Personality Disorders

Front 1

personality trait vs. disorder

Back 1

disorder - when personality style is INFLEXIBLE and MALADAPTIVE

Front 2

is an abrupt personality change a personality disorder?

Back 2

NO. is almost always due to a general medical condition

Front 3

cluster A "weird"

Back 3

a. paranoid
b. schizoid
c. schizotypal

Front 4

cluster B "wild"

Back 4

a. antisocial
b. histrionic
c. borderline
d. narcissistic

Front 5

cluster C "worried"

Back 5

a. avoidant
b. dependent
c. obsessive-compulsive

Front 6

Paranoid personality disorder
- cluster
- essential feature
- key defense mechanism
- distinguish from other paranoid disorders?

Back 6

- A
- distrust, suspiciousness of others and their motives
- expects deception
- "collects" injustices, grudges
- seems to NEED an enemy
- key defense mechanism: PROJection of hostile impulses onto others
- paranoid personality SUSPECTS
- delusional disorder BELIEVES
- schizophrenia, paranoid type BELIEVES, PLUS has markedly impaired fxning

Front 7

schizotypal personality disorder
- cluster
- essential features
- manifestations of the peculiarity
- course and complication

Back 7

- A
- Peculiarity in perceptions, speech, behavior. Chronic INTERPERSONAL DEFICITS (no close friends, discomfort in social interactions, more related to suspiciousness than to shyness)
- ideas of reference, suspiciousness, paranoid. magical thinking. illusions or unusual perceptions. peculiar behavior/appearance
- LIFELONG. likely does NOT deteriorate into schizophrenia. sensitive to stress-producing episodes of BRIEF PSYCHOTIC DISORDER

Front 8

schizoid personality disorder
- cluster
- essential features
- a/w with 1st-degree relatives of pts with schizoprenia?

Back 8

- A
- 1. detached/indfferent to social relationships. 2. Restricted Range of emotinal experience and expression (rarely experiences strong emotion)
- NO! UNLIKE PARANOID AND SCHIZOTYPAL, there is no definite increase in prevalence of schizoid personality in 1st-degree relatives of pts with schizoprenia

Front 9

Tx of cluster B disorders
- establish _____________
- don't ______ feelings of hate, rage, bewilderment at the patient. why?
- look for ___________________ in the patient
- give each request a fair hearing?

Back 9

- establish the ground rules
- don't SUPPRESS emotions. they just become hiddne from view and influence you in ways you are not seeing
- look diligently for something GENUINELY ADMIRABLE/LIKEABLE in the patient. this greatly enhances your ability to be supportive while still setting appropriate limits
- yes (respond to actual merits of the request, not based on how it was asked for)

Front 10

narcissistic personality disorder
- cluster
- essential features
- why would this person ignore/deny illness?

Back 10

- B
- grandiosity. need for admiration. lack of empathy for others
- illness is a blow to self-esteem - disfigurement, separation from tasks for which he receives admiration. will demand "VIP" tx and exemptions from policies

Front 11

antisocial personality disorder
- cluster
- essential features
- these people often have a veneer of _________
- genetics?
- environment?
- part of deviant subgroup? bad associates? living in high crime neighborhood?
- do they "grow out of it"?
- comorbidities

Back 11

- B
- disregard for/violation of the rights of others! BEGINS BEFORE AGE OF 15 and continues into adulthood (lying, repeatedly breaking laws, aggressive, fights. lack of remorse about pain caused to others)
- veneer of charm, seductiveness, and sincerity
- whether raised by father or not, child has ^ risk of antisocial personality disorder
- kids with ASP parents raised by other adults have DECREAsed risk of delinquency. developing consistent emotional ties with any significant adult decreases risk of delinquency
- those thigns play NO ROLE in development of ASP
- yes, some grow out of it.
- depression, alcoholism (25-30%), somatoform disorders

Front 12

histrionic personality disorder
- cluster
- essential features
- tx

Back 12

- B
- excessive emotionality, attention seeking
- dramatic, shallow, seductive, overly concerned with physical appearance
- these patients appreciate more of an AUTHORITARIAN, "trust me, im the doctor. this is what we need to do"

Front 13

borderline personality disorder
- cluster
- essential features
- what drives this instability?
- medical implications

Back 13

- B
- INSTABILITY - of relationships, mood, self-image, impulse control, etc...
- 1. HX OF EARLY ABUSE (as many as 80% of women with borderline personality disorder) - (deep-seated rage)
2. splitting - ppl are all bad, or all good, and categorization can rapidly change
3. lack of object constancy
4. the dramatic triangle - persecutor, victim and rescuer. ppl switch b/t roles, maybe first as a rescuer, then as a persecutor
5. conflict b/t desperate dependency and fear of closeness
6. manipulative suicide gestures - meets dependency needs, punishes ppl who didnt care enough, punishes self in response to feelings of worthlessness
- may tell about all the other awful doctors, that you are the first to "really understand" him/her

Front 14

dependent personality disorder
- cluster
- essential features

Back 14

- C
- dependent behavior (relies on others for basic everyday decisions!)
- submissive behavior due to fears of separation (puts up with abusive relationship)

Front 15

avoidant personality disorder
- cluster
- essential features
- contrast to social phobia
- medical implications

Back 15

- C
- fear of REJECTION or negative evaluation. Social inhibition and feelings of inadequacy
- social phobia is fear of HUMILIATION, and has a different timeline
- avoids significant interpersonal contact B/C of fears of rejection/disapproval
- views self as socially inept, unappealing, inferior, inadequate
- illness forces patient into multiple social contacts (uncomfortable).... initially fearful of, then overly reliant upon docs

Front 16

Obsessive-Compulsive personality disorder
- cluster
- essential features:
1. preoccupied with:
2. at the expense of:
- compare to OCD
- a common dynamic
- medical implications

Back 16

- C
1. orderliness, perfectionism, mental and interpersonal control
2. flexibility, openness, efficiency
- here, it is more "OBSESSIVENESS" as in being "obsessed" with a goal and "obsessing" over decisions
- needs to be IN CONTROL
- productivity/achievement are threatened by illness. yielding to medical team is difficult. explain pathophysiology