Personality disorder Flashcards
Name 2 unhealthy coping mechanims taken up by those with EUPD.
Splitting - primitive way of dealing with ambiguity; objects and/or self are either wholly good or wholly bad, aspects of self are split off.
Projection - intolerable feelings/aspects of self are “externalised” to reduce anxiety; projected onto others; projected into others (e.g. thinking that a good part of you has entered someone else and you cannot live without them)
Define personality.
the range of characteristic behavioural responses that a person deploys in order to negotiate the challenges produced by the outside world + their internal feelings
Define personality disorder.
A series of maladaptive personality traits that interfere with normal function in life.
How common are personality disorders?
It is thought that around 1 in 20 people have a personality disorder.
What are the 4 components of personality?
- cognition,
- impulse control,
- social communication
- affect/emotions
These are CONTINUOUS but psychiatrists assign cut-offs indicating when they become abnormal.
What are the risk factors for personality disorder?
Biological:
- Genetics –> Twin studies have shown that personality disorders share a large genetic component
Psychological:
- Personality –> Higher association with low self-esteem who internalise their stresses
Social:
- Childhood –> Sexual and emotional abuse and insecure family relationships (greatest risk factor)
- Neglect as a child affects the largest area of domains
What are the 5 criteria that should be fulfilled to diagnose a personality disorder?
A personality disorder is where one or more of these components of personality has reached an abnormal level:
- The trait has to be pathological, pervasive and persistent (3P’s)
- It must lead to stereotyped responses which can be traced to childhood
- The trait should be quantitatively significantly different from others of a similar background (beyond cut off)
- It should lead to distress or impair social function for the patient
- It should not be due to another mental disorder or medical condition
What are 5 of the diagnostic criteria for EUPD?
- Intense interpersonal relationships which alternate between love and hate
- Huge fear of abandonment
- Difficulty controlling temper (temper tantrums)
- Unstable affect
- Quasi psychotic thoughts
- Recurrent suicidal behaviour –> often as a poor coping response to stressful events
- Impulsive behaviour in 2 different domains (sex, gambling, drugs)
- Persistent feeling of emptiness and low mood
- Unstable image of self
What is the aetiology of BPD/EUPD?
Things you learn as a child and where they go wrong in EUPD:
- Secure attachment - not experienced in childhood so they later form relationships which are very doubtful/jealous. They later form fast intense relationships which do not last as they are insecure.
- Distress tolerance - did not learn to manage their emotions appropriately and instead threw temper tantrums. They later engage in unhelpful behaviours like self-harm.
- Emotional literacy - don’t learn to be aware of their emotions and react inappropriately in social situations.
- Self-identity - no stable sense of their own identity is developed in adolescence
Compare and contrast BPD and BAD.
EUPD/BPD:
- Usually always a history of child abuse
- Emotions associated with life events
- Impulsivity is a chronic complaint
- Mood changes occur suddenly, from low to agitated and vice versa amidst pervasive low mood
BAD (bipolar affective disorder):
- Not always linked to child abuse
- Depression/Mania not related to life events
- Impulsivity only seen during a manic or depressive phase
- Distinct phases of depression and mania with euthymia in between
What are the two types of EUPD?
Borderline = Very emotionally unstable with repeated acts of self-harm
Impulsive = Display high impulsive behaviours (gambling) without the repeated acts of self-harm
What are the three personality clusers? Give 2 examples in each cluster.
“Mad, bad, sad”
Cluster A - ‘odd or eccentric’
- Paranoid
- Schizoid
- Schizotypal
Cluster B - ‘dramatic, emotional, or erratic’
- Antisocial
- Borderline (Emotionally Unstable)
- Histrionic
- Narcissistic
Cluster C - ‘anxious and fearful’
- Obsessive-Compulsive
- Avoidant
- Dependent
What are the main features of paranoid personality disorder?
- Hypersensitivity and an unforgiving attitude when insulted
- Unwarranted tendency to questions the loyalty of friends
- Reluctance to confide in others
- Preoccupation with conspirational beliefs and hidden meaning
- Unwarranted tendency to perceive attacks on their character
What are the main features of schizoid personality disorder?
- Indifference to praise and criticism
- Preference for solitary activities
- Lack of interest in sexual interactions
- Lack of desire for companionship
- Emotional coldness
- Few interests
- Few friends or confidants other than family
What are the main features of schizotypal personality disorder?
- Ideas of reference* (differ from delusions in that some insight is retained)
- Odd beliefs and magical thinking
- Unusual perceptual disturbances
- Paranoid ideation and suspiciousness
- Odd, eccentric behaviour
- Lack of close friends other than family members
- Inappropriate affect
- Odd speech without being incoherent
*the false belief that irrelevant occurrences or details in the world relate directly to oneself
What is the main trait of each of these personality disorders? What is their origin?
- Paranoid Personality Disorder
- Schizotypal Personality Disorder
- Schizoid Personality Disorder
Paranoid - Trait: impaired ability to form relationships/confide in others; Origin: It stems from impaired trust in relationships, giving constant suspicion
Schizotypal - Trait: impaired cognition, which leads to odd thinking and perceptual abnormalities; Origin: Stems from disorganised thinking (like semi-psychosis)
Schizoid - Trait: Impaired social communication, which leads to insensitivity to social norms; Origin: Stems from emotional coldness
