Personality Disorders Flashcards

Describe the key features of the epidemiology and clinical presentation of personality disorder Be aware of the different approaches used to classify personality disorder Understand the aetiology of personality disorder Understand the general principles that underlie the treatment of individuals with personality disorder

1
Q

What is personality?

A

An enduring pattern of perceiving, relating to, and thinking about the environment and oneself - it makes an individual who they are

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2
Q

Define personality disorder

A

A set of personality traits that are pervasive, ingrained, maladaptive, and create significant functional impairment or subjective distress

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3
Q

Why is personality disorder not an illness?

A

It is not a change from the individual’s normal level of functioning

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4
Q

Define mental illness

A

An impairment of an individual’s normal cognitive, emotional, or behavioural functioning

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5
Q

State the ‘big five’ personality traits

A

Openness, conscientiousness, extraversion, agreeableness, neuroticism

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6
Q

Describe cluster A personality disorders, as defined by ICD-10

A

Characterised by oddness, eccenticity, preference of isolation and a limited number of close relationships. There is a tendency to introspection and fantasy and a suspiciousness of others

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7
Q

Name the 2 cluster A personality disorders, as defined by ICD-10

A

Paranoid and schizoid

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8
Q

Describe cluster B personality disorders, as defined by ICD-10

A

Characterised by flamboyance, dramatism, emotional instability, and aggressiveness towards self (sometimes others). There is a tendency to selfishness and irresponsibility

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9
Q

Name the 3 cluster B personality disorders, as defined by ICD-10

A

Emotionally unstable/ borderline, histrionic, dissocial/ antisocial

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10
Q

Describe cluster C personality disorders, as defined by ICD-10

A

Characterised by anxiety, prone, rigidity, and fear of new situations. There is a tendency to perfectionism and help-seeking

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11
Q

Name the 3 cluster C personality disorder, as defined by ICD-10

A

Anakistic/ obsessive-compulsive, anxious-avoidant, dependent

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12
Q

How did ICD-11 change the classification of personality disorder?

A

It removed all the categories and made it a single diagnosis, which could be mild, moderate, or severe

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13
Q

State the community prevalence of personality disorder

A

4% - with below 1% of cases severe

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14
Q

State the prevalence of personality disorder in the prison population

A

70-80%, with 50% of cases severe

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15
Q

Using the ICD-10 criteria, what was the difference in prevalence between cluster A and cluster B personality disorders?

A

Cluster B prevalence was higher in inner cities, whereas cluster A prevalence was higher in rural areas

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16
Q

Why might rates of personality disorder be more common in unstable countries? (Huang et al, 2009)

A

Difficulty in giving a child a consistent upbringing and childhood exposure to violence

17
Q

What is the effect of personality disorder on life expectancy?

A

It reduces it by 18 years

18
Q

What percentage of those who die by suicide have personality disorder?

A

40%

19
Q

Name the four symptom domains of borderline personality disorder

A

Affective, cognitive, behavioural, interpersonal

20
Q

State the 3 affective traits of borderline personality disorder

A

Inappropriate intense anger or difficulty controlling anger, chronic feelings of emptiness, affective instability

21
Q

State the 2 cognitive traits of borderline personality disorder

A

Transient paranoid ideation or severe dissociative symptoms, identity disturbance

22
Q

State the 2 behavioural traits of borderline personality disorder

A

Recurrent suicidal behaviour, threats, or self-mutilation; impulsively harmful acts other than suicidal behaviour

23
Q

State the 2 interpersonal traits of borderline personality disorder

A

Frantic effort to avoid abandonment, unstable and intense interpersonal relationships

24
Q

How did DSM-IV define antisocial personality disorder?

A

A pervasive pattern of disregard for and violation of the rights of others occurring since the age of 15

25
Q

State some of the criteria for antisocial personality disorder in DSM-IV

A

Failure to conform to social norms of lawful behaviours, deception, impulsivity or failure to plan ahead, irritability and aggressiveness, reckless disregard for safety, consistent irresponsibility, lack of remorse

26
Q

Why is it difficult to assess personality disorder?

A

Individuals tend to fluctuate and often show symptoms only for brief periods, some symptoms cause agitation or a lack of cooperation, there may be confounders e.g. comorbid mood disorders

27
Q

Name a validated semi-structured interview for personality disorder

A

SCID, IPDE

28
Q

What is the main predictor of criminal behaviour? (Bohman, 1996)

A

Alcohol abuse

29
Q

Based on the Swedish adoption study, what is the risk of a child whose biological parents have a criminal record having a criminal record if their adoptive parents do not?

A

12%

30
Q

Based on the Swedish adoption study, what is the risk of a child whose biological parents do not have a criminal record having a criminal record if their adoptive parents do?

A

7%

31
Q

High levels of which big five personality trait are associated with criminal activity?

A

Openness - high levels of novelty seeking and low reward dependence

32
Q

Are genetic or environmental factors thought to be more important in personality disorder?

A

Environmental

33
Q

Name some environmental factors involved in personality disorder

A

Unstable family background, neglect, childhood physical or sexual abuse

34
Q

What percentage of people with borderline personality disorder experienced childhood physical or sexual abuse? (Brodsky et al, 1995)

A

60%

35
Q

Why might personality disorder be associated with attachment?

A

There is a great deal of overlap between the symptoms of personality disorder and insecure attachment