Personaloty Disorders Flashcards
What are personality disorder?
An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individuals culture
Chronic and pervasive
Causes impairment/ distress/ lack insight
What is the epidemiology of personality disorders?
6%
Vary by gender
Onset and course:
In childhood-adolescence with behaviors solidifying with age(often not diagnosed til adult )
What is the etiology of personality disorders?
Genetic factors:
- supported by twin studies
- evidence that a person may inherit certain temperament and traits e.g. shyness
Environmental factors:
-Through interaction with the environment, behaviors are shaped by operant and social learning
How can personality disorders be treated?
Psychotherapy
-long term process where trust building relationship where the patient can practice different ways to behave.
Pharmological
1. Generally not utilized but could help co-morbid symptoms (e.g. anxiety)
What is the prognosis of personality disirder?
Due to disinterest in treatment and difficult unlearning behaviors, prognosis is poor
What are the diagnostic issues of personality disorders?
A person can have more than 1 personality disorders then another psychiatric disorder (e.g. MDD)
A person may have several symptoms without meeting with the full diagnostic.
Describe cluster A personality disorders and give examples
Cluster A: accusatory, awkward and aloof
- paranoid- accusatory
- schizotypal-awkward
- schizoid-aloof
Describe cluster B personality disorder and give examples
Cluster B:Bad, Borderline, flamBoyant, must be the best
Antisocial- Bad
Borderline- borderline
Histrionic - flamboyant
Narcissistic - must be the best
Describe cluster C personality disorders and give an example
Cluster C: coward, obsessive-compulsive and clingy
Avoidant - coward
Obsessive-compulsive
-dependent - submissive and clingy
What is paranoid personality disorder?
Distrust and suspicious
Suspicious that others are exploitative/deceptive
Unjustified doubts of loyalty
Reluctance to confide
Reads hidden, threatening meaning into remarks
Contrast delusional disorder with paranoid personality disorder
Paranoid personality - thought is suspected, but delusional it is believed with certainty
Onset of paranoid personality is gradual during childhood and has pervasive paranoia
Onset of delusional disorder is sudden, occurs in middle age and focus on a single paranoid theme
What is schizoid personality disorder?
Lacks desire for close relationships(differentiates it from social anxiety)
Lacks close friends
Prefers solitary activities
Derived pleasure in few activities
Indifference to praise/ criticism
Emotion coldness, detachment or flat affect
What is schizotypal personality disorder?
- social and interpersonal deficits with acute discomfort with and reduced capacity for close relay
- odd speech/thinking
- believes in paranormal phenomenon
- ideas of reference
- odd appearance/behavior
- unusual perceptual experiences
- suspiciousness(often results in social anxiety)
What is the premorbid personality of schizophrenia?
Schizotypal
How can people with histrionic personality be treated?
The goal of treatment is to help the person clarify and express real emotions
What is borderline personality disorder ?
Relationships are unstable with alternating idealization and devaluation(“splitting”)
Frantically avoids abandonment
- intense uncontrolled anger
- marked reactivity of mood
- chronic feelings of emptiness
- unstable self image
- self damaging impulsivity
- suicidal gestures/self-mutation
- Transient stress-related dissociative/paranoid symptoms
How can borderline personality disorder be treated?
Dialectal behavioral therapy-CBT
Helped with emotional regulation and distress tolerance
What is narcissistic personality disorder?
- grandiose sense of self worth/importance
- preoccupied with success
- requires admiration
- sense of entitlement.
- interpersonally exploitive
- lacks empathy and has haughty
Narcissistic injury- blow to self esteem may result in a rage reaction
Differentiate narcissistic disorder and delusional disorder-grandiose type
Narcissism has general arrogance while DD-grandiose has a single grandiose belief with
Onset of DD-grandiose is usually in older age while narcissistic is gradual from childhood
What is ASPD?
Repeated unlawful acts
Deceitful ness
Irritability and aggressiveness
Reckless disregard for safety of self or others
Irresponsibility (employment or financial)
Lack of remorse-associated with lack of physiological reactivity to stressors
-prevasice disregard for others rights
“Psychopaths” are a subset for ASPD must be 18 years and evidence of conduct disorder before 15
Why is avoidant personality disorder?
- Avoids interpersonal and occupational activities for fear of criticism
- unwilling to start relationship unless certain of being liked
- restraint within relationship for fear of ridicule
- reluctance to engage in new activities
- negative self image
Inferiority complex
Give the differentials of avoidant personality disorder
Social anxiety disorder- social anxiety have higher amounts of physiological hyperarousal
-persons with avoidant personality have some anxiety but not to the extent of social anxiety
Schizoid disorder- persons with schizoid have no desire for a relationship
-persons with avoidant do have a desire for relationship
How can avoidant personality disorder be treated?
The personality disorder has behaviors that are more amendable to treatment
Options: CBT
SSRIs useful as an adjunct
What is dependent personality disorder?
Indecisive
Others must take responsibility for life
Difficulty disagreeing
Difficulty initiating due to low confidence
Excessive lengths to keep/gain support
Feels helpless when alone
Urgently seeks another relationship if one ends
Theme: excess needs to be cared for
How can dependent personality disorder be treated?
CBT with a focus on self-reliance and assertiveness training
Psychotherapy for this personality disorder is successful in increasing independence
As a result, the relationship with the dominant partner may no longer be viable
What is obsessive compulsive disorder?
- preoccupation with details, rules, lists until point of activity is lost
- perfectionism interferes with task completion
- excessive devotion to work
- rigid and stubborn
- overly conscientious, scrupulous
- reluctance to delegate or work with others
- hoarding and miserly behaviour
