Week 4 - B - Personality Disorder - A (Paranoid, Schizoid, Schizotypal), B (Antisocial, borderline, histirionic), C (Avoidant, dependent, obsessive compulsive)

Question 1

What is a personality?

Answer 1

A personality is a cluster of relatively predictable patterns of thinking, feeling and behaving that is generally consistent across time space and context

Question 2

What is a personality again? The structure of a personality can come under openness, conscientiousness, extraversion, agreeableness, neuroticsim What is neuroticism?

Answer 2

Some define neuroticism as the ease of arousal in a patient ie emotional instability

Personality is a cluster of relatively predictable ways of thinking, feeling and behaving that is generally consistent across space time and context.

Question 3

What are the key areas that make up the structure of a personality? Can be remembered under the acronym OCEAN

Answer 3

Openness

Conscientiousness

Extraversion

Agreeableness

Neuroticsm

Question 4

There is a lot of different criteria for diagnosing somebody with a personality disorder There are 6 different points - A to F What are the different points for diagnosing a patient with personality disorder?

Answer 4

Enduring pattern of inner experience and behavior that deviates from expectations of the individuals culture.

The enduring pattern is inflexible and pervasive a well as causing clinically significant distress or impairment in school

The pattern is stable and of long duration and is not better explained by other mental disorders or physiological effects / illness

Question 5

How can you distinguish between it being a personality trait or a personality disorder?

Answer 5

Can distinguish between a personality trait and a personality disorder by understanding if it is pervasive or not

And if the changes in personality cause distress and/or impairment of functioning ie in social groups or school

Ie if personality disorder it will be pervasive as it is present across a broad range of

Question 6

The personality disorders is separated into three main clusters Briefly describe each of these clusters * Cluster A * Cluster B * Cluster C

Answer 6

Cluster A - the patient exhibits odd and eccentric behaviour

Cluster B - the patient is described as dramatic and emotional

Cluster C - the patient is described as exhibiting anxious or avoidant behaviour

Question 7

What is Cluster A description for personality disorders? Which personality disorders come under cluster A?

Answer 7

Cluster A personality disorder - odd and eccentric

Paranoid, schizoid and schizotypal

Question 8

How would you describe Cluster B personality disorder? What are the disorder classified under this heading?

Answer 8

This would be dramatic or emotional behaviour

Disorders - antisocial, bordelrine, histrionic and narcissitic

Question 9

How would you describe Cluster C personality disorder? What are the disorder classified under this heading?

Answer 9

The behaviour is typically described as anxious or avoidant/fearful behaviour

Under this heading have

Avoidant, dependent and obsessie compulsive disorder

Question 10

Describe each cluster for personality disorders and the disorders under each cluster heading?

Answer 10

Cluster A - odd and eccentric

• * Paranoid, Schizoid, Schizotypal

Cluster B - dramatic or emotional behaviour

• * Antisocial, Borderline, Histrionic. Narcissistic

Cluster C - anxious and avoidant/fearful

• Avoidant, Dependent, Obsessive compulsive

Question 11

What is he most common personality disorder?

Answer 11

This would be obsessive compulsive personality disorder

Question 12

What is obsessive compulsive personality disorder also known as? What cluster is it from?

Answer 12

Obsessive compulsive personality disorder is also known as anakastic personality disorder

It is from Cluster C

Question 13

What percentage of the population has a personality disorder?

Answer 13

1in10 - so 10% of the population (2% of the population have the personality disorder - obsessive compulsive disorder)

Question 14

Describe the criteria for diagnosing paranoid personality disorder? Paranoid schizophrenic disorders account for 0.7% of PD When does this PD usually begin?

Answer 14

This is a pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and persistent in a variety of contexts as indicated by four (or more) of the following

• 1. Suspect without sufficient basis, that others are exploiting, harming or deceiving him or her.
• 2. Is preoccupied with unjustified doubts about loyalty or trustworthiness of friends or associates
• 3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously
• 4. Reads hidden demeaning or threatening meanings into benign remarks or events
• 5. Persistently bears grudges
• 6. Perceives attacks on his/her character or reputation that are not appearance to other is quick to react angrily
• 7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

Question 15

So now that you have named the criteria for paranoid personality disorder, state a brief description?

Answer 15

People have a continual pervasive distrust and suspiciousness of others

They suspect others to be attempting to deceive themselves, expect disloyalty and others not to be trusted so is reluctant to confide n others.

Also reads hidden meanings or threats in benign remarks and bears grudges and percieves personal attacks on character.

Is constantly suspicious of their partner.

Question 16

Describe the criteria for schizoid PD?

Answer 16

A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

• * Does not desire or enjoy close relationships, including family
• * Almost always chooses solitary activites
• * Has little if any interest in sexual experiecnes
• * Takes pleasure in few, if any, activities
• * Lacks close friends or confidants other than 1st degree relatives
• * Appears indifferent to praise or criticism of others
• * Shows emotional coldness, detachment or flattened affectivity

Question 17

Briefly describe schizoid PD now we have listed the criteria?

