Personality Disorder Flashcards
(152 cards)
1
Q
What is personality?
A
Personality is a pattern of thoughts, feelings, and behavior that makes each of us the individuals that we are
2
Q
What does “nature vs nurture” refer to?
A
Nature vs nurture refers to the debate on whether genetics (nature) or environment and upbringing (nurture) play a more significant role in shaping an individual’s behavior and traits.
3
Q
Is personality flexible?
A
Yes, personality is flexible; behavior can differ according to the social situation.
4
Q
What is the Five-Factor Model of Personality?
A
The Five-Factor Model of Personality, also known as the Big Five, includes five broad domains that define human personality: Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism.
5
Q
What does the trait ‘Openness’ refer to in the Five-Factor Model?
A
‘Openness’ refers to the degree of intellectual curiosity, creativity, and preference for novelty and variety a person has
6
Q
What does the trait ‘Conscientiousness’ refer to in the Five-Factor Model?
A
‘Conscientiousness’ refers to a person’s tendency to be organized, dependable, and show self-discipline, aim for achievement, and prefer planned rather than spontaneous behavior.
7
Q
What does the trait ‘Extraversion’ refer to in the Five-Factor Model?
A
‘Extraversion’ refers to the extent to which a person is outgoing, energetic, and enjoys interacting with others.
8
Q
What does the trait ‘Agreeableness’ refer to in the Five-Factor Model?
A
‘Agreeableness’ refers to the tendency of a person to be compassionate and cooperative rather than suspicious and antagonistic towards others.
9
Q
What does the trait ‘Neuroticism’ refer to in the Five-Factor Model?
A
‘Neuroticism’ refers to the tendency to experience unpleasant emotions easily, such as anger, anxiety, depression, and vulnerability.
10
Q
What are personality disorders?
A
Personality disorders are characteristic patterns of thinking, feeling, and behaving that are maladaptive, inflexible, and enduring.
11
Q
When do personality disorders typically become evident?
A
Personality disorders are typically evident from early life.
12
Q
What are the characteristics of personality disorders?
A
Personality disorders are enduring, stable, inflexible, and maladaptive.
13
Q
How do personality disorders affect a person’s ability to cope with everyday life?
A
People with personality disorders have a limited range of emotions, attitudes, and behaviors with which to cope with the stresses of everyday life.
14
Q
How do personality disorders deviate from normal behavior?
A
Personality disorders deviate from sociocultural norms and expectations.
15
Q
What impact do personality disorders have on a person’s life?
A
Personality disorders lead to distress and dysfunction in a person’s life.
16
Q
Are personality disorders caused by other medical conditions, substances, or mental disorders?
A
No, personality disorders are not due to another medical condition, substance use, or other mental disorders.
17
Q
Can personality disorders be diagnosed before age 18?
A
No, personality disorders are not diagnosed before age 18.
18
Q
Are personality disorders the same as mental illnesses?
A
No, personality disorders are not the same as mental illnesses.
19
Q
What is the categorical approach to personality disorders?
A
The categorical approach views personality disorders as unique types of abnormal development that are unrelated to “normal” personalities.
20
Q
What is the dimensional approach to personality disorders?
A
The dimensional approach suggests that personality traits are shared among the general population, with individuals having excessive dimensions of these traits in personality disorders.
21
Q
What is a personality disorder according to the DSM-5?
A
According to the DSM-5, a personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture.
22
Q
How many areas of functioning must be affected for a diagnosis of a personality disorder according to the DSM-5?
A
Two or more areas of functioning must be affected.
23
Q
What are the four areas of functioning that can be affected in personality disorders according to the DSM-5?
A
The four areas of functioning are:
- Cognition – ways of perceiving and interpreting self, others, and events,
- Affectivity – appropriateness of emotional response,
- Interpersonal functioning,
- Impulse control.
24
Q
What characteristics define the enduring pattern in personality disorders according to the DSM-5?
A
The enduring pattern is inflexible, pervasive, and of long duration (at least from adolescence or early adulthood).
25
What impact do personality disorders have on an individual's life according to the DSM-5?
Personality disorders lead to significant distress or dysfunction.
26
Can personality disorders be attributed to substance use, another medical condition, or another mental disorder according to the DSM-5?
