distinguished future physicians welcome
to stomp on step 1 the only free video
series that helps you study more
efficiently by focusing on the highest
yield material hi I'm Brian McDaniel and
I will be your guide on this journey
through personality disorders this is
the sixth video in my playlist covering
psychiatry and we're going to review the
major types of personality disorder and
use famous examples from history and TV
to help us illustrate the concepts
personality disorders are rigid ways of
thinking and behaving that differ
greatly from the norm cause distress and
tender function these individuals don't
think they have a disorder so they
rarely seek out help and have low
compliance of suggested therapy this
lack of insight is why diagnosing and
treating these disorders is very
difficult these disorders develop early
in life and primarily affect a person's
relationships we can all identify
somewhat with some of these disorders
but don't go diagnosing yourself or your
friends having a disorder is much more
extreme than having mild characteristics
of these disorders there's a big
difference between personality traits
which everyone has and a personality
disorder which is much more severe and
hinders function in most books you will
see these disorders grouped together in
groups called cluster a cluster B and
cluster C however I won't use these
clusters in my materials because I don't
find the groupings that helpful and you
will never be asked what cluster a
patient is in on step one before we get
started I do want to add a disclaimer I
believe the best way to memorize these
disorders are by using celebrities
historical figures and TV or movie
characters as examples however I want to
stress that I'm not trying to make light
up or make fun of these conditions which
can be debilitating for people who have
them I'm just trying to help people
memorize these things better and to make
this content a little more interesting
and when I mention real people I do so
completely based on speculation and have
no actual knowledge of how these people
are in real life I should also mention
that these are not perfect examples as
there are very rarely people who
perfectly fit the diagnosis but these
famous examples should help clarify the
concepts if you can think of
any other good examples please comment
below we will start with schizoid
personality disorder which you can see
here I give a high yield rating of five
that is a rating scale from zero to ten
which gives you an estimate for how
important each topic is for the USMLE
step 1 Medical Board Exam it is based on
a number of factors including how often
that topic appears in retired step 1
questions people with schizoid
personality disorder are super
introverted they have no desire to have
friends and voluntarily choose to be
socially isolated these individuals may
also be uninterested in sexual contact
with others they often daydream a lot
have a limited range of emotion and are
largely apathetic
examples include Squidward from
SpongeBob SquarePants and Dexter Morgan
from the show Dexter obviously this is
not a picture of Squidward but I'm very
limited by copyrights so this is the
best I could do in the show he hates
both of his neighbors and prefers to be
alone in Dexter especially in the
earlier seasons he has no interest in
human connection or sex of course with
Dexter I'm talking about his personality
and not his serial killing people with
skis Oh typical personality disorder are
extremely nerdy and awkward magical
thinking such as paranormal or
superstitious beliefs is common they
often have odd speech dress and
mannerisms
they usually have voluntary social
withdrawal similar to people with
schizoid so you can think of skis Oh
tipple as skis wait plus magical
thinking and odd behavior good examples
are Kramer from Seinfeld Doc Brown from
Back to the Future and the characters on
the Big Bang Theory people with paranoid
personality disorder are almost always
suspicious of others motives and don't
trust other people they feel like
everyone is out to get them and get
aggravated about minor things paranoid
personality should not be confused with
paranoid delusions and disorders like
schizophrenia the complaints for
somebody with paranoid personality
disorder are at least plausible for
example my wife is cheating on me is
something you might see in paranoid
personality disorder while aliens are
out to get me
more characteristics of psychosis
paranoid personality is like a
distortion of reality while paranoid
delusions are almost entirely
disconnected from reality some of the
best examples are dictators
psychologists have speculated that
Richard Nixon Adolf Hitler Joseph Stalin
and Saddam Hussein may have had paranoid
personality disorder which might explain
their behavior such as secretly
recording meetings or using look like
doubles during public appearances to
avoid assassination another example
would be the stereotypical jealous
husband who constantly accuses his wife
of cheating people with borderline
personality disorder are very
temperamental and have drastic mood
swings they have poor impulse control
which often leads to substance views
they may consider suicide or
self-mutilation during emotional
outbursts and then seemed totally fine
just a few minutes later some people
think a borderline personality is a less
extreme version of bipolar disorder
these patients often display the
spliting defense mechanism where they
think people are all good or all bad
