatment for schizotypal disorder (2)
1) . psychotherapy- FIRST LINE
2) . short course of low dose antipsychotics, antidepressants, benzos to dec anxiety if needed
treatment for histrionic personality disorder
1). psychotherapy individual or group
Narcissistic Personality disorder criteria
pervasive pattern of grandiosity, need for admiration, and lack of empathy (indicated by 5 or more of the following):
- grandiose sense of self importance
- preoccupied with fantasies of unlimited success
- believes he or she is “special” and should only associate with high status people
- requires excessive admiration
- has a sense of entitlement
- interpersonally exploitative
- LACKS EMPATHY
- envious of others
- arrogant behavior
treatment of narcissistic personality disorder
difficult- psychotherapy can be helpful, maybe lithium for mood swings, antidepressants (SSRIs)
Antisocial personality disorder criteria (4)
1). pattern of disregard for and violation of the rights of others
AT LEAST 3:
-failure to conform
-deceitfulness
-impulsivity
-irritability and aggressiveness (ASSAULTS)
-reckless disregard for safety of others
-consistently irresponsible
-lack of remorse
2). individual is at least 18
3). evidence of conduct disorder WITH ONSET BEFORE 15 YO
4). occurrence of antisocial behavior not exclusively during the course of schizophrenia or a manic episode
SERIAL KILLERS
treatment of antisocial personality disorder
- psychotherapy- ESTABLISHING LIMITS
- SSRIs, lithium, valproate, carbamazepine and propanolol may help reduce anxiety, impulsivity, and aggression
- HIGH abuse potential so be cautious with meds
borderline personality disorder criteria
1) pattern of instability of interpersonal relationships, self image, and affect
marked impulsivity beginning by early adulthood
5 or more of the following: B’S
BREAKING UP: avoid real or imagined abandonment
BROKEN: pattern of unstable and intense interpersonal relationships
BAD BEHAVIOR: identity disturbance (not a good sense of self), impulsivity in self damaging areas (sex. drugs, binge eating), recurrent suicidal behavior or self mutilating behavior
BAT: mood swings
BLACK AND WHITE THINKING
BLOWN UP: inappropriate intense anger disproportionate to event
treatment for borderline personality disorder
1) . psychotherapy: dialectical behavior therapy is useful in treating mood disorders, suicidal ideation, and for change in behavioral patterns such as self-harm, and substance abuse.
2) . antipsychotics for hostility and brief psychotic episodes
3) . antidepressants for mood
4) . benzos for anxiety
3 disorders within Cluster C- anxious or fearful
avoidant personality disorder, dependent personality disorder, and obsessive compulsive personality disorder
gender difference for OC personality disorder
more common in males than females
avoidant personality disorder criteria
1). social inhibition due to INTENSE FEAR OF REJECTION, timid, shy, lacks confidence
4 or more:
- avoids activities that involves interpersonal contact that can cause criticism, rejection
- unwilling to get involved with people unless certain people like him or her
- shows restraint within intimate relationships
- preoccupied with being criticized or rejected socially
- inhibited by new interpersonal situations
- views self as socially inept
- unusually reluctant to take personal risks
treatment of avoidant personality disorder
psychotherapy, social skills training, group therapy, assertiveness training
** BB (anxiety) and SSRIs (depression), rejection sensitivity
Dependent personality disorder criteria
excessive need to be taken care of that leads to clinging behavior and fears of separation
5 or more:
- difficulty making everyday decisions
- needs others to assume responsibility
- difficulty expressing disagreement
- difficulty initiating projects
- goes to excessive lengths to obtain nurturance
- feels uncomfortable or helpless when alone
- urgently seeks another relationship
- preoccupied with fears of being left to take care of him/herself
treatment for dependent personality disorder (therapy and meds)
psychotherapy- insight oriented, behavioral, group, family therapy, and assertiveness training
antianxiety meds and antidepressants to target symptoms (maybe)
obsessive compulsive personality disorder criteria
preoccupation with orderliness, perfectionism, and mental and interpersonal control
EGO SYNTONIC- behavior
4 or more:
- preoccupied with details so much that the activity is lost
- perfectionism that interferes with task completion
- excessively devoted to work
- inflexible about matters of morality
- unable to discard worthless objects
- reluctant to delegate tasks
- miserly spending style (money hoarded)
- shows rigidity and stubbornness
treatment for OC personality disorder
- individual or group psychotherapy
- clomipramine and SSRIs may be helpful
