Behavioral Science: Personality Disorders

Question 1

Cluster A disorders

Answer 1

Paranoid, Schizoid, Schizotypal

- psychotic-like, but not psychotic

Question 2

Cluster B disorders

Answer 2

Antisocial, Histrionic, Narcissistic, Borderline

- dreaded disorders, behavioral

Question 3

Cluster C disorders

Answer 3

Avoidant, Dependent, Obsessive-Compulsive

- anxious, but not anxiety disordered

Question 4

Paranoid PD

Answer 4

• pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood
• not exclusively in the course of schiz or another psychotic disorder

Question 5

Schizoid PD

Answer 5

• pervasive pattern of detachment from social relationships and a restricted range of expression of emotions
• not exclusively in the course of schiz or another psychotic disorder

Question 6

Schizotypal PD

Answer 6

• pervasive pattern of interpersonal deficits marked by cognitive or perceptual distortions and eccentricities of behavior
• not exclusively in the course of schiz or another psychotic disorder

Question 7

Antisocial PD

Answer 7

• pervasive pattern of disregard for and violation of rights of others since age 15
• must have evidence of a conduct disorder with onset before 15
• not exclusively in the course of schiz or manic episode

Question 8

Histrionic PD

Answer 8

• pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood, such as:
• sexually seductive or provocative behavior
• self- dramatization, theatricality, exaggerated emotional expression
• easily influenced by others

Question 9

Narcissistic PD

Answer 9

• pervasive pattern of grandiosity beginning in early adulthood
• need for admiration
• lack of empathy
• sense of entitlement

Question 10

Borderline PD

Answer 10

• pervasive pattern of instability of interpersonal relationships, self-image, and affects, marked impulsivity beginning by early adulthood. You need at least 5/9 of the following:
  1. frantic efforts to avoid real or imagined abandonment
  2. unstable and intense interpersonal relationships, alternating idealization and devaluation
  3. persistently unstable self-image or sense of self
  4. impulsivity that is potentially self-damaging
  5. recurrent suicidal behavior or threats, self-mutilation
  6. mood lability and reactivity
  7. chronic feelings of emptiness
  8. frequent or intense anger outbursts
  9. transient paranoid ideation or severe dissociative symptoms

Question 11

Avoidant PD

Answer 11

• pervasive pattern of social inhibition beginning by early adulthood
• inhibited in social situations because of feelings of inadequacy
• hypersensitive to criticism or rejection

Question 12

Obsessive-Compulsive PD

Answer 12

By early adulthood:

• preoccupied with details, rules, lists, schedules
• perfectionism interferes with task completion
• excessively devoted to work and productivity
• scrupulous about morality, ethics, values
• unable to discard worn out objects
• micromanges tasks
• miserly spending style
• rigid and stubborn

Question 13

Dependent PD

Answer 13

• pervasive and excessive need to be taken care of beginning by early adulthood
• indecisive
• submissive and clingy
• difficulty expressing disagreement
• lack of self confidence, feeling of helplessness
• goes to excessive lengths to obtain nurturance and support from others

Question 14

Which PDs are more prevalent in women?

Answer 14

Paranoid, avoidant, dependent

Question 15

Which PDs are more prevalent in men?

Answer 15

Antisocial

Question 16

Risk factors for developing PD

Answer 16

Not married, impoverished, poorly educated

Question 17

Maternal absence

Answer 17

Early maternal deprivation reduces CNS serotonin levels

- nursery rearing conditions do NOT restore serotonin levels

Question 18

Tx for Cluster A

Answer 18

• little studied

- antipsychotics and psychotherapy may provide modest benefit

Question 19

Tx for Cluster B

Answer 19

• psychopharmacology has modest efficacy, especially mood stabilizers and antipsychotics
• benzos may exacerbate
• co-occurring conditions may also respond poorly to meds
• psychotherapy! best for borderlines

Question 20

Tx for Cluster C

Answer 20

Psychopharmacology for avoidant

psychotherapy! CBT and psychodynamic