Personality DOs

Question 1

4 personality disorder characteristics

Answer 1

1) . inflexible and maladaptive behaviors (pt doesn’t change)
2) . social - relationship probs
3) . subjective distress
4) . problems in functioning

Question 2

men are more likely to be dx with _________, ________, and _____________ disorders

Answer 2

paranoid, OCD, and antisocial

Question 3

women are more likely diagnosed with __________, ________, and _________ disorders

Answer 3

borderline, dependent, histrionic

Question 4

how are PD’s patients with treatment?

Answer 4

difficulty complying and very resistant to change

Question 5

symptoms of people with PD tend to be ___________

Answer 5

ego-syntonic- symptoms are built into the personality and feel like normal self (this won’t change)

Question 6

what two things do you need to see in a person to diagnose them with a PD?

Answer 6

1) . personality traits need to be inflexible and maladaptive (current AND long term)
2) . significant impairment in functioning

Question 7

symptoms for PD start when?

Answer 7

childhood or adolescence

Question 8

6 guidelines for diagnosing PD

Answer 8

1) . Over time
2) . Collateral information
3) . Reactions in many different situations
4) . Differentiate from behavior under stress or under effects of substance
5) . Differentiate from other psych disorders
6) . Differentiate from personality changes caused by general medical conditions (head trauma, stroke – change in baseline behavior)

Question 9

paranoid personality disorder criteria (two)

Answer 9

1) . distrust or suspiciousness of others with 4 or more (suspects others are deceiving/harming them, has unjustified doubts, reluctant to confide in others, interprets benign remarks into threatening ones, bears grudges, perceives attacks on his character, has recurrent suspicions with fidelity of spouse)
2) . does not occur during course of schizophrenia or another psychotic DO, not due to medical condition

Question 10

treatment of paranoid PD

Answer 10

psychotherapy FIRST LINE, antianxiety meds or short course of antipsychotics

Question 11

schizoid personality DO criteria (two)

Answer 11

1). detachment from social relationships and restricted range of expression of emotions (ANHEDONIA) with 4 or more: AVOID
A: Anhedonic
V: voluntary social withdrawal (prefers to be alone)
O: odd appearing or eccentric
I: Introvert- loner, hermit
D: Detached, constricted affect
2). does not occur during the course of another psychotic disorder

Question 12

treatment for schizoid

Answer 12

Psychotherapy- FIRST LINE

-low dose short term antipsychotics, antidepressants

Question 13

what are the 3 clusters of personality DOs?

Answer 13

a) . SOCIAL DETACHMENT = odd or eccentric
b) . dramatic, erratic, emotional
c) . anxious or fearful

Question 14

3 disorders within odd or eccentric cluster

Answer 14

1) . paranoid PD
2) . schizoid PD
3) . schizotypal PD

Question 15

gender prevalence for paranoid and schizoid DOs

Answer 15

higher among males

Question 16

schizotypal disorder: higher risk of this among relatives of people with _________

Answer 16

schizophrenia

Question 17

4 disorders within cluster B (dramatic, erratic, emotional)

Answer 17

histrionic PD, narcissistic PD, antisocial PD, and borderline PD

Question 18

gender prevalence for histrionic, narcissistic, antisocial, borderline disorders

Answer 18

histrionic- females more
narcissistic- males more
antisocial- males 3x more
borderline- females 3x more

Question 19

histrionic personality disorder criteria

Answer 19

excessive emotionality and attention seeking

5 H’s ***
1). HEY LOOK AT ME: uncomfortable in situations in which he/she is not the center of attention
2). Come HITHER:
sexually seductive or provocative behavior
3). HISSY FITS
4). HYPE ME UP: seeks reassurance and praise,
easily influenced by others
5). HYPERINFLATED: thinks relationships are more intimate than they are

Question 20

what is Schizotypal personality disorder? criteria?

Answer 20

Odd, eccentric behavior and thought patterns suggestive of schizophrenia WITHOUT psychosis

Criteria: 
at least 5 
1). ideas of reference
2). odd beliefs or magical thinking
3). unusual perceptual experiences
4). may talk to oneself in public 
5). constricted affect
6). discomfort with close relationships: lack of close friends, social anxiety

**does not occur during the course of a psychotic disorder or pervasive developmental disorder

Question 21

treatment for schizotypal disorder (2)

Answer 21

1) . psychotherapy- FIRST LINE

2) . short course of low dose antipsychotics, antidepressants, benzos to dec anxiety if needed

