Week 11- AMH Flashcards
Paranoid personality disorder
Paranoid personality disorder (PPD) is a mental illness characterized by paranoid delusions, and a pervasive, long-standing suspiciousness and generalized mistrust of others. People with this personality disorder may be hypersensitive, easily insulted. They think they are in danger and look for signs and threats of that danger, potentially not appreciating other interpretations or evidence.
People with PPD may have a tendency to bear grudges, suspiciousness, tendency to interpret others’ actions as hostile, persistent tendency to self-reference, or a tenacious sense of personal right. Patients with this disorder can also have significant comorbidity with other personality disorders, such as schizotypal, schizoid, narcissistic, avoidant and borderline.
Schizoid personality disorder
Neither desires nor enjoys close relationships, including being part of a family.
Almost always chooses solitary activities.
Has little, if any, interest in having sexual experiences with another person.
Takes pleasure in few, if any, activities.
Lacks close friends or confidants other than first-degree relatives.
Appears indifferent to the praise or criticism of others.
Shows emotional coldness, detachment, or flattened affectivity.
Few, if any, activities provide pleasure.
Displays emotional coldness, detachment, or flattened affectivity.
Limited capacity to express warm, tender feelings for others as well as anger.
Appears indifferent to either praise or criticism from others.
Little interest in having sexual experiences with another person (taking into account age).
Almost always chooses solitary activities.
Excessive preoccupation with fantasy and introspection.
Neither desires, nor has, any close friends or confiding relationships (or only one).
Marked insensitivity to prevailing social norms and conventions; if these are not followed, this is unintentional.
Not avoiding people but emotional dependency/intimacy. can have work relations etc. Not envious like narcissist but do feel superior- without craving power. Have a pathological reliance on fantasizing and preoccupation with inner experience.
Schizotypal personality disorder
People with this disorder feel pronounced discomfort in forming and maintaining social connections with other people, primarily due to the belief that other people harbour negative thoughts and views about them. Peculiar speech mannerisms and socially unexpected modes of dress are also characteristic. Schizotypal people may react oddly in conversations, not respond, or talk to themselves. They frequently interpret situations as being strange or having unusual meaning for them; paranormal and superstitious beliefs are common. Schizotypal people usually disagree with the suggestion their thoughts and behaviour are a ‘disorder’, and seek medical attention for depression or anxiety instead.
At least five of the following symptoms must be present:
ideas of reference
strange beliefs or magical thinking that influences behaviour and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”, bizarre fantasies or preoccupations)
abnormal perceptual experiences, including bodily illusions
strange thinking and speech (e.g., vague, circumstantial, metaphorical, over-elaborate, or stereotyped)
suspiciousness or paranoid ideation
inappropriate or constricted affect
strange behaviour or appearance
lack of close friends
excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self
Inappropriate or constricted affect (the individual appears cold and aloof);
Behaviour or appearance that is odd, eccentric or peculiar;
Poor rapport with others and a tendency to withdraw socially;
Odd beliefs or magical thinking, influencing behaviour and inconsistent with subcultural norms;
Suspiciousness or paranoid ideas;
Obsessive ruminations without inner resistance;
Unusual perceptual experiences including somatosensory (bodily) or other illusions, depersonalization or derealization;
Vague, circumstantial, metaphorical, over-elaborate or stereotyped thinking, manifested by odd speech or in other ways, without gross incoherence;
Occasional transient quasi-psychotic episodes with intense illusions, auditory or other hallucinations and delusion-like ideas, usually occurring without external provocation.
Antisocial personality disorder
A long-term pattern of disregard for, or violation of, the rights of others as well as a difficulty sustaining long-term relationships. A weak or non-existent conscience is often apparent, as well as a history of rule-breaking that can sometimes lead to law-breaking, a tendency towards substance abuse, and impulsive and aggressive behaviour. Antisocial behaviours often have their onset before the age of 8, and in nearly 80% of ASPD cases, the subject will develop their first symptoms by age 11.
It is characterized by at least 3 of the following:
Callous unconcern for the feelings of others;
Gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations;
Incapacity to maintain enduring relationships, though having no difficulty in establishing them;
Very low tolerance to frustration and a low threshold for discharge of aggression, including violence;
Incapacity to experience guilt or to profit from experience, particularly punishment;
Marked readiness to blame others or to offer plausible rationalizations for the behaviour that has brought the person into conflict with society.
Although the disorder is not synonymous with conduct disorder, presence of conduct disorder during childhood or adolescence may further support the diagnosis of dissocial personality disorder. There may also be persistent irritability as an associated feature.
