Flashcards in Personality Disorders Deck (74):
enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individuals culture and affects life
Personality disorder - population?
NOT under the 18yo (b/c the brain is still growing and developing)
Personality disorder -before dx?
LONG TERM PATTERNS- multiple interview
cautious of 3rd party info
Personality disorder - dx?
pattern of two or more areas:
-cognition: ways of perceiving and interpreting self and others
pattern is INFLEIBLE and PERSVASIVE
distress in life
pattern is STABLE
Personality disorder - etiology?
environmental factors: foster care, large family
Personality disorder - 3 clusters?
Cluster A, B, and C
Personality disorder - Cluster A?
Personality disorder - Cluster B?
Personality disorder - Cluster C?
Other specified PD and unspecified?
personality change d/ to another medical condition
PD - Paranoid personality disorder?
Paranoid PD - dx?
Spousal infidelity suspected
Enemy or friend binary
Confiding in other is feared
Threats perceived in benign events
Paranoid PD - prevalence?
males > females
70 yr male, war veteran
hx of chronic back and knee pain (war) + fibromyalgia
emotional, psychological and physical abuse in childhood
alienated family and friends d/t lack of trust
demanding of friends and family
self sufficient and active
unable to calm down - uses drugs
blame on others
outside party feels "walking on egg shells"
detachment from social relationships AND restricted range of expression of emotions in interpersonal settings
Schizoid PD - dx?
Indifferent to criticism or praise
Sexual experience of little interest (sex w/self - not with others)
Tasks performed solitarily
Absence of close friends
Neither desires nor enjoys close relations
Takes pleasure in few activities
Schizoid PD - discriminating feature?
lack social skills and lack of desire for sexual experiences
Schizoid PD - comorbid?
no hx of romantic relationships, only family
childhood - isolation, friendless
no motivation to seek friends, get good grades, career goals
cognitive or perceptual distortions and eccentricities of behavior
Schizotypal PD - dx?
5+: ME PECULIAR
Magical thinking/odd beliefs
Experiences unusual perceptions
Eccentric behavior or appearance
Unusual thinking and speech
Lack close friends
Ideas off reference
Anxiety in social situation
Rule out psychotic disorder
Schizotypal PD - discriminating features?
how they cope w/ stress
OCD sx to pandas
magical and eccentric thinking in childhood
no hx of pervasive developmental disorders
wars specific articles of clothing to act as "barrier" to others in public
rich and detailed fantasy life
pervasive pattern of disregard of AND violation of the rights of others
MUST have CONDUCT DISORDER @ 15 yo - but must be 18yo
Conduct disorders @ 16yo?
Antisocial PD -dx?
Conformity to law is lacking
Reckless disregard for safety of self or others
Planning insufficient (impulsive)
Antisocial PD - discriminating features?
Antisocial PD - prevalence?
male > female
27 yo male
hx of conduct disorder, acting out (arson, car theft), drug seeking
attempted to manipulate staff in hospital
Antisocial personality disorder
Borderline personality disorder?
instability of interpersonal relationships, self-image and affects
frantic, desperate, dramatic presentation
threats of suicide, self mutilating behavior (now called: non suicide self injury)
Borderline personality PD- dx?
5+ I DESPAIRR:
Disordered, unstable affect
Emptiness is chronic
Suicidal behavior, gestures, and/or threats
Paranoid ideation can be transient, stress-related
Rage is inappropriate and intense
Relationships are unstable, intense extreme
Borderline PD - prevalence?
women > male
Borderline PD - discriminated feature?
unstable self-image/sense of self
Borderline PD - comorbid?
Borderline PD - ddx r/o?
no hx dx
significant hx of childhood emotional, psychologicalc, physical, sexual abuse
relationships characterized by instability
hx of suicide attempts
pattern of excessive emotionality and attn seeking
sexually seductive or provocative behavior
Histrionic PD - discriminating feature?
seek to control romanic partners through emotional manipulation
romantic relationships characterized by lack of emotional intimacy
will dress seductively or extravagantly, often inappropriate for setting
Histrionic PD - dx?
