Ap Personality Disorders

Front 1

Diagnosing a PD

Back 1

-personality traits must be "inflexible, maladaptive, and cause significant functional impairment or subjective distress
-inner experience and behavior that deviates markedly from the expectations of the individuals culture.

Front 2

Cluster A

Back 2

(Odd, Eccentric)
Paranoid, Schizoid, Schizotypal

Front 3

Cluster B

Back 3

(Dramatic, Emotional, Erratic)
Antisocial, borderline, histrionic, narcissistic

Front 4

Cluster C

Back 4

(Anxious, Fearful)
Avoidant, Dependent, Obsessive-Compulsive

Front 5

PDs are:

Back 5

-Chronic-dating back to childhood or adolescence (features present for 1 year if under 18)
-Enduring patterns across situations

Front 6

Paranoid PD Presentation

Back 6

-Need to be self sufficient and autonomous
-need to control those around them
-Projection
-seek to confirm negative beliefs
-hypersensitive to criticism

Front 7

Paranoid PD Presentation (Continued)

Back 7

-premorbid traits include social isolation, hypervigilance, social anxiety, peculiar thoughts, angry thoughts, angry hostility, and idiosyncratic fantasies
-children- may appear odd
-fanatic members of groups
-rigid, controlling, critical, blaming, prejudice
-lengthy and litigious disputes

Front 8

Schizoid Presentation

Back 8

-intellectualization
-passively detached from environment
-appear to lack capacity for pleasure and pain
-do not tend to obtain gratification from self or others

Front 9

Working with Schizoid clients

Back 9

-reliable, stable therapeutic relationship that mirrors the client
-therapist must be more active at first
-must assess tolerance for social relatedness and desire
-client:frustration, helplessness, boredom, may not value therapy

Front 10

Antisocial Personality Disorder Presentation

Back 10

-disregard for and violation of other's rights
-deceitful and manipulative
-symptoms are less evident beginning in middle age, may have learned to channel personality style in less public ways
-consequences rarely play a part in their decision making process, impulses are directly expressed

Front 11

Borderline Personality Disorder presentation

Back 11

-disturbance in self-image manifests as frequent shifts in career and sexual identity
-impulsivity: unsafe sex, substance abuse, other risky behavior
-most commonly diagnosed age 19-34 (most people don't meet full criteria by age 40)

Front 12

BPD Intervention

Back 12

-Goal: balance polarities
-begin with clear boundaries and goal of helping client to be more independent
-therapist should be supportive within those limits
-form stable identity by reducing vacillations between extremes
-help client tolerate anxiety to choose a better response
-self-soothing, communicating emotions

Front 13

Dialectical Behavior Therapy for BPD

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-Combines CBT with assumption that acceptance of client is necessary
-3 stages of DBT
-Group skills training
-Individual outpatient therapy
-telephone consultations for in between session coaching

Front 14

BPD Intervention (continued)

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-a real alliance takes time
-begin supportive then move to supportive confrontation
-confont all good or all bad to help client integrate splits
-help client define self and more solid identity
-help connect behavior to early history (psychodynamic can be helpful)

Front 15

Histrionic PD Presentation

Back 15

-women overdiagnosed
-often have borderline, dependent, or narcissistic traits
-adolescents: may be flamboyant, flirtatious, attention-seeking
-Adults: form new relationships, but have difficulty sustaining them
-may fall in love quickly
-rapidly may be attracted to another person
-not reliable or responsible
-employment history erratic
-impulsive decisions

Front 16

Narcissistic PD Overview

Back 16

-Pervasive pattern of grandiosity, need for admiration, and lack of empathy
-very vulnerable to threats to self-esteem
-may react defensively with rage, disdain, or indifference when actually feeling shock, humiliation, or shame

Front 17

Narcissistic Personality Disorder Course and Presentation

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-Stable Course
-Seemingly well adjusted and successful and occupation and relationships in young adulthood
-Relationships with family, coworkers, partner may become strained over time
-may experience setbacks due to not addressing criticism
-may feel empty and lonely at older age

