Personality Disorders

Question 1

What is a PD?

Answer 1

•An enduring pattern of altered (two at least)

1. Cognition
2. Affectivity
3. Interpersonal functioning
4. Impulse control

Question 2

Here’s some criteria that describe a PD:

Answer 2

• Markedly disharmonious attitudes/behaviours
• Chronic & Pervasive (not episodic)
• Present in wide range of social situations
• Appear young and carry into adulthood
• Cause significant personal distress
• Oft associated with occupation & social problems

Question 3

There are 3 clusters to PDs, what are they?

Answer 3

A - Odd or eccentric (traditionally MAD) - problem with relationships

B - Dramatic or emotional (traditionally BAD) - Problem with control & Stability

C - Anxious or avoidant (traditionally SAD) - Problem with anxiety & managing it in relationships

Question 4

What PDs fall into each cluster?

Answer 4

A - Schizoid PD &Paranoid PD
B - Emotional PD, Narcissistic PD, Antisocial PD, narcissistic
C - Dependant PD, Anxious PD

Question 5

Describe a schizoid PD

Answer 5

Appear cold & detached, taking little interest in relationships, sex or praise/criticism
Also take pleasure in few activities

Question 6

Describe a Paranoid PD

Answer 6

They have a pervasive suspicion or others & their motives, reading hidden meaning, attacks or betrayal into everything

Question 7

Describe a Narcissitic PD

Answer 7

Tend to be grandiose with a need for admiration as well as lacking empathy and taking advantage

Question 8

Describe a Borderline PD

Answer 8

Instability in relationships, self-image, affects and impulsivity

Question 9

Describe an Antisocial PD

Answer 9

Disregard & violate the rights of others

Question 10

Describe a Dependant PD

Answer 10

Excessive need to be taken care of leads them to submissive, clingy behaviour and a fear of seperation

Question 11

Describe an Obsessive Compulsive PD

Answer 11

Preoccupied with orderliness, control &perfectionism to the point of sacrificing flexibility, openness & efficiency

Question 12

Describe an Avoidant PD

Answer 12

Severe anxiety with a pattern of social inhibition, feeling inadequate and hypersensitivity to -ve evaluation

Question 13

What is Psychopathy?

Answer 13

An extreme form of Antisocial PD
They display antisocial behaviour, callous disregard for others and a complete lack of empathy

It requires a long Psychopathy Checklist - Revised (PCL-R) to diagnose

Question 14

What are we treating in a PD?

Answer 14

It’s not a mental illness as such. It’s a person with an extreme personality who needs help integrating into society, hence it’s psychological therapies not medicines.

Although they tend to suffer from higher rates of substance abuse, suicide and other mental illnesses which can be handled as per.

Question 15

How do we treat PD?

Answer 15

Dialectical Behavioural Therapy
Psychodynamic Psychosocial Therapy
Mentalisation based Therapy

Question 16

Describe a Schizotypal PD?

Answer 16

Social deficits/ inability to form close relationships and anxiety . Have perceptual distortion (suspiciousness) and eccentricity.

Question 17

DMS-5 paranoid

Answer 17

Indicated by 4 or more:

1. Suspects (without sufficient basis) that others are exploiting, harming or deceiving him/her
2. Is preoccupied with unjustified doubts about loyalty of friends or associates
3. Is reluctant to confide in others because if unwarranted fear that the information will be used maliciously against him/her
4. Reads hidden demeaning or threatening meanings into benign remarks/event
5. Persistently bears grudges (unforgiving insults)
6. Perceives attacks on his or her character/reputation that are not apparent to others and is quick to react angrily or counterattack
7. Has recurrent suspicionns, without justification, regarding fidelity of spouse or sexual partner.

Question 18

dms-5 schizoid

Answer 18

Indicated by 4 or more of the following
• Neither desires or enjoys close relationships, including being part of a family
• Almost always chooses solitary activities
• Has little, if any, interest in having sexual experiences with another person
• Takes pleasure in few, if any activities
• Lacks close friends and confidants other than first degree relatives
• Appears indifferent to the praise/criticism of others
• Shows emotional coldness, detachment or flattened affectivity

Question 19

DMS-5 - Schizotypal

Answer 19

5 or more of the following
• Ideas of reference
• Odd beliefs or magical thinking that influences our behavior and is inconsistent with subcultural normal e.g. supersticiousness
• Unusual perceptual experiences including bodily illusions
• Odd thinking and speech
• Suspiciousness or paranoid ideation

