Personality Disorders Flashcards Preview

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Flashcards in Personality Disorders Deck (29):
1

What is the general definition of a personality disorder?

Pattern of inner experience and behvaior that deviates a lot from the person's culture

Pervasive, Pernicious, Persistent

Affects 2 or more of the following areas: Cognition, Affectivity, Interpersonal function, Impulse control

2

What are some DSM5 criteria for personality disorders?

Clinically significant impairment in functioning

Enduring (onset at adolescense or early adult)

Not better accounted for by another disorder

Not due to substance or medical condition

3

What are the Cluster A personality disorders?

Paranoid

Schizoid

Schizotypal

4

What are the Cluster B personality disorders?

Antisocial

Borderline

Histrionic

Narcissistic

5

What are the Cluster C personality disorders?

Avoidant

Dependent

Obsessive Compulsive PD

6

What two things in the patient's history are highly linked with personality disorders?

Abuse (physical, emotional, sexual)

Neglect

7

Why aren't PDs often officially diagnosed?

You don't want the diagnosis to follow them in their med record (could harm insurance, etc)

May simply write something like "borderline personality features"

8

Medical comorbidities with PDs

Chronic pain, sequelae of substance use disorders, impulsive/risky behaviors

Compliance issues

9

What is countertransference?

Feelings in the MD that are ignited by the patient's behavior and disposition

Frustration, anger, inadequacy, rescue fantasies

10

Paranoid PD
Describe the primary features

Pervasive mistrust and suspiciousness

Reluctant to confide in others (worried the info will be used against them)

Read hidden meanings into everything

Angry and defensive

11

Schizoid PD
Describe the primary features

Loners
Emotional and social detachment

Restricted range of emotional expression

Indifferent to praise or criticism

12

Schizotypal PD
Describe the primary features

Eccentric -- odd beliefs, magic thinking, metaphorical and overelaborate speech

Loners with social anxiety

Isolated EXCEPT 1st deg relatives

13

Comorbidities with the Cluster A PDs

Depression and anxiety disorders

Substance use

Schizophrenia

14

Describe the Behavior Pattern of a person with Paranoid PD

Expects to be betrayed or exploited

Needs their autonomy

Mistrusting, hostile, low compliance

15

Describe the Behavior Pattern of a person with Schizoid or Schizotypal PD

Stressed by social contact

Tends to withdraw or disconnect, so tough to engage in treatment

Odd beliefs about their symptoms

16

Antisocial PD
Describe the primary features

Disregard for rights of others

Socially irresponsible

Impulse, irritable, aggressive

Lacks empathy and remorse

17

Borderline PD
Describe the primary features

Instability-- stormy relationships; marked mood changes in a day

Impulsivity-- $, sex, eating

Cognition-- poor attention, cog flex, processing, planning

Recurrent suicidal behavior and self injury

18

Histrionic PD
Describe the primary features

Dramatic and attention seeking

Rapidly shifting, shallow emotions

Provocative, seductive

19

Narcissistic PD
Describe the primary features

High sense of self importance

Entitlement, Arrogance

Exploitative interpersonally

Lack empathy

Fragile self esteem

20

Cluster B PDs Comorbidities

Depression, anxiety
Substance Use

Eating disorders

Antisocial PD -- ADHD

Antisocial and Borderline -- dysregulation of 5HT/DA systems

21

Cluster B PDs
Behavior Patterns

Controlling
Acting out
Splitting (all good/all bad)
Self injury
Somatization

22

Avoidant PD
Describe the primary features

Socially inhibited

Hypersensitive to criticism

Low self esteem

Socially inadequate

23

Dependent PD
Describe the primary features

Tough to make decisions

Cannot express disagreement with others

Urgently seeks new relationship when close relationship ends

Helpless

24

Obsessive Compulsive PD
Describe the primary features

Preoccupied with rules, details, order

Perfectionism

High need for control

Overconscientious

Stubborn

25

How do you differentiate between OCPD and OCD?

OCD is egodystonic (they do NOT like it)

OCPD is egosyntonic (they feel OK about their personality)

26

How does CBT help patients?

Uses cognitive restructuring, behavior modification, psychoeducation, coping skills training

27

What pharmacotherapy may be used for Cluster A disorders?

Antipsychotics

28

What pharmacotherapy may be used for Cluster B disorders?

Antipsychotics

SSRIs

Mood stabilizers if needed

29

What pharmacotherapy may be used for Cluster C disorders?

SSRIs with a long acting anxiolytic

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