Personality disorder

Personality
•The term personality refers to those enduring qualities of
an individual that are shown in their ways of behaving in a
wide variety of circumstances.
•Or can be defined its characteristic pattern of thought,
emotion ,behavior ,moral values that determine adaptation
of the person to the environment.
•Personality disorder occur in 10 to 20 % of the general
population.
•Persons with personality disorders are far more likely
refuse psychiatric help and deny their problems In
general.
 Personality factors
(the Big Five model of Costa and McCrae (1992)

•Today, many researchers believe that there are five core personality traits.

•1 . Openness to experience (appreciation of emotion, art, curiosity and

experience)
•2 . Conscientiousness (self-discipline, organised, acts dutifully)
•3 . Extroversion (positive emotions, seeks stimulation, sociability)
•4 . Agreeableness (companionable, cooperative, avoiding antagonism)
•5 . Neuroticism (unpleasant emotions, anger, anxiety depression,
vulnerability)
 Diagnostic Criteria for General Personality Disorder

A. An enduring pattern of inner experience and behavior that deviates markedly

from the expectations of the individual’s culture. manifested in two (or more)
of the following areas:
•(1. Cognition.2. Affectivity ,3. Interpersonal functioning.4. Impulse control.)
•B. The enduring pattern is inflexible and pervasive
•C. The enduring pattern leads to significant distress or impairment in important
areas of functioning.
•D. The pattern is stable and of long duration, and its onset can be traced back
at least to adolescence or early adulthood.
•E. The enduring pattern is not better explained as a manifestation or
consequence of another mental disorder or physiological effects of a substance
•1- Suspicious
•2- Preoccupied with about the
loyalty or trustworthiness of
friends
•3- Reluctant to confide in others
•4- Reads hidden demeaning or
threatening meanings into benign
remarks
•5- Bears grudges.
•6- Perceives attacks on his
character
•7- Recurrent suspicions, regarding
fidelity of spouse
•2–4% in the general population
1- Neither desires nor enjoys
close relationships ,
•2 - Chooses solitary activities.
•3- Has little, interest in having
sexual experiences
•4- Takes pleasure in few
activities.
•5- Lacks close friends
•6- Indifferent to the praise or
criticism of others.
•7- Emotional coldness
• estimated at occurring in less
than 1% of the general
population
•Compliation mood disorder
1- Ideas of reference .
•2- Odd beliefs or magical thinking
•3 - Unusual perceptual
experiences ,
•4- Odd thinking or speech
•5-Suspiciousness or paranoid
ideation.
•6- Inappropriate or constricted
affect
•7- Behavior or appearance that is
odd, eccentric, or peculiar
•8- Lack of close friends
•9- Excessive social anxiety
•Schizotypal personality disorder is
considered to be a risk disorder
for the development of
schizophrenia, in that nearly 30%
of
1- Failure to conform
to social norms
•2- Deceitfulness,
•3- impulsive
•4- Irritable and
aggressive,
•5- Reckless
•6- Irresponsible.
•7- Lack of remorse
• between 0.5 and 3.5
percent.
•m more than f
1- Frantic efforts to avoid real
or imagined abandonment.
•2- unstable relationships
•3- unstable-self-image or
sense of self.
•4- Impulsivity
•5- Recurrent suicidal
behavior, gestures, or threats
•6- Affective instability.
•7- feelings of emptiness.
•8- Inappropriate, intense
anger
•9- paranoid ideation
•three times more often in
women than in men
1- Uncomfortable in
situations in which he or she
is not the center of attention
•2- Inappropriate sexually
seductive behavior.
•3- Shallow expression of
emotions.
•4- Uses physical appearance
to draw attention.
•5- Speech is excessively
impressionistic and lacking
in detail.
•6- Shows self-dramatization
•7- Suggestible .
•8- Considers relationships to
be more intimate than they
actually are.
•1- Has a grandiose sense of
self-importance
•2- Is preoccupied with fantasies
of unlimited success, power,
brilliance, beauty, or ideal love.
•3- Believes that he or she is
"special"
•4- Requires excessive
admiration.
•5- Has a sense of entitlement
•6- Exploitative
•7- Lacks empathy
•8- Envious of others or believes
that others are envious of him.
•9- Arrogant.
Cluster C personality disorder
1- Avoids occupational
activities that involve
significant interpersonal
contact
•2- Is unwilling to get
involved with people unless
certain of being liked.
•3- Shows restraint within
intimate relationships
•4- Is preoccupied with being
criticized or rejected.
•5 - Is inhibited in new
interpersonal situations
•6- Views self as inferior to
others.
•7- Reluctant to take personal
risks
1- Difficulty making everyday
decisions
•2- Needs others to assume
responsibility for most major
areas of his or her life.
•3- Difficulty expressing
disagreement with others
•4- Difficulty initiating projects or
doing things on his own
•5- Goes to excessive lengths to
obtain support from others ,
•6- Feels uncomfortable when
alone
•7- Urgently seeks another
relationship when a close
relationship ends.
•8- Preoccupied with fears of
being left to take care of himself.
1- Preoccupied with details,
rules, lists ,
•2- Perfectionism that
interferes with task
completion
•3- Devoted to work and
productivity
•4- Is over conscientious, and
inflexible about matters of
morality, ethics, or values
•5- Is unable to discard
objects
•6- Is reluctant to work with
others.
•7- Miserly
•8- Rigidity and stubbornness
OTHER SPECIFIED PERSONALITY DISORDER
Passive-aggressive personality
depressive personality
oppositionalism
sadism, or masochism
 PERSONALITY CHANGE DUE TO A General Medical
CONDITION
Head trauma
Cerebrovascular diseases
Cerebral tumors
Epilepsy (particularly, complex partial epilepsy)
Huntington's disease
Multiple sclerosis
Endocrine disorders
Heavy metal poisoning (manganese, mercury)
Neurosyphilis
Acquired immune deficiency syndrome (AIDS)
Etiology
•Biological

•Genetic (more in monozygotic twins ,ClusterA are more common in the

biological relatives of patients with schizophrenia,Cluster B apparently have a
genetic base. associated with alcohol use disorder and mood disorders ,Cluster C
associated with relative with high anxiety levels)

•Neurophysiology(impulsive traits show high levels of testosterone, 1 7-estradiol,

and estrone, Low platelet MAO levels in schizotypal, saccadic (i.e., jumpy) in
persons who are introverted, and who have schizotypal personality,Changes in
(EEG) occur in some patients with antisocial and borderline ; as slow-wave
activity
 Treatment

Medication
•The aim is relive comorbid mental illness
•Antipsychotics may be of some benefit in cluster B(impulsivity ,
cognitive or perceptual symptoms)
•Antidepressants may be of benefit in impulsive, depressed, or self
harming patients
•Mood stabilizers (for affect dysregulation)
 Treatment

social
•Therapeutic communities
is an intense form of psychosocial treatment in which
every aspect of the environment is part of the treatment
setting, in which interpersonal behavior can be challenged
and modified
 Treatment

psychotherapy
Dialectical behavioral therapy
(Group and individual therapy using CBT techniques for 1to
2 years that involve 4 element, Mindfulness, interpersonal
effectiveness, distress tolerance and emotion regulation.)
Cognitive analytic therapy
Psychodynamic therapy
CBT
Outcome of personality disorder
•Morbidity and mortality
•accidents, suicide, and violent death, particularly
cluster B
•Outcome of other disorders in patients with
personality disorder
•The outcome is worse
•Comparison between age groups
•the elderly are more likely to be cautious and rigid,
and less likely to be impulsive and aggressive
Thank you for listening