Personality Disorders Flashcards Preview

Behavioral Health > Personality Disorders > Flashcards

Flashcards in Personality Disorders Deck (60)
Loading flashcards...
1

General DSM 5
Diagnostic Criteria for PD’s
4

(manifested how?)

Enduring pattern of inner experience or behavior that deviates from expectations of culture, manifested in two or more of the following:

1. cognition (perception of self, others)
2. affectivity (intensity, range of emotions)
3. interpersonal functioning
4. impulse control

2

What will their affect look like?
3

1. odd, eccentric,
2. labile,
3. laughing while hurting

3

How will their interpersonal functioning look like?

Impulse control?

unable to respond to social cues.


not good

4

General Diagnostic Criteria for PD’s

4
(has to result in and cannot be due to)

1. Enduring pattern leads to distress, impairment in important areas of functioning (work, relationships)

2. Pattern is stable and of long duration, can be traced back to childhood

3. Pattern not better explained by another disorder (used to be Axis 1)

4. Pattern not due to substance abuse or medical condition

5

Personality disorders have been linked to:
3

1. Mortality (Roberts et al., 2007)
2. Heart disease (Reich & Schatzburg, 2010)
3. Life satisfaction and well-being (Lucas, 2008)

6

1. Treating the Axis I pathology typically ______ help the personality disorder

2. Treating the personality disorder typically ______ the Axis I pathology

1. does not

2. does help

7

Most common PD diagnosis is what? 2

Personality Disorder NOS
and Deferred

8

Problems with DSM-IV

1. Diagnostic overlap (Lenzenweger et al., 2007)
2. Diagnostic Heterogeneity (Widiger & Trull, 2009)
3. Many Personality Disorders are understudied (Widiger & Trull, 2009)
4. No specific treatments (Widiger & Trull, 2009)

9

6 types of PD
Based on trait criteria
for DSM 5

6

1. Antisocial
2. Avoidant
3. Borderline
4. Narcissistic
5. Obsessive-Compulsive
6. Schizotypal

10

5 personality styles?

1. Detachment,
2. psychoticism,
3. Disinbition,
4. negative affectivity,
5. Antagonism

11

Cluster A Disorders described as?

Which are in these? 3

Tx prognosis?

1. (odd or eccentric) NOT psychosis


2. Paranoid, Schizoid, Schizotypal


3. high

12

Cluster B Disorders described as?

Which are these? 4

Tx prognosis?

1. (dramatic, emotional, erratic)

2. Antisocial, Borderline, Histrionic, Narcissistic

3. intermediate

13

Cluster C Disorders described as?

Which are these? 3

Tx prognosis?

1. (anxious or fearful)

2. Avoidant, Obsessive-Compulsive, Dependent

3. low

14

Paranoid Personality Disorder
characteristics?
3

1. Lack of trust in others

2. Fear that friends may be disloyal, unfaithful

3. Being hypersensitive, overly suspicious, perceived as hostile

15

DSM-5 Criteria for Paranoid PD
7

Pervasive distrust, suspicion of others, and four or more of the following:
1. suspects, without basis, that others are exploiting, harming, deceiving
2. is preoccupied with unjustified doubts of loyalty or trustworthiness of people
3. is reluctant to confide in others
4. reads hidden, demeaning, threatening meaning into benign actions
5. persistently bears grudges
6. perceives attacks on reputation
7. has unjustified suspicions about fidelity of others

16

Co-occuring Disorders with PD?
4

1. Generalized Anxiety Disorder
2. Panic Disorder
3. Delusional Disorder
4. Other PDs

17

Treatments for PPD
3

1. Cognitive Behavioral therapy to challenge paranoid beliefs
2. Medication (SSRIs) to reduce suspiciousness
3. Day Treatment Programs

18

DSM-5 Criteria for Schizoid PD
7

Detachment from social relationships, restricted emotions, as indicated by four or more of the following:
1. neither desires nor enjoys social relationships
2. prefers solitary activities
3. has little interest in sexual experiences
4. gets pleasure from few activities
5. lacks close friends
6. appears indifferent to praise or criticism
7. shows emotional coldness, detachment, flat affect

19

What will the patient act like in Schizoid?
4

Least commonly diagnosed personality disorder in the general population

Unsocial, quiet, reserved, serious

20

Differential Diagnosis
Schizoid PD

4


What does Schizoid PD lack?

