[5] Personality Disorders Flashcards

1
Q

What are personality disorders?

A

Ways of thinking, feeling and behaving that deviate from the expectations of the culture, cause distress or problems functioning, and last over time

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2
Q

What are the risk factors for personality disorders?

A
  • Low socioeconomic status
  • Positive family history
  • Poor parenting and parental deprivation
  • Abuse during childhood - physical, sexual, and emotional abuse, as well as neglect
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3
Q

What can personality disorders be divided into?

A
  • A - Odd/eccentric
  • B - Dramatic/emotional
  • C - Anxious/fearful
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4
Q

What are the cluster A personality disorders?

A
  • Paranoid
  • Schizoid
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5
Q

What are the cluster B personality disorders?

A
  • Emotionally unstable (borderline)
  • Dissocial (antisocial)
  • Histrionic
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6
Q

What are the cluster C personality disorders?

A
  • Dependant
  • Avoidant (anxious)
  • Anankastic (obsessional)
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7
Q

What are the features of paranoid personality disorder?

A
  • Suspicious of others
  • Unforgiving
  • Spouse fidelty questioned
  • Perceives attack
  • Envious (jealous)
  • Doesn’t like criticism
  • Cold affect
  • Trust in others reduced
  • Self-reference
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8
Q

What are the features of schizoid personality disorder?

A
  • Detached (flattened) affect
  • Indifferent to praise or criticism
  • Sexual drive reduced
  • Tasks done alone
  • Absence of close friends
  • No emotion
  • Takes pleasure in few activities
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9
Q

What are the features of borderline personality disorder?

A
  • Abandonment feared
  • Mood instability
  • Suicidal behaviour
  • Unstable relationships
  • Intense relationships
  • Poor anger control
  • Impulsivity
  • Disturbed sense of self
  • Chronic emptiness
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10
Q

What are the features of antisocial personality disorder?

A
  • Callous
  • Blames others
  • Reckless disregard for safety
  • Remorseless
  • Deceitful
  • Impulsive
  • Temper
  • Tendency to violence
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11
Q

What are the features of histrionic personality disorder?

A
  • Provocative behaviour
  • Concern for physical attractiveness
  • Attention seeking
  • Influenced easily
  • Shallow
  • Egocentric
  • Inappropriately seductive
  • Exaggerated emotions
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12
Q

What are the features of dependant personality disorder?

A
  • Reassurance required
  • Expressing disagreement is difficult
  • Lack of self-confidence
  • Initiating projects is difficult
  • Abandonment feared
  • Needs others to assume responsibility
  • Companionship sought
  • Exaggerated fears
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13
Q

What are the features of anxious (avoidant) personality disorder?

A
  • Needs to be certain they are liked before getting involved with people
  • Restriction of lifestyle in order to maintain security
  • Inadequacy felt
  • Potential for embarassment prevents involvement in new activities
  • Social inhibition
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14
Q

What are the features of anankastic personality disorder?

A
  • Loses point of activity due to preoccupation with detail
  • Ability to compete tasks compromised due to perfectionism
  • Workholic at the expense of leisure
  • Fussy
  • Inflexible
  • Meticulous attention to detail
    Stubborn
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15
Q

How are personality disorders investigated?

A
  • History
  • MSE
  • Questionnaires, e.g. Personality Diagnostic Questionnaire, Eysenck Personality Questionnaire
  • Psychological testing, e.g. Minnesota Multiphasic Personality Inventory (MMPI)
  • CT/MRI head, to rule out organic causes of personality change, such as frontal lobe tumours and intracranial bleeds
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16
Q

What are the differential diagnoses of personality disorders?

A
  • Mania
  • Depression
  • Schizophrenia
  • Schizoaffective disorder
  • Substance misuse
17
Q

How can the management of personality disorders be outlined?

A

Using the biopsychosocial approach

18
Q

What is included in the biological management of personality disorders?

A
  • Atypical antidepressants may be used for the short-term management of transient psychotic periods in certain PDs, e.g. paranoid PD
  • Mood stabilisers can be used in emotionally unstable PD for symptoms such as mood instability and aggression
  • Small role for antidepressants
19
Q

What is included in the psychological management of personality disorders?

A
  • Cognitive behavioural therapy
  • Psychodynamic psychotherapy
  • Dialetical behavioural therapy
20
Q

What is included in the social management of personality disorders?

A
  • Substance misuse services
  • Assistance with social problems, e.g. housing, finance, employment
  • Support groups
21
Q

What are the general points in the management of personality disorders?

A
  • Recognition and treatment of co-morbid psychiatric illness and substance misuse, which is common in patients with PD
  • Risk assessment, particularly in the case of unstable PD. Potential stressors taht induce crises should be identified and reduced
  • Give the patient a written crisis plan. At times of crisis, if dangerous, violent, or is a suicide risk, consider the Crisis Resolution Team and detention under the Mental Health Act