Behavioral science - personality disorders

Question 1

What is the definition of a personality disorder according to DSM criteria?

Answer 1

an ENDURING pattern of experience and behavior that has

1) Cognitive, emotional, interpersonal, and behavioral components
2) Leads to distress or impairment
3) Pervasive and inflexible
4) Onset in adolescence or early adulthood and stable over time

Question 2

What are the 4 personality types defined by hyppocrates?

What was the cause of the different types?

What was ignored by this model?

What was used as treatments?

Who’s model changed this?

Answer 2

essentially cheerful,
depressed,
lazy,
angry

alterations in balance of bodily fluids/humors

role of environment and genetics

Diet purging or bleeding

Freuds model introduced heredity as a cause of personality disorder

Question 3

Who provided the first attempt at modern classification of personality disorders?

What defined the different subtypes?

Answer 3

Wilhelm Reich

predominant ego defenses (“character armor”

Question 4

What are Reic’s 4 classes?

Answer 4

Hysterical
Compulsive
Narcissistic
Masochistic

Question 5

Which classifcation from Reich?

seductive, anxious, and dramatic, displaying under control over their instincts, emotions, and behaviors

Answer 5

hysterical

Question 6

Which classification from Reich?

long-suffering, complaining, self-deprecatory, and dependent, undervaluing themselves relative to other persons.

Answer 6

masochistic

Question 7

Which classification from Reich?

contemptuous, grandiose, essentially describing persons who overvalue themselves relative to other people

Answer 7

Narcissistic

Question 8

Which classification from Reich?
controlled, decisive, and distrustful, essentially displaying an over control of their instincts, emotions, and behaviors, and a need for perfection

Answer 8

Compulsive

Question 9

In today’s DSM what is Reich’s compulsive personality type called?

Answer 9

obsessive compulsive personality disorder

Question 10

What is hysterical disorder now called?

Answer 10

Histrionic personality disorder

Question 11

What is DSM correlation to masochistic personality?

Answer 11

Depressive personality disorder

Dependent personality disorder

Question 12

What are the Cluster A personality disorders?

Answer 12

Paranoid, Schizoid, Schizotypal

Question 13

What are the Cluster B personality disorders?

Answer 13

Antisocial, Histrionic, Narcissistic, Borderline

Question 14

What does it mean if you feel as though you meet the criteria for every type of personality disorder?

Answer 14

Sign of health and personal reflection ability

Question 15

What characterizes Cluster A disorders?

Answer 15

psychotic-like thinking and mannerisms (NOT psychotic)

Question 16

What characterizes Cluster B disorders?

Answer 16

poorly controlled, impulsive behaviors and unstable mood

engender dread among physicians

Question 17

What characterizes Cluster C disorders?

Answer 17

anxiety

Question 18

What are the Cluster C personality disorders?

Answer 18

Avoidant, Dependent, Obsessive-Compulsive

Question 19

unduly suspicious and distrustful of others, but this does not reach delusional intensity in that they can usually be persuaded otherwise. These are the patients who will accuse you of treating them like a guinea pig.

Answer 19

paranoid personality disorder

Question 20

display a pervasive pattern of detachment from social relationships and emotional flattening, similar to schizophrenia, but not to the same extent. They really prefer to be by themselves and choose solitary profession, like computer programming. (AS3 ck exist

Answer 20

)schizoid personality disorder

Question 21

odd and eccentric, and may have cognitive and perceptual disturbances. For instance, many believe in ESP, may be very superstitious, or display magical thinking, such as believing that their dreams predict future events. They may have an unusual choice of clothing that does not…quite fit together and are inattentive to usual social conventions.

Answer 21

schizotypal personality disorder

Question 22

Pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years
Evidence of a Conduct Disorder with onset before age 15 years

Answer 22

Antisocial personality disorder

Antisocial behavior is not exclusively during schizophrenia or a manic episode

Expect others to be manipulated

Question 23

also called psychopathy and sociopathy. Interactions with physicians may involve deceit, manipulation, and malingering.

Answer 23

Antisocial personality disorder

Question 24

expect that others will reject them

Answer 24

Histrionic personality disorder

Question 25

expect other to be manipulated

Answer 25

antisocial personality disorder

Question 26

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 Is easily influenced by others Considers relationships to be more intimate than they actually are

Answer 26

histrionic personality disorder

Question 27

tend to be excessively emotional and dramatic. They may initially charm us by their enthusiasm, apparent openness, or flirtatiousness. These charms quickly wear thin, however, as they continually demand to be the center of attention.

Answer 27

histrionic personality disorder

Question 28

A pervasive pattern of grandiosity (in fantasy and behavior) beginning by early adulthood Need for admiration Lack of empathy Sense of entitlement

Answer 28

Narcissistic personality disorder

Question 29

expect others will be manipulated

Answer 29

antisocial personality disorder

Question 30

Expect others will humiliate them

Answer 30

Narcissistic personality disorder

Question 31

instability in mood, cognition, behavior, relationships, and sense of self.