1. Paranoid PD
2. Schizotypal PD
3. Schizophrenia
4. Autism


Again, lack of clear cut delusions, hallucinations or other psychotic features

21

Schizoid personality disorder appears to begin 1.when while autism is seen 2.when?

1. in early adulthood

2. in the infant or small child.

22

Treatment for Schizoid PD
3

1. Schizoid PD patients aren’t likely to seek help.

2. Social skills training- modeling , role-playing, shaping, feedback, and reinforcement of positive interactions may be used in SST

3. Low dose antipsychotics or antidepressants

23

DSM-5 Criteria for Schizotypal PD
9

Lacks what?

Acute discomfort with social relationships, eccentric behavior, and five or more of the following:
1. ideas of reference
2. odd beliefs
3. unusual perceptual experiences
4. odd speech
5. Suspiciousness or paranoid ideation
6. inappropriate or constricted affect
7. odd or eccentric appearance and behavior
8. lack of close friends
9. excessive social anxiety


Again, lack of clear cut delusions, hallucinations or other psychotic features

24

Describe some situations that a Schizotypal PD might believe?

1. Ideas of reference: The feeling that casual incidents and external events have a particular and unusual meaning that is specific to the person. This is to be distinguished from a delusion of reference, in which there is a belief that is held with delusional conviction

2. Believing that 'somehow everyone on a passing city bus is talking about them, yet they may be able to acknowledge this is unlikely

3. A feeling that people on television or radio are talking about or talking directly to them

4, Believing that headlines or stories in newspapers are written especially for them

5. Believing that events (even world events) relate to them

6. Believing that the lyrics of a song are specifically about them

Story about MHCD, “What are you doing?” Walking up the stairs backwards.

25

Differential Diagnosis
Schizotypal PD

1. Other PDs in cluster A

2. Psychotic disorders
-The personality disorder must have been present before the onset of psychotic symptoms and persist when the psychotic symptoms are in remission (DSM-5)
-Psychotic disorders are all characterized by a period of persistent psychotic symptoms (DSM-5)

26

Treatment for Schizotypal PD
3

1. Similar to Schizoid
2. Social skills training
3. Low dose antipsychotics or antidepressants


Mental health center
Socialize, social skills training
Mental health center in Denver – music therapy!
M.L. – limit amount of time worrying 30 minutes a day.


27

Contrast Schizoid and Schizotypal
1. Similarities? 1
2. Differences? 2

1. Similarities
-inability to initiate or maintain relationships (both friendly and romantic)

2. Differences
-Schizotypal patients avoid social interaction because of a fear of people.
-Schizoid individuals feel no desire to form relationships

28

1. Whihc kind of disorders? 4

2. Cluster B Personality Disorders described as?
3

1.
-Antisocial
-borderline
-histrionic
-narcissistic personality disorders

2. Dramatic, emotional and erratic
3. Being self-absorbed, prone to exaggerate importance of events
4. Having difficulty maintaining close relationships

29

DSM-5 Criteria for
Antisocial PD
10

Pattern of disregard for rights of others since age 15, as indicated by three or more of the following:
1. failure to conform to social norms, respect lawful behavior
2. deceitfulness, lying, conning others for profit or pleasure
3. impulsivity, failure to plan ahead
4. irritability, aggressiveness, repeated fights
5. reckless disregard for safety of others
6. consistent irresponsibility, failure to honor obligations
7. lack of remorse
8. Individual is at least 18 years old
9. Evidence of conduct disorder before age 15.
10. Occurrence not exclusively during the course of Schizophrenia, or a manic episode

30

What can they act like?

Can be very charming, likeable!