No, personality disorders are not due to substance use, another medical condition, or another mental disorder
27
What percentage of the adult population is affected by personality disorders?
4-12% of the adult population is affected by personality disorders (7% in South Africa).
28
What are some of the challenges associated with personality disorders?
Personality disorders are associated with distress, stigma, and the need for long-term care which is often challenging
29
What are common comorbidities with personality disorders
Common comorbidities include depression, anxiety, substance use disorder, and suicidality.
30
How do personality disorders impact healthcare service use and medical morbidity?
Personality disorders are associated with high service use and excess medical morbidity.
31
What is the heritability percentage range for personality disorders?
The heritability of personality disorders ranges from 30-50%.
32
What is the heritability percentage range for personality disorders?
The heritability of personality disorders ranges from 30-50%.
33
What early life experiences are linked to the development of personality disorders?
Early childhood adversity, including abuse, neglect, and bullying, is linked to the development of personality disorders
34
What are the three clusters of personality disorders in the DSM-5
The three clusters of personality disorders in the DSM-5 are Cluster A (odd and eccentric), Cluster B (dramatic, emotional, and egocentric), and Cluster C (anxious and fearful)
35
What personality disorders are included in Cluster A (odd and eccentric)?
Cluster A includes
Paranoid,
Schizoid, and
Schizotypal personality disorders.
36
What personality disorders are included in Cluster B (dramatic, emotional, and egocentric)?
Cluster B includes Antisocial, Borderline, Histrionic, and Narcissistic personality disorders.
37
What personality disorders are included in Cluster C (anxious and fearful)?
Cluster C includes Avoidant, Dependent, and Obsessive-Compulsive personality disorders.
38
What characterizes paranoid personality disorder?
Paranoid personality disorder is characterized by a pervasive pattern of mistrust and suspiciousness of others, where their motives are interpreted as malevolent
39
When does paranoid personality disorder typically begin?
Paranoid personality disorder typically begins in early adulthood.
40
In what contexts does paranoid personality disorder present?
Paranoid personality disorder presents in a variety of contexts, impacting personal relationships, social interactions, and work environments.
41
How does paranoid personality disorder affect interpersonal relationships?
It often leads to difficulties in maintaining relationships due to persistent suspicion and mistrust, causing conflicts and isolation.
42
What are some common behaviors of individuals with paranoid personality disorder?
Common behaviors include being overly defensive, bearing grudges, and misinterpreting benign comments or actions as hostile or threatening.
43
What is a key characteristic of schizoid personality disorder?
A key characteristic of schizoid personality disorder is detachment from social relationships.
44
How does schizoid personality disorder affect emotional expression?
It is marked by a restricted range of emotional expressions.
45
How does schizoid personality disorder manifest in terms of social interactions?
Individuals with schizoid personality disorder often prefer solitary activities and may have difficulty forming or maintaining close relationships.
46
What are common behaviors or traits of someone with schizoid personality disorder?
Common traits include a lack of interest in social interactions, emotional coldness, and a preference for solitary activities.
47
How might schizoid personality disorder affect daily functioning?
It may lead to difficulties in occupational or social functioning due to the individual's disinterest in forming and maintaining interpersonal relationships
48
What are key features of schizotypal personality disorder?
Key features include odd or eccentric behavior and thinking.
49
What cognitive or perceptual distortions are associated with schizotypal personality disorder?
Individuals may experience cognitive or perceptual distortions such as unusual beliefs, magical thinking, or odd perceptions.
50
What cognitive or perceptual distortions are associated with schizotypal personality disorder?
Individuals may experience cognitive or perceptual distortions such as unusual beliefs, magical thinking, or odd perceptions.
51
What are common social and interpersonal deficits in schizotypal personality disorder?
Common deficits include difficulty forming close relationships, social anxiety, and odd or inappropriate behavior in social situations.
52
What is the risk associated with schizotypal personality disorder?
Individuals with schizotypal personality disorder are at increased risk for developing schizophrenia
53
What is the risk associated with schizotypal personality disorder?
Individuals with schizotypal personality disorder are at increased risk for developing schizophrenia
54
How does schizotypal personality disorder manifest in terms of behavior?
It manifests through odd or eccentric behavior, such as unusual dress, peculiar speech patterns, or unconventional beliefs.
