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Published by vio85
Basic psychiatry book
Basic psychiatry book

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Published by: vio85 on Aug 10, 2012
Copyright:Attribution Non-commercial


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! Definition

o Personality patterns that are pervasive, inflexible & maladaptive
(Maladaptive pattern of behavior)
o Children may have all personality disorders except antisocial personality
disorder (must be > 18 to diagnose). If < 18, it is called conduct disorder

! There are 3 clusters

o Cluster A: (Odd): Peculiar thought processes, inappropriate affect.
o Cluster B (Moody): Mood lability, Amnesia & preoccupation w/ rejection.
o Cluster C (Anxious): Anxiety, sensitive, preoccupation w/ criticism or rigidity.

! Risk Factors/Etiology

o Innate temperamental difficulties, such as irritability;
o Adverse environmental events, such as child neglect or abuse
o Personality disorders in parents.

! Prevalence & Onset

o More males have antisocial & narcissistic personality disorders
o More females have borderline & histrionic personality disorders
o Usually not diagnosed until late adolescence or early adulthood
o Course: Usually very chronic over decades without treatment
o Paranoid, schizoid & narcissistic (moody) personality worsen with age
o Antisocial & borderline (violent) personality disorder improve with age

! Key Symptoms

o Long pattern of difficult interpersonal relationships, problems adapting to
stress, failure to achieve goals, chronic unhappiness, low self-esteem.
o Associated Diagnoses: Mood disorders.

! Differential Diagnosis

o Mood disorders, personality change due to a general medical condition &
adjustment disorders.

! Treatment

o Psychotherapy (Psychodynamic & Cognitive therapy)
o Mood stabilizers & Antidepressants maybe used in Cluster B personality




Cluster A (Odd)

! Paranoid personality disorder

o Distrust & suspiciousness
o Often secretive & isolated, emotionally cold & odd.
o Associated features: brief episodes of psychosis w/ persecutory delusions &
pre-existing sensory impairment.
o Defense mechanism: Projection
o Difference from schizophrenia
! Duration - all life
! Functioning level - Can function
! No psychotic syndromes (No hallucination)

! Schizoid personality disorder (a loner)
o Detachment & restricted emotionality
o Individuals are disinterested in others & indifferent to praise or criticism
o Associated features include social drifting & dysphoria

! Schizotypal personality disorder (The most Odd / Bizarre)
o Discomfort with social relationships; thought distortion; eccentricity
o Individuals are socially isolated & uncomfortable with others
o Can have Schizophrenia if under stress
o Unlike schizoid personality disorder, they have
! Peculiar patterns of thinking: (ideas of reference & persecution)
! Odd preoccupations
! Odd speech & affect

Cluster B (Moody)

! Histrionic personality disorder

o Colorful, exaggerated behavior & shallow expression of emotions
o Uncomfortable in situations where he or she is not the center of attention.
o Uses physical appearance to draw attention to self; sexually seductive

! Borderline personality disorder

o Unstable affect, mood swings, marked impulsivity, recurrent suicidal
behaviors, feelings of emptiness or boredom & inappropriate anger.
o If stressed, may become psychotic.
o Defense mechanism is splitting.

! Antisocial personality disorder

o Antisocial or criminal acts, inability to conform to social rules, disregard for
the rights of others, aggressiveness, lack of remorse & deceitfulness.
o Symptoms start at the age of 15, but the individual is diagnosed at > 18

! Narcissistic personality disorder

o Sense of self-importance, grandiosity & preoccupation w/ fantasies of success.
o This person believes she/he is special, requires excessive admiration,
o Reacts with rage when criticized & interpersonally exploitative.



Cluster C (Anxious, Fearful)

! Avoidant personality disorder

o Social inhibition, feelings of inadequacy & hypersensitivity to criticism
o Shy away from work or social relationships because of fears of rejection
o Feel lonely & substandard and are preoccupied with rejection

! Dependent personality disorder

o Submissive & clinging behavior & worry unrealistically about abandonment.
o Feel inadequate & helpless.
o Avoid disagreements with others.
o They usually focus dependency on a family member or spouse
o Can be found in many abusive relationship
o Associated features include self-doubt, excessive humility, poor independent
functioning, mood disorders, anxiety disorders & adjustment disorder

! Obsessive-compulsive personality disorder

o Individuals are preoccupied with orderliness, perfectionism & control.
o Consumed by the details of everything and lose their sense of overall goals.
o They are strict, perfectionist & inflexible.
o Obsessed with work & are hesitant to delegate tasks to others.
o Other traits include being miserly and unable to give up possessions.
o Associated features: Indecisiveness, dysphoria, anger, social inhibition, &
difficult interpersonal relationships.
! Remember: This personality disorder should not be confused with obsessive -
compulsive disorder (OCD)

Obsessive Compulsive
disorder (OCD)

Obsessive Compulsive
Personality Disorder

Type of Disorder

Anxiety Disorder

Personality Disorder


Been normal before

All life


Can’t function

Can function


Medications: SSRIs




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