Front 18

Avoidant Personality Disorder Overview

Back 18

-Pervasive pattern of timidity, inhibition, inadequacy
-may have strong desire for close relationships, but feels too insecure
-may also meet criteria for DPD
-clingy in relationships

Front 19

Avoidant Personality Disorder Course and Presentation

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-have social phobia in childhood
-adolescence is usually very difficult
-occupational success may not be impaired
-usually don't have good social skills
-tend to be shy, inhibited and timid
-reluctant to express their feelings

Front 20

Dependent Personality Disorder Overview

Back 20

-Pervasive and excessive need to be taken care of
-often have low self esteem, are self critical, and self denigrating
-Deference, politeness and passivity varies with culture
-dependence must be maladaptive to diagnose

Front 21

Dependent PD Course

Back 21

-excessively submissive as children and teens
-job functioning usually impaired or unsatisfactory
-prone to MDD, Dysthymic Disorder, anxiety disorders
-symptoms may decrease with reliable, empathic partner

Front 22

Dependent PD Presentation

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-Intense need for reassurance
-Self esteem dependent on presence of relationship
-often drive partner away which validates their worst fears, they then seek an even less reliable partner to quickly fill the void

Front 23

OCPD Overview

Back 23

-preoccupation with orderliness, perfectionism, mental, and interpersonal control
-devotion to work and productivity varies with culture
-resembles OCD, but does not usually occur

Front 24

OCPD Course and Presentation

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-Childhood:well behaved, responsible, conscientious
-likely to have lots of success in careers
-relationship with partner and children is likley to be strained due to being detached yet authoritarian
-coworker relationships may be strained due to perfectionism, domination, worrying, and anger

Front 25

OCPD comorbidities

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-prone to anxiety and physical disorders due to high levels of stress
-mood disorders may result from realization of own difficulties with work and family sacrifices made

Front 26

PPD vs Psychotic or other PDS

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-paranoid ideation is not psychotic or bizarre, lacks other delusions
-paranoid personality traits may be evident in other disorders also

Front 27

Schizoid PD vs Schizotypal or Avoidant

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-all involve social isolation and withdrawl
-Schizotypal includes intense social anxiety and cognitive-perceptual abberations
-Schizoid: absence of an intense desire for social relationships, indifference toward opinions of others

Front 28

Schizotypal PD vs Avoidant

Back 28

-both have social anxiety and introversion, but in schizotypal social anxiety does not diminish with familiarity

Front 29

Schizotypal PD vs Schizophrenia

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-Schizotypal lacks deterioration in functioning
-schizotypal can eventually move to schizophrenia

Front 30

Antisocial PD vs substance abuse

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-can co occur
-antisocial must begin before age 15
-can be lots of overlap

Front 31

BPD vs Axis I

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-must assess past symptoms and personality pattern
-symptoms must be evident since adolescence
-BPD has impulsivity and anger control

Front 32

Histrionic vs Narcissistic

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-NPD desires admiration while HPD desires any kind of attention they can get

Front 33

NPD vs Avoidant Personality Disorder

Back 33

-narcissistic is more grandiose, exploitation is more likely to be passive

Front 34

Avoidant PD vs Social phobia

Back 34

-look for personality pattern
-difficult to distinguish

Front 35

Avoidant PD vs Dependent PD

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-Avoidant PD is clingy once in relationship
-APD is shy to get involved while DPD has a lot of urgency

Front 36

Dependent PD vs Histrionic or Borderline

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-DPD are more self-effacing, docile, and altruistic
-HPD more assertive and flamboyant
-BPD more dysfunctional and dysregulated emotionally

Front 37

OCPD vs NPD

Back 37

-OCPD: work for its own sake
-NPD: work for its status and recognition
-OCPD: doubts and self criticism
-NPD: overly self assured