Week 4 - Personality & Dissociative Disorders

What is the theme of Cluster A Personality Disorders?

odd or eccentric thinking behavior

What are the Cluster A Personality Disorders?

paranoid, schizoid, schizotypal

What are the clinical manifestations of Cluster A Paranoid Personality Disorders?

- Distrust or suspiciousness of others

- Skeptical or mistrustful of the examiner

Cluster A: Paranoid Personality Disorder is more common in who? (people w/ hx of what?)

Pt's w/ a family Hx of schizophrenia and delusional disorder

What is the management for Cluster A: Paranoid Personality Disorder?

Psychotherapy

What are the clinical manifestations of Cluster A: Schizoid Personality Disorder?

- Theme: Deficient ability or desire to develop meaningful relationships w/ others

- Prefers being alone

What is the treatment for Cluster A: Schizoid Personality Disorder?

- Treatment is generally not needed

- Pharmacotherapy has not been beneficial

What is the prognosis for Cluster A : Schizoid Personality Disorder?

- Many are WELL ADJUSTED

What are the themes/clinical manifestations of Cluster A: Schizotypal Personality Disorder?

Theme: Odd or eccentric behavior and thoughts, "magical" thinking

What is the theme for Cluster B personality disorders?

Dramatic or erratic thinking and behavior

What are the cluster B personality disorders?

- Antisocial

- Borderline

- Histrionic

- Narcissistic

What is Cluster B Antisocial Personality Disorder strongly associated with?

STRONG Association w/ conduct disorder

Do patients with Cluster B: Antisocial Personality Disorder pursue treatment?

Patients rarely pursue treatment

What are the clinical manifestations of Cluster B: Antisocial Personality Disorder?

- Theme: Disregard for the rights and feelings of others

- Lack remorse and empathy

- May neglect their children

Cluster B: Antisocial Personality Disorder - When do symptoms begin? When can it be dx'ed?

- Symptoms begin < 15 years

- Dx'ed >18 yrs or older

What is the management for Cluster B: Antisocial Personality Disorder?

- Most tx refractory of all personality disorder

- Psychotherapy (social based interventions in group context & Intensive community-based tx programs)

-individual therapy is ineffective (manipulative etc)

Cluster B: Borderline Personality Disorder - Clinical Manifestations

- Theme: unstable/intense interpersonal relationships, unstable mood and poor impulse control

- Impulsivity

- Recurrent suicidal threats, self-harm and suicidal gestures

- Excessive attempts to avoid perceived abandonment

Cluster B: Borderline Personality Disorder - Management

- Dialectical Behavior Therapy (DBT)

- Group Therapy

- Psychopharmacology therapy may be useful (lithium, anticonvulsants, antipsychoitics, antidepressants)

Cluster B: Histrionic Personality Disorder - Clinical Manifestations

- Theme: Excessive, dramatic emotions and hyper sexuality

- Seeks attention and wants to be center of attention

- Overly concerned with their appearance and may dress in a seductive/provocative way

Cluster B: Histrionic Personality Disorder - Management

- Psychotherapy - NOT EFFECTIVE

group therapy may be helpful (can call each other out)

Cluster B: Narcissistic Personality Disorder - Clinical Manifestations

Theme: Grandiose thoughts, exaggerated sense of self, need to be admired by others but care little about other people (lacks empathy)

- Sense of entitlement

- Contempt for others

Is Psychopharmacology helpful for Narcissistic Personality Disorder

NOPE

What is the theme for Cluster C Personality Disorders?

Anxious or Fearful thinking and behavior

What are the Cluster C Personality Disorders?

- Avoidant

- Dependent

- Obsessive Compulsive

What are the clinical manifestations of Cluster C: Avoidant Personality Disorder?

- Theme: Persistent avoidance due to anxiety resulting in limited social interactions (aka INTROVERTS)

- Very uncomfortable in social settings

- Avoids new or unfamiliar situations

What are the themes/clinical manifestations of Cluster C: Dependent Personality Disorder?

Theme: Needs to be taken care of; submissive

What are the themes/clinical manifestations of Cluster C: Obsessive Compulsive Personality Disorder?

- Theme: Rigid, inflexible,perfectionist, orderliness

- Likes to have control; does not like to delegate/work with others

What is dissociative amnesia?

A dissociative disorder that involves inability to recall autobiographical info

What is dissociative identity disorder?

- A dissociative disorder in which a person develops two or more distinct personalities (average # is 10)

- Also presents with a lack of continuity in sense of self and loss of memory in everyday activities

dissociative identity disorder (DID) is strongly associated with a Hx of ________________ & __________________?

Sexual Abuse & Signifiant childhood trauma

What is the treatment and management for Dissociative Identity Disorder?

- Psychotherapy (supportive)

What is depersonalization?

Individual is removed from sense of self/feels detached

What is derealization?

Individuals may feel like they are in a dream-state/nothing is real