Personality Disorders

Question 1

What is identity?

Answer 1

Experience of oneself as unique, with clear boundaries between self and others

Question 2

What is self-direction?

Answer 2

Pursuit of coherent and meaningful short term and life goals

Question 3

What is empathy?

Answer 3

Comprehension and appreciation of others’ experiences and motivations

Question 4

What is intimacy?

Answer 4

Depth and duration of connection with others; desire and capacity for closeness;

Question 5

True or false: a healthy personality is flexible

Answer 5

True

Question 6

True or false: a healthy personality has a varied repertoire of coping strategies

Answer 6

True

Question 7

True or false: a healthy personality responds more to internal beliefs that to external stimuli

Answer 7

False–other way around

Question 8

True or false: a healthy personality develops responses driven by current (rather than past) conditions

Answer 8

True

Question 9

What is negative affectivity?

Answer 9

(“proneness to negative emotions”)–Frequent, intense experiences of high levels of a wide range of negative emotions

Question 10

What is detachment?

Answer 10

Avoidance of socioemotional experience, including both withdrawl from interpersonal interactions and restricted affective experience and expression

Question 11

What is antagonism?

Answer 11

Behaviors that put the individual at odds with other people, including an exaggerated sense of self-importances and a concomitant expectation of special treatment

Question 12

What is disinhibition?

Answer 12

Orientation towards immediate gratification leading to impulsive behavior without regard for past learning or future consequences

Question 13

What is psychoticism?

Answer 13

Exhibiting a wide range of culturally incongruent odd, eccentric, or unusual behaviors or cognitions

Question 14

What is the definition of a personality disorder?

Answer 14

An enduring pattern of inner experience and behavior that is markedly different from the expectations of the individuals cultures

Question 15

What are the areas that are affected with personality disorders? How many must be affected to diagnose someone with personality disorder?

Answer 15

• Cognition (“think”)
• Affectivity (“feel”)
• Interpersonal functioning
• Impulse control

2/4

Question 16

True or false: Personality disorders needs to be persistent across a range of situations and is inflexible

Answer 16

True

Question 17

True or false: Personality disorders need to be cause clinically significant distress or impairment

Answer 17

True

Question 18

True or false: personality disorders need to be stable over time

Answer 18

True

Question 19

When do personality disorders present? What happens as you grow older?

Answer 19

Onset of adolescence or early adulthood

Generally become more normal as they age

Question 20

What does it mean for a personality pattern to be inflexible?

Answer 20

Needs to apply to all situations, regardless of variables of the situation

Question 21

What is the prevalence of personality disorders in:

• the general population
• Primary care population
• Psychiatric outpatients

Answer 21

• 10-15% of general populations
• 20-30% of primary care
• 50% of psychiatric outpatients

Question 22

What is the only age at which a personality disorder can be diagnosed?

Answer 22

18+

Question 23

True or false: Those with personality disorders often misperceive the clinician’s intents

Answer 23

True

Question 24

True or false: if the pt and clinician are having difficulty comprehending the other’s perspective, this is suggestive of a personality disorder

Answer 24

True

Question 25

Do personality disorders need to be consistent across time?

Answer 25

Yes

Question 26

What is ego-dystonic?

Answer 26

When past personality is incongruent with current self

Question 27

What is ego-syntonic?

Answer 27

Self now is congruent with past self

Question 28

Are personality disorders generally ego-syntonic or ego-dystonic?

Answer 28

syntonic

Question 29

True or false: maladaptive interpersonal patterns increase under stress

Answer 29

True

Question 30

What percent of individuals who meet full criteria for one personality disorder will meet full criteria for another?

Answer 30

60%

Question 31

What are cluster A disorders? What are the three types?

Answer 31

odd, eccentric - Paranoid - Schizoid - Schizotypal

Question 32

What are cluster B disorders? What are the four types?

Answer 32

Dramatic, emotional - Antisocial - Borderline - Histrionic - Narcissistic

Question 33

What are cluster C disorders? What are the three types?

Answer 33

Anxious, fearful - Avoidant - Dependent - Obsessive-compulsive PD

Question 34

What is paranoid PD?

Answer 34

Pattern of excessive distrust and suspicion of others, and belief that others have malevolent intent

Question 35

What is the treatment approach for paranoid PD?

