8. Personality Disorders

Question 1

What is Personality?

Answer 1

Individual Differences in Characteristic Patterns of Thinking / Feeling / Behaving. Studies look at:

1. Understanding the Individual Differences in Particular Personality Characteristics
2. Understanding how the Various Parts if a Person come together as a Whole

Question 2

What are the ICD-10 Types of Personality Disorder?

Answer 2

1. Paranoid Personality Disorder
2. Schizoid Personality Disorder
3. Dissocial (Antisocial) Personality Disorder
4. Emotionally Unstable (Borderline) Personality Disorder
5. Histrionic Personality Disorder
6. Anankastic (Obsessive-Compulsive) Personality Disorder
7. Anxious (Avoidant) Personality Disorder
8. Dependent Personality Disorder

Question 3

What are the Features of Paranoid Personality Disorder?

Answer 3

1. Excessive Sensitiveness to Setbacks / Rebuffs
2. Persistently Bears Grudges
3. Suspicious, Misconstrues actions as Hostile
4. Combative, Tenacious Sense of Personal Rights
5. Suspicious Regarding Fidelity of Partner
6. Excesive Self-Importance
7. Conspiratorial Explanations of Events

Question 4

What are the Features of Schizoid Personality Disorder?

Answer 4

1. Social Detachment
2. Emotional Coldness, Detachment
3. Few Activities Pleasurable
4. Limited Capacity to Express Feelings
5. Indifference to Praise / Criticism
6. Little Interest in Sexual Experiences
7. Preoccupation with Fantasy and Introspection
8. Lack of Desire for close friends / confiding relationships

Question 5

What are the Features of Dissocial (Antisocial) Personality Disorder?

Answer 5

1. Callous Unconcern for Feelings of Others
2. Gross / Persistent Irresponsibility
3. Incapacity to Maintain Enduring Relationships
4. Low Tolerance to Frustration
5. Low Threshold for Violence / Aggression
6. Incapacity to Feel Guilt
7. Blames Others

Question 6

What is the name of the Severe form of Dissocial (Antisocial) Personality Disorder?

Answer 6

Psychopathy. Characterised by:

1. Antisocial Behaviour
2. Callous Disregard
3. Lack of Ampathy

Question 7

What are the 2 Types / Features of Emotionally Unstable (Borderline) Personality Disorder?

Answer 7

1. Impulsive Type:
2. a) Emotional Instability and Lack of Control
3. b) Outbusrts of Violence / Threatening Behaviour
4. Borderline Type:
5. a) Emotional Instability
6. b) Self-Image (Aims / Internal Preferences) Unclear
7. c) Chronic Feelings of Emptiness / Suicidal
8. d) Intense Unstable Relationships
9. e) Efforts to Avoid Abandonment

Question 8

What are the Features of Histrionic Personality Disorder?

Answer 8

1. Self-Dramatisation - Theatricality
2. Suggestibility
3. Shallow and Liable Affect
4. Seeks Excitement - Centre of Attention
5. Inappropriate Seductiveness
6. Over concern with Physical Attractiveness

Question 9

What are the Features of Anankastic (Obsessive-Compulsive) Personality Disorder?

Answer 9

1. Preoccupation with Details / Rules / Lists / Order
2. Perfectionism interferes with task completion
3. Conscientiousness / Scrupulousness / Undue Preoccupation with Productivity
4. Pedantic, Rigid and Stubborn
5. Insists other submit
6. Insistent Thought or Impulses

Question 10

What are the Features of Anxious (Avoidant) Personality Disorder?

Answer 10

1. Persistent, Pervasive Tensions and Apprehension
2. Believe they are Socially Inept / Inferior to others
3. Preoccupation with being Criticized / Rejected
4. Fear of Criticism / Disapproval / Rejection
5. Restriction in Lifestyle because of need for security

Question 11

What are the Features of Dependent Personality Disorder?

Answer 11

1. Allows other to make important life decisions
2. Subordination of own needs
3. Unwillingness to make a Demand
4. Fear of Abandonment
5. Uncomfortable / Helpless when Alone
6. Unable to make Descisions
7. Fear inability to care for themselves

Question 12

How is a Diagnosis of Personality Disorders made?

Answer 12

Clinical - Importance of History Taking (use structured Interviews)

Question 13

What is the Aetiology of Personality Disorders?

Answer 13

1. Genetics - in particular Borderline Personality Disorder
2. Early Trauma - Physical / Sexual / Verbal Abuse
3. Non-Trauma - Emotionality / Negative Affectivity / Affective Instability / Emotional Dysregulation

Question 14

In Emotionally Unstable (Borderline) Personality Disorder, where might Neuroanatomical Changes occur?

Answer 14

1. Frontal - Subcortical Region
2. Temporal Limbic Region
   Note - this can be confirmed with Neuroimaging

Question 15

What is the Rationale for Pharmacotherapy for Personality Disorders?

Answer 15

1. Pharmacotherapy directly influences Personality Disorders
2. Pharmacotherapy exerts an effect over Core / Nuclear Symptom Clusters
3. Pharmacotherapy Exerts its Therapeutic Effects by treating Comorbid Axis I Disorders

Question 16

What are the Different Therapeutic Options for Personality Disorders?

Answer 16

1. Pharmacotherapy
2. Cognitive Behavioural Therapy (CBT)
3. Mentalisation Based Therapy (MBT)

Question 17

What is Mentalizing (In Mentalisation Based Therapy)?

Answer 17

The process by which we make sense of each other and ourselves, implicitly and explicitly, in terms of subjective states and intentional varied mental processes.