personality ds Flashcards
personality disorder: DSM criteria
- Experience and behavior that deviates markedly from the expectations of the individual’s culture (Hence this varies based on the reference culture). Manifested in at least 2:
- Cognition: Perception and interpretation of self, others and events
- Affect: Range, intensity, lability, and appropriateness of emotional response
- Interpersonal functioning
- Impulse control - The enduring pattern is inflexible and pervasive across a broad range of personal and social situations
- The enduring pattern leads to impairment in social, occupation, or other important areas of functioning
- The pattern is stable and of long duration and its onset can be traced back at least to adolescence or early adulthood
Complications of Personality Disorders: People with a personality disorders are more likely to -
-engage in substance abuse, self-destructive behavior, and reckless sexual behavior
-have inconsistent, detached, overemotional, abusive, or irresponsible parenting styles, leading to medical and psychiatric problems in their children
-suffer “mental breakdowns” as a result of stress
-develop primary mental health illnesses (depression, anxiety, psychosis)
-disregard prescribed treatment regimens
-have poor or even adversarial relationships with clinicians
Personality Disorder: definition and overview
Definition: Enduring, inflexible, and maladaptive behaviors that often cause significant social, interpersonal, and occupational impairment
- chronic and ingrained disease: not like mood ds
- onset: adolescence or early childhood
facts:
-Affect 10-15% of the population
-As many as 25% of psychiatric patients have personality disorders
onset and gender distribution
onset:
- adolescence & established by young adulthood
- Late onset personality changes = Prelude to Major Mental Illness (prodrome of schizophrenia), brain disorder, medical illness (Organic Condition), or substance effects
- antisocial personality ds: must be older than 18, if younger than 18: conduct disorder
gender:
Male: antisocial Social OCd
- Antisocial
- Schizoid
- Obsessive-Compulsive
Female: BAD Hoe
- Borderline, Avoidant, Dependent, Histrionic,
-Schizotypal: M = F
antisocial personality disorder: def + presentation
Definition: Pervasive disregard for, and violation of other people’s rights. Lack of Empathy
CORRUPT:
- Conduct ds before 18
- Obligations with work or finances not honored
- Reckless + disregard for safety/feelings of others
- Remorseless: lack of conscious
- USES others and UNTRUTHFUL/deceitful
- Planning not mediated: impulsive
- Temper: aggressive, irritable, repeated assults and fights
- Societal laws broke (breaks law), Social norms disregarded
cluster A: category and types
cluster A: odd
- abnormal cognition, odd self-expression, or difficulty relating to others.
- exhibit suspiciousness, seclusiveness, or strange speech or behavior
types:
- paranoid
- schizoid: want to be alone
- schotypal: want to be with people but condition doesn’t allow them
factors associated with risk for personality disorder
-Childhood abuse or maltreatment (Borderline & Antisocial PD’s)
-Resulting trauma is thought to cause difficulty in developing trust & intimacy
-Early home environment in which there was domestic abuse, divorce, or separation
-Parental absence or neglect
personality disorders: cluster organization
-Cluster A: ODD or ECCENTRIC
-Cluster B: DRAMATIC, EMOTIONAL, or ERRATIC
-Cluster C: ANXIOUS or FEARFUL
- personality disorder NOS: residual category with pts with mixed/atypical traits that do not better fit into better defined categories
paranoid personality disorder: def + presentation
def: Pervasive Distrust and Suspicion of others so that their motives are interpresent as malevolent
- cluster A: odd or eccentric
presentation:
- Unfounded suspect that others are exploiting, harming, or deceiving them
- Unjustifiably doubts loyalty of others
- Reluctant to confide in others
- Reads hidden demeaning, threatening meanings into benign remarks
- Persistently bears grudges
- Has recurrent suspicions, without justification, about the fidelity of a spouse of sexual partner
Schizoid personality: risk factor
-Genetics: FHx of autism and Schizophrenia
-Psychosocial: Defense mechanism to avoid emotional distress from repeated failures in various aspects of life.
-Slightly more common in patients who grew up in a family deficient in emotional nurturing
paranoid personality disorder: risk factors
- genetics: fam hx of schizophrenia or delusional disorder
- psychosocial: Greater risk in families who overemphasize importance of avoiding scrutiny and failure
- victims of mistreatment: prosoners, refugees, war victims
Schizoid personality - cluster, def, presentation
Definition: Lack of desire for social relationships and a restricted range of emotional expression
- cluster A
- Schizoid personalities enjoy being in solitude, but is a disorder when this solitude attitude is affecting life
presentation:
-Neither desires, nor enjoys, close relationships, including being part of a family
-Almost always chooses solitary activities
-Has little, if any, interest in sexual relations
-Takes pleasure in few, if any, activities
-Lacks close friends or confidants other than first degree relatives
-Appears indifferent to criticism or praise
-Shows emotional coldness, detachment, or flattened affect
schizotypal personality disorder def + presentation
Definition: Acute discomfort with social relationships. Patterns of thought, perception, and behavior suggestive of schizophrenia, without actual psychosis
- wants to hang out with others, but feels discomfort doing so
presentation:
-Acute discomfort and poor functioning in social situations.
-Ideas of Reference
-Odd beliefs or magical thinking
-Unusual perceptual experiences
-Odd thinking and speech
-Inappropriate or constricted affect
-Behavior or appearance that is odd or eccentric
antisocial personality disorder: risk factors
-Genetics: Five times more common in first degree relatives of men with ASPD. Increased risk if father has alcoholism. Adopted twin studies show concordance of antisocial behavior.
-Psychosocial: Lack of consistent person for child to bond with. Neglect and physical abuse in childhood noted
29 year-old male lives in a studio apartment without electrical or phone service because “technology dehumanizes humans.” He has a Masters Degree from Princeton University, but works at an organic food store. He refuses to eat anything that “has been touched by a machine.” He studies all religions as a hobby. “Religion itself has opened my third eye. It allows me to drift into different states of consciousness and feel how we are all connected to each other.”
42 year-old unmarried night-watchman for a warehouse engages in fishing, bird-watching, and building model ships. He has no close friends or romantic partners. While many people his age have started families, he has no interested in getting married or having children.
41 year-old man has quit several jobs because his coworkers “always talk about me behind my back.” He has few friends because, “people always stab you in the back.” He broke up with his last three girlfriends because he suspected them of cheating on him, even though he had no evidence.
match to the personality ds and what cluster
29 yr old: schizotypal personality disorder
42 yrs: schizoid
41 yrs: paranoid
cluster A: odd and eccentric
OCD vs OCPD
Obsessive-Compulsive personality ds:
- they dont see this as problem they like it, its their personality
OCD:
- have to do it or else they will be in distress or anxious
