1 - University of Arizona



1. Explain the difference between personality trait and disorder.

- Personality trait: individuals’ unique way of responding to the environment and interpersonal relationships.

- Personality disorder: when traits become inflexible, are maladaptive, and interfere with interpersonal, vocational, or personal life.

2. List the three clusters of personality disorders and the disorders under each.

- Cluster A: acts peculiar or avoids social relationships but is not psychotic

i. Paranoid, schizoid, schizotypal

- Cluster B: emotional, inconsistent, or dramatic

i. Histrionic, narcissistic, antisocial, borderline

- Cluster C: fearful and anxious

i. Avoidant, obsessive-compulsive, dependent

3. Name three characteristics of each personality disorder.

- Paranoid (A)

i. Distrustful

ii. Suspicious

iii. Litigious

iv. Attributes responsibility for own problems to others

v. Interprets motives of others as malevolent

vi. Isolated and humorless

- Schizoid (A)

i. Longstanding pattern of voluntary withdrawal without psychosis

ii. Detached

iii. Restricted emotions

iv. No weirdness of eccentric presentation or beliefs as seen in those with schizotypal personality disorder

v. Isolation and detachment from social activities

vi. Have restricted range of affect in interpersonal settings

vii. Lack close friends, rarely get married or engage in familial activities

viii. Prefer to work solo

- Schizotypal (A)

i. Peculiar appearance

ii. Magical thinking

iii. Odd thought patterns and behavior without psychosis

iv. Believe in magical properties, place significance in numerology, tarot cards, etc…

v. Exhibit emotional blunting

vi. Believes in frank telepathy

vii. Functions poorly in the work place

viii. Lacks friends or allies

ix. Appearance is bizarre and not consistent with the subculture

x. Often has family history of schizophrenia

- Histrionic (B)

i. Attention seeking

ii. Extroverted

iii. Emotional

iv. Sexually provocative

v. Shallow, vain

vi. Unable to maintain intimate relationships

vii. Need to be center of attention

viii. May invade boundaries of others

- Narcissistic (B)

i. Love of self

ii. Pompous, has sense of special entitlement and lacks empathy for others

iii. Feels superior to others

- Antisocial (B)

i. Refuses to conform to social norms

ii. Dishonest

iii. Associated with conduct disorder in before the age of 15 and criminality in adulthood

iv. Are know in lay terms as “psychopaths,” or “sociopaths”

- Borderline (B)

i. Identity crisis with random behavior changes

ii. Mini psychotic episodes

iii. Erratic, unstable behavior and mood

iv. Boredom

v. Feelings of aloneness

vi. Impulsiveness

vii. Suicide attempts

viii. Self-injury

ix. Often comorbid with mood or eating disorders

x. May invade boundaries of others

- Avoidant (C)

i. Timid

ii. Sensitive to rejection

iii. Socially withdrawn

iv. Feelings of inferiority

- Obsessive-compulsive (C)

i. Perfectionist

ii. Orderly – makes lists

iii. Stubborn

iv. Indecisive

v. Ultimately inefficient

vi. Inflexible and rigid

- Dependent (C)

i. Poor self confidence

ii. Allows others to make their decisions and assume their responsibilities

iii. May end up as an abused spouse

4. Define impulse control disorder.

- Disorders characterized by irresistible urges to commit harmful or illogical acts. Most are chronic and lifelong, and some lead to serious financial and legal problems. They cannot resist engaging in negative behavior. These patients are likely to have experienced family dysfunction in childhood and life stress in adulthood. Increased tension usually exists before the behavior occurs, followed by relief of pleasure after the behavior is completed.

5. Describe each impulse control disorder

- Intermittent explosive disorder

i. 20-minute episodes of extreme rage. Concomitant increased heart rate, palpitations, increased energy, racing thoughts, and decreased awareness before the episode, and feeling of remorse after.

- Kleptomania

i. Failure to resist a recurrent impulse to steal objects that are not needed. Sense of pleasure, gratification or relief follows theft. They are usually embarrassed by their behavior and often seek evaluation or treatment.

- Pathological gambling

i. Criteria

1. Preoccupation with gambling

2. Increased amounts of money needed to attain desired excitement level

3. Withdrawal

4. Multiple attempts to stop of decrease gaming activities to conceal activities

5. Commission of illegal acts

6. Personal or vocational activity jeopardized because of gambling

7. Reliance on others for gambling obligations

ii. Stages

1. Starts with ‘winning’- one sees the initial rewarding behavior.

2. Then ‘losing’ with the concomitant chasing of one losses and a sense of urgency to regain what has been lost.

3. ‘Desperation’ – when gamblers may cross the line and engage in illegal behaviors in order to continue gambling

4. ‘Rock bottom’ – characterized by hopelessness

5.

- Pyromania

i. Fascination with the fire, paraphernalia surrounding fires and pleasure or gratification or relief when setting the fire or witnessing its aftermath.

ii. Onset in childhood

- Trichotillomania

i. Pulling out ones hair or desire to do so.

ii. Tension before recurrent act followed by pleasure, gratification, or relief.

iii. Complications – social isolation, embarrassment, dysphoria, low self esteem, Bezoars (hair ball in stomach), Rapunzel syndrome (strands of hair that stretch from the stomach to the colon)

- Factitious disorder

i. Intentional production of physical or physiological signs or symptoms

ii. Motivation for behavior is to assume the sick role

iii. External incentives are absent.

6. Distinguish between factitious disorder and malingering.

- Malingering disorder is characterized by the presence of obvious secondary gain. In factitious disorder the external incentives are absent.

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