Personality Disorders

Tag yourself I'm obsessive compulsivity personality disorder

personality

individuals’ characteristic pattern of thoughts, behaviors, and feelings which are unique to the individual

extraversion/introversion, sensing/intuition, thinking/feeling, judging/perceiving

What are the parts of the myers-briggs

neuroticism, extraversion, openness to experiences, agreeableness, conscientiousness

What are the parts of the NEO personality inventory?

Personality disorder

an enduring pattern of inner experience and behavior that deviates markedly from expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment

medications, substance abuse, strokes, head injury, tumor, dementia, hypoxia, hypoglycemia

What are some things we need to rule out before diagnosing personality disorders?

General personality disorder

An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individuals culture - the pattern is inflexible and pervasive, leads to clinically significant distress/impairment, stable and of long duration, not better explained by something else, and not attributable to another medical condition.

cognition, affectivity (emotion), interpersonal functioning, impulse control

General personality disorder is manifested in 2+ of

paranoid, schizoid, schizotypal

What is included in cluster A (odd - avoids medical contact)

antisocial, borderline, histrionic, narcissistic

What is included in cluster B (dramatic - seeks medical contact)

avoidant, dependent, obsessive-compulsive

What is included in cluster C (anxious and fearful - avoids medical contact)

Paranoid personality disorder

A pervasive distrust and suspiciousness of other such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of context - not better explained by another psychiatric disorder

paranoid personality

The following is a red flag for: Suspects, without sufficient evidence that others are exploiting, harming, or deceiving them

paranoid personality disorder

The following is a red flag for: Is preoccupied with unjustified doubts about the loyalty or trustworthiness of others

paranoid personality disorder

The following is a red flag for: Is reluctant to confide in others because of unwarranted fear that the information will be used against them

paranoid personality disorder

The following is a red flag for: Reads hidden demeaning or threatening messages into benign remarks or events

Paranoid personality disorder

The following is a red flag for: Persistently bears grudges

paranoid personality disorder

The following is a red flag for: Percieves attacks on their character/reputation that are not apparent to others an is quick to react angrily/counterattack

paranoid personality

The following is a red flag for: Has recurrent suspicions without justifications, regarding the fidelity of their partner

Schizoid

A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings beginning by early adulthood and present in a variety of context - not better explained by another psychiatric disorder

Schizoid

The following is a red flag for: Neither desires nor enjoys close relationships, including being part of a family

Schizoid

The following is a red flag for: almost always choses solitary activity

schizoid

The following is a red flag for: Has little interest (if any) in sex with another person

schizoid

The following is a red flag for: takes pleasure in a few, if any activities

schizoid, schizotypal

The following is a red flag for: lacks close friends or confidants other than 1st degree relatives

schizoid

The following is a red flag for: Appears indifferent to praise or criticism

Schizoid

The following is a red flag for: Shows emotional coldness, detachment, or flattened affect

Schizotypal personality disorder

A pervasive pattern of social and interpersonal deficits marked by an acute discomfort with, and reduced capacity for, closed relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of context - not better explained by another psychiatric disorder

Schizotypal

The following is a red flag for: ideas of reference (mild delusions)

schizotypal

The following is a red flag for: odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms

Schizotypal

The following is a red flag for: unusual perceptual experiences, including bodily illusions

Schizotypal

The following is a red flag for: Odd thinking and speech

Schizotypal

The following is a red flag for: suspiciousness or paranoid ideation

Schizotypal

The following is a red flag for: inappropriate or constricted affect

Schizotypal

The following is a red flag for: excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fear rather than negative judgment about self

manage your own emotions, don’t try to win them over, remain interested but low-key, focus on technical aspects

Tips and tricks for working with cluster As

Antisocial personality disorder

A pervasive pattern of disregard for others and violation of the rights for others, occurring since age 15 - must be 18, evidence of previous conduct disorder, not explained by anything else

antisocial

The following is a red flag for: failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest

antisocial

The following is a red flag for: deceitfulness, repeated lying, use of aliases, or conning others for pleasure

antisocial

The following is a red flag for: impulsivity or failure to plan ahead

antisocial

The following is a red flag for: irritability and aggressiveness, as indicated by repeated physical fights/assualts

antisocial

The following is a red flag for: reckless disregard for safety of self/others

antisocial

The following is a red flag for: consistent irresponsibility (repeated failure to sustain consistent work or honor financial obligations)

antisocial

The following is a red flag for: lack of remorse (indifferent to/rationalizing having hurt, mistreated, or stolen from another)

Borderline personality disorder

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning in early adulthood and present in a variety of context

