Personality disorders

Question 1

What is personality?

Answer 1

A cluster of relatively predictable patterns of thinking, feeling, and behaving that is generally consistent across time, space, and context

Question 2

What are the 5 factors of personality (5-factor model) - OCEAN

Answer 2

• O - Openness
• C - Conscientiousness
• E - Extraversion
• A - Agreeableness
• N - Neuroticism

Question 3

What are some parts of the self that contribute to personality?

Answer 3

• Identity
• Self-evaluation
• Affect regulation
• Direction

Question 4

What are some parts of relationship to others that contribute to personality?

Answer 4

• Intimacy
• Boundaries
• Sense of security in relationships

Question 5

What are personality disorders?

Answer 5

Lifelong, persistent, deeply ingrained maladaptive behaviour that characterizes an individual and deviates markedly from culturally expected or expected ‘normal’ range

Question 6

What are the 3 methods of categorisation of personality disorders according to ICD-11?

Answer 6

Dominant trait
Severity
Borderline (Y/N)

Question 7

What are the 5 ICD-11 classes of personality disorder by dominant trait?

Answer 7

• Negative affectivity
• Detachment
• Dissociality
• Disinhibition
• Anankastia

Question 8

Features of anankastia Pas?

Answer 8

• Perfectionism
• Concern with social rules
• Obligations
• Scrupulous attention to detail
• Rigid routines
• Hyper-scheduling & planfulness
• Emphasis on organisation, orderliness, & neatness
• Rigid control of expressions of emotion
• Inflexibility
• Risk avoidance
• Perseveration
• Deliberativeness

Question 9

Features of negative affectivity PDs?

Answer 9

• Negative emotions with:
  
  • Disproportionate frequency & intensity
  • Labile
  • Poor regulation of emotions
  • Negative attitudes & attributions
  • ↓self esteem & confidence
  • ↓ trust

Question 10

Features of detachment PDs?

Answer 10

• Social & emotional distance
• Avoidance of intimacy
• Reserved
• Aloof
• Limited experience & expression of emotionn.

Question 11

Features of dissociality PDs?

Answer 11

• Disregard for rights & feeling of others
• Egotistic
• Lack of empathy
• Entitled
• Attention-seeking
• Indifferent to the consequences for others & thus uses deception, manipulation, & exploitation

Question 12

Features of disinhibition PDs?

Answer 12

• Acts rashly
• 2-ary to immediate internal or external stimuli
• Impulsive
• Reckless
• Distractible

Question 13

What is meant by borderline pattern?

Answer 13

Pervasive pattern of instability of interpersonal relationships, self-image and affect, & marked impulsivity

Question 14

What are some features of borderline pattern personality disorder?

Answer 14

• Frantic efforts to avoid abandonment;
• Pattern of intense & unstable r-ships;
• Identity disturbance;
• Tendency to act rashly in states of highly –ive affect;
• Recurrent episodes of DSH;
• Emotional instability;
• Chronic feelings of emptiness;
• Intense anger a/o difficulty controlling anger;
• Transient dissociative states in situations of high affective aroused.

Question 15

What are some causes of personality disorder?

Answer 15

• Heritable
• Antenatal adversity
• ACEs (physical, emotional, sexual, abuse, neglect, parental Ψ illness)

Question 16

What are some theoretical models of personality development?

Answer 16

Bowlby’s attachment theory
Object-relations theory
Cognition/behavioural model

Question 17

What is Bowlby’s attachment theory?

Answer 17

Early disruption in relationship with primary care-givers leads to pathology of regulation of affect & development of identity

Question 18

What is the object-relations theory?

Answer 18

Early internal representations of self & important others is recapitulated in adulthood

Question 19

What is the cognitive/behavioural model?

Answer 19

Conditioning (e.g through invalidating environments) and modelling has repercussions on emotions, cognition, behavioural patterns, & on phenotypes

Question 20

What is an alternative to the current ICD-11 dimensional classification of PDs?

Answer 20

3-cluster model

Question 21

What are the 3 clusters of the 3-cluster model of PD

Answer 21

Cluster A - Suspicious
Cluster B - Emotional or impulsive
Cluster C - Anxious

Question 22

What are the 3 sub-types of cluster A (Suspicious) PD?

Answer 22

• Paranoid
• Schizoid
• Schitzotypal

Question 23

What are the 4 sub-types of cluster B (Emotional or impulsive) PD?

Answer 23

• Antisocial
• Borderline
• Histrionic
• Narcisisstic

Question 24

What are the 3 sub-types of cluster C (Anxious) PD?

Answer 24

• Avoidant
• Dependant
• Obsessive-compulsive

Question 25

How can personality disorders be managed?

Answer 25

There is no cure, it is about long term management to find ways around the persons disorder Dialectical behaviour therapy is a form of therapy used in borderline personality disorder and is a way of managing acceptance and change