Psych/Behavioral Health #4 Flashcards
Name the Cluster A personality types
- Schizoid
- Schizotypal
- Paranoid
Name the Cluster B Personality Types
- Antisocial
- Borderline
- Histrionic
- Narcissistic
Name the Cluster C Personality Types
- Avoidant
- Dependent
- Obsessive-Compulsive
What is the treatment choice for all personality disorders?
Cognitive behavioral therapy (Psychotherapy)
Describe a patient with a schizoid personality disorder
- Voluntary social withdrawal and anhedonic introversion
- Most common in males
- Prefers to be alone
- Loner, hermit like behavior
- Detached, cold, flat affect
Describe a patient with a schizotypal personality disorder
- Odd, eccentric, bizarre behavior and thought patterns
- Magical thinking or speech (belief in clairvoyance, telepathy, etc.)
- May talk to self in public
- Pervasive discomfort with close relationships
Describe a patient with paranoid personality disorder
- Pervasive pattern of distrust and suspiciousness of others
- Unjustified doubts regarding the loyalty and trustworthiness of others
- Sees hidden messages, is easily insulted, doesn’t forgive, bears grudges
- Suspicion regarding faithfulness of partner without justification
Describe a patient with antisocial personality disorder
- Behaviors deviating sharply from the norms, values, and laws of society
- May commit criminal acts
- Irritability or aggression toward others
- Lack of remorse for actions
- Failure to maintain work or honor financial obligations
How old must the patient be to diagnose them with antisocial personality disorder?
18 years old
Must have history by age 15 consistent with conduct disorder
What is a patient with borderline personality disorder like?
- Unstable, unpredictable mood and affect
- Unstable self-images and relationships
- Mood swings, impulsivity, self-mutilation
- Fear of abandonment
What is a patient with histrionic personality disorder like?
- Attention seeking: need to be center of attention, overly emotional, dramatic, seductive
- Hissy fits: temper tantrums, self-absorbed
- Often inappropriate, sexually provocative, seductive
- Seeks reassurance and praise often
- May believe their relationships are more intimate than they really are
Narcissistic personality disorder presents as
- Grandiose excessive sense of self-importance, superiority, need for admiration, and lack of empathy
- Fragile self-esteem
- Takes advantage to exploit others for self-gain
- Lacks empathy for others
- Reacts to rejection with rage
Social inhibition due to an intense fear of rejection, affecting daily life. Timid, shy, lacks confidence
Avoidant Personality Disorder
How does avoidant personality disorder differ from schizoid personality disorder?
- Avoidant patients do not want to be alone, they just have a fear of being rejected.
- Schizoid patients prefer to be alone
Describe a patient with dependent personality disorder
- Pattern of excessive need to be taken care of, leading to clingy behavior
- Difficulty expressing disagreement for fear of decreased approval
- Feeling of helplessness when alone
- Serial relationships
- Goes to extreme lengths to gain approval of others
Describe obsessive-compulsive personality disorder
-Characterized by preoccupation with order, details, and perfectionism without obsessions or compulsions
True or False: Behavior in a patient with obsessive-compulsive personality disorder is ego-syntonic
True
Fixed belief despite evidence to the contrary
delusion
What is a non bizarre delusion
False + plausible but highly unlikely (such as being poisoned)
What is the diagnostic criteria to diagnose a patient with delusional disorder?
-At least 1 delusion lasting at least 1 month WITHOUT other psychotic symptoms and no significant impairment in function
Treatment for delusional disorder
Atypical (2nd generation) antipsychotics
What is schizophreniform disorder?
Symptoms of Schizophrenia but duration between 1-6 months
What is schizoaffective disorder?
Schizophrenia + mood disorder (major depressive or manic episode)
Describe the difference in presentation regarding ages between men and women for schizophrenia?
-Men present earlier (early to mid 20s) and women present in the late 20’s.
Men tend to have more negative symptoms and poorer outcome
Risk Factors for Schizophrenia
- Strong genetic predisposition
- Substance use is common: nicotine most common
What are some factors that have a better outcome for a patient with schizophrenia?
- Later age of onset
- Acute onset
- Positive symptoms
- Good social support
- Female gender
- Few relapses
- No family history of mental illness
What are positive symptoms of schizophrenia?
THESE SYMPTOMS ADD TO NORMAL BEHAVIOR
Hallucinations
Delusions
Disorganized Speech
Behavioral Disturbances
What are negative symptoms for schizophrenia?
These symptoms TAKE AWAY from normal behavior
- Absence of normal cognition
- Affect flattening
- Alogia: poverty of speech
- Avolition: poor hygiene and grooming, anergy
- Anhedonia
- Asociality: failure to engage with others socially
What is the pathophysiology of positive symptoms of schizophrenia?
Due to excess dopamine in the mesolimbic pathway
What is the diagnostic criteria for schizophrenia?
-2 or more following symptoms: positive symptom, negative symptom, disorganized behavior for at least 6 months
At least 1 must be hallucinations, delusions, disorganized speech and must manifest for at least 1 month
Must impair function
What is seen on a CT scan for a patient with schizophrenia?
Ventricular enlargement (lateral and third) as well as decreased cortical volume and grey matter
First line pharmacotherapy for schizophrenia
Atypical antipsychotics (Risperidone, Olanzapine, Quetiapine, Aripiprazole)
First-generation antipsychotics such as (Haloperidol, Droperidol, and Chlorpromazine) are used in treatment of schizophrenia, but have increased risk of
Extrapyramidal symptoms, tardive dyskinesia, and neuroleptic malignant syndrome
True or False: with PTSD, the traumatic event happened anytime in the past
True
Symptoms of PTSD
- Re-experiencing: > 1 month as repetitive recollections (distressing dreams) and dissociative reactions (flashbacks)
- Avoidance of stimuli associated with the traumatic event
- At least 2 negative alterations in cognition and mood: inability to remember important aspects of the event, anhedonia, negative emotions
- At least 2 arousal and reactivity symptoms: angry outbursts, irritable behavior, sleep disturbances, startle response
First-line treatment for PTSD
SSRI’s
- Trazodone may be helpful for insomnia
- Cognitive behavioral therapy
What medication may be useful for nightmares and hypervigilance?
Prazosin
What is the diagnostic criteria for acute stress disorder?
Traumatic event occurred < 1 month ago and the symptoms last < 1 month
What is the treatment for acute stress disorder?
Counseling and psychotherapy are first-line because the symptoms will resolve in 1 month
If symptoms last > 1 month, treat as PTSD
What is adjustment disorder?
Maladaptive behavior to an identifiable stressor (job loss, physical illness, leaving home, divorce, etc.) that causes a disproportionate response than would normally be expected within 3 MONTHS of the stressor and resolves WITHIN 6 MONTHS
Treatment of choice for adjustment disorder
Psychotherapy
What is illness anxiety disorder?
-Preoccupation with having or acquiring a serious illness despite constant reassurance and medical workups showing no disease
Formerly known as hypochondriasis
Explain how long the symptoms are present in illness anxiety disorder
At least 6 months
There are no somatic symptoms present in this condition
Not explained by another disorder
Management of illness anxiety disorder
- Regularly-scheduled appointments with their medical provider
- Psychotherapy (CBT)
What is malingering?
Intentional falsification or exaggeration of signs and symptoms for external (secondary) gain (financial gain, food, shelter, avoidance of prison/school/work, to obtain drugs)
What is the difference between malingering and factitious disorder?
In malingering, the patient wants secondary gain; however, in factitious disorder, the primary motive is to assume the sick role and get sympathy
