personality disorders & repertorial approach

8/10/2019 PERSONALITY DISORDERS & REPERTORIAL APPROACH

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PERSONALITY DISORDERS & REPERTORIAL APPROACH

Dr S.K.PANDEY, READER

DEPT. OF REPERTORY

NEHRU HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL


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As per aphorism 215 of Organon of Medicine, all the so-called mental

& emotional diseases are nothing more than corporeal diseases inwhich the symptoms of derangement of the mind and disposition

peculiar to each of them is increased, whilst the corporeal symptoms

decline(more or less rapidly),till it at length attains the most striing

one sidedness, almost as though it were a local disease in thein!isi"le su"tle organ of the mind or disposition# $r %ahnemann has

classified mental diseases into four types(Aphorisms

21,221,22',225)

1#Mental diseases appearing with the decline of corporeal diseases

which threatens to "e fatal(Aphorism-21 omato-psychic type)

2 Mental diseases appearing suddenly as an acute disease in patients

ordinary calm state caused "y some eciting factors(Aphorism-221)

* Mental diseases of dou"tful origin(Aphorism-22')

' Mental diseases arising from prolong emotional cause-(Aphorism-

225+sycho- somatic- type)

n modern medicine personality disorder, as defined in the

$iagnostic and tatistical Manual of the American +sychiatric

Association, ourth .dition, /et 0e!ision ($M--/0), is anenduring pattern of inner eperience and "eha!ior that differs

maredly from the epectations of the indi!iduals culture, is

per!asi!e and inflei"le, has an onset in adolescence or early

adulthood, is sta"le o!er time, and leads to distress or impairment#+ersonality disorders are a long-standing and maladapti!e pattern of

percei!ing and responding to other people and to stressfulcircumstances# /en personality disorders, grouped into * clusters

(i#e#, A, 3, 4), are defined in the $M--/0#1

0.6.748

ndi!iduals may ha!e more than one personality disorder# /he

following are pre!alences for specific personality disorders in the

general population9

+aranoid personality disorder - :#5-2#5;

chi


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%istrionic personality disorder - 2-*;

7arcissistic personality disorder - =ess than 1;

A!oidant personality disorder - :#5-1;

O"sessi!e-compulsi!e personality disorder - 1;

MO0/A=/8> MO03$/8

+atients with personality disorders are at higher ris than the

general population for many (Ais ) psychiatric disorders# Mooddisorders are a particular ris across all personality diagnoses# ome

co mor"idities are more specific to particular personality disorders

and clusters#

4luster A9 +A0A7O$ +.0O7A=/8 $O0$.0 may appear as a

prodrome to delusional disorder or fran schi


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4luster A9 4%O$ +.0O7A=/8 $0O$.0 is slightly more

common in males than in females#

4luster 39 A7/O4A= +.0O7A=/8 $O0$.0 is * times more

pre!alent in men than in women# 3orderline personality disorder is *times more common in women than in men# Of patients with

narcissistic personality disorder, 5:-B5; are male#

4luster 49 O3..-4OM+6=. +.0O7A=/8 $O0$.0 is

diagnosed twice as often in men than in women#

AC.

+ersonality disorders generally should not "e diagnosed in children

and adolescents "ecause personality de!elopment is not complete

and symptomatic traits may not persist into adulthood# /herefore,

the rule of thum" is that personality diagnosis cannot "e made until

the person is at least 1D years of age# 3ecause the criteria fordiagnosis of personality disorders are closely related to "eha!iors of

young and middle adulthood, $M--/0 diagnoses of personality

disorders are notoriously unrelia"le in the elderly population

+A0A7O$ +.0O7A=/8 $O0$.0

ndi!iduals with this disorder display per!asi!e distrust and

suspiciousness# 4ommon "eliefs include the following9

Others are eploiting or decei!ing the person#

riends and associates are untrustworthy#

nformation confided to others will "e used maliciously#

/here is hidden meaning in remars or e!ents others percei!e as

"enign#

/he spouse or partner is unfaithful#

REPERTORIAL APPROACH

87/%. 0.+.0/O08

M7$ .4/O7

Adapta"ility, loss of

Admonition

$ogmatic


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E.7/F 0.+.0/O08

M7$ .4/O7

$elusions, critici


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ndifference

+aranoia

E.7/F 0.+.0O08

M7$ .4/O7

Apathy (+age no#-G)

.stranged from society (+age no#-*G)

uite (+age no#-B:)

olitude (+age no#-D1)

6nfriendly (+age no#-G1)

3340

M7$ .4/O7

Anthropho"ia, a!ersion to others (+age7o-1G2)

A!ersion to, family, certain persons (+age no#-1G*)

Awwardness (+age no#-1G*)

3enum"ed (+age no#-1G*)

4ompany, a!ersion to (+age no#-1G5)

