Lec 79 Personality Disorders Flashcards Preview

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Flashcards in Lec 79 Personality Disorders Deck (30)
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1

Is there FDA approved treatment for personality disorders?

nope! just do psychotherapy

2

What is the core feature of all personality disorders?

difficulty in interpersonal functioning

3

What is the DSM-5 definition of personality disorder?

- enduring pattern of inner experience and behavior that deviates from expectations of one's culture. pattern manifests in 2 or more of the following: cognition, affectivity, interpersonal functioning, impulse control

- inflexible and pervasive pattern
- leads to clinically significant distress or impairment
- stable pattern of long duration, onset traced back at least to adolescence or early adulthood


person is not usually aware of the problem

4

What is development and course of personality disorder?

- person is not usually aware of the problem
- evident during adolescence or early adult life
- relatively stable over time
- hard to diagnose under age 18
- may be exacerbated by loss of significant support or previously stabilizing social situations

5

Is personality disorder dimensional or categorical?

currently in DSM 5 = categorical = not on a continuum with normal personality

6

What is difference axis 1 vs axis 2 disorders DSM4?

axis 1 = symptoms, episodic, pt suffers most, biologic, genetic, treat with meds
axis 2 = traits, stable, those around pt suffer most, psychological, development, treat with therapy

7

What are the 3 clusters of personality disorders?

cluster A = odd or eccentric [weird]
cluster B = dramatic, emotional, erratic [wild]
cluster C = anxious/fearful [worried]

8

What are the cluster A personality disorders? 3 types?

odd/eccentric, inability to develop meaningful social relationships, no psychosis, genetic association with schizophrenia
= Accusatory, Aloof, Awkward

3 types: paranoid, schizoid, schizotypal

9

WHat are the 3 personality clusters and their major characteristics [ABCs]?

cluster A = weird [accusatory, aloof, awkward]
cluster B = wild [bad to the bone]
cluster C = worried [cowardly, compulsive, clingy]

10

What is paranoid personality disorder?

- cluster A
- irrational suspicions and mistrust of others
- projection is major defense mech

11

What is schizoid personality disorder?

- cluster A
- voluntary social withdrawal, limited emotional expression,, content with social isolation
- schizoiD = Distant

12

What is schizotypal personality disorder?

- cluster A
- commonly co-occurs with paranoid PD = high rate of aggression often leading to criminal violence
- classic schizotypal: eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness, difficulty with working memory, lack of close friends, emotionally reserved
- schizoTypal = magical Thinking

don't look obviously mentally ill, could be misdiagnosed as depression, ADHD

13

What are characteristics of cluster B personality disorders? 4 types?

dramatic, emotional, erratic
- genetic association with mood disorders and substance abuse

- antisocial, borderlines, histrionic, narcissistic

14

What are characteristics of cluster C personality disorders? 3 types?

anxious or fearful; genetic association with anxiety disorders

avoidant, obsessive compulsive, dependent

15

Match the personality disorder cluster and which diseases it has genetic association with:

1. cluster A
2. cluster B
3. cluster C

A. mood disorders/substance abuse
B. anxiety disorders
C. schizophrenia

cluster A = schizophrenia
cluster B = mood disorders/substance abuse
cluster C = anxiety disorders

16

What is antisocial personality disorder?

- cluster B
- disregard for violation of rights of others
- criminality, impulsivity
- males > females; > 18yo and have conduct disorder before age 15
- if under age 18 its conduct disorder not personality disorder

17

What is borderline personality disorder?

- cluster B
- emotional instability [esp anger], hypersensitivity to interperonsal interactions esp. rejection, self-injury [to relieve pain], dissociatve symptoms, impulsivity esp aggression, intense unstable mood and interpersonal relationships, extreme "black and white" thinking, boredom, sense of emptiness
- female > male

- high suicide rate [distinct from self-injury]
- onset = adolescence but symptoms evident in child
- childhood trauma increases risk

18

What is histrionic personality disorder?

- cluster B
-pervasive attention-seeking, sexually provocative, overly concerned with appearance, excessive emotionality and excitablity

19

What is narcissistic personality disorder?

- cluster B
- grandiosity, sense of entitlement, lacks empathy and requires excessive admiration, often demands the "best" and reacts to criticism with rage

20

What is avoidant personality disorder?

- cluster C
- hypersensitive to rejection, socially inhibited, avoidance of social interactions, timid, feelings of inadequacy, desires relationships with others
- closely tied to social anxiety disorder
- pt desires affection/acceptance/relationships

21

What is obsessive-compulsive personality disorder?

- cluster C
- preoccupation with order, perfectionism, control
- rigid conformity to rules
- behavior consistent with one's own beliefs and attitudes [vs OCD has intuition]

22

What is dependent personality disorder?

- cluster C
- psychological dependence on others
- submissive and clinging
- excessive need to be taken care of
- low self-confidence

23

What 3 personality disorders most seen in clinic?

- schizotypal
- borderline
- avoidant

24

Which personality disorders more seen in men?

- antisocial personality disorder

25

Which personality disorders more seen in women?

- dependent
- histrionic
- borderline

26

What is neurobiology of schizotypal personality disorder? treat?

eye tracking abnormalities, temporal lobe volume loss, reduced striatal DA

treat = social skills training, low dose antipsychotics

27

What are neuro models of borderline personality disorder?

- amygdala-OFC disconnection --> emotional dysregulation = made worse by benzos/alc

- fialure in habituation to negative emotional stimuli --> reviewing painful memories worsens symptoms + increases self-injury

- social cognition dysfunction --> decreased activity in insula during social interaction, difficult identifying feels in self and others = lack of gut feeling that there is a problem with a relationship

28

What is course of borderline personality disorder?

- impairment and suicide risk decrease with age + relationships stabilize
- if therapy --> benefit w/in 1 yr
- after 10 yrs up to 50% no longer have pattern of behavior that meets full criteria for borderline personality disorder
- 10% commit suicide

29

What is neurobiology of avoidant PD?

inhibited temperament evident prenatally + infancy predicts
high amygdala activity similar to BPD

30

What is treatment for avoidant PD?

psychoanalytic psychotherapy, social skills training, antidepressant