• Onset adolescence or early adulthood, are stable through time and lead to unhappiness and impairment. • When personality traits are rigid and maladaptive and produce functional impairment or subject distress  Personality disorders may be diagnose.

• Person with personality Disorders. far more likely refuse psychiatric help and deny their problems than person with anxiety. depressive and OCD. acceptable to the ego) . the external environment) and ego-syntonic ( ie. • Personality disorders is aloplastic (able to adapt to and alter.

• They often seem disinterested in treatment and impervious to recovery. because they do not routinely acknowledge pay from what others perceive as their symptoms.• Person with personality disorders do not feel anxiety about their maladaptive behavior. .

histrionic and narcissistic personality disorders  person with these disorders often seem dramatic. emotional and erratic.CLASSIFICATION • DSM IV-TR  grouped into three clusters. schizotypal personality disorders  person with these disorders are often perceived as odd and eccentric. . borderline. Cluster B the antisocial. schizoid. Cluster A the paranoid.

Cluster C.Cont. obsessive compulsive and NOS( not otherwise specified) passive aggressive and depressive. Person with those disorders often seem anxious or fearful . The avoidant.

• When the patient meets criteria for more then one personality disorder  Should diagnose each. • Many persons exhibit trait that are not limited to a single personality disorders • Personality disorders are code on Axis 2 of DSM-IV-TR. .

more relatives with mood disorders. schizoid and schizotypal) > biological relative of patient with Schizophrenia. Cluster B (antisocial.Etiology • Genetic factor Cluster A (paranoid. borderline. Histrionic personality disorders somatization disorders . histrionic and narcissistic  associated with alcohol use disorders.

Cluster C. Abnormal DST (dexamethason suppression test) result . dependent. avoidant.Cont. obsessivecompulsive and NOS ask dependent  high anxiety levels obsessive-compulsive  monozygotic twins than dizygotic depressive. REM latency period.

.• Biological Factor Hormones exhibit impulsive  17-estradiol. strong Aggression. sexual behavior  androgen Borderline Personality disorders  DST results Platelet Monoamine Oxidize  student low level  social activities >>. Low level Platelet MAO Schizotypal disorders.

are saccadic (i. Smooth pursuits eye movement. Neurotransmitters Endorphin  analgesia and arousal High endogenous endorphin  phlegmatic Dopaminergic dan seretonergic  arousal activating function . jumpy)  introverted ~low self esteem and then to withdraw  have schizotypal personality disorders.Cont.e.

HIAA low ~ attempt suicide. Metabolite serotonin  5. Electrophysiology. change appear slow wave activity . impulsive and aggressive • The effect neurotransmitter on personality traits have generated much interest and controversy about whether personality traits are inborn or acquired. Changes in electrical conductance on EEG antisocial and borderline.Cont.

Example: Oral character passive and dependent ~ fixated at the oral stage. • Wilhelm Reich  character armor to describe person • Reich Theory  broad influence on contemporary concepts of personality and Personality disorders. Freud  personality trait related to fixation at on Psychosocial stage of development.Psychoanalytic factors • S. .

• Human being’s unique stamp of personality  determined characteristic defense mechanisms  axis II clusters help psychodynamic recognize type character pathology present • Defenses  controlling unpleasant affect  work effectively ~ master feeling anxiety. anger. shame.cont. affect others. guilt. depression.  their behavior ego-synchronic ~ no distress for them. even thought it may adversely affect other .

child abuse Projective identification  borderline .Defense Mechanism • • • • • • • • Fantasy Schizoid Dissociation histrionic Isolation  obsessive compulsive Projection  sensitive to criticism Splitting  ambivalence good and bad Passive aggression  masochism Acting out  tantrum.

trust worthiness of friend Reluctant to confide in other Reads hidden demeaning Persistently bears grudges(unforgiving) Perceives attacks (quick to react agrily) Recurrent suspicions without justification(spouse/patner sex) . Preoccupied. harming.Paranoid personality disorders • • • • • • • Suspects. without basis.exploiting.