Borderline

The following is a red flag for: frantic efforts to avoid real or imagined abandonment

borderline

The following is a red flag for: a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

borderline

The following is a red flag for: identity disturbance - markedly and persistently unstable self-image or sense of self

borderline

The following is a red flag for: impulsivity in at least 2 areas that are potentially self damaging (binge eating, sex, substance abuse, etc)

borderline

The following is a red flag for: recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

borderline

The following is a red flag for: affective instability due to a marked reactivity of mood

borderline

The following is a red flag for: chronic feelings of emptiness

borderline

The following is a red flag for: inappropriate, intense anger/difficulty controlling ager

borderline

The following is a red flag for: transient, stress related paranoid ideation, or severe dissociative symptoms

histrionic personality disorder

A pervasive pattern of excessive emotionality and attention seeking, beginning in early adulthood and present in a variety of context

histrionic

The following is a red flag for: is uncomfortable in situations in which they are not the center of attention

histrionic

The following is a red flag for: interaction with others is often characterized by inappropriate sexually seductive or provocative behavior

histrionic

The following is a red flag for: Displays rapidly shifting and shallow expression of emotions

histrionic

The following is a red flag for: consistently uses physical appearance to draw attention to self

histrionic

The following is a red flag for: Has a style of speech that is excessively impressionistic and lacking in detail

histrionic

The following is a red flag for: shows self-dramatization, theatricality, and exafferated expression

histrionic

The following is a red flag for: Is suggestible (easily influence)

histrionic

The following is a red flag for: considers relationships to be more intimate than they are

Narcissistic personality disorder

a pervasive pattern of grandiosity need for admiration, lack of empathy, beginning by early adulthood and present in a variety of context

Narcissistic

The following is a red flag for: has a grandiose sense of self-importance

Narcissistic

The following is a red flag for: is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

narcissistic

The following is a red flag for: believes they are “special” and unique and can only be understood by/associate with by other high status people

narcissistic

The following is a red flag for: requires excessive admiration

Narcissistic

The following is a red flag for: has a sense of entitlement

narcissistic

The following is a red flag for: is interpersonally exploitative

narcissistic

The following is a red flag for: lacks empathy - is unwilling to recognize/idenitify with the feelings and needs of others

narcissistic

The following is a red flag for: is often envious of others/believes that others are envious of them

narcissistic

The following is a red flag for: shows arrogant, haughty behaviors, attitudes

maintain boundaries, manage own emotions, team treatment due to tendency to split

Tips for working with cluster Bs

Avoidant personality disorder

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of context

avoidant

The following is a red flag for: avoids occupational activities that involves significant interpersonal contact because of fears of criticism, disapproval, or rejection

avoidant

The following is a red flag for: is unwilling to get involved with people unless certain of being liked

avoidant

The following is a red flag for: shows restraint within intimate relationships because of the fear of being shamed or ridiculed

avoidant

The following is a red flag for: is preoccupied with being criticized or rejected in social situations

avoidant

The following is a red flag for: is inhibited by new interpersonal situations because of feelings of inadequacy

avoidant

The following is a red flag for: views self as socially inept, personally unappealing, or inferior to others

avoidant

The following is a red flag for: Is unusually reluctant to take personal risk or to engage in any new activities because they may prove embarassing

be non-judgmental, shows interest, be aware of talking down to the patient

Tips for working with avoidant

Dependent personality disorder

A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of context

dependent

The following is a red flag for: has a difficulty making everyday decision without an excessive amount of advice and reassurance from others

dependent

The following is a red flag for: Needs others to assume responsibility for most major areas of their life

dependent

The following is a red flag for: Has difficulty expressing disagreement with others because of fear or loss of support or approval

dependent

The following is a red flag for: Has difficulty initiating projects or doing things on their own

dependent

The following is a red flag for: goes to excessive lengths to obtain nurturance and support from others to the points of volunteering to do things that are unpleasant

dependent

The following is a red flag for: feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care of themselves

dependent

The following is a red flag for: urgently seeks another relationship as a source of care and support when a close relationship ends

dependent

The following is a red flag for: is unrealistically preoccupied with fears of being left to take care of themselves

set limits of availability, resist needs for constant attention, monitor for own resentment or hostility, schedule regular visits, encourage connections within community for support

Tips for working with patients with dependent personality disorder

Obsessive-Compusive Personality disorder

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of context

obsessive-compulsive

The following is a red flag for: Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of activity is lost

obsessive-compulsive

The following is a red flag for: shows perfectionism that interferes with task completion

obsessive-compulsive

The following is a red flag for: is excessively devoted to work and productivity to the exclusion of leisure activities and friendships

obsessive-compulsive

The following is a red flag for: is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values

obsessive-compulsive

The following is a red flag for: is unable to discard worn-out or worthless objects even when they have no sentimental value

Obsessive-compulsive

The following is a red flag for: is reluctant to delegate take or to work with others unless they submit to exactly their way of doing things

obsessive-compulsive

The following is a red flag for: adopts a miserly spending style towards self/others (money is something to be hoarded)