PERSONALITY DISORDERS

Personality

Enduring qualities of an individual that are shown in his

ways of behaving in a wide variety of circumstances

The importance

as a predisposition

as a pathoplastic factor

In relation to treatment

Origin – familial

childhood temperament

Childhood experience

Personality types

Personality disorders - Diagnostic Criteria

Enduring disturbances in personality and behaviour

Involve several areas of personality

Causing personal distress/ social disruption

Pervasive with inflexible behaviour

Manifest from childhood/ adolescence

Not due to brain insult or another psychiatric disorder

Features

10-20% of the population.

Prevalence by gender – variable

Personality changes due to other causes

Organic brain disease

Severe mental disorder

Catastrophic experience

Categories

Cluster Β: Antisocial Borderline Histrionic Narcissistic

Cluster C: Avoidant Dependent Obsessive/ Compulsive

Cluster A:Paranoid

Schizoid

Schizotypal

Paranoid Personality Disorder

Suspicious

Mistrustful

Non-confiding

Sensitive

Resentful

Litigous

Sexual jealousy.

Schizoid

No close relationships.

Detached and aloof

solitary activities; prone to fantasy

little interest in sexual relationships

Lack of enjoyment

indifferent to praise or criticism.

emotional coldness

Schizotypal

Cognitive and perceptual distortions

Odd / eccentric speech, behaviour and appearance

Narrowed or inappropriate affect.

Few close friends

Excessive social anxiety

Antisocial

Callous

Transient relationships

irresponsible

Inability to follow society rules

impulsive

Irritability, aggression.

Recklessness

Lack of empathy

Lack of guilt.

Borderline

Frantic efforts to avoid abandonment

unstable interpersonal relationships; characterized by

idealization and devaluation

Identity disturbance

Impulsiveness

Recurrent suicidal behavior

Affect instability

Feelings of emptiness

difficulty in controlling anger

Quasi-psychotic/ dissociative symptoms related to stress.

Histrionic

Uncomfortable if not the center of attention.

seductive

shallow and labile emotions

Uses appearance to draw attention.

Impressionistic speech

 self dramatization

 suggestible

Perceives relationshipa as intimate

Narcissistic

grandiose sense of self-importance.

fantasies of unlimited success, power etc.

Feeling special and unique

sense of entitlement

Exploitative

lacks empathy

envies others or believes envied

Contemptuous, haughty, arrogant

Avoids interpersonal relationships

oavoids professional activities

o fear of dislike by others

o fear of shame

oworry of criticism or rejection

o feelings of inadequacies

unwilling to takes part in new activities, for a fear of being embarrassed.

Avoids risk

 

Marked social inhibition, feeling of inadequacy and extreme sensitivity to criticism.

Avoidant

Dependent

Difficulty making everyday decisions

Needs others to take the responsibility for the major areas of life.

Unable to make demands

Overly compliant

uncomfortable being on their own

Compulsion to seek intimate relationships

Fear of being left alone.

Is characterized with a extreme need of being looked after by others, to a

point where there is submissive behavior and fear of separation.

Obsessive-compulsive (anankastic)

preoccupation with details 

perfectionism that interferes with the completion of the task

overly conscientious

inflexible in matters of morality, ethics or values

unable to throw out worthless objects

Does not do apportion of tasks

stingy.

Stubborn and rigid.

Diagnostic difficulties

Categorical classification

Symptom overlap

Treatment

Treat co-morbidities

Psychotherapy

Pharmacotherapy

Prognosis

variable

severity becomes milder as the person grows older.