55
What is a defining feature of histrionic personality disorder?
A defining feature is excessive emotionality.
56
How does attention-seeking behavior manifest in histrionic personality disorder?
It manifests as a need to be the center of attention, which may involve dramatic or exaggerated behavior, and seeking reassurance and approval from others.
57
What types of emotional expression are common in individuals with histrionic personality disorder?
Emotional expressions are often intense, rapidly shifting, and may appear shallow or exaggerated.
58
How might histrionic personality disorder affect interpersonal relationships?
It can lead to difficulties in relationships due to the individual's need for constant attention and validation, which may be perceived as demanding or superficial.
59
What are typical behaviors of someone with histrionic personality disorder?
Typical behaviors include engaging in dramatic gestures, seeking constant praise, and using their appearance or charm to draw attention.
60
What is a central feature of narcissistic personality disorder?
A central feature is grandiosity, which includes an inflated sense of self-importance and a preoccupation with fantasies of unlimited success or power.
61
What is the primary need associated with narcissistic personality disorder?
The primary need is for admiration, often requiring excessive praise and attention from others.
62
How does narcissistic personality disorder manifest in terms of jealousy?
Individuals with narcissistic personality disorder may experience extreme jealousy towards others who they perceive as more successful or favored
63
What behaviors are indicative of arrogance in narcissistic personality disorder?
Arrogance may manifest as a sense of entitlement, dismissiveness of others, and a belief that they are superior and deserving of special treatment.
64
How does lack of empathy present in narcissistic personality disorder?
Lack of empathy is evident through an inability to recognize or care about the feelings and needs of others, often resulting in exploitative or insensitive behavior.
65
What is a defining feature of antisocial personality disorder?
A defining feature is a persistent disregard for the rights of others.
66
How does antisocial personality disorder manifest in terms of violating the rights of others?
It manifests through repeated violations of others' rights, often involving deceit, manipulation, or criminal behavior
67
What characterizes the lack of remorse in antisocial personality disorder?
Individuals with antisocial personality disorder often show a lack of remorse for their actions, even when they cause harm to others.
68
How does antisocial personality disorder affect empathy?
There is a marked lack of empathy, meaning individuals have difficulty understanding or caring about the feelings and experiences of others.
69
What are common behaviors associated with antisocial personality disorder?
Common behaviors include frequent lying, manipulation, impulsivity, aggression, and a general disregard for societal norms and laws
70
What is a key feature of borderline personality disorder?
A key feature is instability in interpersonal relationships, self-image, and affects.
71
How does instability in interpersonal relationships manifest in borderline personality disorder?
It often manifests as intense and unstable relationships, characterized by rapid shifts between idealization and devaluation.
72
What is the nature of self-image instability in borderline personality disorder?
Individuals may have a fluctuating or unstable self-image, leading to frequent changes in goals, values, and identity.
73
How does emotional instability present in borderline personality disorder?
Emotional instability involves intense and rapidly changing moods, such as feelings of emptiness, anger, or anxiety.
74
What is marked impulsivity in borderline personality disorder?
Marked impulsivity includes engaging in reckless behaviors such as spending sprees, substance abuse, unsafe sex, or self-harm.
75
What are key features of avoidant personality disorder?
Key features include feeling socially inhibited and inadequate.
76
How does social inhibition manifest in avoidant personality disorder?
Social inhibition manifests as extreme shyness, fear of rejection, and avoidance of social interactions due to feelings of inadequacy.
77
What characterizes the sensitivity to criticism in avoidant personality disorder?
Individuals are extremely sensitive to any form of criticism or negative evaluation, often experiencing significant anxiety and self-doubt in response to perceived criticism
78
How does avoidant personality disorder affect self-perception?
It affects self-perception by leading individuals to view themselves as socially inept, unappealing, or inferior to others.
79
What are common behaviors of someone with avoidant personality disorder?
Common behaviors include avoiding work or social activities, being reluctant to engage in new experiences, and needing reassurance from others to feel accepted.
80
What is a central characteristic of dependent personality disorder?
A central characteristic is an excessive need to be taken care of, leading to dependent and submissive behavior
81
How does submissive behavior present in dependent personality disorder?
