Personality Disorders - Pheister Flashcards Preview

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Flashcards in Personality Disorders - Pheister Deck (24):
1

Give the (4) major determinants of personality and describe

Which one contributes the most?

  • Temperament: "nature"
  • Development: effects of "nurture" on biology
  • Character: "nurture"
  • Psyche: self awareness, ability to adapt, learn, and change

Temperament determines at least 50%

2

Define defense mechanism

"unconscious mental process that the ego uses to resolve conflicts"

Less obtusely: the processes that help you cope the instinct to do one thing (punch someone in the face) when you should do something else (grin and bear it)

3

When do defenses become pathologic?

When they remain rigid despite changing context/conditions

4

Give the type of defense mechanism:

  • Ignoring reality
  • Mentally separating parts of one's consciousness from real-life events
  • Intentionally pushing down a feeling to deal with later

  • Denial
  • Dissociation
  • Suppression

5

When is personality 'disordered'?

  • Ingrained and inflexible
  • Gets in the way of functioning or relationships
  • Relative stability of personality
  • Distressing to others

6

Define 'ego-syntonic'

Define 'ego-dystonic'

Most personality disorders are which type?

Ego-syntonic: "acceptable to the ego," does not bother the patient

Ego-dystonic: "knows it's a problem," - not acceptable to the ego, do it anyway

Ego-syntonic is more common

7

Personality disorders have approximately what prevalance in the general population?

10-18%

8

Name the (3) Cluster A Personality Disorders

"Eccentric, detached"

  • Schizoid PD
  • Schizotypcal PD
  • Paranoid PD

9

Schizoid PD

  • Key characteristic
  • Desire for relationships?
  • Population prevalence? Sex prevalence
  • Genetic role?
  • How is this different than schizophrenia?

  • Loners, emotionally detached
  • No desire for relationships
  • ~7.5%; M>F
  • Higher incidence of psychosis in relatives
  • No psychotic symptoms (hallucinations, delusions, disordered thought)

10

Describe Schizotypal PD

  • Population prevalence?
  • Genetics?

Cognitive, perceptual, and behavioral eccentricity, including beliefs such as telepathy, clairvoyance, magical thinking (to a degree that exceeds cultural norms)

  • 3% of population
  • Highly genetic: 33% in monozygotic studies

11

Paranoid PD

  • Define
  • Population prevalence? Sex prevalence?
  • Confounding factors to treatment
  • Differentiating factors from schizophrenia

  • Long-standing, baseless mistrust in others, may include reading threats from non-threatening situations and extreme/pathological jealousy in relationships
  • 0.5-2.5%; M>F
  • Confounding: rarely seek treatment
  • absent hallucinations or thought disorder; paranoia is non-bizarre and patients are generally higher-functioning than schizophrenics

12

Name (4) disorders in the Cluster B Personality Disorders

  • Antisocial
  • Borderline
  • Histrionic
  • Narcissistic

13

Borderline PD

  • Define
  • Population prevalence? Sex prevalence?
  • Genetics?

  • Pattern of intense and unstable interpersonal relationships, including frantic efforts to avoid real or imagined abandonment. May include extremes of idealization (best ever, worst ever)
    • May include affective instability, mood swings, and chronic feelings of emptiness
    • Recurrent suicidal behavior (up to 10% succeed)
  • 1-2%; F > M
  • High genetic load -> high degree of MDD and substance abuse in relatives

14

Antisocial PD

  • Define
  • Sex distribution in population?
  • Genetics?

  • Unconcern with the feelings/rights of others and moral bankruptcy that started before age 15
    • Deceit, impulsiveness
    • Irritability and aggressiveness
    • Reckless disregard for safety
    • Consistent irresponsibility (finances?)
    • Lack of remorse
  • 3% of males, 1% of females
  • High genetic load (5x more common if relatives have disorder)

15

Excessive concern with appearance and attention, exaggerated emotional response, and poor frustration tolerance are associated with what personality disorder?

Population prevalence?

Sex prevalence?

Histrionic PD

2-3%

F > M

16

Define and discuss the characteristics of Narcissistic PD

Heightened sense of superiority, self-importance, and lack of empathy

  • Preoccupation with fantasies of grandeur
  • Arrogant, entitled, envious
  • Require excessive admiration
  • Take advantage of others to achieve own ends

17

Name the (3) disorders of Cluster C Personality Disorders

  • OCPD
  • Avoidant
  • Dependent

18

Is OCPD the same as OCD?

No. Obsessive Compulsive PD is not ego-dystonic (like OCD)

19

OCPD

  • Define and discuss major characteristics
  • Sex prevalence?
  • Other risk factors?

  • Preoccupation with details and rules to a fault, including perfectionism that impedes ability to complete tasks. Includes personal values that are inflexible, unreasonable, or overly conscientious.
    • Defenses include: rationalizing, intellectualizing, raction formation, undoing, controlling
  • M > F
  • More common in eldest children

20

Extreme sensitivity to rejection leading to a socially withdrawn life may be a sign of what personality disorder?

Avoidant Personality Disorder

21

Do patients with Avoidant PD desire relationships?

Yes. However, fear of rejection tends to suppress any real efforts to obtain relationships.

22

Lack of self-confidence and decisional capacity, with severe subordination of own needs to those of others might be indicative of what personality disorder?

Which sex appears to be more affected?

More common: eldest child or youngest child?

Dependent PD

F > M

Youngest

23

What is the chief role of pharmacotherapy in PD?

Targeting symptoms. Does not necessarily alter the pathologic defenses.

Examples: Serotonin to manage impulsivity and rejection sensitivity. Mood stabilizers to alter lability and affect dysregulation

24

Give the PD 'cluster'

  • Tend to be more anxious
  • Detached and eccentric
  • Dramatic and self-focused

  • C
  • A
  • B