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Flashcards in Personality Disorders Deck (19):
1

What is a personality disorder?

long-standing, inflexible, maladaptive emotional and behavioral patterns that cause impairment or unhappiness

it is egosyntonic - no matter how maladaptive the behavior/emotions are, the person accepts them as normal and comfortable

2

What are the 3 clusters of personality disorders?

1. Cluster A "wierd" - odd or eccentric
- schizoid
-schizotypal
- paranoid

2. Cluster B "wild" - dramatic or erratic
-antisocial
-borderline
- histrionic
- narcissistic

3. Cluster C "worried" - fearful/anxious
- obsessive compulsive personality disorder
- avoidant
- dependent

3

Peter had a normal childhood but in his early 20s, he started becoming more distrusting and suspicious of others.
He suspects his friends are exploiting and deceiving him and is preoccupied with their trust and loyalty. He bears grudges, refuses to confide in others, and is quick to react angrily to perceived attacks on his character. He reads hidden threats in benign remarks. He frequently becomes suspicious that his girlfriend is cheating on him.

What personality disorder and in what cluster?

Paranoid Personality disorder - Cluster A

*does not meat criteria for schizophrenia or mood disorders with psychotic features due to lack of hallucination/delusion [former] and depressed mood / anhedonia [latter]

4

Sam has no desire for a close relationship. In fact, when people try to get close, he doesn't enjoy it. He prefers to spend time alone in his lab. He has no interest in sex with another person, because he can take care of himself. He takes pleasure in very few [if any] activities. His only "friends" are his brother, sister, and parents.
When he gets a promotion at work, he is indifferent.
When he gets news that his childhood pet dies, he is indifferent. His sister called him to tell him. She was crying and he showed emotional coldness and detachment.

What personality disorder and in what cluster?

Schizoid - Cluster A

*does not meet criteria for schizophrenia or mood with psychotic features

5

Scott has a patter of social deficits marked by social awkwardness and reduced capacity for close relationships. He also has distorted thinking/perceptions with eccentricities of behavior.
He thinks words on the radio speak directly to him, is superstitious and beliefs in magical thinking like telepathy. He has bodily illusions, odd thinking and speech that is vague and metaphorical. He can be paranoid and has inappropriate affect.
His looks disheveled and has odd/eccentric behavior.
He lacks close friends other than immediate family.

What personality disorder and what cluster?

Schizotypal personality disorder- cluster A

It is not schizophrenia because there are no hallucinations or delusions.
It is not mood disorder with psychosis because there is lack of depressed mood/anhedonia.

6

Al has a disregard for the rights of others and frequently violates them. He gets repeated speeding tickets and has been arrested 2 different occasions for fights. He lies, uses aliases and cons people to buy shares in his business. He is impulsive and irritable. He has no regard for the safety of others. He can't keep a job, doesn't honor his financial obligations and has a lack of remorse for everything.

What personality disorder and what cluster?
What childhood disorder often leads to this?

Antisocial personality disorder - cluster B

-Conduct disorder if before age 15

7

Betty takes frantic efforts to avoid real or imagined abandonment. She is unstable and has intense relationships that are idealized and then devaluated. She has issues with self-image and recurrent suicidal behavior. She is impulsive with her spending, sex, substance abuse, eating, and driving. Her mood is reactive and unstable. She feels empty, angry and sometimes has stress-related paranoid ideation .

What personality disorder and what cluster?

Borderline personality disorder- cluster B

8

Helen always makes an effort to be the center of attention. She tends to act sexually seductive and provacative because it gets her more attention. She rapidly shifts through shallow expressions of emotion. She uses physical appearance to draw attention to herself but lacks detailed speech and is excessively impressionistic. She considers relationships with others to be more intimate than they actually are.

What personality disorder and what cluster?

Histrionic - cluster B

9

Ned thinks he is immensely important and is preoccupied with the need for success, power, brilliance, and beauty. He believes he is unique and can only be understood by other special people that are high status. He requires excess admiration. He feels entitled to certain benefits and takes advantage of others to achieve his own needs. He can, but is unwilling, to recognize feelings and needs of others. He finds himself jealous of others, AND believes that others are jealous of him.
He is haughty and arrogant.

What personality disorder and what cluster?

Narcissistic- cluster B

10

What is avoidant personality disorder?

pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation

11

Aaron avoids company picnics because they involve too much interaction and he fears criticism, disapproval or rejection. He constantly things about being criticized or rejected in social situations. He views himself as socially inept, unappealing and inferior to others. He will not take personal risks for fear of embarrassment.
What personality disorder does he have?

avoidant personality disorder - cluster c

12

Delores has difficulty making decisions like what to wear or what sandwich to get without excessive advice and reassurance, She needs others to assume responsibility for major areas of her life. She finds it difficult to express disagreement with others and lacks confidence to initiate projects on her own. She goes to extremes to get people to nurture and care for her and feels uncomfortable being alone. When one relationship ends, she urgently seeks another for care and support.

What personality disorder does she have?

dependent personality disorder - cluster C

13

What is obsessive compulsive personality disorder?

preoccupation with order, perfection, and control at the expense of flexibility, openness, and efficiency

14

Oscar is preoccupied with details, rules, lists, organization and schedules so he misses the major point of activities. His perfectionism often leads to incomplete tasks because they won't be perfect. He is devoted to his work and neglects leisure. He is inflexible in terms of moral, ethics, and values. He cannot discard old/worn-out objects even with no sentimental value.
He will not delegate tasks because he fears it will not get done his way. He is rigid, stubborn and miserly with money.

What personality disorder and what cluster?

obsessive-compulsive personality disorder- cluster C

15

What is the difference between OCD and obsessive-compulsive PERSONALITY disorder?

OCD - anxiety disorder with obsessions and compulsions [desire--> compulsion---> relief--> desire--> compulsion]

OCPD- personality disorder with rigidity and control

16

What comorbid disorder is often associated with:
1. schizotypal personality
2. antisocial personality
3. borderline
4. histrionic
5. avoidant

1. premorbid for schizophrenia
2. antisocial = alcohol abuse
3. borderline = bipolar [or mood disorder]
4. somatization disorder
5. anxiety disorder

17

What is the treatment of choice for personality disorders?
What are the limitations?

Psychotherapy is treatment of choice however:
1. patients don't believe their behavior is a problem [egosyntonic] so there isn't motivation to change
2. patients interact with therapist the same they do for the outside world:
- dependent personality wants therapist to make decisions
- borderline and antisocial act out in sessions
- schizotypal, schizoid, paranoid have suspiciousness of therapist

18

What pharmacotherapy is FDA approved for personality disorders?

none

19

_______ are sometimes used as adjunctive treatment for the impulsivity of antisocial personality disorder.

________ are used for depressed mood or impulsivity of borderline personality disorder.

____________ are used for paranoid personality disorder or stress-related psychosis in borderline-personality disorder.

1. anti-epileptics [mood stabilizers]
2. SSRI
3. low dose antipsychotics