1What is personality?
The sum total of all of the emotional, cognitive, and behavioral attributes of a person
2When is personality formed?
Early in life and is deeply engrained
3Can personality be altered?
Yes, but difficult
4What is ego-syntonic?
In harmony w/ the ego
5What is ego-dystonic?
Impulses, desires, and thoughts are unacceptable to the ego
6What is often the implication of a co-concurrent personality disorder with a psychiatric condition?
Often interferes with treatment outcomes
7At what age is it acceptable to assign a personality disorder diagnosis?
Age 18
8According to the DSM-5, a general personality disorder is an enduring pattern of behavior and inner experiences that deviates significantly from acceptable standards and is rigdly pervasive. What areas are often affected by the disorder?
Cognition
Affect
Interpersonal Function
Impulse Control
9Consideration for the etiology of Cluster A personality disorders, what psychiatric disorder of the patient's relatives may likely be identified?
Schizophrenia
10What comorbid personality disorder is highly associated with alcohol use disorder?
Antisocial
11What psychiatric condition is often identified in the patient's family history for a patient with borderline personality disorder?
Depression
12What other psychiatric condition is often identified for a patient with a histrionic personality disorder?
Somatization disorder
13What other psychiatric condition is often identified with a diagnosis of avoidant personality?
Anxiety
14What sleep changes are notable for a pt with OCD?
REM sleep changes
15What hormones are associated with impulsive traits?
Testosterone, estrogen,estradiol, and estrone
16What EEG findings may be noted for a patient with antisocial or borderline personality disorder?
Slow wave activity
17Norepinephrine=
Fight or Flight Response
18Dopamine=
Reward Response
19Serotonin=
Affective Response
20What is the basis of the S. Freud's description of personality disorders?
The disorder is a result of a fixation at a particular psychosexual stage of development
21What is the basis of Reich's description of personality disorders?
Largely determined by characteristic defense mechanisms
Ex: Paranoid=projection; Schizoid=withdrawn
22What is the basis of internal object relations in the development of a personality disorder?
Children must accomplish 2 tasks: separation and individualization; failure to separate is linked to personality disorders
23What are the 4 concepts associated with unconscious, underlying defenses mechanisms?
Instinct (wish/need)
Reality
Important persons
Conscience
24What is the result of effective defenses?
Axiety is eliminated
Depression is not apparent
**at a conscious level
25What is common about defenses for those with personality disorders when trying to resolve conflict?
They are often abandoned
26What approach should the provider take when dealing with fantasy defenses?
Focus on fears r/t intamacy; be reassuring and quiet w/o insisting on reciprocal responses
27What approach should the provider take when dealing with disassociation defenses?
The pt can seem dramatic, tight, and emotionally shallow so remain calm, firm, and allow for time to discuss anxieties; assist them w/ remembering what may have been forgotten
28What approach should the provider take when dealing with projection defenses?
Need to be straightforward, utilizing strict honesty, and concerned distance; do not utilize confrontation
29What approach should the provider take when dealing with splitting defenses?
Need to address the aspects that no one person/situation is all good or all bad
30What approach should the provider take when dealing w/ passive/aggressive defenses?
allow opportunity to vent anger
31What approach should the provider take when dealing with acting out defenses?
Ensure safety and try to control escalation of the situation
32What defense mechanism is highly associated with borderline personality disorder?
projection
33What personality disorders are included in Cluster A?
Schizotypal
Schizoid
Paranoid
34What personality disorders are included in Cluster B?
Narcissistic
Borderline
Antisocial
Histrionic
35What personality disorders are included in Cluster C?
Obsessive-compulsive
Dependent
Avoidant
36What 4 domains are often impaired by a personality disorder?
Identity
Self-Direction
Empathy
Intimacy
37What is one key way to recall the traits associated with a paranoid personality disorder?
"SUSPECT"
S: Suspiciousness
U: Unforgiving
S: Spouse fidelity suspicions
P: Perceived attacks
E: Enemy or Friend (all or none pattern of thinking)
C: Confiding in others
T: Treats perceived
38What are the characteristics of a paranoid personality disorder?