Question 22

treatment for histrionic personality disorder

Answer 22

1). psychotherapy individual or group

Question 23

Narcissistic Personality disorder criteria

Answer 23

pervasive pattern of grandiosity, need for admiration, and lack of empathy (indicated by 5 or more of the following):

• grandiose sense of self importance
• preoccupied with fantasies of unlimited success
• believes he or she is “special” and should only associate with high status people
• requires excessive admiration
• has a sense of entitlement
• interpersonally exploitative
• LACKS EMPATHY
• envious of others
• arrogant behavior

Question 24

treatment of narcissistic personality disorder

Answer 24

difficult- psychotherapy can be helpful, maybe lithium for mood swings, antidepressants (SSRIs)

Question 25

Antisocial personality disorder criteria (4)

Answer 25

1). pattern of disregard for and violation of the rights of others
AT LEAST 3:
-failure to conform
-deceitfulness
-impulsivity
-irritability and aggressiveness (ASSAULTS)
-reckless disregard for safety of others
-consistently irresponsible
-lack of remorse
2). individual is at least 18
3). evidence of conduct disorder WITH ONSET BEFORE 15 YO
4). occurrence of antisocial behavior not exclusively during the course of schizophrenia or a manic episode
SERIAL KILLERS

Question 26

treatment of antisocial personality disorder

Answer 26

• psychotherapy- ESTABLISHING LIMITS
• SSRIs, lithium, valproate, carbamazepine and propanolol may help reduce anxiety, impulsivity, and aggression
• HIGH abuse potential so be cautious with meds

Question 27

borderline personality disorder criteria

Answer 27

1) pattern of instability of interpersonal relationships, self image, and affect

marked impulsivity beginning by early adulthood

5 or more of the following: B’S
BREAKING UP: avoid real or imagined abandonment
BROKEN: pattern of unstable and intense interpersonal relationships
BAD BEHAVIOR: identity disturbance (not a good sense of self), impulsivity in self damaging areas (sex. drugs, binge eating), recurrent suicidal behavior or self mutilating behavior
BAT: mood swings
BLACK AND WHITE THINKING
BLOWN UP: inappropriate intense anger disproportionate to event

Question 28

treatment for borderline personality disorder

Answer 28

1) . psychotherapy: dialectical behavior therapy is useful in treating mood disorders, suicidal ideation, and for change in behavioral patterns such as self-harm, and substance abuse.
2) . antipsychotics for hostility and brief psychotic episodes
3) . antidepressants for mood
4) . benzos for anxiety

Question 29

3 disorders within Cluster C- anxious or fearful

Answer 29

avoidant personality disorder, dependent personality disorder, and obsessive compulsive personality disorder

Question 30

gender difference for OC personality disorder

Answer 30

more common in males than females

Question 31

avoidant personality disorder criteria

Answer 31

1). social inhibition due to INTENSE FEAR OF REJECTION, timid, shy, lacks confidence

4 or more:

• avoids activities that involves interpersonal contact that can cause criticism, rejection
• unwilling to get involved with people unless certain people like him or her
• shows restraint within intimate relationships
• preoccupied with being criticized or rejected socially
• inhibited by new interpersonal situations
• views self as socially inept
• unusually reluctant to take personal risks

Question 32

treatment of avoidant personality disorder

Answer 32

psychotherapy, social skills training, group therapy, assertiveness training
** BB (anxiety) and SSRIs (depression), rejection sensitivity

Question 33

Dependent personality disorder criteria

Answer 33

excessive need to be taken care of that leads to clinging behavior and fears of separation

5 or more:

• difficulty making everyday decisions
• needs others to assume responsibility
• difficulty expressing disagreement
• difficulty initiating projects
• goes to excessive lengths to obtain nurturance
• feels uncomfortable or helpless when alone
• urgently seeks another relationship
• preoccupied with fears of being left to take care of him/herself

Question 34

treatment for dependent personality disorder (therapy and meds)

Answer 34

psychotherapy- insight oriented, behavioral, group, family therapy, and assertiveness training
antianxiety meds and antidepressants to target symptoms (maybe)

Question 35

obsessive compulsive personality disorder criteria

Answer 35

preoccupation with orderliness, perfectionism, and mental and interpersonal control

EGO SYNTONIC- behavior

4 or more:

• preoccupied with details so much that the activity is lost
• perfectionism that interferes with task completion
• excessively devoted to work
• inflexible about matters of morality
• unable to discard worthless objects
• reluctant to delegate tasks
• miserly spending style (money hoarded)
• shows rigidity and stubbornness

Question 36

treatment for OC personality disorder

Answer 36

• individual or group psychotherapy

- clomipramine and SSRIs may be helpful