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34 Cards in this Set
- Front
- Back
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Personality disorder definition
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chronically maladaptive pattern of interpersonal functioning
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Freud Personality structure
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Id: Basic want; pleasure principle
Ego: mediate btwn internal & external worlds; creative ways of getting needs met Superego: social values/morals |
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Defense mechanisms
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1) Repression: split it off from ourselves; try to deny that it exists
2) Denial: deny what it is 3) Projection: don't want to be way I am -> say someone else has 4) Reaction Formation: unacceptable impulse; go opposite way a. Ex: resent child -> spoil child because not okay to resent child 5) Displacement: aware of feeling but can't express it a. Ex: Hate boss, go home and kick dog 6) Rationalization: justify position (Narcissists do it) a. Very logical; insidious; hard to argue against 7) Regression: regress when sick; stressed; fall back a. Ex: speak native language when angry 8) Sublimation: take all my id type primitive impulses and channel them into a new way a. Ex: Football player aggression -> into sport (socially acceptable) Splitting: all this or all that (either or) - See in Narcissism, Sociopaths etc - Can be best doc or worst doc (disappointing c/o no one can live up to image) |
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Mahler Stages of Separation-Individuation
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Not born psychologically: too much for us to handle
1) Start w/ Normal Infant Autism: we are a personality/psychological egg - no idea that someone is taking care of me 2) Symbiosis: start to have vague idea that someone else is taking care of me 3) Separation-individuation (beginning of hatching) i. Hatching ii. Practicing/Ambitendncy iii. Rapproachment: go out and come back; go to school then reattach at home to see what mom/dad reaction is; recharge by reconnecting (Need safe home base to come back to or cannot experiment with autonomy/own ideas) 4) Object constancy: how to be an individual and relate to rest of world |
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Russell Personality Organization
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Psychotic level: Need for safety
Neurotic Level: Need for attunement Separation-Individuation: Need for mirroring |
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Schizoid personality
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1) Withdraws from emotional interactions c/o lack desire to relate
2) Flat/constricted affect 3) Intelligent 4) Lack Motivation 5) Slow monotonous speech 6) More common in men; link to schizophrenia |
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Schizoid personality treatment implications
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1) Structured interview & competentness (not warm & fuzzy, open-ended or empathy)
2) H&P may be limited in info 3) Pt may be out of touch w/ body |
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Paranoid personality
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1) Always on guard
2) Distance themselves by misinterpreting others as hostile 3) Intelligent (but perception distorted) 4) Can view as self-centered or grandiosity - low self-esteem/inferiority may be cause |
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Paranoid personality treatment implications
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1) Mistrust medical system/physician
2) May not come in/follow treatment regimens |
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Schizotypal personality
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1) Others view as odd/strange
2) Suspicious, desire relationships but anxious and mistrustful 3) Odd beliefs/loose assoc.; magical thinking ("This is a sign") - inhibits social functioning 4) Dress may be peculiar 5) May have odd "collections" 6) Possible link to schizophrenia (at risk) (Ex: Johnny Depp as Willy Wonka; Michael Jackson) |
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Schizotypal personality treatment implications
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1) Info from interview may be UNRELIABLE
2) More easy-going than schizoid (cares more about relating) - warm and caring more effective |
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Histrionic Personality
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1) Dramatic, flamboyant, theatrical - needs attention; seeks approval by entertaining
2) More common in females 3) Exaggerates emotions; poor impulse control 4) Easily taken advantage of (doesn't think things through) 5) Lack insight into their needs/behavior 6) Seductive/manipulative in behavior |
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Histrionic Personality Treatment implications
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1) Set boundaries
2) Consistently redirect 3) Resist getting sucked in by drama (lots of irrelevant info/non-factual info) |
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Anti-social personality
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(aka sociopath/criminal personality)
1) Conduct disorder by age 15, typically male 2) Chronic exploitative behavior w/o guilt/regret; chronic lying 3) Core belief: people are to be used - lack interpersonal bonds 4) Core = empty -> hostility/shame (getting away w/ things gives high/relieves stress) 5) Grandiose/narcissistic - lacks impulse control 6) Do well in prison c/o STRUCTURE |
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Anti-social personality treatment implications
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1) Seek help c/o: referral, detox, desire meds (need to use doc - don't be used)
2) Best treatment is early intervention |
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Borderline personality
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1) Bordering on PSYCHOTIC functioning (most extreme/impaired personality)
2) Unstable mood, impulses, thought process 3) Intense/short-lived relationships 4) Fear rejection/abandonment -> perception of this leads to RAGE 5) Feels misunderstood - list of ways they were wronged 6) Typically female 7) Unrealistic level of attunement (everything is a crisis); others surrounding: always on eggshells 8) Splitting: all or nothing thinking |
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Borderline personality treatment implications