$epression (+age no#-1GD)

oolish, silly a"surd (+age no#-2:2)

ntrospecti!e, intro!erted, a"sor"ed (+age no#-2:G)


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6nsocial (+age no#-22:)

4%O/8+A= +.0O7A=/8 $O0$.0

+eople with this disorder ehi"it mared eccentricities of thought,perception, and "eha!ior# /ypical eamples are as follows9

deas of reference (i#e#, "elie!ing that pu"lic messages are directed

personally at them)

Odd "eliefs or magical thining

ague, circumstantial, or stereotyped speech

.cessi!e social aniety that does not diminish with familiarity

diosyncratic perceptual eperiences or "odily illusions


87/%. 0.+.0/O08

M7$ .4/O7

Admonition

Aloof

Aniety

E.7/F 0.+.0/O08


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M7$ .4/O7

uite (+age no#-B:)

olitude (+age no#-D1)

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M7$ .4/O7

3enum"ed (+age no#-1G')

%eadstrong (+age no#-2:*)

magination, fancies (+age no#-2:B)

deas, fied (+age no#-2D')

A7/O4A= +.0O7A=/8 $O0$.0

Antisocial personality disorder9 ndi!iduals with antisocialpersonality disorder display a per!asi!e pattern of disregard for and

!iolation of the rights of others and the rules of society# Onset mustoccur "y age 15 years & includes following features9

0epeated !iolations of the law

+er!asi!e lying and deception

+hysical aggressi!eness

0ecless disregard for safety of self or others

4onsistent irresponsi"ility in wor and family en!ironments

=ac of remorse


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ome person with antisocial disorder are terrorists & some terrorists

suffer from Antisocial personality disorder# Many terroristsdemonstrate diagnostic feature of A+$ without possessing the

actual disorder# /errorists are not "orn terrorists# Most people

"elie!e in something "igger than life#


87/%. 0.+.0/O08

M7$ .4/O7

A"usi!e

Adulterous

Anger

Antisocial

3rutality

4orrupt

$esire, to ill

$estructi!eness

Misanthropy

0age

0aes

E.7/F 0.+.0/O08


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n the meantime, the international community adopted a series of

sectoral con!entions that define and criminali


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precipitously in those two countries for a decade "efore declining

eKually dramatically# Other countries, such as 4anada and /he7etherlands, ha!e pro!en to "e more resistant, and ha!e

eperienced only a few isolated terrorist incidents#

n general, democratic countries ha!e pro!ided more fertile ground

for terrorism "ecause of the open nature of their societies# n such

societies citi


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inally, some terrorists are moti!ated "y !ery specific issues, such as

opposition to legali


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/he 6## $epartment of tate has designated se!en countries as

state sponsors of terrorism9 ran, raK, yria, =i"ya, 4u"a, 7orthEorea, and udan# n the year 2:::, it named ran as the most acti!e

supporter of terrorism for aid to groups such as %e


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87/%. 0.+.0/O08

M7$ .4/O7

Anarchist

Antisocial

3rutality

4orrupt

Mania, homicial

+assionate

+rogramming e!erything

6nsympathetic

ecreti!e

E.7/F 0.+.0/O08

M7$ .4/O7

Audacity (+age no#-*)

4ruelty (+age no#-1B)

.stranged from family , society (+age no#-*G)


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%ard hearted (+age no#-51)

nsanity, "eha!e lie cra


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/hreatening (+age no#-DD)

6nfilling (+age no#-G1)

iolent (+age no#-G1)

3O0$.0=7. +.0O7A=/8 $O0$.0

/he central feature of "orderline personality disorder is a per!asi!e

pattern of unsta"le and intense interpersonal relationships, self-perception, and moods# mpulse control is maredly impaired#

/ransiently, such patients may appear psychotic "ecause of the

intensity of their distortions# 3orderline personality disorder is one of

the most commonly o!erused diagnoses in $M--/0# $iagnosticcriteria reKuire at least 5 of the following features9

rantic efforts to a!oid epected a"andonment

6nsta"le and intense interpersonal relationships

Maredly and persistently unsta"le self-image

mpulsi!ity in at least 2 areas that are potentially self-damaging(e#g#, se, su"stance a"use, recless dri!ing)

0ecurrent suicidal "eha!iors or threats or self-mutilation

Affecti!e insta"ility

4hronic feelings of emptiness

nappropriate and intense anger

/ransient paranoia or dissociation


87/%. 0.+.0/O08

M7$ .4/O7


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Anger (+age no#-G1)

$eath, desire (+age no#-G1)

Moping (+age no#-G1)

E.7/F 0.+.0/O08

M7$ .4/O7 (+age no#-G1)

Anger (+age no#-G1)

.motional (+age no#-G1)

n?ure, fears to "e alone, lest he should himself (+age no#-G1)

