DSM PDs + SCID

Question 1

What general pattern can be seen within the PDs in Cluster A?

Answer 1

A pattern of odd/eccentric thinking, avoidance, rigidity and/or impairment of reality testing.

Question 2

Which three PDs fall under Cluster A?

Answer 2

• Paranoid Personality Disorder (PPD)
• Schizoid Personality Disoder (SPD)
• Schizotypal Personality Disorder (STPD)

Question 3

What general pattern can be seen within the PDs in Cluster B?

Answer 3

A pattern of dramatic, emotional (dysregulation), erratic behaviours/thoughts and/or antisocial attitudes and impulsivity

Question 4

What PDs constitute Cluster B?

Answer 4

• Antisocial Personality Disorder (ASPD)
• Borderline Personality Disorder (BPD)
• Histrionic Personality Disorder (HPD)
• Narcissistic Personality Disorder (NPD)

Question 5

What general pattern can be seen within the PDs in Cluster C?

Answer 5

A pattern of avoidance and preoccupied anxiety

Question 6

What PDs constitute Cluster C?

Answer 6

• Avoidant Personality Disorder (APD)
• Dependent Personality Disorder (DPD)
• Obsessive-Compulsive Personality Disorder (OCPD)

Question 7

General Personality Disorder (GPD) is something described in the DSM, what does this mean?

Answer 7

It describes the criteria & general patterns that broadly cover all personality disorders

Question 8

Criteria A of GPD describes the pattern, what is this exactly (do not include the 4 sub-facets)

Answer 8

An enduring pattern of inner experience/behaviour that deviates from the person’s expectations within a culture

Question 9

Criteria A of GPD can affect four major areas (facets) which are these?

Answer 9

1. Cognition (ways of perceiving the self/others/events)
2. Affectivity (range/intensity/lability/appropriateness of emotional response)
3. Interpersonal functioning
4. Impulse control

2+ minimum

Question 10

Criteria B and D in GPD constitute the range and stability seen in PDs, what are these criteria?

Answer 10

B. The pattern is inflexible and pervasive across a broad range of personal/social situations

D. The pattern is stable and of long duration + its onset can be traced back at least to adolescence or early adulthood

inflexible = persistent, pervasive is another p

Question 11

What are criteria C, E and F (functioning, exclusion) in GPD?

seen in basically all mental disorders

Answer 11

B. The pattern is inflexible and pervasive across a broad range of personal/social situations

E. The pattern is not better explained as a manifestation or consequence of another mental disorder

F. Same as E, but for physiological effects of a substance or another medical condition

Question 12

Criteria A of PPD describes what pattern?

Answer 12

Distrust and suspicion of others (motives are interpreted as malevolent)

Question 13

What are the seven symptoms of criteria A in PPD and how many do you need to have?

Answer 13

4+ symptoms:
1. Suspicion of exploitation, harm or deceit by others without sufficient basis
2. Preoccupation with doubts about loyalty/trustworthiness of friends/associates (unjustified)
3. Reluctance to confide in others because of unwarranted fear that the information will be used against them
4. Reads hidden demeaning or threatening meanings into benign remarks/events
5. Persistently bears grudges
6. Perceives attacks on their character/reputation that are not apparent to others and is quick to react angrily or counterattack
7. Has recurrent suspicions regarding fidelity of romantic partner (unjustified)

Question 14

What range/stability criteria is seen in all PDs (with the exception of ASPD)?

This is officially a part of criteria A

Answer 14

Pattern begins by early adulthood and presents itself in a variety of contexts

Question 15

What are the exclusion criteria for PPD (5)?

Answer 15

Does not occur exclusively during:
- Schizophrenia
- BD
- Depressive disorder with psychotic features
- Another psychotic disorder
- Physiological effects of another medical condition

Question 16

Criteria A of SPD describes what pattern?

Answer 16

Detachment from social relationships and a restricted range of expression of emotions in interpersonal settings

Question 17

What are the 7 symptoms of criteria A in SPD and how many does one need?

Answer 17

4+ symptoms:
1. Neither desires nor enjoys close relationships, including being part of a family
2. Almost always chooses solitary activities
3. Has little, if any, interest in having sexual experiences with another person (weird criteria)
4. Takes pleasure in few, if any, activities
5. Lacks close friends or confidants other than first-degree relatives
6. Appears indifferent to the praise/criticism of others
7. Shows emotional coldness, detachment or flattened affectivity

Question 18

Exclusion criteria of SPD? (6)

Answer 18

Does not occur exclusively during:
- Schizophrenia
- BD
- Depressive disorder with psychotic features
- ASD
- Another psychotic disorder
- Physiological effects of another medical condition

Question 19

Criteria A of STPD describes what pattern?

Answer 19

Social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships + cognitive/perceptual distortions and eccentricities of behaviour

Question 20

What 9 symptoms are seen in criteria A of STPD and how many does one need?

Answer 20

5+ symptoms:
1. Ideas of reference (excluding delusions)
2. Odd beliefs or magical thinking that influences behaviour and is inconsistent with subcultural norms
3. Unusual perceptual experiences, including bodily illusions
4. Odd thinking and speech
5. Suspiciousness or paranoid ideation
6. Inappropriate or constricted affect
7. Behaviour or appearance that is odd, eccentric or peculiar (?)
8. Lack of close friends or confidants other than first-degree relatives
9. Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgement of self

Question 21

Exclusion criteria of STPD? (5)

Answer 21

Does not occur exclusively during:
- Schizophrenia
- BD
- Depressive disorder with psychotic features
- ASD
- Another psychotic disorder

Question 22

Criteria A of ASPD describes what pattern?

Answer 22

Disregard for and violation of the rights of others

Question 23

What 7 symptoms constitute criteria A of ASPD and how many are needed?

