First Aid Psych 5-2 Personality Disorders

Front 1

21. Cluster B Personality Disorder includes what 4 disorders?

Back 1

1. Antisocial
2. Borderline
3. Histrionic
4. Narcissistic
b. These pts are often emotional, impulsive, and dramatic.

Front 2

22. Diagnosis of Antisocial Personality Disorder?

Back 2

a. Pattern of disregard for others and violation of the rights of other since age 15.
b. Patients MUST be at least 18 for this diagnosis; Hx of behaviour as a child/adolescent must be consistent w/conduct disorder.
c. 3 or more of the following should be present:
1. Failure to conform to social norms by committing unlawful acts
2. Deceitfulness/repeated lying/manipulating by committing unlawful acts.
3. Impulsivity/failure to plan ahead.
4. Irritability and aggressiveness/repeated fights or assaults.
5. Recklessness and disregard for safety of self or others.
6. Irresponsibility/failure to sustain work or honour financial obligations.
7. Lack of remorse for actions.

Front 3

23. Tx of antisocial personality disorder?

Back 3

a. Psychotherapy is generally ineffective.
b. Dialectical behaviour therapy (DBT) and behavioural therapy best choice.
c. Pharmacotherapy may be used to tx sx of anxiety or depression, but use caution due to high addictive potential of these pts.

Front 4

24. Borderline Personality Disorder overview?

Back 4

a. Pts w/BPD have unstable moods, behaviours, and interpersonal relationships.
b. They fear abandonment and have poorly formed identity.
c. Relationships begin w/intense attachments and end w/the slightest conflict.
d. Aggression is common.
e. They are impulsive and may have a hx of repeated suicide attempts/gestures or episodes of self-mutilation.

Front 5

25. DSM diagnosis of Borderline Personality Disorder?

Back 5

a. Pervasive pattern of impulsivity and unstable relationships, affects, self-image, and behaviours, present by early adulthood and in a variety of contexts.
b. At least 5 of the following must be present:
1. Desperate efforts to avoid real or imagined abandonment.
2. Unstable, intense interpersonal relationships (eg, extreme love-hate relationships)
3. Unstable self-image.
4. Impulsivity in at least 2 potentially harmful ways (spending, sexual activity, substance abuse, binge eating, etc.
5. Recurrent suicidal threats or attempts or self-mutilation.
6. Unstable mood/affect
7. General feeling of emptiness
8. Difficulty controlling anger
9. Transient, stress-related paranoid ideation of dissociative sx.

Front 6

26. Course of Borderline Personality Disorder?

Back 6

a. Usually has a stable, chronic course.
b. High incidence of coexisting major depression and/or substance abuse.
c. ↑ risk of suicide (often bc pts will make suicide gestures and kill themselves by accident).

Front 7

27. Symptoms of borderline personality disorder- IMPULSIVE?

Back 7

a. Impulsive
b. Moody
c. Paranoid under stress
d. Unstable self-image
e. Labile, intense relationships
f. Suicidal
g. Inappropriate anger
h. Vulnerable to abandonment
i. Emptiness

Front 8

28. What defence mechanism is often used by Borderline Personality Disorder?

Back 8

a. Splitting- They view others as all good or all bad. i.e you are the only doc who has ever helped me. Every doctor I met before you was horrible”.

Front 9

29. Can Rx be used in Borderline Personality Disorder?

Back 9

a. Yes, Pharmacotherapy has been shown to be more useful in BPD than any other personality disorder.

Front 10

30. “Borderline”

Back 10

a. The name borderline comes the pt’s being on the borderline of neurosis and psychosis.

Front 11

31. Treatment of choice for borderline personality disorder?

Back 11

a. Psychotherapy (DBT) is the tx of choice- behaviour therapy, cognitive therapy, social skills training, etc.
b. Pharmacotherapy to treat psychotic or depressive sx as necessary.

Front 12

32. Histrionic Personality Disorder (HPD)?

Back 12

a. Pts w/HPD exhibit attention-seeking behaviour and excessive emotionality.
b. They are dramatic, flamboyant, and extroverted but are unable to form long-lasting, meaningful relationships.
c. They are often sexually inappropriate and provocative.

Front 13

33. DSM Diagnosis of Histrionic Personality Disorder?

Back 13

a. Pattern of excessive emotionality and attention seeking, present by early adulthood and in a variety of contexts.
b. At least 5 of the following must be present:
1. Uncomfortable when not the centre of attention.
2. Inappropriately seductive or provocative behaviour.
3. Uses physical appearance to draw attention to self.
4. Has speech that is impressionistic and lacking in detail.
5. Theatrical and exaggerated expression of emotion.
6. Easily influences by others or situation.
7. Perceives relationships as more intimate than they actually are.

Front 14

34. Who is more likely to have Histrionic PD, Men or Women?

Back 14

a. Women.

Front 15

35. What defence mechanism is often used by pts w/Histrionic PD?

Back 15

a. Regression-they revert to childlike behaviours.

Front 16

36. Course of Histrionic?

Back 16

a. Usually has a chronic course, w/some improvement of sx w/age.

Front 17

37. Tx of Histrionic?

Back 17

a. Psychotherapy is the tx of choice.
b. Pharmacotherapy to treat associated depressive or anxious sx as necessary.

Front 18

38. Narcissistic Personality Disorder (NPD)?

Back 18

a. Pts w/NPD have a sense of superiority, a need for admiration, and a lack of empathy.
b. They consider themselves “special” and will exploit others for their own fragile gain.
c. Despite their grandiosity, however, these pts often have fragile self-esteem.

Front 19

39. DSM diagnosis of Narcissistic Personality Disorder (NPD)?

Back 19

a. Pattern of grandiosity, need for admiration, and lack of empathy beginning by early adulthood and present in a variety of contexts.
b. 5 or more of the following must be present:
1. Exaggerated sense of self-importance
2. Preoccupation w/fantasies of unlimited money, success, brilliance, etc.
3. Believes that he or she is “special” or unique and can associate only w/other high-status individuals.
4. Needs excessive admiration.
5. Has a sense of entitlement
6. Takes advantage of others for self-gain.
7. Lacks empathy
8. Envious of others or believes others are envious of him or her.
9. Arrogant or haughty.

Front 20

40. Quick on Narcissism?

Back 20

a. Characterized by an inflated sense of entitlement.
b. People w/narcissistic PD are often “fishing for compliments” and become irritated and anxious when they are not at the centre of attention.

Front 21

41. Difference between antisocial personality disorder and Narcissistic PD?

Back 21

a. Both types of pts exploit others, but NPD pts want status and recognition, while antisocial pts want material gain or simply the subjugation of others.

Front 22

42. Tx of choice for NPD?

Back 22

a. Psychotherapy. Group therapy may help these pts learn empathy.
b. Antidepressants or lithium may be used as needed (for mood swings if a comorbid mood disorder is diagnosed.