Personality Disorders General Flashcards
Personality
Innate and enduring chars (traits and patts) which shape attit, thoughts, motivat emot and behav in resp to a sit.
Changes dur life eg inj, organic brain dis, sev mental disorder, sev stressful life exper.
PD
When enduring chars cause distress or diffics for selves or in rels. Malad traits in resp to sits. Imapired thoughts, feelings, actions. Impaired function.
ICD10- enduring persis and pervasive disorders of inner exper and behav that cause or sig imapir in soc func and cause distress. Inflexib resps to range of personal and soc sits. Feats probs in cognit about self an dothers, affect (emot resp), and behav (interpersonal, occupat, soc, impulse). Not due to other MH condits, and out of keeping with soc and cult norms. Sig deviat to norm in percep, thinking, feeling, and esp rel to others.
-feats-
Symps since adolescence.
Stable over time desp flucs in mood.
Manif in diff envs.
Recog by friends.
ICD10 categs
-cluster A- odd/eccentric- MAD
Paranoid- not delusional.
Schizoid- cold, detached, no int in others, excess introspection and fantasy, lack empathy. Like aspergers but not since birth.
Schizotypal- interpersonal discomf, strange ideas, percep, app, behav.
-cluster B- dramatic, emotional, flamboyant, erratic- BAD.
Dissocial- no resposnib, aggress, poor rels, violat others rights, childhood conduct disorder.
EU impulsive- cant control anger or plan, unpredic affect and behav.
EU borderline- unclear ID, intense unstable rels, unpredic affect, self harm, impulsiv.
Histrionic- self drama, shallow affect, egocentric, atten and excitem craving, manip, flirty. Often plus EUPD.
Narcisistic- grandiose, lack empathy, need admirat.
-cluster C- anxious/fearful- SAD.
Anxious avoidant- tension, self conc, fear of neg eval by others, hide, insec.
Anankastic- doubt, indecisive, cautious, rigid, perfectionist, preocc with order and control, checking, obsessive.
Dependant- clingy, submissive, need care, fear helplessness, no indep decis.
Psyhcopathy is basically dissoc PD- PCLR checklist.
Aetiology
Genetic
Neurophys- immat EEG, decr amygdala activ
childhood dev- conduct disorder, ADHD
psychodynamic
Cog behav theories- maladap schemata.
Early life exper- abuse, separat, fam rejec, lack rules.
Prevalence
10% of community. More in yng and males.
40% of psychiatric pts. Around 10% primary diag.
Common comorbidities
Avoidant PD and soc phobia Subst misuse and cluster B ED and cluster B/C Neurotic disorders and cluster C Somatoforms disorders and cluster B/C Habit and impulse disorder and cluster B PTSD and borderline. Delusional disorder and paranoid. Dep and cluster B.
Investigation
Hx, obs, collateral
Qairres, intervs, specif checklists.
List abn traits, desc assoc distress and comorb disorders, desc interf with func.
Mx general
Tx comorb Staff rel work Admiss in crisis Therap community Psychotherp poor ev, can be bad as remove their maladap coping mech.
Mx specif
No ev for medication for PD itself, but sometimes used-
AntiP for cluster B/A
AntiD if impulsive, dep, self harm. And cluster C avoidant and anakastic.
Anticonvuls and lithium if affective instabil and impulsiv.
Therap comm in resid or day unit- Chall and modif interpersonal behav. Democatisat, permissiven, communalism, reality confrontation.
DBT- CBT, trauma proc, self esteem and goals. Ev for borderline.
Cog analytic therapy- recog self states and recip role procedures. Countertransferance.
Psychodynamic therapy.
CBT- schema focused.
Psychotherapy poor ev for cluster A/C. Can be bad as remove their maladap coping mech.
Prognosis
High suic, violence, accidents.
Lot mental comorb.
Outcome of other illness is worse.
?burnout or maturat in dissoc. Assoc with childhood behav.
For borderline 1/3 recov in 10-20yr. Poor facs eg rep self harm, comorb dissoc.
Paranoid PD
Susp of others and motives Others not trustworthy or making plans against Sensitiv to setbacks Preoccup with conspiracy explans Bears grudges Excess self importance
Schizoid PD
Soc withdrawal
Emot cold Detached Remote, aloof Unresp to praise or criticism Pref loneliness
Schizotypal
Distorted reality
Odd or eccentric Illusions, magical thinking Thought disorder or paranoia Transient psychosis Obessions w/o resis Superstit Suspicious Reclusive
Histrionic
Self dramatisation Forms rels fast but demanding Shallow labile affect Seek atten and excitement Inapprop seductive
Narcissistic
Grandiose Fantasize about succ and power Thinks special Req excess admiration Exploits others Lack empathy Envious and thinks other envy him Arrogant
