What are the characteristics of paranoid PD? what is the mnemonic?
pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent
“SUSPECT”, needs at least 4
- S - spouse fidelity suspected
- U - unforgiving (bears grudges)
- P - perceives attacks (and reacts quickly)
- E - “enemy or friend” suspects associates and friends
- C - confiding in others feared
- T - threats perceived in benign events
What are the characteristics of schizoid PD? and the mnemonic for the criteria?
pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings
“DISTANT”, need at least 4
- D - detached/flattened affect
- I - indifferent to criticism/praise
- S - sexual experiences of little interest
- T - tasks done solitarily
- A - absence of close friends
- N - neither desires nor enjoys close relations
- T - takes pleasure in few activities
What are the characteristics of schizotypal PD? and the mnemonic for the criteria?
pervasive pattern of social and interpersonal deficits marked by aute discomfort with and reduced capacity for, close relationships, as well as by cognitive or perceptual distortions and eccentricties of beliefs and behaviour
“ME PECULIAR”, needs at least 5
- M - magical thinking or odd beliefs
- E - experinces unusual perceptions
- P - paranoid ideation
- E - eccentric behaviour or appearance
- C - constricted/inappropriate affect
- U - unusual thinking and speech
- L - lacks close friends
- I - ideas of reference
- A - anxiety in social situations
- R - rule out psychoticdisorders and pervasive developmental disorder
What does each Cluster of Personality Disorders represent?
Cluster A - odd/eccentric
Cluster B - dramatic/eotional/erratic
Cluster C - anxious/inhibited
Name the PDs in Cluster A.
- paranoid PD
- schizoid PD
- schizotypal PD
Name the PDs in Cluster B.
- antisocial PD
- borderline OD
- narcissitic BD
- histrionic PD
Name the PDs in Cluster C.
- avoidant PD
- dependent PD
- obsessive compulsive PD
- passive-aggressive PD
definition of personality.
persistent internal experience open to psychological modification.
Maladaptive (causes person adn people around them distress/inconvenience) and affects ability to function
What are the characteristics of antisocial PD? and what is the mmenmonic for the criteria?
pervasive pattern of disregard for and violation of the rights of others
“CORRUPT”, needs at least 3
- C - conformity to law lacking
- O - obligations ignored
- R - reckless disregard for safety of self and others
- R - remorse lacking
- U - underhanded (deceitful)
- P - planning insufficient
- T - temper (irritable, aggressive)
What are the characteristics of borderline PD? and what is the mnemonic for the criteria?
pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity
“AM SUICIDE”, needs at least 5
- A - abandonment
- M - mood instability (marked reactivity)
- S - suicidal (self-mutlitating) behaviour
- U - unstable and intense relationships
- I - impulsivity (in two potentially self damaging areas)
- C - control of anger
- I - identity disturbance
- D - dissociative/paranoid symptoms that are transient/stress-related
- E - emptiness (chronic feeling of)
What are the characteristics of histrionic PD? and what is the mnemonic for the criteria?
pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood
“PRAISE ME”, needs at least 5
- P - provocative behaviour
- R - relationships (considered more intimate than they are)
- A - attention (uncomfortable when not the centre of attention)
- I - influenced easily
- S - style of speech (impressionistic, lacks detail)
- E - emotions (rapidly shifting and shallow)
- M - made up (physical appearance used to draw attention to self)
- E - emotions exaggerated (theatrical)
What are the characteristics for narcissistic PD? and what is the mnemonisc for the criteria?
pervasive pattern of grandiosity, need for admiration and lack of empathy for others
“SPECIAL”, needs at least 5
- S - special (believes that he/she is unique)
- P - preoccupied with fantasies (of unlimited sucess, power, beauty)
- E - envious (of others or believes others envious of him/her)
- E - entitlement
- E - excess admiration required
- C - conceited (grandiose sense of self importance)
- I - interpersonal exploitation
- A - arrogant
- L - lacks empathy
What are the characteristics of avoidant PD? and what is the mnemonic for the criteria?
pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation
“CRINGES”, needs at least 4
- C - certainty (of being liked required before willing to get involved with others)
- R - rejection/criticism preoccupies one’s thoughts in social situations
- I - intimate relationships (in inhibited in)
- N - new interpersonal relationship )in inhibited in)
- G - gets around occupation activity (involving significant interpersonal contact)
- E - embarassment (potential) prevents new activity or taking risks
- S - self-viewed as unappealing, inept, inferior
What are the characteristics of dependent PD? and what is the mnemonic for the criteria?
pervasive and excessive need to be taken care of that leads to clinging and submissive behaviour, and fears of separation
“RELIANCE”, needs at least 5
- R - reassurance (required for decisions)
- E - expressing disagreement difficult (due to fear of loss of approval/support)
- L - life responsibilities (need to be assumed by others)
- I - initiating projects difficukt (due to lack of self-confidence)
- A - alone (feels helpless and discomfort when alone)
- N - nurturance (goes to excessive lengths to obtain nurturance and support)
- C - companionship sought urgently when close relationship ends
- E - exaggerated fears of being left to care for self
What are the characteristics of obsessive- compulsive PD? and what is the mnemonic for the criteria?
pervasive pattern of preoccupation with orderliness, perfectionism and mental and interpersonal control at the expense of flexibility, openness and efficiency.
“LAW FIRMS”, needs at least 4
- L - loses point of activity (due to preoccupation with detail
- A - ability to complete tasks (compromised by perfectionism)
- W - worthless objects (unable to discard)
- F - friendships excluded (due to preoccupation with work)
- I - inflexible, overconstientious (on ethics, values, morality, not accounted for by religion or culture)
- R - reluctance to delegate (unless others submit to exact guidelines)
- M - miserly (toward self and others)
- S - stubborness/rigidity
what differential diagnosis is there for cluster B PDs?
- bipolar disorder, depressive disorders
- ABI
- cerebral malignancy
- CVD
- dementia
what differential diagnoses are there for cluster A PDs?
- schizophrenia, depressive disorders
- ABI
- CVD
- dementia
- cerebral malignancy
what differential diagnoses are there for cluster C PDs?
- anxiety disorders, depressive disorders
- ABI
- dementia
- CVD
- cerebral malignancy
When can a PD diagnosis be made?
After the DSM criteria have been satisfied and patient is older than 18 (dx should only be considered as putative until after the age of 25)