Answer 17

The patient lacks the desire to be close to others and prefers to be solitary when doing any activities

They lack close friends and has little interest in sexual relations or activities

They appear cold and detached and are indifferent to praise or criticism

BRUCE WAYNE IN DARK KNIGHT RISES BEGINNING

Question 18

How is schizoid PD different to schizotypal?

Answer 18

Schizotypal - the patient is socially anxious, freindless with magical thinking / odd fantasies

MORE LUNA LOVEGOOD FROM HARRY POTTER

Question 19

Describe the criteria for antisocial PD? What age does it occur at?

Answer 19

A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years, as indicated by three (or more) of the following:

• * They have a failure to conform to social norms with respect to lawful behaviours
• * There are deceitful, as indicated by repeated lying,
• * Impulsive or failure to plan ahead
• * Irritable & aggressive shown by repeated fights or assaults
• * Consistent irresponsibility, as iindicated by failure to sustain consistent work behaviour
• * Lack of remorse as indicated by being indifferent to having been hurt, mistreated or stolen from another

Question 20

Describe antisocial PD in less words now?

Answer 20

Antisocial PD is when the patient develops antisocial behaviour ie they behave badly, get into lots of fights, are irresponsible and reckless and there is a lack of remorse

BASICALLY NEDS IN SCHOOL

Question 21

What were the other disorder in cluster B PD?

Answer 21

Borderline, histrionic and narcissistic

Question 22

Describe Borderline PD?

Answer 22

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Question 23

Describe borderline personality disorder briefly?

Answer 23

This is when the patient has an identity disturbance meaning they are unstable about who they are themselves, have at least two impulsive disorders eg spending, binge eating and have recurrent suicidal attempts

NIGHTMARE ANNOYING NEEDY GF (DO ANYTHING TO AVOID ABANDONMENT eg suicide attempts or threats)

Question 24

Describe the criteria for histrionic PD? Think RWP

Answer 24

A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

• * Is uncomfortable in situations in which he or she is not the center of attention.
• * Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.
• * Displays rapidly shifting and shallow expression of emotions.
• * Consistently uses physical appearance to draw attention to self.
• * Has a style of speech that is excessively impressionistic and lacking in detail.
• * Shows self-dramatization, theatricality, and exaggerated expression of emotion.
• * Is suggestible (i.e., easily influenced by others or circumstances).
• * Considers relationships to be more intimate than they actually are.

Question 25

Briefly describe histrionic PD now?

Answer 25

Patient is self centered and sexually provocative who utilities physical appearance to draw attention to themselves and thinks relationships are more intimate than they actually are

ATTENTION SEEKING WHORE WHO IS A WHORE - RWP

Question 26

What were the different cluster C PDs again?

Answer 26

Avoidant

Dependent

Obsessive compulsive

Question 27

Describe avoidant PD?

Answer 27

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

• * Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection.
• * Is unwilling to get involved with people unless certain of being liked.
• * Shows restraint within intimate relationships because of the 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 unappealing, or inferior to others.
• * Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.

Question 28

How does avoidant PD differ from schizoid PD? (think ryan for avoidant - fear of rejection if getting close to someone)

Answer 28

In avoidant - the patient fears inadequacy and rejection and therefore avoids social situations and relationships (RAMSAY AROUND GIRLS)

In schizoid - the patient lacks desire to be in relationships or have friends and is seen as cold

Question 29

Criteria for dependent PD? (think JOHN or RU around exams)

Answer 29

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Question 30

Briefly describe dependent PD?

Answer 30

The patient is unable to take care of themselves, and requires approval from others and feels uncomfortable when made to make decision alone - constantly seeks advice - hence ruaridh around exams

Question 31

What is the criteria for obsessive compulsive personality disorder? (anakastic disorder)

Answer 31

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

• * Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.
• * Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met).
• * Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).
• * Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification).
• * Is unable to discard worn-out or worthless objects even when they have no sentimental value.
• * Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.
• * Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.
• * Shows rigidity and stubbornness.

Question 32

Briefly describe obsessive compulsive personality disorder? How does it differ from OCD?

Answer 32

The person present simila to OCD, has rituals they need to do (rituals are a compulsion - have to do it)

The obsessions and compulsions are perceived as the patient as nonsensical in OCD and it distresses them but in OCPD - they like being perfectionists

Question 33

What personality deficits would make someone a psychopath? (think Berlin from money heist)

Answer 33

Superficially charming however manipulative.

They have a grandiose self worth and are often pathological liars. They lack remorse, guilt and empathy.

They tend to fail to accept responsibility for their actions.

They need stimulation and are prone to boredom.

They are often impulsive and irresponsible and lack long term goals.

They have poor behavioural controls, early behavioural problems and have criminal versatility.

Question 34

Can you treat personality disorder?

Answer 34

Not really. However can treat co-morbidities e.g. depression, schizophrenia etc.

Question 35

What is the main psychological treatment used for PD?

Answer 35

Dialectical Behavioural Therapy -

Dialectical behavior therapy (DBT) treatment is a type of psychotherapy — or talk therapy — that utilizes a cognitive-behavioral approach.

DBT emphasizes the psychosocial aspects of treatment. (however mentalisation has become increasingly popular)