NB13-3 & 13-4 - Personality, Disruptive, Impulse Control, and Conduct Disorders Flashcards
(37 cards)
List the personality disorders and describe how they are grouped together.
Cluster A (aka - odd/eccentric) - paranoid, schizoid, and schizotypal
Cluster B (aka - dramatic/emotional/erratic) - histrionic, borderline, narcissistic, antisocial
Cluster C (aka - anxious/fearful) - avoidant, dependent, obsessive-compulsive
What is the general definition of a personality disorder? When do these disorders typically start to present?
A chronic and pervasive pattern of perceiving, relating, & thinking about the environment and oneself that is culturally deviant, maladaptive, and/or distressful.
The characteristics of these disorders typically start to appear in childhood-adolescence with behaviors solidifying with age. Not usually diagnosed until adulthood
What is the general treatment plan and prognosis for personality disorders.
Treatment is usually some kind of CBT. Medications can be used as an adjunct
Prognosis isn’t good because treatment can be difficult due to:
- patient disinterest
- the inherent difficulty in unlearning entrenched behaviors
How does a person with a paranoid personality disorder (PPD) generally behave? What are some differential diagnoses for this disorder?
The general theme of their behavior is distrust and suspicion.
Differential Diagnoses:
- Delusional Disorder Persecutory Type - these patients are sure of their paranoias while PPD patients are just suspicious
How does a person with a schizoid personality disorder typically behave?
The general theme of their behavior is interpersonal detachment. They typically:
- lack a desire for close relationships
- prefer solitary activities
- derive pleasure in few activities
- are indifferent to praise/criticism
- are emotionally cold/detached
How does a person with a schizotypal personality disorder typically behave?
The general them of their behavior is eccentricity. Example symptoms:
- ideas of reference (assuming things are directed right at you)
- odd beliefs or magical thinking
- unusual perceptual experiences (almost like a hallucination)
- odd thinking and speech (vague/metaphorical)
- suspiciousness
- odd appearance
- problematic social relatedness
What are the differential diagnoses for schizotypal personality disorder?
Schizotypal behaviors are on the schizophrenia spectrum those disorders should be considered as before diagnosis. Schizotypals don’t have psychotic symptoms but they may eventually develop them.
E
B
How does a person with a histrionic personality disorder typically behave?
The general them of their behavior is excessive emotionality. Example symptoms:
- need to be center of attention
- inappropriately provocative behavior
- shallow and rapidly shifting emotions
- impressionistic speech that lacks detail
- exaggerated emotional expression
- considers relationships intimate
How does a person with a borderline personality disorder typically behave?
The general them of their behavior is instability. Example symptoms:
- unstable intense relationships with alternating idealization and devaluation
- frantically avoids abandonment
- marked reactivity of mood
- chronic feelings of emptiness
- unstable self-image
- self-damaging impulsivity
- suicidal gestures/self-mutilation
- transient stress related dissociation/paranoia
How is borderline personality disorder usually treated?
With dialectical behavioral therapy (DBT) which is essentially CBT with a focus on self-acceptance yet the need to change. Usually utilizes the following techniques:
- Mindfulness
- Distress Tolerance
- Emotion regulation
- Interpersonal effectiveness
The goal is to help the patient become aware of the sequence of emotions and thoughts that precede destructive behavior and to break that sequence.
How does a person with narcissistic personality disorder (NPD) typically behave?
The general theme of their behavior is grandiosity. Example Symptoms:
- grandiose sense of self-importance
- preoccupied with success
- requires admiration
- sense of entitlement
- interpersonally exploitative
- lacks empathy with haughty attitudes
- An insult to their narcissism often results in a rage reaction
What differential diagnoses should be considered before diagnosing narcissistic personality disorder?
- Delusional disorder grandiose type - these patients typically have a single grandiose belief of delusional proportion and the belief usually occurs abruptly and at an older age. In NPD, the person just shows a general arrogance
- BPI Disorder - these patients must have mood disturbances with more symptoms than grandiosity
How would a person with antisocial personality disorder (ASPD) typically behave?
The general theme of their behavior is a pervasive disregard for other’s rights. Example symptoms:
- repeated unlawful acts
- deceitfulness
- irritability and aggressiveness
- reckless disregard for safety of self or others
- irresponsibility
- lack of remorse
Person must be at least 18 and there must be evidence of a Conduct Disorder with onset before 15
E
It’s not “B” because several ASPD symptoms are required for diagnosis
B
How would a person with avoidant personality disorder typically behave? What are the differential diagnoses?
The general theme to their behavior is an inferiority complex. Differential diagnoses are:
- Schizoid Personality Disorder (SPD) - SPD patients have no desire for a relationship while avoidant personality patients desire relationships but are reluctant to initiate them
- Social Anxiety Disorder - SAD patients will exhibit markedly higher amounts of fear of negative evaluations
How would a person with dependent personality disorder behave?
The general theme of their behavior is excessive need to be cared for. Example symptoms are
- indecisive
- difficulty disagreeing
- difficulty initiating due to low confidence
- goes to excessive lengths to keep/gain support
- feels helpless when alone
- urgently seeks another relationship if one ends
A
How would a person with obsessive-compulsive personality disorder (OCPD) behave?
The general them to their behavior is inflexible perfectionism and control. Example symptoms:
- preoccupation with details, rules, and lists until point of activity is lost
- excessive devotion to work
- rigid and stubborn
- over conscientious/scrupulous
- reluctance to delegate or work with others
- hoarding and miserly behavior
What are the differential diagnoses for OCPD?
- OCD - this disorder also involves uncontrolled intrusive thoughts and/or repeated rituals
What is the most common way for physicians to assess a patient’s personality traits?
The Minnesota Multiphasic Personality Inventory-2 (MMPI-2)
Lis the disruptive, impulse-control, and conduct disorders (DICCDs) we need to know and say what the common features between these disorders are.
- Oppositional defiant disorder
- Conduct disorder
- Intermittent explosive disorder
- Kleptomania
- Pyromania
Patients with these disorders have problems with the self-control of emotions and behaviors to the point that they begin violating the rights of others and/or bring others into conflict with societal norms or authority figures.