Answer 35

- Be very open about what you are doing and why | - Acknowledge patient's feelings and concerns

Question 36

True or false: Paranoid PD pts may take a slightly more friendly tone

Answer 36

False--overtones of friendliness may be met with suspicion

Question 37

What is schizoid personality disorder?

Answer 37

Neither desires or enjoy close relationships

Question 38

How are Social anxiety disorders different from schizoid personality disorders?

Answer 38

Schizoids Neither desire or enjoy close relationships, but social anxiety want relationships

Question 39

True or false: schizoid personality disorders have little interest in sexual activities with another person

Answer 39

True

Question 40

What is the treatment approach for schizoid personalities?

Answer 40

- Maintain a professional style, and interest in their well being. - Respect privacy

Question 41

Why must you explain why schizoid pts need to follow your your advice?

Answer 41

Do not care to please you--need a good reason to f/u

Question 42

What is the schizotypal PD?

Answer 42

- Discomfort with close relationships - Odd beliefs or magical thinking - Odd perceptual experiences ("psychosis-light")

Question 43

What is the approach to pts with schizotypal PD? (2)

Answer 43

- Avoid confronting odd beliefs or behaviors | - Screen for more florid forms of psychosis

Question 44

What is an antisocial PD?

Answer 44

- Persistent disregard for the right of others without remorse - Consistent deceitfulness - Irritability

Question 45

What is the approach to antisocial PD?

Answer 45

- Set clear patient-clinician relationship boundaries | - Be mindful of drug-seeking or malingering

Question 46

What is the key defining quality of antisocial PD?

Answer 46

Lack of remorse

Question 47

What is borderline PD?

Answer 47

- Desperation to avoid abandonment | - Intense, All good or all bad relationships

Question 48

What is the approach toward pts with borderline PD? (3)

Answer 48

- Avoid rescuing or abandoning - Be predictable and stable - Establish realistic expectations and boundaries

Question 49

What is the classic defining feature of borderline PD?

Answer 49

All good or all bad relationships

Question 50

True or false: pts with borderline PDs often have intense, poorly controlled anger

Answer 50

True

Question 51

True or false: pts with borderline PDs do not have suicidality

Answer 51

False--diagnostic criteria that they do

Question 52

What is histrionic PD?

Answer 52

- Desire to be center of attention at all times | - Often seductive or sexually provocative

Question 53

What does it mean to say that histrionic PDs are suggestible?

Answer 53

Your suggestions influence their responses

Question 54

What is the approach to a histrionic PD?

Answer 54

Maintain clear boundaries

Question 55

What is narcissistic PD?

Answer 55

- Sees self as superior and expects others to do the same | - Lacks empathy

Question 56

True or false: narcissistic PDs tend to lack empathy

Answer 56

True

Question 57

What is the approach to narcissistic PD?

Answer 57

Avoid confronting the entitlement--frame suggestions with a statement about the patient deserving the best care possible

Question 58

What is an avoidant PD?

Answer 58

Very strong fears of criticism and rejection that leads to avoidance of activities of personal contact

Question 59

What is the approach to avoidant PD?

Answer 59

Be calm, transparent, and reassuring.

Question 60

What is depended PD?

Answer 60

- Requires excessive advice and reassurance to make small decisions - Feels uncomfortable or helpless when alone

Question 61

What is the approach to dependent PD?

Answer 61

Avoid making decisions for patient--offer options and support them

Question 62

What is obsessive-compulsive PD?

Answer 62

- Preoccupied with details and order more than the main point of the task - Perfectionist to a level that impairs functioning

Question 63

What is the approach to obsessive-compulsive PD?

Answer 63

Assume a consultant role

Question 64

What are the comorbidities with cluster C PDs?

Answer 64

Depression | substance abuse

Question 65

What are the comorbidities with cluster B PDs?

Answer 65

Elevated risk of suicide

Question 66

What is the treatment for PDs?

Answer 66

- Management is the goal | - psychotherapy

Question 67

How can you manage your feelings of a PD pt?

Answer 67

-Consult with colleagues

Question 68

What is the major issue with obtaining a history with a schizoid personality disorder?

Answer 68

Unlikely to volunteer information