5+ PRAISE ME:
Relationships considered more intimate than really are
Emotions rapidly shift and are shallow
Histrionic PD vs antisocial PD?
histrionic: attn seeking
antisocial: profit, power, material gain
30 bisexual female
complains of abdominal pain
presents in revealing, provocative clothing
idealization of providers and dismissive of support staff
significant hx of childhood/adolescent emotional, psychological and sexual abuse
romantic relationships: little emotional intimacy and/or domestic violence
need for admiration
lack of emphty
beginning by early audlthood
Narcissistic PD - dx?
Preoccupied with fantasies of success and power
Excessive need for admiration
Lack of empathy
Narcissistic PD - discriminated feature?
expect others to agree w/ them and go alone w/t their desires/plans
Narcissistic PD - prevalence?
male > female
Histrionic PD vs Narcissistic PD?
excessive pride in achievements
Borderline PD vs Narcissistic PD?
relative stability of self-image, lack of self-destructiveness
Avoiddant vs Social phobia?
-avoid ANY opportunity to be neg evaluated
-suspicious of compliments
-avoid performance situations and social interactions
-estabilsh and maintain close interpersonal relationships w/select others
Avoidant PD - dx?
Certainty of being liked required
Intimacy is avoided
New relationships are avoided
Gets around interpersonal contact
Embarrassment is expected, prevents new activities
Self viewed as inept, inferior, unappealing
Avoidant PD - comorbid?
panic disorder w// agoraphobia
35 gay man computer programmer
hx of social phobia
interpersonal distant - avoids eye contact
anxious in social settign: clammy palms, tightness in chest, flush easily, freezes when noticed
avoid intimate social gathering
anxious about medical appointments due to fear of being criticed or negaitve eval
submissive and clinging behavior and fears of separation
Dependent PD - prevalence?
female > male
Dependent PD - dx?
Require reassurance and advice
Expressing disagreement is difficult
Life responsibilities are assumed by others
Inability to initiate projects
Avoid being alone
Nurturance is ultimate goal
Companionship sought urgently
Exaggerated fears of being left to care for self
Dependent PD - discriminating feature?
intense fear of seperation from care givers
timid and afraid to disagree/disapprove of others opinions or actions
hx dx: panic disorder w/ agoraphobia
refuses to be alone w/out husband or son
husband and son assume majority of responsibility for her care taking
intense and unrealistic fear of abandoment, chronic care seeking inappropriate for developmentla dn chronological age
Obsessive compulsive PD?
preoccupation with orderliness, perfectionism and mental interpersonal control
OCPD- discriminated feature?
preoccupie w/ orderliness and mental and interpsonal control
rigid maintenance of rituals, schedules
4+ LAW FIRMS:
Loses sight of greater pic d/t rules and details
Ability to complete tasks
Worthless objects retained
Friends and leisure << WORK
Reluctant to delegate
OCPD vs narcissistic PD?
NPD: achieved perfectionism
OCPD: more self critical in striign to obtain and maintain perfectionism
OCPD vs OCD?
OCD: true obsessiona dn compulsoins and should be considered when hoarding is extreme
type A personality
numerous car accidents due to distraction by min details while driving
hx of nervous breakdown
hoards money (but not poor)
Personality change d/t another medical condition?
d/t medical condition (primary)
Other specified PD & Unspecified PD?
-full criteria for ANOTHER PD NOT met
-full criteria for another PD not met and clinician does not indicate specific reason
-not enough info
"Others are untrustworthy and they try to take advantage of me"
"I'd like to have friends but its hard b/c people find me pretty strange"
"I enjoy taking advantage of people and I never feel bad"
"I need people desperately and fall apart completely when they reject me"
"I'm emotional and sexually charming person and I need to be the center of attn!"
"I'm talented and special and I get angry and depressed when ppl don't recognize me"
"I'm really afraid of what people will think of me so I avoid making new friends"
"I'm passive and dependent on other and I go far out of my way to please those who are important to me"