Answer 23

3+ symptoms:
1. Failure to conform to social norms with respect to lawful behaviours, indicated by performance of acts that are grounds for arrest
2. Deceitfulness; lying, use of aliases or conning others for profit/pleasure
3. Impulsivity or failure to plan ahead
4. Irritability and aggressiveness as indicated by repeated physical fights or assaults
5. Reckless disregard for the safety of others or self
6. Consistent irresponsibility as indicated by repeated failure to sustain consistent work or honour financial obligations
7. Lack of remorse as indicated by being indifferent to/rationalizing having hurt, mistreated, or stolen from another

Question 24

What is different about ASPD’s range/stability criteria?

aka what is it

Answer 24

Instead of early adulthood; Pattern occuring since age 15 (although diagnoses cannot be made until 18)

Question 25

What evidence, before age 15, is needed for ASPD?

Answer 25

Conduct disorder

Question 26

Exclusion criteria ASPD? (2)

Answer 26

Not exclusively during: - Schizophrenia - BP

Question 27

Criteria A of BPD describes what pattern?

Answer 27

Instability or interpersonal relationships, self-image, and affects, and marked impulsivity

Question 28

What 9 symptoms are a part of criteria A of BPD and how many are needed?

Answer 28

5+ symptoms: 1. Frantic efforts to avoid real/imagined abandonment (crit. 5 cannot be included for this) 2. Unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation 3. Identity disturbance (unstable self-image or sense of self) 4. Impulsivity in at least two areas that are potentially self-damaging (again exclude crit. 5) 5. Recurrent suicidal behaviour, gestures, threats or self-mutilating behaviour 6. Affective instability due to a marked reactivity of mood 7. Chronic feelings of emptiness 8. Inappropriate, intense anger or difficulty controlling anger 9. Transient, stress-related paranoid ideation or severe dissociative symptoms

Question 29

What pattern does criteria A of HPD describe?

Answer 29

Excessive emotionality and attention seeking

Question 30

What 8 symptoms are a part of criteria A in HPD and how many are needed?

Answer 30

5+ symptoms: 1. Uncomfortable in situations in which they are not the centre of attention 2. Interaction with others is often characterized by inappropriate sexually seductive or provocative behaviour 3. Displays rapidly shifting and shallow expressions of emotions 4. Consistently uses physical appearance to draw attention to self 5. Has a style of speech that is excessively impressionistic and lacking in detail 6. Shows self-dramatization, theatricality and exaggerated expression of emotion 7. Is suggestible 8. Considers relationships to be more intimate than they actually are

Question 31

Criteria A of NPD describes what pattern?

Answer 31

Grandiosity, need for admiration and lack of empathy

Question 32

What 9 symptoms are a part of criteria A in NPD and how many are needed?

Answer 32

5+ symptoms: 1. Grandiose sense of self-importance 2. Preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love 3. Believes that they are "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions) 4. Requires excessive admiration 5. Sense of entitlement 6. Interpersonally exploitative 7. Lacks empathy; unwilling to identify/recognize with the feelings/need of others 8. Envious of others or believes that others are envious of them 9. Shows arrogant, haughty behaviours/attitudes

Question 33

Criteria A of APD describes what pattern?

Answer 33

Social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation

Question 34

What 7 symptoms are a part of criteria a in APD and how many are needed?

Answer 34

4+ symptoms: 1. Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval or rejection 2. Unwilling to get involved with people unless certain of being liked 3. Shows restraint within intimate relationships because of fear of being shamed/ridiculed 4. Preoccupied with being criticized or rejected in social situations 5. Inhibited in new interpersonal situations because of feelings of inadequacy 6. Views self as socially inept, personally unappealing or inferior to others 7. Unusually reluctant to take personal risks or to engage in new activities because they may prove embarrassing

Question 35

Criteria A of DPD describes what pattern?

Answer 35

Excessive need to be taken care of that leads to submissive and clinging behaviour and fears of separation

Question 36

What 8 symptoms are a part of criteria A in DPD and how many are needed?

Answer 36

5+ symptoms: 1. Difficulty making everyday decisions without an excessive amount of advice and reassurance from others 2. Needs others to assume responsibility for most major areas of their life 3. Has difficulty expressing disagreement with others because of fear of loss of support or approval (does not include realistic fears) 4. Difficulty initiating projects or doing things on their own (lack of self-confidence) 5. Excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant 6. Uncomfortable or helpless when alone because of exaggerated fears of being unable to care for self 7. Urgently seeks another relationship as a source of care and support when one ends 8. Unrealistically preoccupied with fears of being left to take care of self

Question 37

Criteria A in OCPD describes what pattern?

Answer 37

Preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency

Question 38

What 8 symptoms are a part of criteria A in OCPD and how many are needed?

Answer 38

4+ symptoms: 1. Preoccupied with details, rules, lists, order, organization or schedules to the extend that the major point of the activity is lost 2. Perfectionism that interferes with task completion 3. Excessively devoted to work/productivity to the exclusion of leisure activities and friendships (excl. economic nessecity) 4. Overconscientious, scrupulous and inflexible about matters or morality, ethics or values (excl. cultural/religious identification) 5. Unable to discard worn-out or worthless objects even when they have no sentimental value 6. Reluctant to delegate tasks or to work with others unless they submit to exactly their way of doing things 7. Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes 8. Shows rigidity and stubbornness

Question 39

What is the order that the SCID goes through the PD clusters and why this order?

Answer 39

C > A > B, because starting with A can be too confrontational for clients and more rapport is generally needed to get truthful answers to them

Question 40

What are the three P's in context of the SCID? | + description

Answer 40

- Problematic (causing distress/impairment) - Pervasive (across a broad range of situations) - Persistent (across a long time)