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IBI Test 4 > B3.062 Personality Disorders in Psychiatry > Flashcards

B3.062 Personality Disorders in Psychiatry Flashcards

1
Q

what is personality

A

way of understanding normal human behavior and information processing
affects cognition, emotion, and behavioral responses
provides stability and tendencies across setting and contexts

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2
Q

nature

A

emphasis on biological factors to predispose people to certain traits or personality features

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3
Q

nurture

A

emphasis on psychological, social, and environmental factors to help express, inhibit, or reinforce underlying predispositions toward tendencies of thinking, feeling and behaving

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4
Q

what evidence is there for personality disorders having a strong genetic influence

A

higher concordances between monozygotic twins than dizygotic twins

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5
Q

what is a personality disorder

A

when personality features are extreme or skewed they can be maladaptive and represent a disorder that requires treatment

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6
Q

APA definition of personality disorder

A

enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of important social and personal contexts, and are inflexible and maladaptive, and cause either significant functional impairment or subjective distress

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7
Q

general symptoms of a personality disorder

A 
frequent mood swings
stormy relationships
social isolation
angry outburst
suspicion and mistrust of others
difficulty making friends
a need for instant gratification
poor impulse control
alcohol or substance abuse
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8
Q

what types of problems are personality disorders frequently comorbid with

A 
mood disorders
anxiety disorders
adjustment problems
substance abuse
frequent ER visits
social problems
illegal activities
poor, inflexible coping strategies
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9
Q

core features of personality disorders

A

present by adolescence (age 15)
pervasive and inflexible
associated with impaired functioning (social, occupational, or other important area)

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10
Q

cluster A disorders

A

“odd or eccentric”
paranoid
schizoid
schizotypal

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11
Q

cluster B disorders

A 
"dramatic, emotional, and erratic"
borderline
narcissistic
histrionic
antisocial
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12
Q

cluster c disorders

A

“anxious, avoidant, fearful”
obsessive-compulsive personality disorder
dependent personality disorder
avoidant personality disorder

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13
Q

paranoid personality disorder

A

characterized by a pattern of irrational suspicion and mistrust of others, interpreting motivations as malevolent

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14
Q

schizoid personality disorder

A

lack of interest and detachment from social relationships, and restricted emotional expression
“autistic thinking”

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15
Q

schizotypal personality disorder

A

a pattern of extreme discomfort interacting socially, distorted cognitions and perceptions, behavioral eccentricities
“magical thinking”
thought to be “akin” to schizophrenia-spectrum disorders

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16
Q

what are some common themes among cluster B disorders

A

commonly seen in emergency settings
externalizing
individuals get in trouble and physical harm due to their choices

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17
Q

borderline personality disorder

A

pervasive pattern of instability in relationships, self-image, identity, behavior and affect often leading to self harm and impulsivity
often mistaken for bipolar mood disorder

18
Q

narcissistic personality disorder

A

a pervasive pattern of grandiosity, need for admiration, and lack of empathy

19
Q

histrionic personality disorder

A

a pervasive pattern of attention-seeking behavior and excessive emotions
seduction/manipulation of others

20
Q

antisocial personality disorder

A

a pervasive pattern of disregard for and violation of the rights of others, lack of empathy
must have history of conduct disorder during childhood (longstanding)

21
Q

obsessive compulsive personality disorder

A

characterized by rigid conformity to rules, perfectionism and control

22
Q

dependent personality disorder

A

pervasive psychological need to be cared for by other people

23
Q

avoidant personality disorder

A

pervasive feelings of social inhibition and inadequacy, extreme sensitivity to negative evaluation
strong social anxiety

24
Q

personality disorder due to a general medical condition

A

must be attributable to medical condition

head/brain trauma most common

25
Q

risk factors for personality disturbance

A 
temperament problems in childhood
adverse environmental events
parents with personality disorders
low socioeconomic status
physical or sexual abuse in childhood
psychological and physical neglect
chaotic family life
conduct problems
loss of parents
26
Q

% of people w BPD who experienced childhood sexual abuse

A

40-71%

27
Q

% of people w antisocial personality disorder who have a history of risk factors

A

childhood physical abuse 42%
parental marital abuse 49%
poverty 42%
foster care 40%

28
Q

discuss the relationship between trauma and childhood brain development

A

traumatic events have been shown in animal models to sensitize the HPA system
sensitization by stress hormones result in altered functioning of the amygdala and limbic connection with the prefrontal lobes in animal models and post-mortem studies
repetitious brain exposure to higher levels of neurotransmitters such as noradrenaline affect development of hippocampus (decreased size)

29
Q

function of cortisol

A

increases excitatory neurotransmission

30
Q

sympathetic nervous system

A

contributes to arousal

exaggerated startle response

31
Q

limbic system

A

hippocampus: involved in memory formation, retrieval

anterior cingulate: initial emotional regulation

32
Q

frontal lobe

A

prefrontal cortex and orbitofrontal cortex

  • involved in short term memory
  • problem solving
  • executive functioning, decision making
  • automatic and controlled emotional regulation
33
Q

discuss the neuroimaging and anatomical findings associated with BPD and antisocial personality disorder

A

dysfunction of prefrontal-limbic circuits

lower volume of hippocampus, LPFC, cingulate in BPD

34
Q

discuss the neuroimaging and anatomical findings associated with schizotypal

A

compromise of the temporal lobe and basal striato-thalamic structures

35
Q

what type of attachments in infancy and childhood lead to more emotional and physical health

A

secure

36
Q

how do you assess a personality disorder?

A

clinical interview

psychological testing

37
Q

what are components of a clinical interview when assessing personality disorders

A

comprehensive history
functioning back to childhood and adolescence
functioning in multiple domains
corroboration from family

38
Q

different types of psychological testing

A 
DSM
SCID-II
MMPI-2
MCMI-III
PAI
39
Q

how do you treat a personality disorder?

A 
no pharma treatment for personality disorders
treatment typically symptomatic in nature
-antidepressants
-anxiolytics
-mood stabilizers
-atypical antipsychotics
reduction in comorbid symptoms
psychotherapy
40
Q

how is psychotherapy utilized in PDs

A

primary treatment modality
patients respond to structured therapies as well as less structured therapies
counseling directed towards problem areas–supportive therapy

41
Q

disorders with greater treatment response to CBT spectrum counseling

A

BPD
OCPD
avoidant
dependent

42
Q

disorders with less response to therapy

A

cluster A

antisocial

IBI Test 4 (21 decks)

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