Psych 3 Flashcards
1
Q
Antisocial (disoccial now) personality disorder
A
- Pattern of disregard for the rights of others
- Lack of empathy and engage in manipulative, impulsive action
- Manifests as aggressive, unremorseful behaviour. Failure to obey laws and social norms
- Associated with conduct disorder as a child. Can prevent through parenting programmes and group based CBT
2
Q
Borderline personality disorder
A
- Pattern of abrupt mood swings, unstable personal relationship and self image instability
- Tends towards: self harm, bulimia, substance misuse
- Relationships fluctuate between idealisation and devaluation.
- Inability to control temper and manage response
- May have history of trauma including sexual abuse
- Management: Dialectical behaviour therapy (DBT0
3
Q
Histrionic personality disorder
A
- Attention seeking behaviour with excessive displays of emotion. May have inappropriate sexual behaviour
- Emotional expression: shallow, dramatic and exaggerated
- Think relationships are more intimate then they are, distorted perceptions of interpersonal boundaries
4
Q
Narcissistic personality disorder
A
- Pattern of grandiosity, a strong need for the admiration of others, and a marked lack of empathy.
- Sense of entitlement and will exploit others to fulfil their own desires
- Tendency to be arrogant and preoccupied with personal fantasies and desires, often at the cost of disregarding others’ feelings and needs.
5
Q
Avoidant personality disorder
A
- Intense feeling of social inadequacy, fear of rejection and hypersensitivity to criticism
- Patients often self-impose isolation to avoid potential criticism, despite a strong desire for social acceptance and interaction
6
Q
Dependent personality disorder
A
- Pervasive and excessive need to be taken care of, leading to submissive and clinging behaviour
- Individuals often lack self-confidence and initiative, relying excessively on others for decision-making
- Patients may urgently seek new relationships as a source of care and support when existing ones end
7
Q
Obsessive compulsive personality disorder
A
- Excessive preoccupation with orderliness, perfectionism, and control, often at the expense of flexibility, openness, and efficiency
- Contrary to OCD its not associated with recurrent, intrusive thoughts or rituals
- Strict adherence to routines, perfectionism to the point of dysfunction, and a persistent reluctance to delegate tasks to others
- Symptoms are generally ego-syntonic, meaning the patient perceives them as rational and desirable. Whilst in OCD symptoms are ego-dystonic and distressing to the individual
8
Q
Management of personality disorders
A
- CBT and DBT for borderline (can use for others)
- Schema focused therapy for various personality disorders
- Medication: none are licensed. But SSRI’s, mood stabilisers and atypical antipsychotics for symptoms of impulsivity, aggression, anxiety or depressive symptoms. Dont use long term
- Social: Community Mental Health Team (CMHT): coordinate care, OT for daily functioning
- Crisis management plans: identifying triggers, early warning signs of crisis, coping strategies, and emergency contacts.
9
Q
Management of personality disorder: general conversation approaches
A
- Calm approach
- Validating feelings
- Need for sense of safety
- Focus on the next 24 hours
- Establishing risk – don’t just ask direct initially, good to establish other routes that would support first
- Try to establish 1 positive thing that could happen tomorrow
10
Q
Mild personality disorder
A
- Disturbances affect some areas of personality functioning but not others and may not be apparent in some contexts
- There are problems in many interpersonal relationships and/or in performance of expected occupational and social roles, but some relationships are maintained and/or some roles carried out.
- Is typically not associated with substantial harm to self or others.
- May be associated with substantial distress or with impairment in personal, family, social, educational, occupational or other important areas of functioning that is either limited to circumscribed areas or present in more areas but milder
11
Q
Moderate personality disorder
A
- Disturbances affect multiple areas of personality functioning. However, some areas of personality functioning may be relatively less affected.
- There are marked problems in most interpersonal relationships and the performance of most expected social and occupational roles are compromised to some degree. Relationships are likely to be characterized by conflict, avoidance, withdrawal, or extreme dependency.
- Is sometimes associated with harm to self or others.
- Is associated with marked impairment in personal, family, social, educational, occupational or other important areas of functioning, although functioning in circumscribed areas may be maintained.
12
Q
Severe personality disorder
A
- There are severe disturbances in functioning of the self
- Problems in interpersonal functioning seriously affect virtually all relationships and the ability and willingness to perform expected social and occupational roles is absent or severely compromised.
- Specific manifestations of personality disturbance are severe and affect most, if not all, areas of personality functioning.
- Is often associated with harm to self or others.
- Is associated with severe impairment in all or nearly all areas of life, including personal, family, social, educational, occupational, and other important areas of functioning.
13
Q
Schizophrenia
A
- Chronic or relapsing and remitting form of psychosis
- Characterized by positive symptoms (such as hallucinations, delusions, thought disorders) and negative symptoms (including alogia, anhedonia, and avolition).
- Clinical diagnosis
- Symptoms persist for at least 1-6 months causing significant impairement
14
Q
Subtypes of schizophrenia
A
- Paranoid Schizophrenia: Characterized by delusions and hallucinations, often with a persecutory theme.
- Catatonic Schizophrenia: Features motor disturbances and waxy flexibility. Can include catonic stupor. May be immobile or exhibit agitated, purposeless movment
- Hebephrenic/disorganised Schizophrenia: Marked by disorganized thinking, emotions, and behavior.
- Residual Schizophrenia: Residual symptoms persist after a major episode.
- Simple Schizophrenia: Characterized by a gradual decline in functioning without prominent positive symptoms.
15
Q
Schizophrenia: risk factors
A
- Genetics
- Environmental factors: childhood trauma, heavy cannabis use, maternal health conditions (malnutrition, rubella, CMV), birth trauma, urban living, pre-term
16
Q
Schizophrenia clinical features: positive symptoms
A
- Auditory hallucinations: third-person auditory experiences, broadcasting of thoughts, control issues, and delusional perceptions.
- Broadcasting of thoughts
- Control issues: sense of external control over your thoughts or actions
- Delusional perceptions: distorted interpretation of reality, often with false beliefs
- Lack of insight is an important feature
17
Q
Schizophrenia: Schneiders first rank symptoms
A
Schneider’s first rank symptoms may be divided into auditory hallucinations, thought disorders, passivity phenomena and delusional perceptions:
- Auditory: 2 or more voices discussing the patient, thought echo, voices commenting on the patients behaviour
- Thought disorder: thought insertion/withdrawal/broadcasting
- Passivity phenomena: bodily sensation controlled by an external influence (actions/impulses/feelings)
- Delusional perception: where a normal object is perceived and a delusion is imposed on it. ‘The traffic light is green therefore I’m the king’
18
Q
Other schizophrenic symptoms
A
- Ideas of reference: a false belief that unconnected events or details in the world relate to them
- Grossly disorganized behaviour that impedes goal-directed activity (e.g., behaviour that appears bizarre or purposeless, unpredictable or inappropriate emotional responses that interferes with the ability to organise behaviour.)
- Psychomotor disturbances such as catatonic restlessness or agitation, posturing, waxy flexibility, negativism, mutism, or stupor.
19
Q
Schizophrenia: negative symptoms
A
- Alogia
- Anhedonia
- Affective incongruity or blunting
- Avolition
- Negative symptoms are more common in chronic and treated schizophrenia
20
Q
Schizophrenia: investigations
A
- Clinical diagnosis based on history and exam. Investigations to exclude organic causes;
- Brain imaging (CT/MRI) to rule out structural abnormalities
- Blood tests to exclude infectious (e.g.,HIV, syphilis) or metabolic causes (e.g., thyroid function tests)
- Drug screening to identify substance misuse
