Personality Disorders (10 High Yield Facts)

(1) Personality disorders in cluster B are said to combine abnormalities in both thinking and affect, but not to be predominantly one or the other cluster, such as cluster A (thinking) or cluster C (affect).

(2) Because patients with antisocial PD are so indifferent to how their actions affect others, this is the personality disorder most resistant to treatment.

(3) Under stress, borderline patients may also experience brief reactive psychotic states (also known as “micropsychotic episodes”)

(4) Narcissistic Personality disorder pt lack empathy for others, although less so than the antisocial personality patient.

(5) For some narcissistic patient, aging is the ultimate blow to their self-esteem, as many of the qualities that help maintain their identity (e.g., career, health, beauty, and youth) must naturally begin to fade. Consequently, the narcissistic patient is prone to severe midlife crises.

(6) Avoidant personality disorder are at especially high risk for anxiety disorders and for social phobia

(7) Patients with a history of childhood separation anxiety or chronic illness may be predisposed to the Dependent personality disorder.

(8 ) Interviewing for signs and symptoms of a personality disorder requires a longitudinal developmental perspective. Such longitudinal interviewing should assess the quality of the patient's social function in the areas of school, career, family, romantic relationships, peer group function, and interactions with authority figures. Across these categories, clinicians should listen for recurring themes of interpersonal conflict, disappointment, exploitation, or emptiness, because these can all indicate a personality disorder.

(9) While personality-disordered individuals often use lower-level defense mechanisms, such as projection and denial, and commonly disown responsibility for their actions, they often confirm a public or family consensus about their behavior if couched in sympathetic terms: “Have you ever been unjustly accused of taking things at your various jobs? How often?” “Do people fail to understand and admire your assertiveness and your refusal to get pushed around? Really? Tell me about that.”

(10) Select pharmacotherapy on the presence of specific target symptoms rather than on a given personality disorder diagnosis