Long-standing suspiciousness
Mistrust of persons in general
Assign responsibility to others
Hostile, irritable, angry
Pathologically jealous
Rarely seek treatment on their own
39According to the DSM-5, how many of the key features must be present to diagnose a paranoid personality disorder?
4
40What are the hallmarks of paranoid personality disorders?
Excessive suspiciousness
Distrust of others
Assumption that they are being exploited
41What is one key way to recall the traits associated with a schizoid personality disorder?
DISTANT
D: Detatched or flattened affect
I: Indifferent
S: Sexual experiences
T: Tasks
A: Absence of close friends
N: Neither desires or enjoys close relationships
T: Takes pleasure in few activities
42What is one key way to recall the traits associated with a schizotypal personality disorder?
ME PECULIAR
M: Magical Thinking
E: Experineces; unusual perceptions
P: Paranoid ideation
E: Eccentric behavior or appearance
C: Constricted affect
U: Unusal thinking/speech
L: Lacks close friends
I: Ideas of reference
A: Anxiety in social situations
R: R/O psychotic disorder and pervasive developmental disorders
43What personality disorder includes disturbed thinking, speech that is only meaningful to the patient, superstitious/claims powers of clarivoyance, and may act inappropriately?
Schizotypal
44What personality disorders are included in Cluster B?
Antisocial
Borderline
Histrionic
Narcissistic
45What is one key way to recall the traits associated with a antisocial personality disorder?
CORRUPT
C: Conformity to law is lacking
O: Obligations ignored
R: Reckless disregard to the safety of self or others
R: Remorse lacking
U: Underhanded
P: Planning is insufficient
T: Truancy
46What personality disorder can be described as a con man?
Antisocial (lying, illegal activities, manipulate, involved in schemes, and SUD is common)
47What is one key way to recall the traits associated with a borderline personality disorder?
AM SUICIDE
A: Abandonment
M: Mood instablity
S: Suicidality or self-injuring behavior
U: Unstable and intense relationships
I: Impulsive
C: Control of Anger
I: Identity disturbance
D: Dissociative or paranoid symptoms that are transient and stress related
E: Emptiness
48What is one key way to recall the traits associated with a histrionic personality disorder?
PRAISE ME
P: Provacative
R: Relationships considered more intimate than they actually are
A: Attention (needs to be the center of)
I: Influenced easily
S: Style of speech (impressionistic, lacking detail)
E: Emotions
M: Made up (physical appearance is utilized to draw attention)
E: Extroverted
49What is one key way to recall the traits associated with a narcissistic personality disorder?
SPECIAL
S: Special
P: Preoccupied w/ fantasies
E: Entitled
C: Conceited
I: Interpersonal exploitation
A:
L:
50What medication is beneficial for control of the mood in those w/ narcissistic personality disorder?
Lithium
51What personality disorders are included in Cluster C?
Avoidant
Dependent
Obsessive compulsive
52What is one key way to recall the traits associated with a avoidant personality disorder?
CRINGES
C: Certainty of being liked by others
R: Rejection preoccupies ones thoughts
I: Intamate relationships
N: New interpersonal relationships
G: Gets around occupational activity
E: Embarrasment
S: Self-views as unappealing
53What is one key way to recall the traits associated with a dependent personality disorder?
RELIANCE
R: Reassurance
E: Expressing disagreement
L: Lacks responsibilities
I: Initiating projects
A: Alone
N: Nurturance
C: Companionship
E: Exaggerated fears of being left to care for self
54What is one key way to recall the traits associated with a obsessive compulsive personality disorder?
LAW FIRMS
L: Loses point of activity due to preoccupation w/ details
A: Ability to complete tasks
W: Worthless
F: Friendships and leisure activities exclude r/t preoccupations
I: Inflexible
R: Reluctant
M: Mizerly
S: Stubborn