personality disorders adesola ogunsakin. personality disorders? inflexible, maladaptive and rigidly...
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Personality Disorders
Adesola Ogunsakin
Personality Disorders?
• Inflexible, maladaptive and rigidly pervasive pattern of behavior causing subjective distress and/or impaired functioning
• Person is usually not aware of problem
• Presents by early adulthood
General characteristics:
• Inflexible, inability to adapt• One way of responding• Lifelong• All areas of life are affected• Maladaptive patterns of behavior• Ego-syntonic- when a person’s behavior is
acceptable to the aims of the ego and the related psychological needs of the individual
• Cluster A- Odd or EccentricParanoidSchizoidSchizotypal• Cluster B- Dramatic and EmotionalHistrionicNarcissisticBorderlineAntisocial• Cluster C- Anxious and FearfulAvoidantObsessive-compulsiveDependent
Cluster A
• Higher prevalence in biologic relative of schizophrenics
• Higher prevalence in males
PARANOIDSCHIZOIDSCHIZOTYPAL
Cluster A- PARANOID• Long-standing suspiciousness or mistrust of others• Reluctant to confide in others• Preoccupied with issues of trust• Reads hidden meaning into comments or events• Carries grudgesDifferentiate from: Paranoid schizophrenic has hallucinations and formal thought
disorders; PPD does not Delusional disorder, paranoid type has fixed, focal delusions; PPD
does not
Cluster A- SCHIZOID
• Lifelong pattern of social withdrawal, and they like it that way
• Seen by others as eccentric, isolated, withdrawn
• Restricted emotional expression
Cluster A- SCHIZOTYPAL
• Very odd, strange, weird• Magical thinking, ideas of reference, illusions• Social anxiety • Suspiciousness• Lack of close friends• Incongruous affect• Odd speech, social isolation• May have short-lived psychotic episodes
Cluster B
• Dramatic and Emotional• Genetic association with mood disorders &
substance abuse
HISTRIONICNARCISSISTICBORDERLINEANTISOCIAL
Cluster B- HISTRIONIC
• Colorful, dramatic, extroverted
• Inability to maintain long-lasting relationships
• Attention-seeking• Seductive behavior
Cluster B- NARCISSISTIC• Grandiose sense of self-
importance• Preoccupation with fantasies of
unlimited wealth, power, love• Demands constant attention• Fragile self-esteem, prone to
depression• Criticism met with indifference or
rage• Genuine surprise and anger
when others don’t do as they want
• Can be charismatic
Cluster B- BORDERLINE• Females 2x more than males• Very unstable affect, behavior, self-image• In constant state of crisis, chaos• Self-detrimental impulsivity: promiscuity, gambling, overeating, substance
abuse• Unstable but intense interpersonal relationships: very dependent and hostile,
love/hate• Great problems with being alone• Self-injurious behavior• History of sexual abuse• Common defenses: splitting, passive-aggressive• Particularly incapable of tolerating anxiety• Often coupled with mood disorder• 50% commit suicide
Cluster B- BORDERLINE
• Instability of mood, self-image and relationships
• W>M• Increased mood
disorders in families
• Associated defense mechanism- splitting
Cluster B- ANTISOCIAL
• 3% males, 1% females• Continual criminal acts• Inability to conform to social
norm: truancy, delinquency, theft, running away
• Cant hold job, no enduring attachments, reckless, aggressive
• Onset before age 15; if younger than 19, diagnose as conduct disorder
Cluster C
• Anxious and Fearful
AVOIDANTOBSESSIVE-COMPULSIVEDEPENDENT
Cluster C- AVOIDANT• Extreme sensitivity to rejection• Sees self as socially inept• Excessive shyness, high anxiety
levels• Social isolation, but an intense,
internal desire for affection and acceptance
• Wants the world to change, to be nicer, more accepting
• Tends to stay in same job, same life situation, same relationships
Cluster C- OBSESSIVE-COMPULSIVE
• Orderliness, inflexible, perfectionist• More common in males, firstborn, harsh discipline upbringing• Loves lists, rules, order• Unable to discard worn-out objects• Doesn’t want change• Excessively stubborn• Lack sense of humor• Wants to keep routine
Differentiate from: Obsessive-compulsive anxiety disorder the anxiety disorder has
obsessions and compulsions that are focal and acquired. Personality disorders are lifelong and pervasive
Cluster C- DEPENDENT
• Gets others to assume responsibility
• Subordinates own needs to others
• Cant express diasgreement
• Great fear of having to care for self
• May be linked to abusive spouse
Sources
• Kaplan• First Aid- USMLE STEP 1 2014