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Flashcards in Personality Disorders Deck (60)
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General DSM 5
Diagnostic Criteria for PD’s

(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


What will their affect look like?

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


How will their interpersonal functioning look like?

Impulse control?

unable to respond to social cues.

not good


General Diagnostic Criteria for PD’s

(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


Personality disorders have been linked to:

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


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


Most common PD diagnosis is what? 2

Personality Disorder NOS
and Deferred


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)


6 types of PD
Based on trait criteria
for DSM 5


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


5 personality styles?

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


Cluster A Disorders described as?

Which are in these? 3

Tx prognosis?

1. (odd or eccentric) NOT psychosis

2. Paranoid, Schizoid, Schizotypal

3. high


Cluster B Disorders described as?

Which are these? 4

Tx prognosis?

1. (dramatic, emotional, erratic)

2. Antisocial, Borderline, Histrionic, Narcissistic

3. intermediate


Cluster C Disorders described as?

Which are these? 3

Tx prognosis?

1. (anxious or fearful)

2. Avoidant, Obsessive-Compulsive, Dependent

3. low


Paranoid Personality Disorder

1. Lack of trust in others

2. Fear that friends may be disloyal, unfaithful

3. Being hypersensitive, overly suspicious, perceived as hostile


DSM-5 Criteria for Paranoid PD

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


Co-occuring Disorders with PD?

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


Treatments for PPD

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


DSM-5 Criteria for Schizoid PD

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


What will the patient act like in Schizoid?

Least commonly diagnosed personality disorder in the general population

Unsocial, quiet, reserved, serious


Differential Diagnosis
Schizoid PD


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


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.


Treatment for Schizoid PD

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


DSM-5 Criteria for Schizotypal PD

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


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.


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)


Treatment for Schizotypal PD

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.


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


1. Whihc kind of disorders? 4

2. Cluster B Personality Disorders described as?

-narcissistic personality disorders

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


DSM-5 Criteria for
Antisocial PD

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


What can they act like?

Can be very charming, likeable!