Personality and mood d/o Flashcards Preview

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Flashcards in Personality and mood d/o Deck (21):
1

Personality d/o definition by DSM

-Enduring pattern of inner experience and behavior that deviates from the expectations of the individual's culture
-Manifests in two or more areas: cognition, affectivity, interpersonal functioning, impulse control
-Must be inflexible and pervasive across situations
-Must lead to clinically significant distress or impairment in function
-Pattern is stable and can be traced to adolescence or early adulthood
-Not due to another mental d/o or substances
-D/o are divided into 3 clusters

2

Cluster A (odd and eccentric personality d/o): paranoid personality

-Paranoid personality d/o: pervasive distrust and suspiciousness of others' motives (interpreted as malevolent)
-Doubts others loyalty/motives, reluctant to confide in others, reads meanings in actions that do not exist, bears grudges, very suspicious

3

Cluster A (odd and eccentric personality d/o): schizoid personality

-Pervasive pattern of detachment from social relationship and a restricted range of expressing emotions w/ people
-Does not desire or enjoys close relationships (including family)
-Choses solitary actions, no sex or pleasurable activities
-Lacks close friends, indifferent to praise or criticism, flat affect

4

Cluster A (odd and eccentric personality d/o): schizotypal personality

-Pervasive pattern of social and interpersonal deficits marked by acute discomfort w/ (and reduced capacity for) close relationships
-Also cognitive/perceptual distortions and eccentric behavior
-Can have ideas of reference, magical thinking that influences behavior, illusions, paranoid ideations, inappropriate/flat affect, excessive social anxiety

5

Cluster B (dramatic, emotional, erratic personality d/o): antisocial personality

-Pervasive pattern of disregard for and violation of the rights of others (since age 15)
-Failure to conform to social norms w/ respect to law (repeatedly performing illegal acts)
-Repeated lying, fights/assault failure to plan ahead
-Lack of remorse

6

Cluster B (dramatic, emotional, erratic personality d/o): borderline personality

-Pervasive pattern of instability of interpersonal relationships, self-image, and affects w/ impulsivity
-Effort to avoid real or imagined abandonment
-Identity disturbance (unstable self-image), impulses that can be self-damaging
-Recurrent suicidal behavior, affect/mood instability, chronic feeling of emptiness, difficulty controlling anger
-Always appear to be in a state of crisis

7

Cluster B (dramatic, emotional, erratic personality d/o): histrionic personality

-Excessive emotionality and attention seeking
-Uncomfortable in situations in which they are not the center of attention
-May be sexually seductive, using physical appearance to draw attention to self
-Rapidly shifting or shallow expression of emotions, can be dramatic, theatric and exaggerative in expressing emotions
-Suggestible (influence by others), considers relationships more intimate than they are

8

Cluster B (dramatic, emotional, erratic personality d/o): narcissistic personality

-Pervasive pattern of grandiosity need for admiration, lack of empathy
-Grandiose sense of self-importance, fantasies of unlimited success, power, brilliance, beauty (believes they are special)
-Requires excessive admiration, sense of entitlement, arrogant behavior, lack of empathy

9

Cluster B (anxious and fearful personality d/o): avoidant personality

-Pervasive pattern of social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation
-Avoids occupational activities that involve interpersonal contact due to fear of criticism, disapproval or rejection
-Unwilling to get involved w/ people in fear of not being liked
-Restraint of intimate relationships b/c fear of being shamed or ridiculed
-Views self as socially inept, reluctant to take risks

10

Cluster B (anxious and fearful personality d/o): dependent personality

-Pervasive and excessive need to be taken care of that leads to submissive and clinging behavior, fear of separation
-Requires excessive amounts of advice for simple decisions
-Needs others to assume responsibility, difficulty expressing disagreement/doing things on their own
-Uncomfortable on their own b/c feel like they need to be taken care of, seeks out relationships for this care

11

Cluster B (anxious and fearful personality d/o): obsessive-compulsive personality

-Pervasive pattern of preoccupation w/ orderliness, perfectionism, and control at the expense of flexibility, openness, and efficiency
-Preoccupied w/ details, rules, organization
-Interferes w/ task completion, inflexible about matters of morality, ethics, values (not related to culture or religion)
-Rigidity and stubbornness in multiple settings

12

Mood vs affect

-Mood: sustained emotional tone perceived along a continuum from sad to happy (internal state)
-Affect: external expression of present emotional content
-Mood d/o: prolonged and abnormal disturbance of mood, generally depressed, elated, or irritable. Results in significant distress and disturbance of functioning

13

Major depressive episode

-Changes in feelings, thinking, behavior, body
-Must have one: depressed mood most of the day, nearly everyday for at least 2 weeks
-OR diminished interest/pleasure in most activities nearly everyday for at least 2 weeks (anhedonia)
-Must have at least 4 of the following: weight change, insomnia or hypersomnia, psychomotor agitation, fatigue, feeling of worthlessness or guilt, diminished ability to think, recurrent thoughts of death/suicide, plan or attempt of suicide
-Must be at least 2 wks w/ significant impairment of function

14

Info about major depressive episode

-2x prevalence in females
-Over 50% have 2nd episode, 80% recover
-Age of onset at anytime in life
-Is excruciatingly painful
-Severe depression can manifest in other ways (hallucinations and/or delusions)
-Risk factors: temperamental (negative affect), environmental (adverse experiences), genetic & physiological (inheritance and NTs involved), psychiatric comorbidity (other d/o)

15

Rx of MDD (major depressive d/o)

-Antidepressants (SSRI), exercise
-Psychotherapy: CBT (cognitive behavioral Rx), IPT (interpersonal psychotherapy), relaxation
-Social elements: address real stressors, involve family

16

Bereavement

-Not a DSM Dx, consists of feelings of emptiness and loss due to grief over loss of loved one
-May include thoughts of death and wanting to be with person who died (not suicide ideation/plan/attempt)
-May include guilt or worthlessness or other associations but around the memories of the deceased

17

Adjustment d/o w/ depressed mood

-Depressed mood secondary to identifiable stressor causing distress and impairment
-Sx must start w/in 3 mo of acute stressor and resolve within 6 mo
-If you meet criteria for MDD you don't have adjustment d/o
-If you are bereaved you don't have adjustment d/o

18

Bipolar d/o

-Bipolar I w/ or w/out depression: manic episodes w/ or w/o MDD, lasts 7 days, age of onset usually late adolescence, can be severe life-long illness
-Bipolar II: hypomanic episodes plus MDD, more episodes than MDD or BD I, duration of episodes 4 days
-The intensity of manic episode Sx is less severe than BD I
-Risks: genetic and physiological (family hx of BP and schizophrenia)
-Presence of psychotic features increases risk of recurrence
-Lifetime risk of suicide 15x higher than general public

19

Rx of BD

-Mood stabilizers: lithium and/or valproate usually w/ atypical antipsychotics
-Antidepressants can induce manic episode
-Family support, regular sleep/wake schedule

20

Manic episode

-At lease 1 wk of abnormally elevated, expansive or irritable mood
-At least 3 of the following: grandiosity, inflated self-esteem, decreased need for sleep, talkative, FOI, distractibility, excessive involvement in pleasurable activities that may have painful consequences
-Must have marked impairment in normal functioning

21

Other causes of mood d/o

-Can be secondary to medical conditions (neuro, metabolic, GI, endocrine, CV, pulm, heme, autoimmune)
-Can be secondary to substances (corticosteroids, opiates, chemo, BZD, cocaine/amphetamine, etoh, ect)
-Suicide is worst possible outcome

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