Conduct disorder (CD) is a mental disorder diagnosed in childhood or adolescence that presents itself through a repetitive and persistent pattern of behaviour that includes theft, lies, physical violence that may lead to destruction and wanton breaking of rules
Borderline personality disorder (BPD)/ Emotionally unstable personality disorder (EUPD)
BPD is characterized by nine signs and symptoms. To be diagnosed, a person must meet at least five of the following:
Frantic efforts to avoid real or imagined abandonment
Unstable and chaotic interpersonal relationships, often characterized by alternating between extremes of idealization and devaluation, also known as “splitting”
Markedly disturbed sense of identity and distorted self-image
Impulsive or reckless behaviours (e.g., impulsive or uncontrollable spending, unsafe sex, substance use disorders, reckless driving, binge eating)
Recurrent suicidal gestures or self harm
Intense or uncontrollable emotional reactions and rapidly shifting between different emotional states
Chronic feelings of emptiness
Inappropriate, intense anger or difficulty controlling anger
Transient, stress-related paranoid ideation or severe dissociative symptoms
Types
F60.30 Impulsive type
At least three of the following must be present, one of which must be:
marked tendency to act unexpectedly and without consideration of the consequences;
marked tendency to engage in quarrelsome behaviour and to have conflicts with others, especially when impulsive acts are thwarted or criticized;
liability to outbursts of anger or violence, with inability to control the resulting behavioural explosions;
difficulty in maintaining any course of action that offers no immediate reward;
unstable and capricious (impulsive, whimsical) mood.
F60.31 Borderline type
At least three of the symptoms mentioned in F60.30 Impulsive type must be present, with at least two of the following in addition:
disturbances in and uncertainty about self-image, aims, and internal preferences;
liable to become involved in intense and unstable relationships, often leading to emotional crisis;
excessive efforts to avoid abandonment;
recurrent threats or acts of self-harm;
chronic feelings of emptiness;
demonstrates impulsive behaviour, e.g., speeding in a car or substance use.
Histrionic personality disorder
A personality disorder characterized by a pattern of excessive attention-seeking behaviours, usually beginning in early childhood, including inappropriate seduction and an excessive desire for approval. People diagnosed with the disorder are said to be lively, dramatic, vivacious, enthusiastic, extroverted and flirtatious.
People with HPD are usually high-functioning, both socially and professionally. They usually have good social skills, despite tending to use them to manipulate others into making them the centre of attention. HPD may also affect a person’s social and romantic relationships, as well as their ability to cope with losses or failures. They may seek treatment for clinical depression when romantic (or other close personal) relationships end.
Individuals with HPD often fail to see their own personal situation realistically, instead dramatizing and exaggerating their difficulties. They may go through frequent job changes, as they become easily bored and may prefer withdrawing from frustration (instead of facing it). Because they tend to crave novelty and excitement, they may place themselves in risky situations. All of these factors may lead to greater risk of developing clinical depression.
Additional characteristics may include:
Exhibitionist behaviour
Constant seeking of reassurance or approval
Excessive sensitivity to criticism or disapproval
Pride of own personality and unwillingness to change, viewing any change as a threat
Inappropriately seductive appearance or behaviour of a sexual nature
Using factitious somatic symptoms (of physical illness) or psychological disorders to garner attention
Craving attention
Low tolerance for frustration or delayed gratification
Rapidly shifting emotional states that may appear superficial or exaggerated to others
Tendency to believe that relationships are more intimate than they actually are
Making rash decisions
Blaming personal failures or disappointments on others
Being easily influenced by others, especially those who treat them approvingly
Being overly dramatic and emotional
Influenced by the suggestions of others
Some people with histrionic traits or personality disorder change their seduction technique into a more maternal or paternal style as they age.
Mnemonic
A mnemonic that can be used to remember the characteristics of histrionic personality disorder is shortened as “PRAISE ME”:
Provocative (or seductive) behaviour
Relationships are considered more intimate than they actually are
Attention-seeking
Influenced easily by others or circumstances
Speech (style) wants to impress; lacks detail
Emotional lability; shallowness
Make-up; physical appearance is used to draw attention to self
Exaggerated emotions; theatrical
Narcissistic personality disorder
Narcissistic personality disorder (NPD) is a mental disorder characterized by a life-long pattern of exaggerated feelings of self-importance, an excessive craving for admiration, and a diminished ability to empathize with others’ feelings.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-5, 2013) describes NPD as possessing at least five of the following nine criteria.
A grandiose sense of self-importance
Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
Believing that they are “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
Requiring excessive admiration
A sense of entitlement (unreasonable expectations of especially favourable treatment or automatic compliance with their expectations)
Being interpersonally exploitative (taking advantage of others to achieve their own ends)
Lacking empathy (unwilling to recognize or identify with the feelings and needs of others)
Often being envious of others or believing that others are envious of them
Showing arrogant, haughty behaviours or attitudes
Narcissistic personality disorder usually develops either in youth or in early adulthood.
Narcissistic rage is a reaction to a perceived threat to a narcissist’s self-esteem or self-worth. Narcissistic supply is a concept introduced into psychoanalytic theory by Otto Fenichel in 1938, to describe a type of admiration, interpersonal support, or sustenance drawn by an individual from his or her environment and essential to their self-esteem.
Avoidant personality disorder
Avoidant individuals are preoccupied with their own shortcomings and form relationships with others only if they believe they will not be rejected. They often view themselves with contempt, while showing a decreased ability to identify traits within themselves that are generally considered as positive within their societies. Loss and social rejection are so painful that these individuals will choose to be alone rather than risk trying to connect with others.