they will say you're the best doctor in
the world while your nurse is completely
incompetent or vice versa examples
include the stereotypical teenage drama
queen and the Hulk because out of
nowhere he gets pissed off about
something and then ends up destroying a
city because of it people with
histrionic Personality Disorder are
childish prima donnas that are overly
theatrical or dramatic these patients
are usually very colorful extroverted
and flirtatious they always need to be
the center of attention and are willing
to act impulsively or in a sexually
inappropriate manner to get that
attention they are very concerned with
how they look and often display the
defense mechanism of regression
examples include Madonna Paris Hilton
and most reality TV stars people with
antisocial personalities or der are
basically Psychopaths
they are predators that exploit others
without feeling any guilt these patients
are exploitive deceitful good at reading
social cues and often appear charming to
others they have a disregard for others
well-being and frequently violate the
right
of others these individuals often have a
history of committing crimes now when
most non-medical people use the term
anti-social they are using an adjective
that does not have the same meaning as
antisocial personality disorder usually
people use the adjective antisocial to
describe somebody who is avoiding social
situations which is much closer to
schizoid personality disorder so don't
get that confused with antisocial
personality disorder
examples of antisocial personality
disorder are serial killers the Joker
and the Grinch individuals who have the
symptoms of antisocial personality
disorder but are under the age of 18 are
classified as having conduct disorder
this is a precursor that usually
progresses to antisocial personality
once they turn 18 people with
narcissistic personality disorder are
vain and egotistical they have a sense
of entitlement and an inflated grandiose
self-image narcissists require
recognition of their success and lack
empathy or patience for others they are
preoccupied with power and prestige
often these individuals exploit others
however this exploitation is for status
or recognition
unlike antisocial people who exploit
others for material gain or just because
they enjoy it examples include Gregory
House m.d. Walter White from Breaking
Bad and Stephen Colbert the character
not the actual actor people with
avoidant personality disorder want to
have friends but are usually socially
isolated because they are insecure
scared of rejection and overly sensitive
and negative criticism they are
painfully shy with feelings of
inadequacy these people wish they had
friends but don't because of how shy
they are don't confuse this with
schizoid schizotypal or paranoid people
who don't have friends because they
don't want friends you should also make
sure you don't confuse avoidant with
narcissistic people who often don't have
friends because they are jerks
examples of avoidant personality
disorder include Michael Jackson we do
things like build
or his own theme park so it can boy
people as well as Heisman Trophy winner
Ricky Williams who once gave an
interview with his helmet still on
because he felt inadequate when
interacting with the media people with
dependent personality disorder have very
low self-esteem which leads them to be
very reliant on others the person they
are reliant on can be a significant
other a partner or even their physician
these patients feel like they need to be
taken care of and are afraid of being
abandoned they are willing to surrender
even very important responsibilities
like making medical decisions they
generally agree with whatever their
caretaker says they are clingy and often
display the regression ego defense
examples include Buster from Arrested
Development and people who stay in an
abusive relationship simply because they
don't think they can function on their
own people with obsessive-compulsive
personality disorder are extreme
perfectionist to the point that it can
hinder their ability to complete tasks
organization lists schedules and small
details are valued by people with this
disorder they are overly devoted to
their work and rarely take leisure time
they become upset if they cannot control
the environment they are in and the
people around them people with OCPD have
interpersonal problems but can have
academic and occupational success in the
right setting an example would be Steve
Jobs his attention to detail was a big
part of his success but he was also
notoriously difficult to work for
because he insisted on controlling
everything and cared a lot about
seemingly unimportant things
obsessive-compulsive personality
disorder should not be confused with the
anxiety disorder obsessive compulsive
disorder or OCD the two are distinct
conditions even though there is some
overlap and the names are very similar
OCD patients have insight while people
with OCPD
do not in OCD they view their thoughts
as abnormal unwanted and distressing in
OCPD they view their way of thinking as
normal and beneficial a person with OCD
viii may seek out help from a healthcare
professional due to interpersonal
problems but not about their way of
thinking or acting because they don't
realize they have a problem people with
OCPD
also lack repetitive actions like
washing their hands over and over again
that are classically seen in OCD that
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