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AIP: Self-harm > EUPD > Flashcards

EUPD Flashcards

1
Q

What is the definition of a personality disorder?

A

deeply ingrained and enduring pattern of inner experience and behaviour that deviates markedly from expectations in the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time and leads to distress or impairment

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2
Q

When is the onset of personality disorders?

A

adolescence or early adulthood

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3
Q

What are the 2 types of factors which contribute to personality disorders?

A
  1. Biological
  2. Environmental
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4
Q

What are 2 types of biological factors for personality disorders?

A
  1. Genetic
  2. Neurodevelopmental: abnormal cerebral maturation
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5
Q

What are 2 types of envionmental factors which can contribute to personality disorder development?

A
  1. Adverse social circumstances
  2. Difficult childhood experiences such as abuse
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6
Q

What are the 3 clusters of personality disorders?

A
  • Cluster A: odd/eccentric
  • Cluster B: dramatic/emotional
  • Cluster C: anxious fearful
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7
Q

What are 2 examples of personality disorders in cluster A?

A
  1. Paranoid
  2. Schizoid
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8
Q

What are 3 examples of cluster B personality disorders?

A
  1. Emotionally unstable (borderline)
  2. Histrionic
  3. Dissocial (antisocial)
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9
Q

What are 3 examples of cluster C personality disorders?

A
  1. Dependent
  2. Avoidant (anxious)
  3. Anankastic (obsessional)
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10
Q

What proportion of the population has a personality disorder of at least mild severity?

A

4-13%

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11
Q

What proportion of GP attendees who are adult suffer from a personality disorder?

A

20%

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12
Q

What are the 3 most prevalent personality disorders?

A
  1. Dissocial (3%)
  2. Histrionic (2-3%)
  3. Paranoid (0.5-2.5%)
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13
Q

What are 4 key examples of risk factors for personality disorders?

A
  1. society: low socioeconomic status and social reinforcement of abnormal behaviour
  2. genetics: higher incidence in positive FH
  3. dysfunctional family: poor parenting, parental deprivation
  4. abuse during childhood: physical, sexual (EUPD), emotional, neglect
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14
Q

How can you remember 9 key features of emotionally unstable (borderline) PD?

A

AM SUICIDE

  • Abandonment feared
  • Mood instability
  • Suicidal behaviour
  • Unstable relationships
  • Intense relationships
  • Control of anger poor
  • Impulsivity
  • Disturbed sense of self (identity)
  • Emptiness (chronic)
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15
Q

What is the key differentiating factor between paranoid and schizoid personality disorders vs psychotic disorders such as schizophrenia?

A

hallucinations and true delusions absent in Cluster A PDs

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16
Q

What are 6 types of questions you could ask in the history of someone with suspected EUPD?

A
  1. How do you think your friends and family would describe your personality?
  2. How would you describe your relationships with people in your life?
  3. Do other people ever say you have a temper?
  4. Do you ever feel life is not worth living?
  5. Do you have any worries about being alone?
  6. Detailed personal and social history
    • relationships, friendships, occupation
17
Q

What is insight often like in personality disorders?

A

patients often have no insight

18
Q

Due to the lack of insight in personality disorders, what is needed to make a diagnosis of personality disorder?

A

reliable collateral history needs to be taken to elicit pervasiveness and stability of the presentation

19
Q

What are 3 types of investigations which can be performed in suspected personality disorders?

A
  1. Questionnaires e.g. Personality Diagnostic Questionnaire, Eysenck Personality Questionnaire
  2. Psychological testing: Minnesota Multiphasic Personality Inventory (MMPI)
  3. CT head/MRI: rule out organic causes of personality change such as frontal lobe tumours and intracranial bleeds
20
Q

What are 3 differentials for personality disorders?

A
  1. mood disorders: mania/ depression
  2. psychotic disorders: schizophrenia, schizoaffective disorder
  3. substance misuse
21
Q

What are the 5 main principles of managing personality disorders?

A
  1. identify and treat co-morbid mental health disorders
  2. treat any co-existing substance misuse
  3. help patient to deal with situations that provoke problem behaviours or traits
  4. provide general support to reduce tension and anxieties
  5. give support and reassurance to family and friends
22
Q

What is essential as part of the assessment of a patient with emotionally unstable personality disorder?

A

risk assessment - may be suicidal. need to identify potentially stressors that induce crises to reduce them

23
Q

What are 3 types of specific therapies for personality disorders?

A
  1. psychosocial interventions e.g. CBT, psychodynamic psychotherapy, dialectical behavioural therapy, support groups, substance misuse services
  2. pharmacological management e.g. antipsychotics, antidepressants, mood stabilisers
  3. Written Crisis Plan
24
Q

What are 3 examples of pharmacological aspects of management of PD?

A
  1. atypical antipsychotics: in short term for transient psychotic in certain PDs (e.g. paranoid PD)
  2. mood stabilisers: in EUPD for mood instability and aggression
  3. small role for antidepressants
25
Q

What are 3 types of psychological therapies for personality disorders?

A
  1. Cognitive behavioural therapy (CBT)
  2. Psychodynamic pscyhotherapy: individual or group
  3. Dialectical behavioural therapy: emphasis on developing coping strategies to improve impulse control and reduce self-harm in EUPD
26
Q

What is psychodynamic psychotherapy?

A

aim is to explore the unconscious using free association (client says whatever comes into their mind) and therapist interprets these statements. conflicts and defence mechanisms explored and client develops insight to manage their maladaptive behaviour

1-5 50-minute sessions per week, possibly for number of years

27
Q

What is dialectical behavioural therapy (DBT)?

A

specific for EUPD, therapy adopts components of CBT and provides group skills training to provide the individual with alternative coping strategies (rather than deliberate self-harm) when faced with emotional instability

28
Q

What may be necessary interventions at times of crisis in EUPD?

A

if dangerous and violent or there is a suicide risk, consider Crisis Resolution Team and detention under the Mental Health Act

29
Q

What are 4 examples of specific social interventions for PDs?

A
  1. Support groups
  2. Substance misuse services
  3. Assistance with social problems e.g. housing, finance and employment
  4. Help to access education, voluntary work, meaningful occupation and work

AIP: Self-harm (15 decks)

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