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Cluster C Personality Disorders

by Helen Farrell, MD
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    00:01 Now, let?s look at cluster C personality disorders in more detail.

    00:06 Starting with the avoidant personality, this is a pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contacts.

    00:22 Patients will meet four or more of the following criteria, avoiding occupational activities that involve significant interpersonal contact, because they fear criticism, disapproval or rejection.

    00:38 The need of guarantee of being liked before getting involve with others, showing resistance when intimate relationships start to form because of fear of being shamed or ridiculed.

    00:52 They?re preoccupied with being criticized or rejected.

    00:56 They feel inhibited in new interpersonal situations because they fear inadequacy and they view themselves as socially inept, personally unappealing or inferior to others.

    01:09 These people are unusually reluctant to take personal risks or engage in any kind of a new activity because they fear being embarrassed.

    01:20 The differential diagnoses include social phobia.

    01:24 This occurs equally amongst men and women, and they are able to function in relationships, provided however that they feel very safe and accepted in that relationship.

    01:37 The treatment really relies on creating that safe environment so the person free from ridicule, medications are seldom used but sometimes anxiolytics can be helpful such as Benzodiazepine and possibly SSRI or anti-depressants.

    01:56 The dependent personality disorder is as follows.

    02:00 A pervasive and excessive need to be taking care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and persisting in a variety of contacts.

    02:16 The patient will meet five or more of the following criteria.

    02:20 They have difficulty making everyday decisions without an excessive amount of advice or reassurance from others.

    02:28 They need others to assume responsibility for most major areas of their lives.

    02:34 They have difficulty expressing disagreement with others because of fear of loss of support.

    02:40 They have difficulty initiating projects or doing things on his or her own time.

    02:46 And they go to excessive lengths to obtain nurturance and support from others.

    02:53 They often feel uncomfortable or helpless when alone because of exaggerated fears of being unable to care for themselves.

    03:03 They urgently seek out another relationship as a source of care and support when one relationship ends.

    03:10 And they are unrealistically preoccupied with fears of being left to take care of themselves.

    03:17 Females are more commonly affected than males with dependent personality, and patients with a history of childhood separation anxiety or chronic illness might be predisposed to this type of personality disorder.

    03:31 The co-morbidities include dysthymia, major depression, and alcohol abuse.

    03:38 The dependent personality disorder treatment includes individual psychotherapy and also group therapy.

    03:46 Medications might be intermittently effective and usually are in the form of SSRIs or antidepressants at low doses.

    03:54 The final cluster C personality disorder is obsessive compulsive personality.

    04:00 This is a pervasive pattern of preoccupation with orderliness, perfectionism and mental and interpersonal control at the expense of flexibility, openness, and efficiency.

    04:13 Beginning by early adulthood, and present in a variety of contacts.

    04:18 There are four or more criteria that are met as follows.

    04:23 The individual is preoccupied with details, rules, list, order, organization.

    04:28 They show perfectionism that interferes with task completion.

    04:34 They are excessively devoted to work and productivity to the exclusion of leisure activities and they are over conscientious, scrupulous and inflexible about matters of morality, ethics, and values.

    04:50 This patient is unable to discard worn-out or worthless objects even when they have no sentimental value.

    04:58 They are reluctant to delegate tasks or to work with others, unless they submit to exactly his or her own way of doing things.

    05:06 And they adopt a miserly spending style, where they are extremely for goal.

    05:11 They show rigidity and stubbornness.

    05:14 This is more common in males, increased concordance in identical twins, and it tends to run in families. The co-morbidities of OCPD include depression, somatoform disorders, and alcohol abuse.

    05:31 The treatment is hopeful, individuals often have good insight into the impact of their behavior and tend to seek out treatment.

    05:39 Psychodynamic in group therapy can be very helpful in these cases.

    05:44 And cognitive behavioral therapy can be used to help modifies specific behaviors such as impulse control, frustration tolerance and impaired cognition with strategies.

    05:56 Let?s go through a quiz now using a few case examples.

    06:01 Consider this, a 26-year-old woman lives at home with her parents.

    06:06 She graduated college but has opted not to look for a job and rather clings to her parents for financial and emotional support.

    06:15 She tends to be submissive in a relationships and does not assert for own needs out of fear that any expression of anger will result in her being rejected.

    06:25 What personality disorder do you think she has? Well, she has a dependent personality disorder.

    06:33 How about this case, Jim is a 32-year-old single man who has a successful career and interest in a social life including marriage and children someday.

    06:45 But he feels stuck because he tends to decline invitations out to eat with friends and opts to have lunch alone in his office rather than in the cafeteria where he might actually meet someone.

    06:56 He describes himself as shy and afraid of embarrassing himself in front of others.

    07:01 What personality disorder do you think he has? He has an avoidant personality disorder.

    07:09 And final case is a 40-year-old attorney who is brought to the emergency department with complaints of severe chest pain, and the doctors want to rule out an acute heart attack.

    07:20 The attorney says that he?s very important. That he?s late for client meeting and that he will prefer to attend to his own health needs later when his work is finished. What personality disorder do you think he has? That?s an obsessive-compulsive personality disorder.

    07:39 You now have a background understanding of the various personality disorders that fall under the category of cluster C.

    07:48 And now you know a little bit about their diagnosis and how to approach the patient and offer some treatment options.


    About the Lecture

    The lecture Cluster C Personality Disorders by Helen Farrell, MD is from the course Personality Disorders. It contains the following chapters:

    • Cluster C
    • Assessment – Dependent Personality
    • Assessment – OCP

    Included Quiz Questions

    1. Avoidant personality disorder
    2. Obsessive compulsive disorder
    3. Paranoid disorder
    4. Borderline disorder
    5. Schizoid disorder
    1. Dependent personality disorder
    2. Obsessive-compulsive personality disorder
    3. Histrionic personality disorder
    4. Avoidant personality disorder
    5. Borderline personality disorder
    1. Childhood separation anxiety
    2. Attention dependent hyperactivity disorder
    3. Antisocial behavior
    4. Conduct disorder
    5. Childhood autistic disorder
    1. A grandiose sense of self-importance
    2. Shows perfectionism with task completion
    3. Is unable to discard worn-out or worthless objects even when they have no sentimental value
    4. They are reluctant to delegate tasks or work with others
    5. Shows rigidity and stubbornness
    1. Depression
    2. ADHD
    3. Post-traumatic stress disorder
    4. Cocaine abuse
    5. Bipolar disorder

    Author of lecture Cluster C Personality Disorders

     Helen Farrell, MD

    Helen Farrell, MD


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    the explanations are concise and clear
    By Juanita M. on 15. May 2018 for Cluster C Personality Disorders

    The disorders are well explained, the examples help to understand more easily and the therapeutic approach for these patients is useful

     
    Great presentation
    By Paramjit V. on 22. November 2017 for Cluster C Personality Disorders

    Explicit explanation and very well presented Short and concise and I really loved the questions which made the disorders more easy to grasp.