Psychiatry-Personality Disorders

Question 1

What are major contributing factors of personality disorders?

Answer 1

Parental expectations, parental behavior and abuse.

Question 2

What concepts of human context do you need to be aware of when treating patients with personality disorders?

Answer 2

Transference and countertransference (positive and negative button pushing)

Question 3

What are the three clusters of personality disorders?

Answer 3

*

Question 4

A patient comes to see you who has trouble trusting others. What type of personality disorder might she have and what are the diagnostic criteria?

Answer 4

Cluster A: paranoid personality disorder: suspicious about everything and thinks that everyone is out to get them. These are often associated with schizophrenia.

Question 5

A patient comes to see you because he has not friends. He is very awkward with his interpersonal relationships. During the exam he recounts unusual perceptual experiences, odd thinking & speech and magical thinking. What personality disorder might this patient have?

Answer 5

Cluster A: schizotypal personality disorder. These are often associates with schizophrenia.

Question 6

A patient comes to see you because his girlfriend broke up with him. She said that he was detached from social relationships, did not care about having friends and enjoyed being alone. What type of personality disorder might this patient have?

Answer 6

Cluster A: schizoid personality disorder.

Question 7

What are common treatments for cluster A personality disorders?

Answer 7

CBT. However, most patients in this cluster do not come in for treatment.

Question 8

What is the most common presentation of personality disorders?

Answer 8

Cluster B: They often present dramatically, as if someone continued faking suicides.

Question 9

A 17 year old boy is being interviewed because he killed 17 people at a local mall. History reveals fire starting and animal killing as a young child. He is deceitful, does not conform with social norms and lacks remorse. What type of personality disorder might this boy have?

Answer 9

Cluster B: antisocial PD. It is often associated with conduct disorder before age 15.

Question 10

What defense mechanisms are employed by sociopaths (antisocial PD) use when they feel threatened?

Answer 10

Passive-aggressiveness, externalization (wan’t my fault he left his car open), displacement, projection and projective identification.

Question 11

You are breaking up with your girlfriend and suddenly she becomes unstable and angry. She begins to act suicidal because she wants to keep you from leaving her. What type of personality disorder might she have?

Answer 11

Cluster B: borderline personality disorder.

Question 12

What defense mechanism do patients with borderline personality disorder often present with?

Answer 12

Splitting (idealizations/devaluations). They see the world in black and white (people are only great or horrible)

Question 13

What should always be in your differential when assessing someone with possible personality disorder?

Answer 13

Psychosis, PTSD, substance abuse and eating disorders.

Question 14

How do you treat patients with borderline personality disorder?

Answer 14

Dialectical Behavioral Therapy (DBT). It works to acknowledge the fear of abandonment. Antidepressants, mood stabilizers and antipsychotics.

Question 15

A patient presents with big sweeping emotions and the need to be the center of attention. She uses provocative behavior to achieve this. What personality disorder might she present with?

Answer 15

Cluster B: histrioinic PD

Question 16

Your friend really thinks he’s the bee’s knees. He needs a lot of admiration and lacks empathy. He is very grandiose in the way he speaks of himself. What personality disorder might he have?

Answer 16

Cluster B: Narcissistic PD.

Question 17

You are talking to someone on the subway. He seems sad when you talk to him. He says he embarrasses himself all the time and fears being shamed and rejected. What personality disorder might he have?

Answer 17

Cluster C: Avoidant PD.

Question 18

You are talking to someone on the subway. He seems sad because he always submits to whatever people want him to do. He has difficulty making everyday decisions and seeks a relationship as soon as the previous one ended. What personality disorder might he have?

Answer 18

Cluster C: Dependent PD.

Question 19

What type of personality disorder is OCD?

Answer 19

Cluster C