Lecture 4: Personality Disorders Flashcards Preview

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Flashcards in Lecture 4: Personality Disorders Deck (16):
1

When do personality traits become disorders?

o When traits are so maladaptive that they significantly impair one’s work life and social life or cause major subjective distress

2

What are personality disorders?

o Inflexible and maladaptive responses to stress
o Global, affecting work and relationships
o Stable and enduring
o Non-psychotic, except under severe stress
o Ego-syntonic (the world is the problem, not me)
o Multiple complications

3

Age of onset of PD

Age of onset in late adolescence, early adulthood
(if later life personality changes -> look for medical causes!!)

4

modifiable over time?

studies suggest yes

5

Common co-morbid psychiatric conditions

i) Mood disorders
ii) Anxiety disorders
iii) Substance abuse/dependence

6

True/False. There is significant diagnostic overlap among PDs

True

7

prevalence of PD

(1) 1-5% of general population
(2) 10-30% of outpatients mental health facilities
(3) 15-30% of psychiatric inpatients

8

Gender differences

Antisocial PD male > female
Borderline PD female > male

9

causes

i) Almost certainly a combination of biological and environmental factors.
(1) Example: Antisocial PD
(a) 1000+ children followed ages 3-21.
(b) 2 genetic polymorphisms: low MAO-A activity, hi MAO-A activity
(c) Maltreatment, no maltreatment
(d) Low MAO-A genotype + severe maltreatment -> antisocial behavior
(85%)
(e) Hi MAO-A genotype + maltreatment -> no antisocial behavior

10

Borderline personality disorder

i) Among the most common PDs
ii) High users of health care
iii) Challenging patients
(1) Chronic suicidality
(2) Medication abuse
(3) Desperate care-seeking
(4) Intense anger
(5) Dividing a health care team into good guys and bad guys

11

Diagnostic criteria (at least 5) for Borderline personality disorder

(1) Frantic efforts to avoid abandonment
(2) Unstable, intense relationships
(3) Unstable self-image
(4) Self-damaging impulsivity
(5) Recurrent suicidal behavior, self-mutilation
(6) Affective instability
(7) Feelings of emptiness
(8) Intense and inappropriate or uncontrolled anger
(9) Transient paranoia or severe dissociative symptoms

12

Treatment options for personality disorders

i) treat co-morbid psychiatric disorders
ii) Biological Treatments
(1) Medication
iii) Psychosocial Treatments
(1) Psychotherapies
(a) Cognitive/behavioral
(b) Insight-oriented
(c) Supportive
(d) Individual/group/family
(2) Skills training, e.g., coping skills for managing self-harm urges or
emotional instability
iv) Alternative Treatments
(1) Self-help groups

13

Ground rules for treating people with personality disorders

i) Focus on behavior, not explanations of it
ii) Maintain a collaborative stance
iii) Attend to your own rescue fantasies
iv) Set limits on threats to safety
v) Do not shield patients from the consequences of their actions
vi) Manage your own feelings with support and consultation

14

Cluster A

odd or eccentric:
▪ Paranoid
▪ Schizoid
▪ Schizotypal

15

Cluster B:

dramatic, emotional, or erratic
▪ Antisocial
▪ Borderline
▪ Histrionic
▪ Narcissistic

16

Cluster C

anxious or fearful
▪ Avoidant
▪ Dependent
▪ Obsessive-compulsive