Personality Disorders

Personality

"characteristic patterns of thought, emotion and behaviour together with the psychological mechanisms -hidden or not"

Approaches to study

Twin studies 54-80% correlation

Nomothetic

• Type

• Trait

  • Eysenck

    • Neuroticism

    • Extroversion/Introversion

    • Psychoticism

  • Costa & McCrae

    • Openness

    • Conscientiousness

    • Extraversion

    • Agreeableness

    • Neuroticism

Idiographic

• Psychoanalytic

  • Freud

  • Jung

  • Neo-Freudians

• Humanistic

  • Maslo

• Behavioural

  • Classical learning

  • Operant conditioning

Abnormality

(ICD 10) "an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individuals culture is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time and leads to distress or impairment"

Cluster A - Odd/eccentric

• Paranoid

  • excessively sensitive, suspicious, self-referent

• Schizoid

  • Emotional coldness

  • Eccentric

  • aloof

Cluster B - Dramatic / emotional

• Histrionic

  • dramatic

  • shallowness of mood

  • egocentric

• Dissocial

  • no guilt

  • intolerant

  • callous unconcern

• Emotionally unstable

  • unclear self-image

  • intense and unstable relationships

    • Impulsive - unable to plan ahead, can't control anger

    • ?Psychotic

Cluster C - fearful / anxious

• Anankastic
  • perfectionist
  • pedant
  • parsimonious
• Dependent
  • Can't take responsibility for actions
  • need constant reassurance
  • helpless when close relationships break down
• Anxious / avoidant
  • hypersensitive to rejection

Schroeder & Livesely

• Psychopathic entitlement
• Dependant emotionality
• Social avoidance
• Compulsiveness

Aetiology

• Genetic
• Sociocultural
• Temperament
• Deviant children grown up (Conduct disorders, ADHD)
• Negative childhood experiences (CSA)

Treatments

• Dialectical Behavioural therapy
• Cognitive Behavioural therapy
• Psychodynamic
• Behavioural
  • Anger management
  • Impulse training
  • Exercise
• Therapeutic communities
• Pharmacological
  • Antidepressants
    • Selective Serotonin Reuptake Inhibitors
    • Tricyclic Antidepressants
    • Monoamine Oxidase Inhibitors
  • Antipsychotics
  • Mood stabilisers
    • lithium

Prognosis

• Borderline PDs
  • 10% suicide
  • 60 % clinical maturation

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