First Aid Psych 5-1 Personality Disorders

Front 1

1. Personality Disorders?

Back 1

a. Involve deeply engrained, inflexible patterns of relating to others that are maladaptive and cause significant impairment in social or occupational functioning.
b. The disorders include marked limitations in problem solving and low stress tolerance.

Front 2

2. Do pts w/personality disorders have insight into their problems?

Back 2

a. No.
b. Their symptoms are either ego-syntonic or viewed as immutable.
c. They have a rigid view of themselves and others and around their fixed patterns have little insight.

Front 3

3. On what axis are personality disorders?

Back 3

a. Axis II.

Front 4

4. DSM criteria for personality disorder?

Back 4

a. Pattern of behaviour/inner experience that deviates from the person’s culture and is manifested in 2 or more of the following ways:
1. Cognition
2. Affect
3. Personal relations
4. Impulse control
b. The pattern: Is pervasive and inflexible in a broad range of situation
c. Is stable and has an onset no later than adolescence or early adulthood.
d. -> Significant distress in functioning
e. Is not accounted for by another mental/medical illness or by use of a substance.

Front 5

5. 3 Cluster A personality disorders?

Back 5

a. Schizoid, schizotypal, and paranoid.
b. Pts seem eccentric, peculiar, or withdrawn.
c. Familial association w/psychotic disorders.
d. These pts are perceived as eccentric or hermetic by others and can have sx that meet criteria for psychosis.

Front 6

6. Cluster B personality disorders?

Back 6

a. Antisocial, borderline, histrionic, and narcissistic.
b. Pts seem emotional, dramatic, or inconsistent.
c. Familial association w/mood disorders.

Front 7

7. Cluster C personality disorders?

Back 7

a. Avoidant, dependent, and obsessive-compulsive
b. Pts seem anxious or fearful
c. Familial association w/anxiety disorders.

Front 8

8. Personality Disorder NOS?

Back 8

a. Includes disorders that do not fit into cluster A, B, or C (including passive-aggressive personality disorder and depressive personality disorder).

Front 9

9. Paranoid Personality Disorder (Cluster A)?

Back 9

a. Pts w/PPD have a pervasive distrust and suspiciousness of others and often interpret motives as malevolent.
b. They tend to blame their own problems on others and seem angry and hostile.
c. They are often characterized as being pathologically jealous, which leads them to think that their sexual partners or spouses are cheating on them.

Front 10

10. DSM diagnosis of Paranoid Personality Disorder?

Back 10

a. Diagnosis requires a general distrust of others, beginning by early adulthood and present in a variety of contexts.
b. At least 4 of the following must also be present:
1. Suspicion (w/out evidence) that others are exploiting or deceiving him or her
2. Preoccupation w/doubts of loyalty or trustworthiness
3. Reluctance to confide in others
4. Interpretation of benign remarks as threatening or demeaning.
5. Persistence of grudges
6. Perception of attacks on his or her character that are not apparent to others; quick to counterattack.
7. Recurrence of suspicions regarding fidelity of spouse or lover.

Front 11

11. Paranoid schizophrenia vs. paranoid personality disorder?

Back 11

a. Unlike pts w/schizophrenia, pts w/paranoid personality disorder do not have any fixed delusions and are not frankly psychotic, although they may have transient psychosis under stressful situations.

Front 12

12. Tx of Paranoid Personality Disorder?

Back 12

a. Psychotherapy is the tx of choice.
b. Pts may also benefit from antianxiety meds or short course of antipsychotics for transient psychosis.

Front 13

13. Schizoid Personality Disorder (Axis II, Cluster A)?

Back 13

a. Have a lifelong pattern of social withdrawal.
b. They are often perceived as eccentric and reclusive.
c. They are quiet and unsociable and have a constricted affect.
d. They have no desire for close relationships and prefer to be alone.

Front 14

14. Diagnosis of Schizoid Personality Disorder?

Back 14

a. A pattern of voluntary social withdrawal and restricted range of emotional expression, beginning by early adulthood and present in a variety of contexts.
b. Plus 4 of 7 criteria

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15. 4 or more of the following must be present for Schizoid Personality Disorder?

Back 15

1. Neither enjoying nor desiring close relationships (including family)
2. Generally choosing solitary activities
3. Little (if any) interest in sexual activity w/another person
4. Taking pleasure in few activities (if any)
5. Few close friends of confidants (if any)
6. Indifference to praise of criticism
7. Emotional coldness, detachment, of flattened affect.

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16. Prevalence of schizoid personality disorder?

Back 16

a. Prevalence in men is 2x that of women.
b. There is no ↑ incidence of schizoid personality disorder in families w/hx of schizophrenia.

Front 17

17. Tx of schizoid personality disorder?

Back 17

a. Psychotherapy is the tx of choice; group therapy is often beneficial.
b. Low-dose antipsychotics (short course) if transiently psychotic, or anti-depressants if comorbid major depression is diagnosed.

Front 18

18. Schizotypal Personality Disorder?

Back 18

a. Pts w/schizotypal personality disorder have a pervasive pattern of eccentric behaviour and peculiar thought patterns.
b. They are often perceived as strange and eccentric.
c. The disorder was developed out of the observation that certain family traits predominate in first-degree relatives w/schizophrenia.

Front 19

19. Diagnosis of Schizotypal Personality Disorder?

Back 19

a. A pattern of social deficits marked by eccentric behaviour, cognitive or perceptual distortions, and discomfort w/close relationships, beginning by early adulthood and present in a variety of contexts.
b. 5 or more of the following must be present?
1. Ideas of reference (excluding delusions of reference
2. Odd beliefs or magical thinking, inconsistent w/cultural norms.
3. Unusual perceptual experiences (such as bodily illusions)
4. Suspiciousness
5. Inappropriate or restricted affect
6. Odd or eccentric appearance or behaviour
7. Few close friends/confidants
8. Odd thinking or speech (vague, stereotyped, etc)
9. Excessive social anxiety.

Front 20

20. Tx of Schizotypal Personality Disorder?

Back 20

a. Psychotherapy is the tx of choice to help develop social skills training.
b. Short course of low-dose antipsychotics if necessary (for transient psychosis).
c. Antipsychotics may help decrease social anxiety and suspicion in interpersonal relationships.