Personality Disorders

Question 1

DSM criteria of personality disorder

Answer 1

1. different from culture
2. pervasive, pernicious, persistent

Pattern manifest in 2 or more areas of functioning

1. cognition
2. affectivity
3. interpersonal functioning
4. impulse control

adolescent or early adulthood
(if before 18 must be present for 1 year at least)

Question 2

A, B, C cluster

Answer 2

weird
wild
worried

Question 3

Cluster A

Answer 3

-odd or eccentric; inability to develop meaningful social relationships
-no psychosis
-genetic association with schizophrenia
Accusatory aloof awkward

Comorbidities

1. depression and anxiety
2. substance abuse
3. schizophrenia

Question 4

Cluster A types

Answer 4

1. Paranoid-pervasive distrust and suspiciousness; projection is the major defense mechanism
   - males
2. Schizoid-voluntary social withdrawal, limited emotional expression, content with social isolation
   - males
   - increased prevalence in relative with schizophrenia or schizotypal
3. Schizotypal-Eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness, social anxiety except first degree relatives
   - familial link

Question 5

Cluster B

Answer 5

Dramatic, emotional, or erratic; genetic association with mood disorders and substance abuse

Wild
Bad to the Bone

Comorbidities

1. depression, anxiety
2. somatoform, anorexia
3. substance abuse
4. ADHD (antisocial)
5. serotonin reduced-impulsivity

Question 6

Cluster B types

Answer 6

1. Antisocial-disregard for and violation of rights of others, criminality, impulsivity; males>females; must be >18 years old and have a history of conduct disorder before age 15.
2. Borderline-unstable mood and interpersonal relationships, impulsiveness, self mutilation, boredom, sense of emptiness, female>males; splitting is a major defense mechanisms, increased risk suicide
   - women more
   - familial pattern
3. Histrionic-excessive emotionality and excitability, attention seeking, sexually provocative, overly concern
4. Narcissistic-grandiosity, sense of entitlement; lacks empathy and requires excessive admiration; often demands the best and reacts to criticism with rage
   - men more common

Question 7

Cluster C

Answer 7

anxious or fearful; genetic association with anxiety disorders
Worried
(cowardly, compulsive, clingy)
Comorbities
1. anxiety, social phobia, panic disorder with agoraphobia
2. depression
3. substance abuse

Question 8

Cluster C types

Answer 8

1. avoidant-hypersensitive to rejection, socially inhibited, timid, feeling of inadequacy, desires relationships with others (vs. schizoid)
   - men/women equal
2. obsessive-compulsive-preoccupation with order, perfectionism, and control; ego-syntonic; behavior consistent with one’s own beliefs and attitudes
   - men more
3. dependent-submissive and clingy, excessive need to be taken car of, low self-confidence

Question 9

What leads to higher risk of PD?

Answer 9

abuse and neglect
1. physical abuse-antisocial and depressive PDs

2. Sexual abuse-borderline PD**
3. Neglect-antisocial, avoidant, borderline, narcissistic, passive aggressive

Question 10

Are PD more likely to have mood disorders and suicidal ideation/behavior and substance abuse ?

Answer 10

yes

Question 11

What personality disorders worsen over time?

Answer 11

schizotypal

obsessive compulsive

Question 12

Countertransference

Answer 12

evoke strong reactions from the people around them

Question 13

Whats one way to treat borderline personality?

Answer 13

biopsychosocial model-creation of a life worth livign

Question 14

What do you use to treat cluster A?

Answer 14

antipsychotics-cognitive and perceptual organization problems related to dysfunction of dopaminergic system

Question 15

What do you use to treat cluster B?

Answer 15

antipsychotics

SSRI-for impulsivity and aggressive and mood stabilization

Question 16

What do you treat cluster C with?

Answer 16

SSRI for anxiety related to dysfunction in serotonergic and noradrenergic systems