1PSYCHIATRY: PERSONALITY DISORDERS

PERSONALITY DISORDERS fixation at one psychosexual stage of

Cluster A Personality Disorders development. e.g. those with oral
• Also known as the odd and eccentric character are passive and dependent.
clusters While those of an anal character are
• These are exemplified by the stubborn, parsimonious and highly
following: conscientious because of struggle over
– Schizotypal personality toilet training.
disorder PARANOID P.D.
– Schizoid Personality disorder • Prevalence rate is 0.5 to 2.5% of the
– Paranoid personality disorder general population.
• They are characterized by long-
Cluster B Personality Disorders standing suspiciousness and mistrusts
• Also known as the dramatic, erratic of person in general. They refuse
and emotional responsibility of their own feelings and
• These are exemplified by the following assign responsibility to others. They
group are often hostile, irritable, and angry.
– Histrionic P.D. Bigots, injustice collectors,
– Antisocial P.D. pathologically jealous spouses, and
– Narcissistic P.D. litigious.
– Borderline P.D. • They are usually formal in manner,
usually serious and humorless.
Cluster C personality disorders • The essential feature is a pervasive
• Also known as the anxious and fearful and unwarranted tendency to interpret
cluster other person’s action as demeaning
• These are exemplified by the following or threatening.
– Avoidant • They usually dispute friend’s loyalty or
– Dependent trustworthiness.
– Obsessive-compulsive • This persons are pathologically jealous
and questions the fidelity of the
Genetic Factors spouse or sexual partners.
• All clusters have genetic basis • Their affect are usually restricted and
• Cluster A are more common in unemotional.
biological relatives patients with
schizophrenia than in control groups SCHIZOTYPAL PD
• Cluster B especially the antisocial P.D. • Persons with this PD are strikingly odd
is associated with alcohol use or strange even to laymen.
disorders. In borderline P.D., • Magical thinking, peculiar notions,
depression and mood disorder is ideas of reference, illusions and
common. Histrionic PD with derealizations are part of his daily
somatization disorder. world.
• Cluster C especially with Avoidant P.D. • They exhibit disturbed thinking and
have high anxiety levels. communicating
• They may be superstitious or claim
Psychoanalytic factors power of clairvoyance and believe
• Sigmund Freud suggested that they have special powers of thought
personality traits are related to a and insight. This is the premorbid
2PSYCHIATRY: PERSONALITY DISORDERS

personality of patient with thefts, fights, substance abuse and

schizophrenia. illegal activities
• Promiscuity, spousal abuse, child
SCHIZOID PD abuse and animal cruelty is common.
• Patients display a lifelong pattern of
social withdrawal Diagnostic Criteria
• They are introvert with constricted • Failure to conform with the social
affect. norms with respect to lawful behaviors
• They are often seen as eccentric, • Deceitfulness as indicated by repeated
isolated or lonely. lying, use of aliases or conning others
• Prevalence rate is about 7.5% of the for personal profit
general population. • Impulsivity or failure to plan ahead.
• Always cold and aloof; they display a • Irritability and aggressiveness by
remote reserve and show no repeated physical fights
involvement with everyday events and • Reckless disregard of safety of self or
the concerns of the others. others
• They are quiet, distant, seclusive, and • Consistent irresponsibility
unsociable • Lack of remorse
• They are the last to be aware of the • At least 18 years old
social fashion. • Presence of conduct disorder before
• The life histories of such persons age 15.
reflect solitary interests and success
at noncompetitive levels BORDERLINE PD
• Their sexual lives may exist • This PD stands on border between
exclusively at fantasy levels neurosis and psychosis.
• They are usually involved in • Almost always appear in the state of
nonhuman interests such as crisis.
astronomy and mathematics • Patients may have micropsychotic
episodes
ANTISOCIAL PD • They cannot tolerate being alone
• Is an inability to conform to the social • They consider each person as either
norms that ordinarily govern many all good or all bad.
aspects of adolescents and adult
• The defense mechanism is projective
behavior.
identification wherein the intolerable
• Constitute about 75% of the prison aspects of self are projected onto
population another.
• Patients usually appear composed and
credible Diagnostic Criteria
• There is usually tension, hostility, • Frantic efforts to avoid real or
irritability and rage. imagined abandonment
• They are usually charming and • Unstable and intense interpersonal
ingratiating relationship.
• They life histories revealed many • Identity disturbance markedly and
areas of life functioning such as lying, persistently unstable self image or
truancy, running away from home, sense of self.
3PSYCHIATRY: PERSONALITY DISORDERS

• Impulsivity that are potentially self • They consider themselves as special

damaging and expect special treatment
• Recurrent suicidal behavior or threats • They become enraged when criticized
or self mutilating behaviors • They can make other furious by their
• Affective instability due to marked refusal to obey conventional rules of
reactivity of mood behavior.
• Chronic feeling of emptiness
• Inappropriate, intense anger or AVOIDANT PD
difficulty in controlling anger. • Commonly described as persons with
• Transient stress related paranoid inferiority complex.
ideation • They show extreme sensitivity to
rejection and may lead to a socially
HISTRIONIC PD withdrawn life.
• They are excitable and emotional and • Hypersensitivity to rejection by others
behave in a colorful, dramatic, is the central feature.
extroverted fashion but unable to • Their main personality trait is timidity
maintain deep, long lasting • When talking with someone, they
attachments. expect uncertainty, show a lack of
• Usually cooperative and eager to give self-confidence, and may speak in self-
a detailed history. Gestures and effacing manner.
dramatic punctuations in their
conversations DEPENDENT PD
• They make frequent slips of the • They subordinate their own needs to
tongue and use colorful language those of others.
• They show a high degree of attention- • Get others to assume responsibility for
seeking behavior. major areas of their lives. Lack self-
• They display temper tantrums, tears confidence
and accusations when they are not the • Pessimist
center of attraction. • Fear of sexuality
• Seductive behavior is common on both • Self doubt
sexes • Passivity
• Woman maybe anorgasmic while men • Suggestibility
are impotent • Lack of perseverance
• Their need for reassurance is endless • Persons with this disorder cannot
• They may act on their sexual impulses make decisions without an excessive
to reassure themselves that they are amount of assurance or advice
attractive to other sex.
OBSESSIVE-COMPULSIVE PD
NARCISSISTIC PD • This is characterized by emotional
• They are characterized by heightened constriction, orderliness,
self-importance and grandiose feelings perseverance, stubbornness and
of uniqueness. indecisiveness.
• They have a grandiose sense of self- • A pervasive pattern of perfectionism
importance and inflexibility.
4PSYCHIATRY: PERSONALITY DISORDERS

• They are preoccupied with rules,

regulations, orderliness, neatness and
details.
• They cannot tolerate infractions
So, what is your personality disorder?