Week 4 - B - Personality Disorder - A (Paranoid, Schizoid, Schizotypal), B (Antisocial, borderline, histirionic), C (Avoidant, dependent, obsessive compulsive) Flashcards
What is a personality?
A personality is a cluster of relatively predictable patterns of thinking, feeling and behaving that is generally consistent across time space and context
What is a personality again? The structure of a personality can come under openness, conscientiousness, extraversion, agreeableness, neuroticsim What is neuroticism?
Some define neuroticism as the ease of arousal in a patient ie emotional instability
Personality is a cluster of relatively predictable ways of thinking, feeling and behaving that is generally consistent across space time and context.
What are the key areas that make up the structure of a personality? Can be remembered under the acronym OCEAN
Openness
Conscientiousness
Extraversion
Agreeableness
Neuroticsm
There is a lot of different criteria for diagnosing somebody with a personality disorder There are 6 different points - A to F What are the different points for diagnosing a patient with personality disorder?
Enduring pattern of inner experience and behavior that deviates from expectations of the individuals culture.
The enduring pattern is inflexible and pervasive a well as causing clinically significant distress or impairment in school
The pattern is stable and of long duration and is not better explained by other mental disorders or physiological effects / illness
How can you distinguish between it being a personality trait or a personality disorder?
Can distinguish between a personality trait and a personality disorder by understanding if it is pervasive or not
And if the changes in personality cause distress and/or impairment of functioning ie in social groups or school
Ie if personality disorder it will be pervasive as it is present across a broad range of
The personality disorders is separated into three main clusters Briefly describe each of these clusters * Cluster A * Cluster B * Cluster C
Cluster A - the patient exhibits odd and eccentric behaviour
Cluster B - the patient is described as dramatic and emotional
Cluster C - the patient is described as exhibiting anxious or avoidant behaviour
What is Cluster A description for personality disorders? Which personality disorders come under cluster A?
Cluster A personality disorder - odd and eccentric
Paranoid, schizoid and schizotypal
How would you describe Cluster B personality disorder? What are the disorder classified under this heading?
This would be dramatic or emotional behaviour
Disorders - antisocial, bordelrine, histrionic and narcissitic
How would you describe Cluster C personality disorder? What are the disorder classified under this heading?
The behaviour is typically described as anxious or avoidant/fearful behaviour
Under this heading have
Avoidant, dependent and obsessie compulsive disorder
Describe each cluster for personality disorders and the disorders under each cluster heading?
Cluster A - odd and eccentric
- * Paranoid, Schizoid, Schizotypal
Cluster B - dramatic or emotional behaviour
- * Antisocial, Borderline, Histrionic. Narcissistic
Cluster C - anxious and avoidant/fearful
- Avoidant, Dependent, Obsessive compulsive
What is he most common personality disorder?
This would be obsessive compulsive personality disorder
What is obsessive compulsive personality disorder also known as? What cluster is it from?
Obsessive compulsive personality disorder is also known as anakastic personality disorder
It is from Cluster C
What percentage of the population has a personality disorder?
1in10 - so 10% of the population (2% of the population have the personality disorder - obsessive compulsive disorder)
Describe the criteria for diagnosing paranoid personality disorder? Paranoid schizophrenic disorders account for 0.7% of PD When does this PD usually begin?
This is a pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and persistent in a variety of contexts as indicated by four (or more) of the following
- Suspect without sufficient basis, that others are exploiting, harming or deceiving him or her.
- Is preoccupied with unjustified doubts about loyalty or trustworthiness of friends or associates
- Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously
- Reads hidden demeaning or threatening meanings into benign remarks or events
- Persistently bears grudges
- Perceives attacks on his/her character or reputation that are not appearance to other is quick to react angrily
- Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.
So now that you have named the criteria for paranoid personality disorder, state a brief description?
People have a continual pervasive distrust and suspiciousness of others
They suspect others to be attempting to deceive themselves, expect disloyalty and others not to be trusted so is reluctant to confide n others.
Also reads hidden meanings or threats in benign remarks and bears grudges and percieves personal attacks on character.
Is constantly suspicious of their partner.
Describe the criteria for schizoid PD?
A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
- * Does not desire or enjoy close relationships, including family
- * Almost always chooses solitary activites
- * Has little if any interest in sexual experiecnes
- * Takes pleasure in few, if any, activities
- * Lacks close friends or confidants other than 1st degree relatives
- * Appears indifferent to praise or criticism of others
- * Shows emotional coldness, detachment or flattened affectivity
Briefly describe schizoid PD now we have listed the criteria?
