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Psychiatry > Personality Disorders > Flashcards

Personality Disorders Flashcards

1
Q

What is personality?

A

Cluster of relatively predictable patterns of thinking, feeling and behaving that is consistent across time, space and context

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2
Q

Describe the five factor model of personality

A 
Openness
Conscientiousness
Extraversion
Agreeabilness
Neuroticism
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3
Q

Define a personality disorder

A

Individuals characteristic and enduring patterns of inner experience and behaviour deviate markedly as a whole from the culturally expected and accepted range

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4
Q

What is the criteria for the diagnosis of a personality disorder?

A

More than one of - cognition, affectivity, impulse control, interpersonal functioning
Must be - pervasive, cause personal distress, stable/long duration and not explained by another mental disorder

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5
Q

What percentage have genetic influence?

A

60%

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6
Q

What percentage of the population are affected by a personality disorder?

A

10%

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7
Q

What percentage of psychiatric inpatients have a personality disorder?

A

54%

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8
Q

Name the three classifications of personality disorder

A
  • Cluster A (odd and eccentric)
  • Cluster B (dramatic and emotional)
  • Cluster C (anxious and avoidant)
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9
Q

What conditions come under cluster A?

A

Paranoid
Schizoid
Schizotypal

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10
Q

Describe paranoid PD

A

4 of

  • excessive sensitivity to set backs
  • tendency to bear grudges
  • tendency to misconstrue neutral/friendly actions
  • combative/tenacious sense of personal rights out with social situation
  • recurrent suspicious self referential attitude
  • preoccupation with conspitatorail explanation
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11
Q

Describe Schizoid PD

A

4 of

  • few activities provide pleasure
  • emotional coldness
  • detachment
  • limited capacity to express warm feelings
  • indifferent to praise/criticism
  • no interest in sexual experience
  • solitary activities
  • preoccupation with fantasy
  • no close friends
  • insensitive to social norms
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12
Q

Describe Schizotypal PD

A

5 of

  • ideas of reference
  • odd beliefs or magical thinking
  • unusual perceptual experiences
  • odd thinking and speech
  • suspicious/paranoid ideation
  • inappropriate/constricted affect
  • peculiar behaviour
  • lack of close friends
  • excessive social anxiety
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13
Q

What disorders are classed as cluster B?

A

Dissocial
Emotionally unstable and borderline
Histrionic
Narcissistic §

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14
Q

Describe Dissocial PD

A

3 of

  • callous unconcern for feeling of others
  • irresponsible and disregard for social norms
  • incapacity to maintain enduring relationships
  • low tolerance to frustration and violence
  • incapacity to experience guilt
  • marked process to blame others
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15
Q

What is the difference between dissocial PD and psychopathy?

A

Psychopathy has deficits in emotional and cognitive function

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16
Q

Describe emotionally unstable PD

A

3 of

  • tendency to act unexpectedly without consideration of consequences
  • quarrelsome behaviour
  • liability of outbursts
  • unstable mood
  • difficult to maintain course of action of no reward
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17
Q

In addition to emotionally unstable what is need for a diagnosis of borderline PD?

A

Uncertainty of self image, intense and unstable relationships, excessive efforts to avoid abandonment, recurrent threats/acts of self harm, chronic feeling of emptiness

18
Q

Describe Histrionic PD

A

4 of

  • self dramatisation
  • suggestible shallow/labile affect
  • seek excitement/activities where they are at the centre
  • inappropriately seductive
  • only concerned with physical attractiveness
19
Q

Describe Narcissistic PD

A

5 of

  • grandiose
  • fixation of fantasies of infinite success
  • credence they are exceptional and should only connect with important people
  • unwarranted administration
  • no empathy
  • sense of entitlement
  • resentment for those who are restful towards them
  • egotistical attitude
  • interpersonally oppressive behaviour
20
Q

What disorders are within cluster C?

A

Anakastic, anxious, dependent

21
Q

Describe anakastic PD

A

4 of

  • feelings of excessive doubt and caution
  • preoccupation with organisation, rules, lists
  • perfectionism
  • conscientiousness
  • scrupulousness
  • preoccupation with productivity - exclusion of pleasure and relationships
  • pedantic/stubborn
  • reluctant to let others do things
22
Q

Describe anxious PD

A

4 of

  • persistent pervasive feelings of tension
  • belief that one is socially inept
  • excessive preoccupation about being criticised
  • unwilling to be involved unless they are liked
  • restricted lifestyle due to security
  • avoidance of situations due to fear of rejection
23
Q

Describe dependent PD

A

4 of

  • encouraging/allowing others to make most of important life decisions
  • subordination of one’s own needs to those of others who they are dependent on
  • unwilling to make reasonable demands of people
  • uncomfortable or helpless when alone (inability to care for themself)
  • preoccupation of fear of being left alone
  • limited capacity to make decisions without reassurance
24
Q

Can you treat personality disorder?

A

No cure - can impair functioning or development but can treat comorbidities

25
Q

When can anti-psychotics be used?

A

Cluster A and borderline if paranoid

- haloperidol, quetiapine, olanzapine

26
Q

When can anti-depressants be used?

A

Cluster B, borderline,dissocial, anxiety in cluster C

- SSRI

27
Q

When can mood stabilisers be used?

A

Unstable/impulsive disorders, borderline

- lamotrigine

28
Q

Can benzodiazepines be used in PD?

A

Only for short term sedation

29
Q

How is avoidant PD be managed?

A

Social skills training

30
Q

How is emotionally unstable PD managed?

A

Dialectical Behavioural Therapy

31
Q

Describe dialectical behavioural therapy

A

6 months to 1 year of therapy - aim to learn to accept and regulate emotions individual and group sessions.

32
Q

What are the four pillars of dialectical behavioural therapy?

A
  • mindfulness
  • regulate emotions
  • tolerate distress
  • interpersonal effectiveness
33
Q

What is metallisation based therapy?

A

Individual and group sessions, focus on what is going on in your mind and other peoples. In order to better understand and control behaviour

34
Q

What does STEPPS stand for?

A

Systems Training for Emotional Predictability and Problem Solving

35
Q

Describe STEPPS

A

CBT based focus on stabilisation as an add on to usual treatment - 20 weeks plus homework, involvement of significant others as reinforcement team

36
Q

Is impatient care recommended in PD?

A

No
Only used if acute increase in suicide, changes to medication and clarification/treatment comorbid diagnosis
72 hours recommended no more than 2 weeks

37
Q

How is antisocial PD managed?

A

Group based approach to address thoughts and behaviour - impulsivity, antisocial, interpersonal

38
Q

Which drugs are used in patients with difficulties with impulse control?

A

1st line SSRI

2nd/3rd line Olanzaping, sodium valproate, carbamazepine, low dose antipsychotic

39
Q

What drugs are used in affective dysregulation?

A

1st/2nd line SSRI/Mirtazepine

3rd line - Olanzaping, sodium valproate, carbamazepine, low dose antipsychotic

40
Q

What drugs are used in cognitive perceptual symptoms?

A

Low dose antipsychotic

41
Q

Can any drugs be used in patients with interpersonal difficulties?

A

No

Psychiatry (18 decks)

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