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This Concept Map, created with IHMC CmapTools, has information related to: Personality Disorders, Personality Disorders NOS Personality d/o w/ Passive-Aggressive Features Personality d/o w/ Self-Defeating Patterns, Personality Disorders Cluster B (Bad) -related to Mood d/os, Substance abuse, somatization? ANTISOCIAL -disregard for, violation of others' rights -not necessarily criminals -conduct d/o before 15yo (set fire, etc) -grandiose or manipulative -LACK OF REMORSE -superficial or trivial personal r'ships -can be charming, seductive, smart -NO delusions -low autonomic arousal (skin conductivity) -often father had ASPD Defenses: Projection, Projective Blaming, Rationalization, Prevarication, Personality Disorders Cluster C (Sad) -easier to treat -SSRIs, esp DEPENDENT women>men -cultrually tolerated in women -submissive behavior-clingy -fear of separation -always in a relationship, but unbalanced -insignificant member -no affective lability or oral aggression (BPD) -comorbid w/ depression Defenses: projective ID, Idealization, symbolization, Personality Disorders Definition Impaired personalities Stable, coded on Axis II Ego-syntonic-behavior not distressing to ppl w/ those disorders -may not be ego-syntonic w/ affect -may or may not w/ perceptions, Personality Disorders Cluster B (Bad) -related to Mood d/os, Substance abuse, somatization? BORDERLINE women>men -instability of mood, affect, behavior -often had been sexually abused -may also have Axis I d/o -volatile interpersonal r'ships -black or white distinctions -inappropriate, intense anger -lonely or empty "excessive oral aggression" -impulsivity-spending, sex, drugs, etc. -self-mutilation, suicidal gestures -"identity d/o" if under 18yo -Severe-can->transient psychotic states Defenses: Splitting, Projective ID'tion, Personality Disorders Defenses PRIMITIVE ɚyo (attachment, bod control) Projection-no, YOU overspend! Splitting-separate good from bad in external world -overidealizing, devaluing Denial-thus you don't have to feel Projective Identification-get others to feel what you feel -teen's risky beh to make parents feel anxious Reaction Formation-xform emotion into opposite Projective Blaming-blame others for misdeeds, Personality Disorders Defenses IMMATURE 3-10yo Displacement-shift emotion to less threatening person Rationalization-explain away Prevarication-lie to avoid facing consequences Symbolization-unconscious disabling of ego function Isolation of Affect-move emotion into unconscious, Personality Disorders Defenses MATURE - healthy individuals Suppression-conscious! Sublimation-turn drives into constructive work Intellectualization-verbalize unconscious material Humor-condensed version Disidentification -define self as diff from parents, BORDERLINE women>men -instability of mood, affect, behavior -often had been sexually abused -may also have Axis I d/o -volatile interpersonal r'ships -black or white distinctions -inappropriate, intense anger -lonely or empty "excessive oral aggression" -impulsivity-spending, sex, drugs, etc. -self-mutilation, suicidal gestures -"identity d/o" if under 18yo -Severe-can->transient psychotic states Defenses: Splitting, Projective ID'tion Tx Psychotherapy, Behavioral Therapy, Rx, Personality Disorders Cluster A (Mad) -genes related to psychoses? SCHIZOID-up to 7.5% of pop'n -"computer geek"-socially clumsy -social withdrawal, restricted emotional range of expression -can't or won't form relationships -higher incidence of exhibitionism -because they just want a reaction -no significant loss of reality testing -NOT LIKELY TO BE HARMFUL TO OTHERS, Personality Disorders Cluster C (Sad) -easier to treat -SSRIs, esp OBSESSIVE-COMPULSIVE 2%; white, married males -perfectionism, inflexibility in all areas -some adaptive features -EGO-SYNTONIC (unlike OCD) -formulaic behavior, devoid of affect, detail-oriented -might feel undervalued by parents, need dependency Defenses: Isolation of Affect, Reaction formation -also intellectualization, undoing, Personality Disorders Cluster B (Bad) -related to Mood d/os, Substance abuse, somatization? NARCISSISTIC ə% pop'n -grandiosity, lack of empathy -self-important, brash behavior BUT low self-esteem -when will be discovered a fraud -don't pursue adoration (like HPD) ->DEMAND IT -ppl are objects to suit their needs -childhood-abrupt realization that parents aren't perfect -intense injuries to self-esteem -contempt for physician Defenses: diplacement, rationalization, OBSESSIVE-COMPULSIVE 2%; white, married males -perfectionism, inflexibility in all areas -some adaptive features -EGO-SYNTONIC (unlike OCD) -formulaic behavior, devoid of affect, detail-oriented -might feel undervalued by parents, need dependency Defenses: Isolation of Affect, Reaction formation -also intellectualization, undoing Tx Antidepressants, esp SSRIs, Personality Disorders Cluster B (Bad) -related to Mood d/os, Substance abuse, somatization? HISTRIONIC-2-3% pop'n, esp WOMEN -excessive emotionality, attn-seeking -ALEXITHYMIA-instead ACT OUT MOOD -shallow, manipulative displays -vague, impressionistic, superficial comm -"paint w/ broad brush" -try to seduce either sex -doesn't necessarily follow through -idealizes physician Defense: Somatization, Personality Disorders Freud Id-unmodulated drives Ego-conscious and unconscious executive fcn -mediates id, external world Superego-governing fcn (societal, parental) -called on when ego can't handle id -via guilt -strong emotions during development ->dmg to ego->defenses protect ego -defenses become rigid or reflexive -so you don't feel the feelings, PARANOID-politicians MEN, 2% pop'n -suspicious, distrustful -not quite delusional (interpretive, not perceptual) -not hallucinations (schizophrenia) -do well in politics and business -e.g. paranoid international ideology -hostile, stubborn, defensive -not fun to be around! -avoids intimacy, emotions -preoccupied w/ hierarchichal systems -primary defense-PROJECTION Tx Provide safety, sense of control for pt Encourage verbalization, not acting out, Personality Disorders Cluster A (Mad) -genes related to psychoses? SCHIZOTYPAL-3% of pop'n -interpersonal deficits -cognitive, perceptual distortions -anxiety, depression, other dysphoria -eccentric behaviors, beliefs: ESP, rituals, magical thinking, odd speech -overt psychotic Sx are transient -?sub-clinical schizo? - often FHx of schizo, Personality Disorders Cluster C (Sad) -easier to treat -SSRIs, esp AVOIDANT 1-10% pop'n -social isolation -feelings of inadequacy (used to be Dx as schizoid) -BUT WANTS to be around others -though avoids r'ships -interprets critical intent form neutral behaviors of others -shy, eager to please -avoid personal r'ships, but crave contact, acceptance, Personality Disorders Cluster A (Mad) -genes related to psychoses? PARANOID-politicians MEN, 2% pop'n -suspicious, distrustful -not quite delusional (interpretive, not perceptual) -not hallucinations (schizophrenia) -do well in politics and business -e.g. paranoid international ideology -hostile, stubborn, defensive -not fun to be around! -avoids intimacy, emotions -preoccupied w/ hierarchichal systems -primary defense-PROJECTION