Term
| what is the definition of personality? |
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Definition
| an identifiable set of traits and characteristics which define a person. they are consistent from one day to the next and include appearance as well as behavior. a person's personality is fairly defined by early adulthood. |
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Term
| what is a personality disorder? |
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Definition
| the lack of ability to adjust personality traits to changes in exterior conditions. this maladaption leads to difficulty in interpersonal relationships, even as the pt may not consider their fixed traits disturbing. these develop slowly over time during development and cannot be linked to just one experience. |
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Term
| what is an ego dystonic vs ego syntonic disorder? |
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Definition
| ego dystonic: a disorder which has symptoms bothersome to the pt. ego syntonic: a disorder which doesn't bother the pt, only the people in relationships w/the pt |
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Term
| how common are personality disorders? |
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Definition
| they are seen in 10% of the population |
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Term
| why are pts w/personality disorders difficult to treat in a medical setting? |
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Definition
| these pts can be noncompliant, demanding, multiple complaints, and have an overriding sense of self aggrandizement |
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Term
| what are the 3 personality disorder clusters? |
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Definition
| A: personality disorders known as paranoid, schizoid, schizotypal (mad). B: antisocial disorder, borderline personality disorder, histrionic disorder, narcissistic (bad). C: avoidant, dependent, obsessive compulsive (sad) |
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Term
| when is the onset of personality disorder symptoms? |
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Definition
| adolescent to young adult years. if pts show signs of a personality disorder later in life = think organic cause. |
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Term
| what are some medical correlations for the personality disorders? |
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Definition
| monozygotic twins raised apart from each other have been shown to exhibit the same personality disorder. cluster A disorders tend to run in families. antisocial personality disorders are more common in families w/a hx of alcoholism. people w/impulse control issues have higher levels of testosterone and 17-estradiol. schizotypal personality disorder pts have low platelet monoamine oxidase levels. |
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Term
| what characterizes the paranoid personality disorder pt (cluster A)? |
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Definition
| innate, persistent mistrust of people. difficulty in relationships due to the idea that anyone they interact w/is going to take advantage of them. these pts are suspicious about everyone and have difficulty forming relationships above the superficial level. these pts are guarded and have a constant sense of being violated. these pts always have something peripheral bothering them, they constantly question loyalty and will bear grudges. small problems are made into bigger problems - these pts are easily angered/provoked and can sometimes be pushed into psychosis. these pts are not however delusional. |
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Term
| what characterizes the schizoid personality disorder pt (cluster A)? |
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Definition
| these pts are loners, very emotionally detached and don't want relationships. when others interact w/them they get no sense of feeling or connection. these pts are often perceived as cold and indifferent and thus have difficulty in relationships - even though otherwise they are mentally fine and intellectually function. these pts are not tuned in to fashion or appearance and may seem absent minded. these pts spend a lot of time in fantasy - as they have less relationships, they build them internally (daydream a lot). men are affected by this disorder 2x more than women. this disorder may present earlier in childhood when the pt doesn't participate in normal social interaction occurring through development. |
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Term
| what characterizes the schizotypal personality disorder pt (cluster A)? |
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Definition
| these pts are more eccentric, stranger in appearance/behavior and have difficulty in relating to people - but not due to coldness. they can get lost in clairvoyance and magical thinking and are socially inept. generally they dress unusually, carry interesting speech patterns (digressive, hard to follow) and may theatrically stand out. if exposed to significant stress, these pts can go completely psychotic and appear schizophrenic. |
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Term
| what characterizes the antisocial personality disorder pt (cluster B)? |
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Definition