The patient lacks the desire to be close to others and prefers to be solitary when doing any activities
They lack close friends and has little interest in sexual relations or activities
They appear cold and detached and are indifferent to praise or criticism
BRUCE WAYNE IN DARK KNIGHT RISES BEGINNING
How is schizoid PD different to schizotypal?
Schizotypal - the patient is socially anxious, freindless with magical thinking / odd fantasies
MORE LUNA LOVEGOOD FROM HARRY POTTER
Describe the criteria for antisocial PD? What age does it occur at?
A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years, as indicated by three (or more) of the following:
- * They have a failure to conform to social norms with respect to lawful behaviours
- * There are deceitful, as indicated by repeated lying,
- * Impulsive or failure to plan ahead
- * Irritable & aggressive shown by repeated fights or assaults
- * Consistent irresponsibility, as iindicated by failure to sustain consistent work behaviour
- * Lack of remorse as indicated by being indifferent to having been hurt, mistreated or stolen from another
Describe antisocial PD in less words now?
Antisocial PD is when the patient develops antisocial behaviour ie they behave badly, get into lots of fights, are irresponsible and reckless and there is a lack of remorse
BASICALLY NEDS IN SCHOOL
What were the other disorder in cluster B PD?
Borderline, histrionic and narcissistic
Describe Borderline PD?
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Describe borderline personality disorder briefly?
This is when the patient has an identity disturbance meaning they are unstable about who they are themselves, have at least two impulsive disorders eg spending, binge eating and have recurrent suicidal attempts
NIGHTMARE ANNOYING NEEDY GF (DO ANYTHING TO AVOID ABANDONMENT eg suicide attempts or threats)
Describe the criteria for histrionic PD? Think RWP
A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
- * Is uncomfortable in situations in which he or she is not the center of attention.
- * Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.
- * Displays rapidly shifting and shallow expression of emotions.
- * Consistently uses physical appearance to draw attention to self.
- * Has a style of speech that is excessively impressionistic and lacking in detail.
- * Shows self-dramatization, theatricality, and exaggerated expression of emotion.
- * Is suggestible (i.e., easily influenced by others or circumstances).
- * Considers relationships to be more intimate than they actually are.
Briefly describe histrionic PD now?
Patient is self centered and sexually provocative who utilities physical appearance to draw attention to themselves and thinks relationships are more intimate than they actually are
ATTENTION SEEKING WHORE WHO IS A WHORE - RWP
What were the different cluster C PDs again?
Avoidant
Dependent
Obsessive compulsive
Describe avoidant PD?
A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
- * Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection.
- * Is unwilling to get involved with people unless certain of being liked.
- * Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.
- * Is preoccupied with being criticized or rejected in social situations.
- * Is inhibited in new interpersonal situations because of feelings of inadequacy.
- * Views self as socially inept, personally unappealing, or inferior to others.
- * Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.
How does avoidant PD differ from schizoid PD? (think ryan for avoidant - fear of rejection if getting close to someone)
In avoidant - the patient fears inadequacy and rejection and therefore avoids social situations and relationships (RAMSAY AROUND GIRLS)
In schizoid - the patient lacks desire to be in relationships or have friends and is seen as cold
Criteria for dependent PD? (think JOHN or RU around exams)
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Briefly describe dependent PD?
The patient is unable to take care of themselves, and requires approval from others and feels uncomfortable when made to make decision alone - constantly seeks advice - hence ruaridh around exams
What is the criteria for obsessive compulsive personality disorder? (anakastic disorder)
A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
- * Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.
- * Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met).
- * Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).
- * Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification).
- * Is unable to discard worn-out or worthless objects even when they have no sentimental value.
- * Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.
- * Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.
- * Shows rigidity and stubbornness.
Briefly describe obsessive compulsive personality disorder? How does it differ from OCD?
The person present simila to OCD, has rituals they need to do (rituals are a compulsion - have to do it)
The obsessions and compulsions are perceived as the patient as nonsensical in OCD and it distresses them but in OCPD - they like being perfectionists
What personality deficits would make someone a psychopath? (think Berlin from money heist)
Superficially charming however manipulative.
They have a grandiose self worth and are often pathological liars. They lack remorse, guilt and empathy.
They tend to fail to accept responsibility for their actions.
They need stimulation and are prone to boredom.
They are often impulsive and irresponsible and lack long term goals.
They have poor behavioural controls, early behavioural problems and have criminal versatility.
Can you treat personality disorder?
Not really. However can treat co-morbidities e.g. depression, schizophrenia etc.
What is the main psychological treatment used for PD?
Dialectical Behavioural Therapy -
Dialectical behavior therapy (DBT) treatment is a type of psychotherapy — or talk therapy — that utilizes a cognitive-behavioral approach.
DBT emphasizes the psychosocial aspects of treatment. (however mentalisation has become increasingly popular)