Answer 31

borderline personality disorder

Question 32

What is the DSM criteria for borderline personality disorder?

Answer 32

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood. > 5/9 characteristic behaviors are needed

Question 33

What are the 9 characteristic behaviors of borderline personality disorder?

Answer 33

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, or 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 34

What is the interpersonal drama triangle? What PD does it define?

Answer 34

evil perpetrator, innocent victim, or heroic rescuer perception of the behavior of those around them borderline PD

Question 35

Which cluster of personality disorders are anxiety-ridden, but generally higher functioning?

Answer 35

Cluster C - disorders have an anxious component, but not enough to qualify for an anxiety disorder.

Question 36

Avoidant Obsessive-Compulsive Dependent are sub-types of which cluster of PDs?

Answer 36

Cluster C

Question 37

Pervasive pattern of social inhibition beginning by early adulthood Inhibited in social situations because of feelings of inadequacy Hypersensitive to criticism or rejection

Answer 37

Avoidant PD

Question 38

____ PD essentially represents an exaggerated shyness

Answer 38

avoidant

Question 39

_____ personality disorder - generally want relationships, but are afraid of rejection or humiliation. _____ personality disorder - don't care about relationships or opinions of others

Answer 39

Avoidant Schizoid

Question 40

preoccupied with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, spontaneity, and openness

Answer 40

Obsessive compulsive PD

Question 41

How does OCD differ from OCPD?

Answer 41

OCD is characterized by obsessions and compulsions, such as counting, checking, and hand-washing. More severe manifestation of symptoms OCPD symptoms

Question 42

By early adulthood: Preoccupied with details, rules, lists, schedules Perfectionism interferes with task completion Excessively devoted to work and productivity Scrupulous about morality, ethics, and values Unable to discard worn-out objects Micro-manages tasks Miserly spending style Rigid and stubborn

Answer 42

Obsessive compulsive personality disorder

Question 43

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

Answer 43

Dependent personality disorder

Question 44

craves to be taken care of and told what to do. Behavior tends to be submissive, indecisive, and clingy, with fears of separation.

Answer 44

Dependent personality disorder

Question 45

What distinguishes borderline and dependent personality disorder?

Answer 45

BPD alternates from clingy and dependent behavior to periods of angry and defiant behavior

Question 46

What is the 5 factor mordel? What are the factors?

Answer 46

system of classification of personality types rather than method to diagnose a disorder ``` Extraversion Neuroticism Openness to experience Conscientiousness Agreeableness ```

Question 47

Which personality disorders are more common in women? men?

Answer 47

Women: Paranoid, avoidant, and dependent PDs Men: Antisocial PD

Question 48

What are the risk factors for developing a PD

Answer 48

not married, impoverished, poorly educated | Prevalence rates vary by country, setting, and gender

Question 49

What factors should be considered in a differential diagnosis of a PD/might exacerbate PD symptoms

Answer 49

Substances Medical/psychiatric disorders Stress Close relationships

Question 50

Are biomarkers (e.g. neuoimaging) useful?

Answer 50

No. Can't distinguish between cause and effect.

Question 51

Low CSF serotonin levels are associated with what behavior?

Answer 51

impulsive agression

Question 52

Genetic factors can predispose:

Answer 52

mood instability impulsive aggression social inhibition

Question 53

What environmental factor can significantly associate with development of PDs?

Answer 53

parenting behaviors

Question 54

Treatments for Cluster A disorders

Answer 54

Antipsychotics and psychotherapy may have modest benefit although generally understudied

Question 55

Treatments for Cluster B disorders

Answer 55

Psychopharmacology: Modest efficacy, especially mood stabilizers, antipsychotics. Benzodiazepines may exacerbate condition Co-occurring conditions (depression, anxiety, etc.) may also respond poorly to medications

Question 56

Psychotherapy is most effective for what PDs? Specifically what type of therapy?

Answer 56

Borderline, histrionic, narcissistic - RCTs show responsiveness to PSYCHODYNAMIC psychotherapy - although high remission rates after treatment Dialectic behavioral therapy (type of CBT) is no better than psychodynamic therapy antisocial PD is less amenable to psychotherapy treatment

Question 57

What is the only personality disorder for which parmacotherapy has shown significant benefit?

Answer 57

Avoidant personality disorder - benefit from both benzos and SSRIs

Question 58

T/F dependent and obsessive compulsive personality disorders can be effectively treated with medications

Answer 58

False

Question 59

T/F there is good evidence that Cluster C disorders are effectively treated with psychotherapy

Answer 59

True - both cognitive behavioral and psychodynamic approaches are helpful