Review of DSM5 Mental Disorders for NCMHCE Study

1. Avoidant Personality Disorder2. Dependent Personality Disorder3. Obsessive-Compulsive Personality

Disorder

Known as Anxious type

Pervasive patterns of thinking, moods and actions Relative to self perception, distressing or exciting

circumstances, personal impulses and urges, other people

Begun in youth, consistent and inflexible in many personal and social situations and stable over time

Causes problems

S2. Assess Testing Personality Disorders

Questionnaire- 4 MCMI3 (Millon) MMPI CATI (Coolidge ) Dimensional

Assessment of Personality Pathology—Basic Questionnaire

Structured Clinical Interview

International Personality Disorder Examination

NEO Five-Factor Inventory Thematic Apperception

Test Global Assessment of

Functioning scale Adult Attachment

Interview

S4. TreatmentTherapy Psychodynamic Therapy CBT CBT Schema Therapy DBT Mindfulness Therapy Mentalization Focused Therapy

Diagnosis IKey: Social inhibition Feelings of inadequacy Extreme sensitivity to negative evaluation Avoidance of social interaction

Diagnosis IIRequires at least four:1. Avoids occupational activities

that involve significant social contact, due to fears of disapproval or rejection

2. Unwilling to deal with people unless sure of being liked

3. Restraint within intimate relationships due to fear of being shamed or ridiculed

4. Preoccupied with being criticized or rejected in social situations

5. Inhibited in new social situations because of feelings of inadequacy

6. Views themselves as socially inept, personally unappealing, or inferior to others

7. Unusually reluctant to take risks or to engage in new activities because they may prove embarrassing

Diagnosis IIICo-occurring: Panic Disorder with

Agoraphobia Social Anxiety Disorder Generalized Anxiety

Disorder Obsessive Compulsive

Disorder

Rule out: Social Anxiety Disorder:

Monitors the other’s reactions, not just self

Dependent Personality Disorder

Paranoid, Schizoid and Schizotypal Personality Disorders

S1. Find Out S2. Assess & Refer MCMI3 (Millon) MMPI Structured Clinical

Interview

S4. Treatments Very challenging since clients fear therapist will dislike them Highly non-critical, non-

judgmental stance Simple supportive client

centered approach

Psychotherapy Psychodynamic

Therapy CBT Schema Social Skills Training Exposure Therapy Cognitive Therapy Group therapyMedications Antidepressants

S5. Monitoring Improved social functioning

S6. Termination

Diagnosis IKey: Excessive and pervasive need to be taken care of Submissive Clinging, needy behavior due to fear of abandonmentAppears in adolescence and young adulthood

Diagnosis IIRequires at least five:1. Needs excessive

reassurance and advice to make everyday decisions

2. Needs others to take responsibility for areas of their lives

3. Difficult to disagree with others out of fear of disapproval

4. Difficult to initiate projects or do things on their own

5. Excessively seeks nurturance and support from others, even by offering to do unpleasant things

6. Feels stressed or helpless when alone due to exaggerated fears of being unable to care for themselves

7. Urgently seeks another source of care when a close relationship ends

8. Preoccupied with fears of being left to take care of himself or herself

S1. Diagnosis 3Co-occurring: Domestic and other

kinds of abuse Substance abuse Depression and dysphoria

Rule out: Borderline Personality

Disorder Histrionic Personality

Disorder

S1. Find Out S2. Assess & Refer MCMI3 (Millon) MMPI Structured Clinical

Interview

S4. Treatments Important to build initial

rapport or clients leave Non-critical, non-

judgemental stance

Possible treatments: Psychodynamic Therapy CBT Schema Brief, Solution Based

TherapyMedications Depression

S5. Monitoring Improved autonomy

6. Termination

S1. Diagnosis 1Key: Preoccupation with

orderliness, perfectionism, details, mental and social control, and power over one's environment

At the expense of flexibility, openness, and efficiency

Requires at least 4:Preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met) is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity) is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification) is unable to discard worn-out or worthless objects even when they have no sentimental value is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes shows rigidity and stubbornness

S1. Diagnosis 2Requires at least 4:1. Preoccupied with details, such

that the point of the activity is lost

2. Perfectionism that interferes with task completion

3. Too devoted to productivity to the exclusion of friends and leisure activities

4. Inflexible about morality, (apart from religion)

5. Unable to discard worth-less objects even with no sentimental value

6. Reluctant to delegate tasks or to work with others unless they submit to their way of doing things

7. Miserly; money hoarded for future crisis

8. Rigid and stubborn

S1. Diagnosis IICo-occurring: OCD Autism Spectrum Eating disorders

Rule out: OCD: Personality disorder

sees traits as rational, not distressed

S1. Find Out S2. Assess & Refer Dysfunctional Thought

Record MCMI3 (Millon) MMPI Structured Clinical

Interview

S4. Treatments to Use Very challenging since

clients deny symptoms and avoid confronting their irrational beliefs

Non-critical, non-judgemental stance is essential

Therapy Psychodynamic

best CBT Cognitive

Analytic Therapy Medications Antidepressants(SSRIs)

S5. Monitoring Progress Improved flexibility

S6. Termination