Personality disorder

Question 1

Paranoid

Answer 1

Strong belief that others are intent on causing harm to them and they would not be able to cope with this
Excessive vigilance for signs of danger
Questioning of people’s motives, tendency to counter-attack in perceived danger

Question 2

Schizoid

Answer 2

Indifference to relationships and others’ feelings

Solitariness, few friendships and a restricted range of emotional expression

Question 3

Dissocial

Answer 3

Belief that desires justify actions
Regard selves as infallible, others’ needs and risks of their conduct not important
Appear impulsive, irresponsible, callous, exploit others, have unstable relationships and are drawn to criminality

Question 4

Emotionally unstable

Answer 4

Marked tendency to act impulsively, without consideration of the consequences, along with affective instability
Impulsive type: predominantly lack of impulse control and emotional instability. Outbursts of violence or threatening behaviour are common, particularly in response to criticism
Borderline type: marked instability of mood, relationships and self-image. Recurring impulsive self-damaging behaviour. Persistent lack of identity, sense of emptiness or boredom, may engage in frantic efforts to avoid real or imagined abandonment

Question 5

Histrionic

Answer 5

Believe they are incapable of looking after themselves, that other people hold the key to fulfilment and being loved by virtually everyone is essential
Relentless search for reassurance, approval and praise
Seek to be centre of attention
Exaggerated and inconsistent emotional responses

Question 6

Anankastic

Answer 6

Feelings of excessive doubt and caution
Preoccupation with details, rules, lists etc
Perfectionism that interferes with task completion
Pedantry, rigidity and stubbornness

Question 7

Anxious/avoidant

Answer 7

Underlying beliefs that they are defective and unlikeable
Wish to be accepted, expect to be rejected
Excessive hurt following criticism
Avoid involvement with others
Fear being embarrased

Question 8

Dependent

Answer 8

Believe are helpless and should be protected by someone else
Excessively submissive
Leave important decisions to others
Easily hurt by criticism
Fear rejection

Question 9

Prognosis

Answer 9

Those which do not socially isolate individual (dissocial, emotionally unstable, histrionic, dependent) improve over time
Those which isolate people from learning opportunities (paranoid, schizoid, anankastic) change little and may become more fixed over time

Question 10

Management

Answer 10

Long term psychotherapy only for mild - not suitable for most
Support through times of crisis
Long-term consistent relationship with concerned clinician
Problem focused therapies for specific difficulties
Some place for tranquilisers and SSRIs
Treat any mental illness