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Psychiatry 2023 > wamss notes personality disorders > Flashcards

wamss notes personality disorders Flashcards

1
Q

personality disorders

A

Mental disorders categorised by enduring maladaptive patterns of behaviour, cognition & inner experience
across a variety of contexts that deviate markedly from the individuals culture

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2
Q

the cluster A personality disorders

A

paranoid
schizoid
schizotypal

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3
Q

paranoid personality disorder

A

Assume that other ppl with exploit, harm or deceive them even if no evidence exists to support this expectation

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4
Q

criteria of paranoid personality disorder

A

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

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5
Q

acronym for remembering the criteria of paranoid personality disorder

A

SUSPECT

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6
Q

SUSPECT stands for

A
  • 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
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7
Q

pathophysiology of paranoid personality disorder

A

Genetics
Connection with schizophrenia

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8
Q

symptoms of paranoid personality disorder

A

Hypersensitive, easily insulted
Reduced capacity for emotional involvement, general social withdrawal
Bear grudges, suspicious

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9
Q

treatment of paranoid personality disorder

A

Psychotherapy

Antidepressants & anti-anxiety medications

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10
Q

schizoid personality disorder

A

Lack of interest in social relationships, a tendency towards a solitary or sheltered lifestyle, secretiveness, emotional coldness, and apathy.

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11
Q

criteria of schizoid personality disorder

A

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

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12
Q

acronym for remembering criteria of schizoid personality disorder

A

DISTANT

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13
Q

DISTANT stands for

A
  • 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
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14
Q

pathophysiology of schizoid personality disorder

A

Genetics
Premature birth, LBW, malnutrition

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15
Q

symptoms of schizoid personality disorder

A

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

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16
Q

Ddx for schizoid personality disoder

A

Avoidant or Narcissistic PD
Depression

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17
Q

treatment for schizoid personality disorder

A

Psychotherapy
Nil available meds

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18
Q

schizotypal personality disorder

A

Severe social anxiety, paranoia, and often unconventional beliefs. People with this disorder feel extreme discomfort with maintaining close relationships with people

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19
Q

criteria for schizotypal personality disorder

A

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

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20
Q

acronym for remembering criteria of schizotypal personality disorder

A

ME PECULIAR

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21
Q

ME PECULIAR stands for

A
  • 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
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22
Q

pathophysiology of schizotypal personality disorder

A

Genetic – association with schizophrenia
Parenting styles
Early separation, trauma or neglect

23
Q

treatment for schizotypal personality disorder

A

Difficult to treat with psychotherapy
Group therapy recommended
Antipsychotics – psychotic Sx
Mood stabilisers – social anxiety

24
Q

cluster B personality disorders

A

borderline
histrionic
narcissistic
antisocial

25
Q

borderline/emotionally unstable personality disorder

A

Long term pattern of abnormal behaviour characterized by unstable relationships with other people, unstable sense of self, and unstable emotions

26
Q

criteria for emotionally unstable personality disorder

A

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

27
Q

acronym for remembering criteria of EUPD

A

IMPULSIVE

28
Q

IMPULSIVE stands for

A
  • Impulsive
  • Moodiness
  • Paranoia or dissociation under stress
  • Unstable self-image
  • Labile intense relationships
  • Suicidal gestures
  • Inappropriate anger
  • Vulnerability to abandonment
  • Emptiness- feelings
29
Q

screening for EUPD

A

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

30
Q

symptoms of EUPD

A

Same as above
Intense labile relationships
Self harm or suicide attempts
Cant deal effectively with stressors
Manipulative

31
Q

risk factors of EUPD

A

Family history
Childhood trauma or neglect

32
Q

how can CBT help EUPD

A

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)

33
Q

how can DBT help EUPD

A

Dialectical Behavioural Therapy (recognise triggers that lead to reactive states & assists to
learn new coping mechanisms to deal with undesirable events, feelings, emotions, behaviours)

34
Q

Tx for EUPD

A

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

35
Q

histrionic personality disorder

A

Characterized by a pattern of excessive attention-seeking emotions, usually beginning in early
adulthood, including inappropriately seductive behaviour and an excessive need for approval

36
Q

criteria of histrionic personality disorder

A

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)

37
Q

acronym to remember features of histrionic personality disorder

A

PRAISE ME

38
Q

PRAISE ME stands for

A
  • 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)
39
Q

symptoms of histrionic personality disorder

A

Need for attention, loud & inappropriate appearances
Exaggerate their behaviours & actions
Sexual or provocative behaviour
Express strong emotions, exaggerate things
Multiple superficial relationships

40
Q

risk factors for histrionic personality disorder

A

Exposure to early trauma or loss of loved one eg parental divorce
Female

41
Q

Tx for histrionic persoanlity disorder

A

psychotherapy

42
Q

narcissistic personality disorder

A

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.

43
Q

criteria of narcissistic personality disorder

A

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

44
Q

acronym for criteria of narcissistic personality disorder

A

SPEEECIAL

45
Q

SPEEECIAL stands for

A
  • Special (believes they are special & unique)
  • Preoccupied with fantasies (unlimited success, power)
  • Envious
  • Entitlement
  • Excessive admiration required
  • Conceited
  • Interpersonal exploitation
  • Arrogant
  • Lacks empathy
46
Q

risk factors for development of narcissistic personality disorder

A

Genetics
Overindulgent, permissive of overcontrolling parenting
Emotional abuse

47
Q

antisocial personality disorder

A

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

48
Q

criteria for antisocial personality disorder

A

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

49
Q

acronym for remembering criteria of antisocial personality disorders

A

CORRUPT

50
Q

CORRUPT stands for

A
  • Conformity to law lacking
  • Obligations ignored
  • Reckless Disregard for safety of self or others
  • Remorse lacking
  • Underhanded (deceitful, lies, cons)
  • Planning Insufficient (impulsive)
  • Temper
51
Q

risk factors for development of antisocial personality disorder

A

Genetics eg MAO-S gene
Hormones & NTs
Negative experiences early in life
Damage to prefrontal cortex

52
Q

Tx for antisocial personality disorder

A

Very difficult to treat due to failure of pt insight or motivation
Some psychotherapies

53
Q

prognosis of antisocial personality disorder

A

treatment resistant
overrepresented in prison populations

Psychiatry 2023 (21 decks)

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