Mutilating (+age no#-G1)

uicidal disposition (+age no#-G1)


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3340

M7$ .4/O7

rrita"le (+age no#-2:G)

3eside, oneself frantic, madness (+age no#-1G')

.cstasy (+age no#-1GG)

uicidal (+age no#-21D)

%/0O74 +.0O7A=/8 $O0$.0

+atients with histrionic personality disorder display ecessi!e

emotionality and attention-seeing "eha!ior# /hey are Kuite dramatic

and often seually pro!ocati!e or seducti!e# /heir emotions arela"ile# n clinical settings, their tendency to !ague and

impressionistic speech is often highlighted


87/%. 0.+.0/O08

M7$ .4/O7

4oKuettish


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ri!olous

E.7/F 0.+.0/O08

M7$ .4/O7

Amorous (+age no#-2)

7A04/4 +.0O7A=/8 $O0$.0

7arcissistic patients are grandiose and reKuire admiration from

others# +articular features of the disorder include the following9

.aggeration of their own talents or accomplishments

ense of entitlement

.ploitation of others

=ac of empathy

.n!y of others

An arrogant, haughty attitude


87/%. 0.+.0/O08


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M7$ .4/O7

Arrogant

Admiration

%aughty

+ompous

anity

E.7/F 0.+.0/O08

M7$ .4/O7

Arrogance (+age no#-G)

.n!y (+age no#-*G)

Jealousy (+age no#-:)

%aughty (+age no#-51)

+ride (+age no#-G)

3340

M7$ .4/O7

4ontemptuous, mocing (+age no#-1G)

$ogmatic (+age no#-1GG)


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$omineering (+age no#-1GG)

mportance feels his (+age no#-2:B)

+roud, arrogant, self esteem, haughty (+age no#-21')

AO$A7/ +.0O7A=/8 $O0$.0

A!oidant patients are generally !ery shy# /hey display a pattern ofsocial inhi"ition, feelings of inadeKuacy, and hypersensiti!ity to

re?ection# 6nlie patients with schi


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E.7/F 0.+.0/O08

M7$ .4/O7

A"andoned (+age no#-1)

Aniety (+age no#-')

$e?ection (+age no#-1D)

ear, people, of (+age no#-')

orsaen (+age no#-'G)

rightened easily (+age no#-'G)

ensiti!e (+age no#-BG)

hy (+age no#-D:)

olitude (+age no#-G)


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3340

M7$ .4/O7

6nsocia"le, shy, a!erse to society (+age no#-22:)

$.+.7$.7/ +.0O7A=/8 $O0$.0

Lhile many people ehi"it dependent "eha!iors and traits, peoplewith dependent personality disorder ha!e an ecessi!e need to "e

taen care of that result in su"missi!e and clinging "eha!ior,

regardless of conseKuences# $iagnosis reKuires at least 5 of the

following features9

$ifficulty maing decisions without guidance and reassurance

7eed for others to assume responsi"ility for most ma?or areas of the

persons life

$ifficulty epressing disagreement with others

$ifficulty initiating acti!ities "ecause of lac of confidence

.cessi!e measures to o"tain nurturance and support

$iscomfort or helplessness when alone

6rgent seeing for another relationship when one has ended

6nrealistic preoccupation with fears of "eing left to fend for

themsel!es


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87/%. 0.+.0/O08

M7$ .4/O7

taciturn

E.7/F 0.+.0/O08

M7$ .4/O7

4linging (+age no#-

12)

4ompany, desire for (+age no#-12)

ear, alone, of "eing (+age no#-'*)

rresolution (+age no#-5B)

Magneti


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3340

M7$ .4/O7

$e?ection (+age no#-1GB)

$epression (+age no#-1GD)

$espair (+age no#-1GD)

=ow pirited (+age no#-21:)

Melancholy (+age no#-215)


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O3..-4OM+6=. +.0O7A=/8 $O0$.0

+eople with o"sessi!e-compulsi!e personality disorder are maredlypreoccupied with orderliness, perfectionism, and control# /hey lac

flei"ility or openness# /heir preoccupations interfere with their

efficiency despite their focus on tass# /hey are often scrupulous and

inflei"le a"out matters of morality, ethics, and !alues to a point"eyond cultural norms# /hey are often stingy as well as stu""orn#


87/%. 0.+.0/O08

M7$ .4/O7

Acti!ity, desires

4hecing

4ompulsions

$ogmatic

oppish

7eurosis


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2#3oger 3oenninghausen 4haracteristic 0epertory

*# 3orderline +ersonality $isorder $M-

'# %offman 3, inside terrorism 4olum"ia 6ni!ersity

5# EentFs repertory

# EnerrFs repertory

B# =eft wing etremist data & satp(2:1:)

D# Organon of Medicine #ynthesis repertory

G# ynthesis 0epertory


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personality disorders & repertorial approach

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