wamss notes personality disorders Flashcards
personality disorders
Mental disorders categorised by enduring maladaptive patterns of behaviour, cognition & inner experience
across a variety of contexts that deviate markedly from the individuals culture
the cluster A personality disorders
paranoid
schizoid
schizotypal
paranoid personality disorder
Assume that other ppl with exploit, harm or deceive them even if no evidence exists to support this expectation
criteria of paranoid personality disorder
Pervasive distrust & suspiciousness of others such that their motives are interoperated as
malevolent, beginning in early adulthood, 4 or more:
Distrust & suspiciousness of others indicated by at least 4 of:
- Suspects without basis that others are exploiting, harming or deceiving
- Unforgiving (bears grudges)
- Spousal infidelity suspected without grounds
- Perceives attacks on reputation that are not apparent to others
- Enemy or Friend? Preoccupied with doubts about trustworthiness
- Confiding in others is feared
- Threats perceived in benign events
acronym for remembering the criteria of paranoid personality disorder
SUSPECT
SUSPECT stands for
- Suspects without basis that others are exploiting, harming or deceiving
- Unforgiving (bears grudges)
- Spousal infidelity suspected without grounds
- Perceives attacks on reputation that are not apparent to others
- Enemy or Friend? Preoccupied with doubts about trustworthiness
- Confiding in others is feared
- Threats perceived in benign events
pathophysiology of paranoid personality disorder
Genetics
Connection with schizophrenia
symptoms of paranoid personality disorder
Hypersensitive, easily insulted
Reduced capacity for emotional involvement, general social withdrawal
Bear grudges, suspicious
treatment of paranoid personality disorder
Psychotherapy
Antidepressants & anti-anxiety medications
schizoid personality disorder
Lack of interest in social relationships, a tendency towards a solitary or sheltered lifestyle, secretiveness, emotional coldness, and apathy.
criteria of schizoid personality disorder
Pervasive pattern of detachment from social relationships & restricted range of expression of
emotions in interpersonal settings, 4 or more:
- Detached or flattened affect (emotional coldness / detachment)
- Indifferent to Criticism or Praise
- Sexual experiences of little interest
- Tasks done Solitarily
- Absence of close Friends
- Neither enjoys desires close relationships
- Takes pleasure in few Activities
acronym for remembering criteria of schizoid personality disorder
DISTANT
DISTANT stands for
- Detached or flattened affect (emotional coldness / detachment)
- Indifferent to Criticism or Praise
- Sexual experiences of little interest
- Tasks done Solitarily
- Absence of close Friends
- Neither enjoys desires close relationships
- Takes pleasure in few Activities
pathophysiology of schizoid personality disorder
Genetics
Premature birth, LBW, malnutrition
symptoms of schizoid personality disorder
Tend to be cold & indifferent
Often have trouble developing interpersonal relationships
Happy in relationship with few emotional demands
Some state life passes them by or feel disassociated from life
Ddx for schizoid personality disoder
Avoidant or Narcissistic PD
Depression
treatment for schizoid personality disorder
Psychotherapy
Nil available meds
schizotypal personality disorder
Severe social anxiety, paranoia, and often unconventional beliefs. People with this disorder feel extreme discomfort with maintaining close relationships with people
criteria for schizotypal personality disorder
Pervasive pattern for social & interpersonal deficits marked by discomfort with & decreased
capacity for close relationships as well as cognitive or perceptual distortions & eccentricities
of behaviour
- Magical thinking/odd beliefs,
- Experiences unusual perceptions
- Paranoid ideation
- Eccentric behaviour/appearance
- Constricted affect
- Unusual thinking and speech
- Lacks close friends
- Ideas of reference
- Anxiety in social situations
- Rule out psychotic disorder and pervasive developmental disorder
acronym for remembering criteria of schizotypal personality disorder
ME PECULIAR
ME PECULIAR stands for
- Magical thinking/odd beliefs,
- Experiences unusual perceptions
- Paranoid ideation
- Eccentric behaviour/appearance
- Constricted affect
- Unusual thinking and speech
- Lacks close friends
- Ideas of reference
- Anxiety in social situations
- Rule out psychotic disorder and pervasive developmental disorder
pathophysiology of schizotypal personality disorder
Genetic – association with schizophrenia
Parenting styles
Early separation, trauma or neglect
treatment for schizotypal personality disorder
Difficult to treat with psychotherapy
Group therapy recommended
Antipsychotics – psychotic Sx
Mood stabilisers – social anxiety
cluster B personality disorders
borderline
histrionic
narcissistic
antisocial
borderline/emotionally unstable personality disorder
Long term pattern of abnormal behaviour characterized by unstable relationships with other people, unstable sense of self, and unstable emotions
criteria for emotionally unstable personality disorder
Pervasive pattern of instability of interpersonal relationships, self-image & affects with 5 or
more of the following:
- Impulsive
- Moodiness
- Paranoia or dissociation under stress
- Unstable self-image
- Labile intense relationships
- Suicidal gestures
- Inappropriate anger
- Vulnerability to abandonment
- Emptiness- feelings
acronym for remembering criteria of EUPD
IMPULSIVE
IMPULSIVE stands for
- Impulsive
- Moodiness
- Paranoia or dissociation under stress
- Unstable self-image
- Labile intense relationships
- Suicidal gestures
- Inappropriate anger
- Vulnerability to abandonment
- Emptiness- feelings
screening for EUPD
Have you done many things impulsively that could have gotten you into trouble or taken
unnecessary risks eg: abusing ETOH, unsafe sex, gambling
Previous self-harm or suicide
Do your relationships often feel like roller-coaster: labile
Do you often feel confused about who you are as a person?
