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Behavioral Medicine > Personality disorders > Flashcards

Personality disorders Flashcards

1
Q

what percent of the population has personality disorders?

A

10-20%

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2
Q

what is ecosyntonic?

A

acceptable to the go

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3
Q

which pts are more likley to refuse txment and deny their problems?

A

pts with axis II conditions

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4
Q

what is the definition of personality disorders?

A

enduring subjective experiences and behavior that deviate from cultural standards, are rigid and stable through time

commonly have adolescent or early adulthood onset

often lead to unhappiness and impairment

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5
Q

what do you use to help understand a person’s personality disorder?

A

defense mechanisms

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6
Q

what is concerning about labeling ppl with personality disorders?

A

the label is stigmatizing and follows them around for life

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7
Q

which personality disorders are part of cluster A?

A

paranoid

schizoid

schizotypal

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8
Q

which personality disorders are part of cluster B?

A

borderline

antisosial

narcissistic

histrionic

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9
Q

which personality disorders are part of cluster C?

A

avoidant

dependent

obsessive-compulsive

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10
Q

what are characteristics of paranoid PD?

A

long-standing suspiciousness and mistrust of ppl in general

hostile, irritable, angry

men>women

may have disdain for ppl who are weak, sickly or impaired

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11
Q

how is paranoid PD different from delusional disorder?

A

there are not fixed delusions

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12
Q

how is paranoid PD different from schizophrenia ?

A

there are no hallucinations or formal thought problems

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13
Q

what are common relational problems that paranoid PD ppl have?

A

occupational

marital

medications may be used to calm pts anxiety

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14
Q

what are characteristics of schizoid disorder?

A
  1. pattern of social withdrawal
  2. isolated/lonely, uncomfortable with human interaction
  3. seem lost in daydreams, but are connected to reality
  4. no delusions/hallucinations
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15
Q

what are DDx of schizoid-type behaviors?

A

schizophrenia

delusional disorder

autism spectrum

paranoid

schizotypal

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16
Q

how do you treat schizoid PD?

A

antipsychotics

antidepressants

stimulants

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17
Q

what are characteristics of schizotypal PD?

A
  1. odd, strange, bizarre behavior and thinking
  2. magical thinking
  3. vivid imagery, clairvoyance, child-like fantasies
  4. may decompensate and develop psychosis
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18
Q

what is DDx of schizotypal-type behaviors?

A

paranoid PD

schizoid PD

schizophrenia (no psychosis)-may develop into this

19
Q

what is an important risk to consider with schizotypal PD?

A

more likely to commit suicide

20
Q

how do you treat schizotypal PD?

A

antipsychotics mostly

may use antidepressants

21
Q

what are characteristics of antisocial PD?

A
  1. against society
  2. can not experience empathy
  3. often a/w criminal behavior
  4. lack of remorse (no conscience)
22
Q

what is a common progression of antisocial PD?

A

onset before age 15

starts as ODD, then conduct disorder, then ASPD

strong genetic component

23
Q

how would an antisocial PD patient present in the clinic?

A

may appear charming, persuasive, and have a mask of sanity

often very intelligent

24
Q

what is DDx of ASPD type behaviors?

A

drug abuse

schizophrenia

depressive disorder

25
Q

how do you treat ASPD?

A

firm limits are essential

challenge them to deal honestly with ppl

medications may be used

be cautious of drug abuse

26
Q

what are chacteristics of borderline PD?

A
  1. unstable affect, mood, behavior and self-image
  2. always in a state of crisis
  3. repetitive self-destructive acts including suicidal gestures
  4. feel both hostile and dependent, cannot tolerate being alone, chronic feelings of emptiness
  5. ppl are either all good or all bad
27
Q

what is DDx of borderline PD?

A

schizophrenia (no prolonged psychotic episodes)

schizotypal

28
Q

how do you treat borderline PD?

A
  1. difficult (regressive behavior, acting out, hostility)
  2. good to stay reality based, give feedback on their behavior
  3. hospitalizations are common

4 medications (antipsychotics, antidepressants, benzos)

29
Q

what are characteristics of histrionic PD?

A
  1. dramatic attention-seeking behavior, very colorful language
  2. unable to maintain deep, long-lasting relationships
  3. temper tantrums, tears, accusations are common, may be coy or flirtatious
  4. have trouble explaining their motivations
30
Q

what is DDx of histrionic type behaviors?

A

borderline

decreased sxs with age (less energy to put into their exaggerations)

31
Q

how do you treat histrionic PD?

A

focus on clarifying their inner feelings

meds can help tx borderline-type sxs

32
Q

what are characteristics of narcissistic PD?

A
  1. heightened sense of self importance and grandiose feelings of uniqueness
  2. unrealistic sense of omnipotence, beauty, talent
  3. do not handle criticism (everyone is an idiot)
  4. fragile relationships, follow their own rules, commonly exploit others, incapable of empathy
33
Q

what is DDx of narcissistic PD?

A

can be seen in cluster B disorders

lack suicidal gestures present in other disorders

34
Q

how do you treat narcissistic PD?

A

difficult (they have to renounce their narcissism in order to make progress)

aging is difficult for pts

group therapy may be helpful

antidepressants and mood stabilizers

35
Q

what are characteristics of avoidant PD?

A
  1. extreme sensitivity to rejection leading to social withdrawal
  2. interviewing reveals anxiety and vulnerable to comments or criticism
  3. seek employment away from ppl
36
Q

what is DDx of avoidant type behaviors?

A

schizoid (wanting to be alone)

can maintain family relationships that are safe

37
Q

how do you treat avoidant PD?

A

trust and acceptance are essential

pts are encouraged to take risks

group therapy can be helpful

meds to manage anxiety and depression

38
Q

what are characteristics of dependent PD?

A
  1. subordinate their needs to the needs of others
  2. lack self confidence and uncomfortable when left alone
  3. pervasive pattern of dependent, submissive behavior
  4. cannot make decisions w/o lots of information, advice and reassurance
39
Q

what is DDx of dependent type behaviors?

A

histrionic and borderline (no long term relationships)

40
Q

how do you treat dependent PD?

A
  1. require constant supervision, have trouble working independently
  2. insight oriented therapies
  3. teach how to become more assertive and self reliant
  4. be careful about txment engaging primary relationships
  5. meds used to manage anxiety, depression
41
Q

what are characteristics of OCPD?

A
  1. emotional constriction, orderliness, stubbornness
  2. extreme perfectionism and inflexibility
  3. controlling, preoccupied with rules, regulations, details
  4. few friends b/c of imposing rules on others
  5. lack sense of humor
42
Q

how do you distinguish between OCPD and OCD?

A

OCD has recurrent obsessions and compulsions

OCPD can develop into OCD or sxs may go away

43
Q

how do you treat OCPD?

A
  1. long and complex
  2. group and behavior therapy
  3. meds for anxiety and depression

Behavioral Medicine (12 decks)

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