Submissive behavior manifests as a tendency to defer to others, avoid decision-making, and seek constant approval and reassurance.
82
What is the nature of fear of separation in dependent personality disorder?
Fear of separation involves an intense fear of being alone or abandoned, often leading individuals to cling to others and avoid situations that might result in separation.
83
How does dependent personality disorder affect decision-making?
It affects decision-making by causing individuals to rely heavily on others for guidance and to avoid making decisions independently due to a lack of confidence.
84
What are common behaviors of someone with dependent personality disorder?
Common behaviors include seeking constant support from others, having difficulty initiating projects or tasks independently, and feeling uncomfortable or helpless when alone.
85
What is a defining feature of Obsessive-Compulsive Personality Disorder?
A defining feature of OCPD is a preoccupation with orderliness and perfectionism.
86
How does Obsessive-Compulsive Personality Disorder affect interpersonal control?
Individuals with OCPD often exhibit a strong need for mental and interpersonal control.
87
How does Obsessive-Compulsive Personality Disorder differ from Obsessive-Compulsive Disorder?
OCPD is not the same as Obsessive-Compulsive Disorder (OCD). OCPD involves a pervasive pattern of preoccupation with orderliness and control, while OCD involves unwanted repetitive thoughts and behaviors.
88
What should be considered when recognizing a personality disorder?
When recognizing a personality disorder, it can be useful to consider "traits" rather than solely focusing on the PD label.
89
What are key strategies for managing oneself as a clinician in the context of personality disorders?
Key strategies include managing counter-transference and practicing mindfulness.
90
How can a therapeutic alliance be developed with patients having personality disorders?
therapeutic alliance can be developed by exploring the diagnosis together, understanding the implications and risks, and using techniques such as motivational interviewing (MI) and problem-solving therapy (PST).
91
Why is setting and securing boundaries important in therapy for personality disorders?
Setting and securing boundaries is crucial to maintain a professional relationship and to provide a safe and structured therapeutic environment.
92
What does "playing the long game" entail in the context of treating personality disorders?
"Playing the long game" involves being patient and persistent in therapy, recognizing that progress may be slow and incremental.
93
What is a consideration for therapeutic admission in the context of personality disorders?
Consider therapeutic admission in specialized settings, such as VBH ward 1 or LGH ward 15, if the patient requires intensive support or a controlled environment for treatment.
94
How does antisocial personality disorder (ASPD) differ from asocial behavior?
Antisocial personality disorder involves a pattern of disregard for others' rights and social norms, while asocial behavior refers to a lack of interest in social interactions
95
What is the approximate prevalence of antisocial personality disorder?
Antisocial personality disorder affects about 3-4% of the population.
96
What is the gender ratio for antisocial personality disorder?
The male-to-female ratio for antisocial personality disorder is approximately 3:1.
97
What is the gender ratio for antisocial personality disorder?
The male-to-female ratio for antisocial personality disorder is approximately 3:1.
98
What factors might contribute to the development of antisocial personality disorder?
Both genetic and environmental factors, such as "absent" fathers and childhood abuse, may contribute to the development of antisocial personality disorder.
99
How might antisocial personality disorder evolve over time, particularly in relation to personal relationships?
Individuals with antisocial personality disorder may "burn out" or experience a decrease in symptoms in later life, especially if they marry a strong, supportive partner.
100
What is the DSM-5 definition of antisocial personality disorder?
Antisocial Personality Disorder is characterized by a pervasive pattern of disregard for, and violation of, the rights of others, starting since age 15.
101
What are some behaviors that indicate a lack of conformity to social norms in antisocial personality disorder?
Behaviors may include repeated arrests or unlawful behavior.
102
What is a common example of deceitfulness in antisocial personality disorder?
Examples include repeated lying or conning others for profit or pleasure.
103
How might impulsivity present in individuals with antisocial personality disorder?
Impulsivity can manifest as a failure to plan ahead or engaging in spontaneous, risky behaviors.
104
What are some indicators of irritability and aggression in antisocial personality disorder?
Indicators include frequent assaults or physical fights
105
How does antisocial personality disorder show a reckless disregard for safety?
It shows through a disregard for the safety of oneself or others, such as engaging in dangerous activities without concern.
106
What is an example of consistent irresponsibility in antisocial personality disorder?
