Personality disorders Flashcards Preview

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Flashcards in Personality disorders Deck (29):
1

What is personality

• Personality:
- Enduring patterns of-perceiving, thinking about, relating to
- Oneself and the environment
- In a wide range of contexts

2

What do personality disorders do?

- Inflexible
- Maladaptive
- Cause significant stress/ interference

3

DSM 5

- Enduring pattern of inner experience and behavior
- Pattern shown in 2 or more areas: cognition, affectivity, interpersonal functioning, impulse control

4

Prevalence

- Unknown
- Est. 9-13% of adults

5

Problems with category

- Not as stable as DSM suggests
- Test retest reliability
- High: anti social
- Low: schizotypal

6

50% meet other personality disorder

• 50% diagnosed with a PD meet criteria for another PD/ clinicians often find its hard to distinguish between

7

Comorbid with

• Comorbidity with other disorders

8

• Cluster A (detached quality, some characteristics of psychotic disorders): more common in males

- Paranoid= rarely seeks treatment, unwanted suspiciousness, lack intimacy
- Schizoid= withdraw, reclusive, detached, flat affect, lack social relationships
- Schizotypal= ideas things refer to them but don’t, “weak form of schizophrenia”

9

• Cluster B (dramatic, over reactive, emotional): more common in women

- Antisocial
- Borderline
- Histrionic= interpersonal relationship problems, instant emotional connection, “an amazing or horrible day”
- Narcissistic= lack of empathy/ concern for others, care more about selves, exploitation

10

Cluster C

- Avoidant
- Dependent
- Obsessive compulsive

11

Borderline personality disorder

- Frequently used diagnosis
- Est 1- 2.5% of general population
- 75% are women

12

BPD instability in

- Moods
- Self image
- Impulsivity
- Relationships

13

BPD

- Impulsive behaviors that are harmful to self
- Fears of abandonment (real or imagined abandonment)

14

Antisocial Personality disorder prevalence

- (est. 3% of men, less than 1% of women)

15

Antisocial personality disorder

- Associated with crime, violence
- Persistently violate others rights
- Often “conduct disorder” before 15 years
- Still fight, harassing, manipulating as adults
- Hard to keep jobs
- They lie, are reckless, manipulative, no remorse, self- centered, problems maintaining relationships, rarely seek therapy
- High rates of alcoholism and substance abuse

16

Cluster C

- Avoidant: people that have strong fear of rejection, avoid social interaction
- Dependent: really dependent on other people, feel like they cant function independently
- Obsessive compulsion: rigid, restrictive, trouble with feelings, inflexible, perfectionist

17

Treatment

- Thought to be treatment resistant
- Seek treatment for (Axis I)
- Harder to treat than (Axis I) alone
- New treatments developed: especially borderline personality
- “increased perceived control”

18

Treatment Cont.

- Meditation
- Outpatient therapy
- Day treatment
- Lack of outcome research with most personality disoders

19

Borderline etiology

- Genetic contribution: heritability is 60%, especially impulsivity, emotional dysregulation
- Serotonin
- Pre frontal lobe
- Amygdala
- High rates of self- reported verbal and emotional abuse
- Separation

20

Linehans theory

- Diathesis stress model: genetics and the environment
- Biological interacts with “invalidating environment” growing up
- Go from “your best therapist” to “how could you do this”

21

Dialectical behavior therapy

- Dialectic: acceptance and change
- Integrates cognitive, behavioral, client centered mindfulness

22

DBT( Learning to observe/ describe without judgement)

- Acceptance/ validation of client
- Concrete problem solving skills and training
- Mindfulness

23

4 parts of DBT

- Acceptance/ validation of client
- Concrete problem solving skills and training
- Mindfulness

24

DBT skills

- Distress tolerance (teach ways to tolerate distress instead of cutting)
- Emotional regulation
- Interpersonal effectiveness
- Mindfulness

25

Other therapies

- Transference focused
- Schema

26

Suicide asscoiated w

pelessness
Poor problem-solving
Impulsivity
Low “life satisfaction”
Severe stressful event

27

Gender and suicide

Men: 4x rate of suicide

Women: 3x rate of uncompleted attempts

(pattern – worldwide, not China)

Different methods



Highest rates (white) men over 50 (U.S.)

28

Risk factors suicide


Mental illness
Alcohol/drug abuse
Hopelessness
Impulsiveness and/or aggressiveness
History of trauma or abuse
Previous attempts
Family history of suicide

29

Bipolar mood stabilizers

Lithium (blood salt)
Therapeutic dose/Toxic dose

Anti-seizure drugs


(Combination of above)

(mood stabilizer and atypical antipsychotic)