| these pts often have a hx of repetitive, unlawful acts/behaviors which are socially irresponsible. they may be totally unconcerned w/the rights of other people and have no sense of guilt, legality, remorse - even though on the surface they can appear pleasant and socially engaging. these pts act charming but are prone to deceit, illegal activity, substance abuse, and promiscuous behavior w/no concern about how their actions affect others (when in prison - may only be sad about getting caught). this is usually observed in pts by the time they turn 15 due to trouble in school - it may appear similar to or present w/ADD. this is more common in men than women and 75% of the prison population likely has antisocial personality disorder. it does run in families (5x greater risk if 1st degree relative is affected) and tx is very challenging as it has to be done in a controlled environment where good behavior gets you privileges. |
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Term
| what characterizes the borderline personality disorder pt (cluster B)? |
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Definition
| this affects women more than men. pts will have a very labile, unstable affect - they may appear initially bright/cheery, but if you say the wrong thing the person becomes angry/enraged/explosive and experiences intense emotions. sometimes the only way to discharge emotions is for the pt to non-fatally cut themselves. these pts may perform "splitting" where they assign a specific emotion to different people, then switch it later. even though these pts can appear very normal, they have difficulty in forming stability in interpersonal relationships. these pts can be very seductive, then drastically change emotionally later. these pts greatly *fear being alone and if they are - they can become depressed and may cut or talk suicide. often pts w/borderline personality disorder where *abused as children. they can be a problem to treat as they act very disturbed then snap right back - may "split" in their relationship w/their therapist. the therapist may be challenged in their own response to the pts rapid changes. these pts do respond well to rx, symptoms of impulsivity are targeted w/mood-stabilizing medications. |
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Term
| what characterizes the histrionic personality disorder pt (cluster B)? |
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Definition
| these pts are characterized by excess concern w/appearance and attention and may overreact emotionally, dramatically, w/little toleration for frustration. these pts are concerned w/being physically attractive and come across as being overly sexy. everything is an overreaction - all headaches are the "worst ever". these pts will frequently test the environment to see if others recognize how attractive they are - and the worst case scenario is being ignored. these pts respond well to individual psychotherapy. this is seen more in women than men. |
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Term
| what characterizes the narcissistic personality disorder pt (cluster B)? |
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Definition
| these are overwhelmingly self-absorbed and ambitious people who feel as if they are the most important people in the entire world. these pts are often involved w/the business world, are very driven and will devote all of their energy to proving they are the best and do become successful. if these pts fail at being the best - they fall in a terrible crash of depression (sense of personal attack). these pts exhibit self-aggrandizement, bend the rules and don't care if it affects others. these pts are easily disappointed when others don't recognize their greatness - and thus they are often co-morbid w/depressive disorders. |
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Term
| what characterizes the avoidant personality disorder pt (cluster C)? |
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Definition
| these pts often sound like a schizoid or paranoid, but are different in that they would like to have relationships, but are too afraid of being rejected or humiliated to enter. these pts may have a disfiguring appearance or illness which occurs spontaneously that keeps them from developing relationships they want. these pts are at high risk for phobias, depression and are treated w/anti-anxiety, behavioral desensitization, and psychotherapy. |
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Term
| what characterizes the dependent personality disorder pt (cluster C)? |
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Definition
| these pts fear abandonment/being alone and will go to all lengths to preserve a relationship, even one which is physically/emotionally abusive. these pts are prone to depression and may not express emotion in relationships for fear of precipitating a breakup. these pts may become very attached to their physicians and depend on them to make decisions. |
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Term
| what characterizes the obsessive compulsive personality disorder pt (cluster C)? |
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Definition
| *this is not OCD* these pts are preoccupied w/perfection, efficiency, rules, trivia, and procedures to the point where they can't see the forest for the tress. they can get involved w/an inflexible approach to dealing w/life to the point of being unable to delegate tasks to others out of a sense the task won't be done right. |
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Term
| what is passive aggressive/negativistic personality disorder? |
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Definition
| an unofficial dx describing pts who constantly miss deadlines, resist usual social/occupation demands, may be sullen and argumentative and don't like authority or being evaluated by authority (defiant). |
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Term
| what medical conditions may underlie personality disorders? |
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Definition
| head trauma commonly, neurosurgery/CVA/tumor, MS, huntington's, AIDS, and heavy metal poisoning. |
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