An example is a failure to sustain consistent work or meet financial obligations.
107
How is lack of remorse demonstrated in antisocial personality disorder?
is demonstrated by indifference or lack of concern for having mistreated others.
108
Antisocial personality disorder must include 3 of the following
- Doesn’t conform to social norms re lawful behaviour (eg repeated arrests)
- Deceitfulness (eg repeated lying, conning other for profit/pleasure)
- Impulsivity or failure to plan
- Irritability & aggression (eg assaults)
- Reckless disregard for safety of self/others
- Consistent irresponsibility (eg failure to sustain work)
- Lack of remorse (eg indifferent to having mistreated another)
- At least 18yrs old
- Evidence of conduct d/o onset before 15 yrs
- Not due to another mental d/o
109
What are some characteristics associated with the term "psychopath" in the context of ASPD?
Characteristics include charm, intelligence, egocentric behavior, exploitative tendencies, and a lack of remorse.
110
What are common issues that may be present alongside antisocial personality disorder?
Common issues include malingering (faking illness for gain) and substance abuse.
111
Why is early identification and intervention important in managing antisocial personality disorder?
Early identification and intervention are crucial for improving outcomes through enhancing parenting skills, problem-solving abilities, emotional awareness, self-concept, and control over arousal and emotions.
112
What should be assessed in adolescents suspected of having antisocial personality disorder?
Assess for forensic history, risk factors, and the need for secure placement
113
What is an important consideration when working with individuals with antisocial personality disorder?
It is crucial to maintain firm boundaries to manage the therapeutic relationship effectively.
114
Why might individuals with antisocial personality disorder typically present challenges in seeking help?
They usually don’t seek help voluntarily and may have poor adherence to treatment, often compounded by substance use disorders.
115
What is the evidence for the effectiveness of psychological interventions for antisocial personality disorder?
The evidence for the effectiveness of psychological interventions is generally lacking or limited.
116
According to NICE guidelines, what type of psychological intervention is recommended for antisocial personality disorder?
NICE guidelines recommend group-based cognitive behavioral therapy (CBT) focused on reducing offending behavior.
117
What other types of interventions might be used in managing antisocial personality disorder?
Other interventions include anger management and violence reduction programs.
118
When might individuals with antisocial personality disorder be involved in the forensic psychiatric system?
They may be involved in the forensic psychiatric system when their behavior poses significant risks or requires intensive supervision and intervention.
119
What is important for providers working with individuals with antisocial personality disorder?
Providers need support and supervision to effectively manage and maintain boundaries while treating individuals with antisocial personality disorder.
120
What is the prevalence of Borderline Personality Disorder?
Borderline Personality Disorder has a prevalence of approximately 2%
121
What is the male-to-female ratio for Borderline Personality Disorder?
The male-to-female ratio for Borderline Personality Disorder is approximately 1:2.
122
What are the primary aetiological factors for Borderline Personality Disorder?
The aetiology is primarily environmental, with up to 80% of individuals having a history of abuse or neglect, particularly sexual abuse in childhood.
123
What are common comorbid conditions associated with Borderline Personality Disorder?
Common comorbid conditions include depression, anxiety, self-harm, dissociative symptoms, relationship problems, and substance abuse.
124
What is the long-term prognosis for individuals with Borderline Personality Disorder?
About 1/3 of individuals with Borderline Personality Disorder are considered "recovered," and 2/3 are in stable employment 15 years after diagnosis.
125
What is the suicide rate associated with Borderline Personality Disorder?
The suicide rate for individuals with Borderline Personality Disorder is approximately 9%.
126
What are the core features of Borderline Personality Disorder in the DSM-5?
The DSM-5 defines Borderline Personality Disorder as a pervasive pattern of instability in interpersonal relationships, self-image, and affects, along with marked impulsivity.