Do you have difficulty managing your emotions; emotional roller-coaster
Do you experience a feeling of intense emptiness?
Do you feel concerns about ppl you love leaving you
symptoms of EUPD
Same as above
Intense labile relationships
Self harm or suicide attempts
Cant deal effectively with stressors
Manipulative
risk factors of EUPD
Family history
Childhood trauma or neglect
how can CBT help EUPD
focus on changing unhelpful and maladaptive patterns in cognitions (thoughts, beliefs,
attitudes), behaviours an emotional regulation focusing on the development of personal coping
strategies (behaviour ↔ thoughts ↔ feeling)
how can DBT help EUPD
Dialectical Behavioural Therapy (recognise triggers that lead to reactive states & assists to
learn new coping mechanisms to deal with undesirable events, feelings, emotions, behaviours)
Tx for EUPD
CBT – focus on changing unhelpful and maladaptive patterns in cognitions (thoughts, beliefs,
attitudes), behaviours an emotional regulation focusing on the development of personal coping
strategies (behaviour ↔ thoughts ↔ feeling)
DBT- Dialectical Behavioural Therapy (recognise triggers that lead to reactive states & assists to
learn new coping mechanisms to deal with undesirable events, feelings, emotions, behaviours)
MBT- Mentalisation Based Therapy, Schema focused therapy (correcting maladaptive thinking)
Crisis management & my safety plan
Coping strategies
Medications not recommended
Symptomatic management or management of comorbidities
histrionic personality disorder
Characterized by a pattern of excessive attention-seeking emotions, usually beginning in early
adulthood, including inappropriately seductive behaviour and an excessive need for approval
criteria of histrionic personality disorder
Pervasive pattern of excessive emotionally & attention seeking beginning in early adulthood
indicated by 5 or more of the following:
- Provocative behaviour
- Relationships (considered more intimate than they are)
- Attention (uncomfortable when not the centre of attention)
- Influenced easily
- Style of speech (impressionistic, lacks detail)
- Emotions (rapidly shifting and shallow)
- Made up (physical appearance used to draw attention to self)
- Emotions exaggerated (theatrical)
acronym to remember features of histrionic personality disorder
PRAISE ME
PRAISE ME stands for
- Provocative behaviour
- Relationships (considered more intimate than they are)
- Attention (uncomfortable when not the centre of attention)
- Influenced easily
- Style of speech (impressionistic, lacks detail)
- Emotions (rapidly shifting and shallow)
- Made up (physical appearance used to draw attention to self)
- Emotions exaggerated (theatrical)
symptoms of histrionic personality disorder
Need for attention, loud & inappropriate appearances
Exaggerate their behaviours & actions
Sexual or provocative behaviour
Express strong emotions, exaggerate things
Multiple superficial relationships
risk factors for histrionic personality disorder
Exposure to early trauma or loss of loved one eg parental divorce
Female
Tx for histrionic persoanlity disorder
psychotherapy
narcissistic personality disorder
Long-term pattern of abnormal behaviour characterized by exaggerated feelings of self-
importance, an excessive need for admiration, & a lack of understanding of others’ feelings.
criteria of narcissistic personality disorder
Pervasive pattern of grandiosity, need for admiration & lack of empathy
- Special (believes they are special & unique)
- Preoccupied with fantasies (unlimited success, power)
- Envious
- Entitlement
- Excessive admiration required
- Conceited
- Interpersonal exploitation
- Arrogant
- Lacks empathy
acronym for criteria of narcissistic personality disorder
SPEEECIAL
SPEEECIAL stands for
- Special (believes they are special & unique)
- Preoccupied with fantasies (unlimited success, power)
- Envious
- Entitlement
- Excessive admiration required
- Conceited
- Interpersonal exploitation
- Arrogant
- Lacks empathy
risk factors for development of narcissistic personality disorder
Genetics
Overindulgent, permissive of overcontrolling parenting
Emotional abuse
antisocial personality disorder
Long term pattern of disregard for, or violation of, the rights of others. An impoverished moral sense or conscience is often apparent, by history of crime, legal problems, or
impulsive and aggressive behaviour
Can be well-functioning in society due to an ability to manipulate others
Often referred to as psychopathy or sociopathy but this is not diagnostic
criteria for antisocial personality disorder
Pattern of pervasive disregard & violation of the rights of others occurring since age 15
indicated by 3 or more:
- Conformity to law lacking
- Obligations ignored
- Reckless Disregard for safety of self or others
- Remorse lacking
- Underhanded (deceitful, lies, cons)
- Planning Insufficient (impulsive)
- Temper
acronym for remembering criteria of antisocial personality disorders
CORRUPT
CORRUPT stands for
- Conformity to law lacking
- Obligations ignored
- Reckless Disregard for safety of self or others
- Remorse lacking
- Underhanded (deceitful, lies, cons)
- Planning Insufficient (impulsive)
- Temper
risk factors for development of antisocial personality disorder
Genetics eg MAO-S gene
Hormones & NTs
Negative experiences early in life
Damage to prefrontal cortex
Tx for antisocial personality disorder
Very difficult to treat due to failure of pt insight or motivation
Some psychotherapies
prognosis of antisocial personality disorder
treatment resistant
overrepresented in prison populations