interest in having sexual with another person • Takes pleasure in few. including being part of family • Almost always chooses solitary activities • Has little. activities • Lack close friend • Appears indifferent to the praise • Show emotional coldness .Schizoid Personality Disorder • Neither desires nor enjoys close relationship. if any.

eccentric.Shizotypal Personality Disorder • Ideas of reference • Odd beliefs or magical thinking  behavior • Unusual perceptual experiences bodily illusions • Odd thinking and speech(circumstancial) • Suspiciousness or paranoid ideation • Inappropriate & constricted affect • Behavior appearance odd. • Lack of close friend(first degree relatives) • Excessive social anxiety (paranoid fear) .

conning others for personal profit or pleasure • Impulsivity or failure to plan ahead • Irretabelity and aggresiveness  by repeated physical fight or assaults • Reckless disregards for safety of self or others.Antisocial personality disorder • Failure to conform to social norm  respect lawful  ground to arrest. • Man 3% :Women 1% can be found in prison • Generally compares to sociopathy . • Repeated lying.

stress-related paranoid ideation .Borderline personality disorder • • • • • • • • • Frantic efforts to avoid real A pattern of unstable Identity disturbance Impulsivity in at least two areas that are potentially Recurrent suicidal behavior Affective instability due to a mark reactivity of mood Chronic feelings of emptiness Inappropriate Transient.

provoactive behavior) • Display rapidly shifting • Consistenly use Psysical app  attention • Style of speech that is excessively impressionistic and lacking in detail • Shows self-dramatization Threatically • Suggestible(easy influence by others) • Considers relationship to be intimate .Histrionic Personality Disorders • Uncomfortable in situations(is not the center of attention) • Interaction with other(sexually seductive.

naughty behaviors or attitudes .Narcissistic personality disorder • • • • • • • • • Grandiose sense of self-importance Preoccupied with fantasies Believes that he or she is “special” and unique Requires excessive admiration Sense of entitlement Interpersonally exploitative Lacks empathy Often envious of others Shows arrogant.

Avoidant personality disorder • • • • • • • Avoids occupational activities Unwilling to get involved Shows restraint Preoccupied with being criticized Inhibited in new interpersonal situations Views self as socially inept Unusually reluctant to take personal risks .

Dependent personality disorder • Difficulty making everyday decisions • Needs others to assume responsibility for most major areas of his/her life • Difficulty expressing disagreement with others • Difficulty initiating project • Excessive lengths to obtain nurturance • Feels uncomfortable • Urgently seeks another relationship as a source of care • Unrealistically preoccupied with fears .

• Show rigidity and stubbornness .Obsessive-compulsive personality disorder • • • • • • • Preoccupied with details Shows perfectionism Excessively devoted Over conscientious Unable to discard worn-out Reluctant to delegate tasks Adopts a miserly spending style toward both self.

unhappiness. pesimisstic • Sadomasochistic Psychological abusive. sadism or masochism  com. joylessness.Personality disorder not otherwise specified • Passive aggressive • Depressive. Of both • Sadistic not include in DSM-IV TR derive sexual arousal behavior. usual mood is dominated by dejection. Paraphilia  sexual sadism .

Personality change due to a general medical condition • • • • • • • • • • Head trauma Cerebrovascular diseases Cerebral tumors Epilepsy Huntington’s diseases Multiple sclerosis Endocrine disorders Heavy metal poisoning Neurosyphilis Acquired immune deficiency syndrome .

group therapy. Insight oriented therapy. Ie . cognitive behavior therapy.Psychotherapy • Is treatment of choise for personality disorders. often long and complex . • Countertransferance problems. behavior therapy.

low dose antipsychotic • Mood dysregulation  serotonergic. • Behavior dyscontrols  Lithium.Pharmacotherapy • Target symptom Domain of Personality disorders. • Psychotic symptoms antipsychotic low dose . antopsychotic • Anxiety  benzodiazepines. serotonergic drug. anticonvulsan. antipsychotic. MAOIs’.

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