127
According to DSM 5, to have borderline personality disorders, what are the five things that need to be present since early adulthood
- Dreads abandonment
- Unstable and intense relationships (idealisation vs devaluation)
- Identity disturbance
- Impulsivity
- Recurrent suicidal behaviour
- Affective instability
- Chronic feelings of emptiness
- Inappropriate anger
- Transient paranoia or dissociation under stress (“micropsychotic episodes”)
128
Borderline personality disorder categorisation
1. Cognitive and/ or self disturbance
2. Interpersonal instability
3. Affective and/or emotional dysfunction
4. Behavioural dysregulation
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Interpersonal instability
-Avoid abandonment
- Intense unstable relationships
130
Cognitive and/or self disturbances
- Paranoid ideations or dissociative symptoms
- Identity disturbance
131
Affective and/or emotional dysregulation
- Mood instability
- Anger
- Feelings of emptiness
132
Behavioural dysregulation
- Suicidal or self harming behaviours
- Impulsivity
133
What is a key consideration when working with patients with Borderline Personality Disorder (BPD) who are typically help-seeking?
Be aware of idealization, where patients might place therapists on a pedestal, which can lead to unrealistic expectations and potential disappointment
134
What should be considered when setting treatment targets for patients with BPD?
Set realistic treatment targets, and be mindful of the risks and side effects of interventions, ensuring that expectations align with the patient’s progress and capabilities
135
What type of approach is recommended when managing patients with BPD?
Use a cautious and structured approach to provide stability and predictability in treatment, which can be reassuring for patients with BPD.
136
What type of approach is recommended when managing patients with BPD?
Use a cautious and structured approach to provide stability and predictability in treatment, which can be reassuring for patients with BPD.
137
How important is collaboration in the management of BPD?
Maximizing collaboration between the patient and the therapist is crucial for effective treatment, as it helps build trust and ensures that the patient is actively involved in their own care.
138
What should be the focus when treating patients with BPD?
Treat the presenting pathology, addressing the specific symptoms and challenges the patient is facing, rather than focusing on potentially misleading symptoms or labels.
139
What are some common pitfalls to avoid in the treatment of BPD?
Avoid being misled by “red herrings” such as labeling symptoms as “depression” or “voices in the head” without addressing the underlying BPD issues.
140
How should therapists approach their interactions with patients with BPD?
Maintain honesty, consistency, and a non-judgmental, non-punitive stance to foster a supportive therapeutic relationship.
141
What is important to remember about the duration and goals of treatment for BPD?
Adopt a long-term perspective, acknowledging that there are no quick fixes and that treatment requires time, patience, and ongoing effort.
142
Major evidence based treatment for borderline PD
1. Dialectical behaviour therapy
2. Mentalization based tree
3. Transference focused psychotherapy
4. General (‘good’) psychiatric management
143
What is the primary purpose of medication in the treatment of Borderline Personality Disorder (BPD)?
Medication is not used to treat BPD itself but may be considered to alleviate problematic symptoms or manage comorbid mental disorders.
144
What types of medications might be considered for patients with BPD?
Atypical antipsychotics, mood stabilizers, and omega-3 fatty acid supplements may be considered, though evidence for their efficacy is primarily based on small, single studies.
145
How does the NICE guideline view the use of medications for BPD?
The use of atypical antipsychotics, mood stabilizers, and omega-3 fatty acids is not specifically recommended by NICE guidelines due to limited evidence.
146
When might antidepressants be beneficial for patients with BPD?
Antidepressants may be helpful if there is coexisting depression or anxiety alongside the BPD.
147
What is an adjustment reaction in the context of personality changes?
An adjustment reaction involves personality changes in response to significant stressors or life events, which may resolve once the stressor is addressed.
148
How might a primary psychiatric disorder present with personality changes?
A primary psychiatric disorder, such as BPD or schizophrenia, may manifest with significant and persistent changes in personality, often with accompanying symptoms specific to the disorder.
149
What role do central nervous system disorders play in personality changes?
Central nervous system disorders, such as brain injuries or neurodegenerative diseases, can lead to noticeable personality changes due to alterations in brain function.
150
How can medical disorders contribute to changes in personality?
Medical disorders, such as endocrine or metabolic disorders, can influence mood, behavior, and personality, sometimes mimicking psychiatric conditions.
151
What impact can medication use have on personality changes?
Medication use, especially with certain psychotropic or neurological drugs, can lead to side effects that alter personality, mood, or behavior.
152
How does substance abuse or dependence affect personality?
Substance abuse or dependence can cause significant personality changes, including mood swings, impaired judgment, and behavioral changes, often related to the substance’s effects or withdrawal.