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1) Hx of help-seeking to draw others in
2) all-or-nothing thinking: best or worst physician 3) SET BOUNDARIES 4) Encourage to help self (may get lots of crisis calls) 5) Watch for danger to self/others |
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Narcissistic Personality
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(Ex: Darth Vader)
1) Excessive grandiosity & entitlement (needs admiration, recognition, attention) 2) Only their needs important (lack empathy) 3) Isolated/conflicted: want to be seen but not let others know feel inadequate/ashamed 4) Rationalizes all failures/weakness 5) Everything done to avoid pain by supporting own self-image 6) Typically male |
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Narcissistic Personality Treatment implications
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1) Only see doc who is "worthy"
2) Doc expected to clear schedule for them/make extra time 3) Info filtered/exaggerated to seem more flattering |
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Avoidant personality
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1) Avoids relationship despite wanting them - very painful conflict (Schizoid not motivated to relate)
2) fear of rejection overpowering - create distance for safety 3) Shy, self-conscious, sensitive to criticism 4) Low self-esteem at core |
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Avoidant personality treatment implications
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1) May avoid treatment to avoid discomfort or embarassment
2) Will be uncomfortable in doctor-patient relationship (Doc must work VERY hard to create empathy/accepting relationship) |
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Dependent Personality
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1) Incapable of simple decisions w/o input from other
2) Fear of abandonment -> excessive need to please 3) Desperation/neediness pushes others away or attract abusive partner 4) Female (may have anti-social partner) 5) Makes bad-decisions to please others/puts self in harms way |
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Dependent Personality Treatment Implications
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1) Overly-compliant patient, overly reliant on doctor (even for small things)
2) Directive interviewing; use warmth but set boundaries to avoid excessive dependence |
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Obsessive-Compulsive Personality
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1) Overly concerned w/ perfectionism to maintain control
(avoid painful issues like inadequacy, powerlessness, dependency by focus on order) 2) Black & White thinking (If not perfect then total failure) 3) Detail-oriented (misses forest for trees) 4) Work oriented but accomplish little c/o perfectionism |
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Obsessive-Compulsive Personality Treatment Implication
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1) Opposite of histrionic: present w/ little emotion & lots of facts/rationalizations
2) Provide structure & guide/redirect interview to stay on track |
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What axis are Personality disorders on?
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Axis 2: Development/Personality Disorder (traits also Axis 2)
More at risk of having an Axis 1 diagnosis (clinical) (Axis 1 = clinical diagnosis: depression, anxiety, etc) |
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Somatization disorder
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Somatization: before 30, gradual onset
- LOTS of symptoms (life seems to revolve around them/relationships w/ medical professionals) - Often have anxiety/mood disorders too - More common in females (usually unmarried, lower SES) - Treatment difficult, reassure, reduce stress another way |
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Conversion Disorder
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Conversion: usually more neurological in nature
- La Belle indifference: unconcerned with condition - Mainly female (3%, 1-14% of medical settings) - Need to address underlying trauma/issue (similar to conversion) |
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Pain disorder
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Pain Disorder: pain is real
- Psychological factors causing pain; tough to differentiated btwn chronic pain |
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Hypochondriasis
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Hypochondriasis: fears of having disease based on misinterpreting own signs/symptoms
- Poor insight that fears are excessive - Concerns unfounded - Reassurance rarely works - M/F 50/50 Runs in families |
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Body dysmorphic disorder
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Body Dysmorphic Disorder: obsession that something wrong w/ specific part of body
- Imagined defect in physical appearance - Repeated attempts to "fix" problem (repeated surgeries) - May avoid work/social c/o extreme self-conscious - Often w/ anxiety, depression, OCD - OCD meds can sometimes help |
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Malingering
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Malingering: faking disorder for EXTERNAL gain
- Medication, physicians note, insurance issue, legal issue |
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Munchausen's Disorder
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Factitious disorder:
Munchausen's - Create/fabricate real sign/symptom for purpose of playing sick role (burn self, etc) - False signs (heat thermometer) - Self-inflicted conditions - Exaggerate previous conditions - Need to fulfill attention, affection, secondary gain - Light form: more common in female - Heavy form: more common in male - Chronic hospitalization pattern - RED FLAGS: □ Atypical presentation inconsistent w/ condition □ Symptoms only when being observed □ Pathological lying □ Non-compliance/disruptiveness/argue w/ med professionals □ Evidence of multi treatments (scars, etc.) □ Few visitors □ Lots of traveling |
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Munhcausen's By Proxy
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Munchausen's by proxy
- Typically mother & young child - 98% perpetrators are female - Feign signs/symptoms in another person under individuals care - Usually in hospital setting - 75% of victims die - Glee at fooling medical professionals - Older victims may help/participate |
