Personality Disorders (2nd edition)

0:00Hi, this is Tom, and in this episode I'm going to be going through personality disorders. And you can find notes at 0tofinals.com and in the 0tofinals Pediatrics book. And you can find flashcards and questions at members.0tofinals.com. So let's jump straight in. Personality disorders cover a variety of maladaptive personality traits that cause significant psychosocial distress and interfere with functioning. These traits remain relatively persistent over time and they affect the person's life and relationships. Personality disorders are characterized by patterns of thought, behavior and emotion that differ from what's normally expected. They often lead to difficult relationships, reduce quality of life and poor physical health. Personality disorders are thought to result from a combination of genetic and environmental

1:01factors. Patients often have a history of early childhood trauma and difficult circumstances. Let's talk about the presentation. A wide range of symptoms and behaviors occur with personality disorders. The symptoms typically emerge during the teenage or early adult years. symptoms vary on the type of personality disorder and the individual. For example, possible symptoms in someone with borderline personality disorder, which we'll talk about in more detail shortly, include strong and intense emotions, for example outbursts of anger, emotional instability with rapidly changing emotions, difficulty managing their emotions, difficulty maintaining relationships, a poor sense of identity, feelings of emptiness, fear of abandonment, impulsive and risky behavior, recurrent self-harm and recurrent suicidal

2:03behaviors. Let's talk about the types. There are 10 different types of personality disorder based on the dominant features. In the DSM-5, they fall into three categories, cluster A being suspicious, cluster B being emotional or impulsive, and cluster C being anxious. Let's talk about the suspicious personality disorders. Paranoid personality disorder features difficulty in trusting or revealing personal information to others. Paranoid personality disorder features a lack of interest or desire to form relationships with others and feelings that this is of no benefit to them. Skit-so-typled personality disorder features odd or magical beliefs, thoughts and behaviors as well as social anxiety that makes forming relationships difficult. Next let's go through the emotional and impulsive personality disorders.

3:07Community social personality disorder features reckless and harmful behavior with a lack of concern for the consequences or the impact of their behavior on other people. It often involves criminal misconduct. Borderline personality disorder, which is also called emotionally unstable personality disorder, features fluctuating strong emotions and difficulties with identity and maintaining relationships. Organic personality disorder involves a need to be the center of attention and they will perform for others to maintain that attention. And to narcissistic personality disorder features feelings that they're special and need others to recognize this or else they get upset. They always put themselves first. Finally let's go through anxious personality disorders. Avoidant personality disorder features severe anxiety about rejection or disapproval

4:09and the avoidance of social situations and relationships. Dependent personality disorder features a heavy reliance on others to make decisions and take responsibility for their lives, taking a very passive approach. And obsessive compulsive personality disorder features unrealistic expectations of how things should be done by themselves and others. They experience perfectionism and they seek control, rigidity and order. Let's go through management. Management of personality disorders can be challenging. The thought patterns and behaviors are deeply ingrained and they're difficult to change. Patient and care are education is very important to help them understand the condition. Risk management is important considering short and long term risks, for example ongoing self harm, suicide and harm to others.

5:09Risks are reviewed regularly and managed across the multidisciplinary team. Supportive care is provided during crises to help keep the patient safe. Psychological therapy is the main treatment, for example cognitive behavioral therapy or dialectical behavior therapy. Medications are not recommended for the long-term treatment of personality disorders. Sedative medications, for example sedative anti-histamines, are sometimes used short term, for example for less than one week, in a crisis. Personality disorders can coexist with other psychiatric disorders, for example depression, where medications may be beneficial. So let's go through some questions on personality disorders. Question one, what are the three DSM-5 clusters of personality disorders?

6:17The A is suspicious, cluster B is emotional or impulsive, and cluster C is anxious. Question two, what type of personality disorder features fluctuating strong emotions and difficulties with identity and maintaining healthy relationships? Personal Deline personality disorder, also known as emotionally unstable personality disorder. Question three, which personality disorder is characterized by distrust and suspicion of others? Paranoid personality disorder. Question four, which personality disorder involves little interest in relationships with others?

7:19Skitsoid personality disorder. Question six, which personality disorder is associated with criminal behavior and a lack of remorse? Anti-social personality disorder. Question seven, which personality disorder involves a strong need to be the center of attention? Historyonic personality disorder. Question eight, which personality disorder involves grandiosity and a need for admiration? A narcissistic personality disorder. Question nine, which personality disorder involves fear of rejection and avoidance of relationships?

8:21Avoidant personality disorder. Question ten, which personality disorder involves excessive reliance on others for decisions? Dependent personality disorder. Question eleven, which personality disorder is characterized by perfectionism and a need for control? Obsessive, compulsive personality disorder. Question twelve, what is the main treatment approach for personality disorders? Psychological therapy. So thanks for listening to this episode on personality disorders. As always, a big thank you to Harry Watchman for perfectly editing the podcast and I hope you join us for the next episode where we'll go through Tourette's and Tix.

9:27Thank you for listening to the podcast and I hope you join us for the next episode of Tourette's and Tix.