Personality Disorders and OCD

personality

aspects of oneself that are brought to every situaton

• A person’s attitudes, thoughts, feelings are part of personality

• These are persistent, endure across time

healthy personality

When a person’s thoughts, feelings, and behaviors are consistent with reality of the outside world

• can evaluate strengths and weaknesses

• can interpret life events and cope with situations/relationships accurately and effectively

• can interpre the environment accurately

personality disorder

• When an individual cannot accurately perceive and interpret their experiences

• When personality traits consistently cause signifcant distress,impair relatonships and occupatonal performance

cluster A (suspicious, odd, eccentric) 

Dominated by distorted thinking, social awkwardness or withdrawal

• paranoid, schizoid, and schizotypal PD

cluster B (emotional, dramatic, and impulsive)

intense emotions responses and dramatic mood swings; black and white thinking, poor impulsive control 

• antiosocial, borderline, histrionic, and narcissistic 

cluster C (anxious, fearful)

Patterns of social inhibition, feelings of inadequacy, and hypersensitivity to critcism

• avoidant, dependent, and obsessive-coumpulsive PD 

diagnosis of PD

Enduring paterns afect 4 main areas:

• Thinking (rigid, extreme, distorted)

• Feeling (problematc responses)

• Interpersonal relatonships

- Considered the most typical of ALL PD

• Impulse Control

• Before diagnosis, individual typically has dysfuncton in at least 2/4 areas

etiology of PD

Biological and environmental basis

• Events of early childhood influence behavior later in life and contribute to development of PD

• Born with primitive personality tendencies

• Genetic predisposition → moderately inheritable

• Neurotransmitter dysregulation

• Serotonin, dopamine, norepinephrine

• Adverse childhood experiences may be a risk factor

• Match between infant temperament and caregiver disposition

epidemiolgy of PD 

• 6-10% of adults diagnosed with personality disorders

• OCPD is most prevalent at 8% of populaton, followed by narcissistc PD at 6%

• Prevalence by Cluster- A most prevalent, followed by C and then B

gender differences within PD

• Males-antisocial

• Females- borderline, histrionic, dependent PD

• Schizoid and OCD have no gender-specifc diferences

typical course of PD

• Features associated with disorder usually recognized during adolescence or early adult life

• Features must be present for 1 year if person is to be diagnosed younger than 18 years of age

• PD formerly considered “stable,” however studies demonstrate moderate stability with ability to improve over tme

client factors- values (PD)

Cluster A- strong sense of autonomy

OCD

Mental health conditon characterized by unreasonable thoughts and fears that lead to compulsive behaviors

• Involve repeated thoughts, urges, or mental images that cause anxiety

• Anxiety disorders differ in the essental feature in that this disorder suggests obsessions and/or compulsions must be present

obessions 

Recurrent and persistent thoughts, urges, and/or images that are experienced as intrusive and unwanted

• (fear that something will or won’t happen)

compulsion

Repetitve behaviors (hand washing, checking that doors are locked) or mental acts (counting) that the individual feels driven to perform in response to obsessive thoughts or to comply with perceived rules

• (Action due to the obsession)

effects of obsessions

• This results in increased anxiety and distress

• Individuals typically have “range” of obsessive thoughts

effects of compulsions 

Behaviors and mental acts intended to prevent or reduce anxiety and distress

• These are excessive, often not realistic to what it was intended to prevent (feel powerless to stop)

difference from regular repetitive thoughts

• beyond control

• interfere with work, social life, performing occupations

• arent enjoyable

• take uo more than 1 hour in one’s day

OCD types and symptoms

• Checking

• Contaminaton

• Symmetry and Order

• Ruminatons and Intrusive Thoughts

OCD related conditions

• Body dysmorphic disorder (BDD)

• Hoarding disorder

• Trichotllomania

• Excoriaton

• Hypochondriasis

etiology- risk factors

• Parent, sibling, child with OCD

• Physical differences in the brain

• Experience with trauma

• Depression, anxiety, or tics

epidemiology of OCD

• OCD has a lifetime prevalence of 2-3% in the United States

• Two-thirds of cases have their onset earlier than age 25, and only 15% occur afer age 35

• About one-third of cases have onset in childhood or early adolescence

• Males tend to have earlier onset (childhood), whereas females are impacted by OCD more frequently in adulthood

course of OCD 

•  The disease follows a chronic waxing and waning course

• Peaks in early adolescence and early adulthood

client factors- body structures (OCD) 

• Cardiovascular, digestve and metabolic functons

         - 25% elevated risk for heart disease

• Integumentary system (Skin and related structure functons per OTPF- Hair, skin, nails)