Question 20

DMS-5 Antisocial

Answer 20

Indicated by 3 or more of the following

• Failure to conform to social norms with respect to lawful behavior as indicated by repeatedly persorming acts that are grounds for arrest
• Deceitfulness as indicated by continuos lying, use of aliases, or conning others for personal profit/pleasure
• Impulsivity or failure to plan ahead
• Irritability and aggressiveness as indicated by repetead physical fights/ assaults.
• Reckless disregard for safety, or self or others
• Consistent irresponsibility as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
• Lack of remorse as indicated by being indifferent to or rationalizing having hurt, mistreat or stolen from another

Question 21

DMS-5 borderline

Answer 21

Indicate by 5 or more of the following

• Frantic efforts to avoid real or imagined abandonment
• A pattern of unstable and intense interpersonal relationships characterised by alternating between extremes of idealisation and devalusation
• Identity disturbance: markedly and persistently unstable self-image or sense of self
• Impulsivity in at least two areas that are potentially self-damaginge.g. substance abuse, reckless driving, bing eating
• Recurrent suicidal behaviour
• Affectivity instability due to marked reactivity of mood
• Chronic feelings of emptiness
• Inappropriate anger or management of anger
• Transient, stress-related paranoid ideation or severe dissociative symptoms

Question 22

DMS-5 Histrionic

Answer 22

Indicated by 5 or more
- Uncomfortable situations in which he or she is not the centre of attention
- Interaction with others is often characterised by inappropriate sexually seductive and provocative behaviour
- Displays rapid shifting and shallow expressions of emotion
- Consistently uses physical appearance to draw attention to self
- Has a style of speech that is excessively impressionistic and lacking in detail
- Shows self-dramatisation, theatricality and exaggerated expression of emotion
- Is suggestible
- Considers to be relationships more intimate than they actually are
• Often anxious at how they are seen

Question 23

DMS-5 narcissistic

Answer 23

Indicated by 5 or more of the following

• Has grandiose sense of self-importance
• Is preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love
• Believes that he or she is special and uniquea and can only be understood by or should associate with other special or high-status people
• Requires excessive admiration
• Has a sense of entitelement
• Is interpersonally exploitatitive
• Lacks empathy: is unwilling to recognise or identify with the feelings and feed of others
• Is othen envious of others or believes they are envious of him
• Shows arrogant, haught behabiour or attitudes

Question 24

What is a treatment often used for borderline behaviour?

Answer 24

Dialectical therapy

• individual + group therapy
• CBT
• Mindfullness
• Easter philosophy

Question 25

DMS-5 OCD

Answer 25

Indicated by 4 or more of the following - Is pre-occupied with details, lists, order, organisation or schedules to the extent that the major point of the activity is lost - Shows perfectionism that interferes with the task completion - Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships - Is overconscientious, scrupulous and inflexible about matters of morality, ethics or values - Is unable to discard worn-out worthless objects even when they have no sentimental value - Is reluctant to delegate tasjs or to work with others unless they submit to exactly his or her way of doing things - Adopts a misely spending style toward both self and others; monet is viewed as something to be hoarded for future catastrophies - Shows rigidity and stubborness

Question 26

DMS-5 Avoidant personality?

Answer 26

Indicated by 4 or more of the following - Avoids occupational activity that involve significant interpersonal contact because of fears of criticism, disapproval, rejection - Is unwilling to get involved with people unless certain of being liked - Shows restraint within intimate relationships because of fear of being shamed or ridiculed - Is preoccupied with being criticized or rejected in social situations - Is inhibited in new interpersonal situations because of feelings of inadequacy - Views self as socially inept, personally unappeling or inferior to others - Is usually reluctant to take personal riskor to engage in any new activities because they might prove embarrassing

Question 27

DMS-5 dependent personality

Answer 27

Indicated by 5 or more of the following - Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others - Need others to assume responsibility for most major areas of his/ her life - Has dis difficulty exoressing disagreement with others because of fear or loss of support or approval - Has difficulty initiating projects or doing things on his or her own - Goes to excessive lengths to obtain nurturance and support from others to the point of volunteering to doing things which are unpleasant - Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself/herself - Urgently seeks another relationship as a source of care and support when a close relationship ends - Is unrealistically pre-occupied with the fears of being left to take care of himself/herself

Question 28

Emotional personality classification

Answer 28

1- Borderline - pattern on instability in inter-personal relationships, self-image, affects 2- Impulsive

Question 29

Borderline personality DMS-5

Answer 29

Indicate by 5 or more of the following - Frantic efforts to avoid real or imagined abandonment - A pattern of unstable and intense interpersonal relationships characterised by alternating between extremes of idealisation and devalusation - Identity disturbance: markedly and persistently unstable self-image or sense of self - Impulsivity in at least two areas that are potentially self-damaginge.g. substance abuse, reckless driving, bing eating - Recurrent suicidal behaviour - Affectivity instability due to marked reactivity of mood - Chronic feelings of emptiness - Inappropriate anger or management of anger - Transient, stress-related paranoid ideation or severe dissociative symptoms