Some with this disorder fantasize about idealized, accepting and affectionate relationships because of their desire to belong. They often feel themselves unworthy of the relationships they desire, and shame themselves from ever attempting to begin them. If they do manage to form relationships, it is also common for them to preemptively abandon them out of fear of the relationship failing.
Individuals with the disorder tend to describe themselves as uneasy, anxious, lonely, unwanted and isolated from others. They often choose jobs of isolation in which they do not have to interact with others regularly. Avoidant individuals also avoid performing activities in public spaces for fear of embarrassing themselves in front of others.
Symptoms include:
Extreme shyness or anxiety in social situations, though the person feels a strong desire for close relationships
Heightened attachment-related anxiety, which may include a fear of abandonment
Substance use disorders
Dependent personality disorder
People who have dependent personality disorder are overdependent on other people when it comes to making decisions. They cannot make a decision on their own as they need constant approval from other people. Consequently, individuals diagnosed with DPD tend to place needs and opinions of others above their own as they do not have the confidence to trust their decisions. This kind of behaviour can explain why people with DPD tend to show passive and clingy behaviour. These individuals display a fear of separation and cannot stand being alone. When alone, they experience feelings of isolation and loneliness due to their overwhelming dependence on other people. Generally people with DPD are also pessimistic: they expect the worst out of situations or believe that the worst will happen. They tend to be more introverted and are more sensitive to criticism and fear rejection. Symptoms can include anything from extreme passivity, devastation or helplessness when relationships end, avoidance of responsibilities and severe submission.
Obsessive compulsive disorder (OCD)
An obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters your mind, causing feelings of anxiety, disgust or unease.
A compulsion is a repetitive behaviour or mental act that you feel you need to do to temporarily relieve the unpleasant feelings brought on by the obsessive thought.
Obsessive–compulsive disorder (OCD) is a mental and behavioural disorder in which a person has intrusive thoughts and/or feels the need to perform certain routines repeatedly to the extent where it induces distress or impairs general function. As indicated by the disorder’s name, the primary symptoms of OCD are obsessions and compulsions. Obsessions are persistent unwanted thoughts, mental images, or urges that generate feelings of anxiety, disgust, or unease. Common obsessions include fear of contamination, obsession with symmetry, and intrusive thoughts about religion, sex, and harm. Compulsions are repeated actions or routines that occur in response to obsessions. Common compulsions include excessive hand washing, cleaning, arranging things, counting, seeking reassurance, and checking things. Many adults with OCD are aware that their compulsions do not make sense, but they perform them anyway to relieve the distress caused by obsessions. Compulsions occur so often, typically taking up at least one hour per day, that they impair one’s quality of life.
Psychotic depression
Psychotic depression, also known as depressive psychosis, is a major depressive episode that is accompanied by psychotic symptoms.
Psychotic symptoms tend to develop after an individual has already had several episodes of depression without psychosis. However, once psychotic symptoms have emerged, they tend to reappear with each future depressive episode.
Cotard delusion
Cotard’s delusion, also known as walking corpse syndrome or Cotard’s syndrome, is a rare mental disorder in which the affected person holds the delusional belief that they are dead, do not exist, are putrefying, or have lost their blood or internal organs. Often with another illness.
Delusions of negation are the central symptom in Cotard’s syndrome. The patient usually denies their own existence, the existence of a certain body part, or the existence of a portion of their body. Cotard’s syndrome exists in three stages:
Germination stage: symptoms of psychotic depression and of hypochondria appear;
Blooming stage: full development of the syndrome and delusions of negation; and;
Chronic stage: continued severe delusions along with chronic psychiatric depression.
Sometimes related to mortality salience- awareness by individuals that their death is inevitable. Related to fear of death or low self esteem.
Solipsism
A philosophical idea that only one’s mind is sure to exist. As an epistemological position, solipsism holds that knowledge of anything outside one’s own mind is unsure; the external world and other minds cannot be known and might not exist outside the mind.
A philosophical zombie is a thought experiment in philosophy of mind that imagines a hypothetical being that is physically identical to and indistinguishable from a normal person but does not have conscious experience, qualia, or sentience.
Capgras delusion
Capgras delusion is a psychiatric disorder in which a person holds a delusion that a friend, spouse, parent, or other close family member (or pet) has been replaced by an identical impostor. The delusion most commonly occurs in individuals diagnosed with schizophrenia but has also been seen in brain injury, dementia, depression. Associated with ketamine, diabetes, hypothyroidism.
Fregoli delusion
The Fregoli delusion is a rare disorder in which a person holds a delusional belief that different people are in fact a single person who changes appearance or is in disguise. The syndrome may be related to a brain lesion and is often of a paranoid nature, with the delusional person believing themselves persecuted by the person they believe is in disguise.
A person with the Fregoli delusion can also inaccurately recall places, objects, and events. This disorder can be explained by “associative nodes” of neural activity.
