Personality Disorder
Prepared by:
Catherine Atas/ Zarina Adorador/Emelica Sabran/ Carlo Azul
Professor:
Dra. Hazel Tan

Pe...
Diagnosis
If symptoms of PPD are present, the doctor will begin an evaluation by performing a complete medical and psychia...
•

You almost always choose solitary activities.

•

You have little, if any, interest in sexual experiences with another ...
Prognosis: Schizotypal personality disorder is usually a long-term (chronic) illness. The outcome of treatment varies
base...
•

Repeatedly conning or lying to others

•

Being irritable and aggressive, repeatedly engaging in physical fights or ass...
•

Suicidal behavior or self-injury

•

Wide mood swings

•

Chronic feelings of emptiness

•

Anger-related problems, suc...
If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or
psychologis...
•

Are self-centered and boastful

•

Seek constant attention and admiration

•

Seek constant attention and admiration

•...
Also known as Anxious personality disorder. Is a Cluster C personality disorder recognized in the DSM
handbook as afflicti...
People with DPD become emotionally dependent on other people and spend great effort trying to please others. People with
D...
helplessness, procrastination, stubbornness, resentment, sullenness, or deliberate/repeated failure to accomplish requeste...
There are no controlled studies on the relative effectiveness of different antidepressants for the treatment for
depressio...
Drugs have limited effects. They can be misused or used in suicide attempts. When anxiety and depression result from a
per...
Personality disorder final
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Personality disorder final

  1. 1. Personality Disorder Prepared by: Catherine Atas/ Zarina Adorador/Emelica Sabran/ Carlo Azul Professor: Dra. Hazel Tan Personality Disorder Definition • A class of mental disorder characterised by enduring maladaptive patterns of behavior, cognition and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's culture. • Difficulty in social judgement that is not as serious as neurosis or psychosis but includes inadequacies in motivational and emotional processes. • First evident in late adolescence or early adulthood. Classifications  Cluster A: Odd and Eccentric - Paranoid, Schizoid and Schizotypal  Cluster B:Dramatic, Emotional and Erratic - Antisocial, Borderline, Historinic, Narcissistic  Cluster C: Anxious and Fearful - Obssesive-Compulsive, Avoidant, and Dependent  Other PDs -Passive-Aggressive, Depressive, Sadistic, and Self-Defeating Paranoid Personality Disorder Characterized by a pattern of irrational suspicion and mistrust of others, interpreting motivations as malevolent Characterized by paranoia and a pervasive, long-standing suspiciousness and generalized mistrust of others. Paranoid individuals are eager observers. They think they are in danger and look for signs and threats of that danger, potentially not appreciating other evidence.. Prognosis: Lifelong problems and working with others. Defense mechanisms: Projection, denial and rationalization.
  2. 2. Diagnosis If symptoms of PPD are present, the doctor will begin an evaluation by performing a complete medical and psychiatric history and, if indicated, a physical exam. Although there are no laboratory tests to specifically diagnose personality disorders, the doctor might use various diagnostic tests to rule out physical illness as the cause of the symptoms. If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder. Symptoms • Chronic and pervasive distrust and suspicion of others. • Feelings that they are being lied to, deceived, or exploited by other people. • May believe that friends, family, and romantic partners are untrustworthy and unfaithful. • Outburst of anger in response to perceived deception. • Often described as cold, jealous, secretive, and serious. • Look for hidden meanings in gestures and conversations. Treatment • Openness, consistency, avoidance of humor. • Support healthy parts of the ego. • Emphasize reality. • Cognitive-behavioral Therapy is often effective in helping individuals adjust distorted thought patterns and maladaptive behaviors Schizoid Personality Disorder Is characterized by a lack of interest in social relationships, a tendency towards a solitary lifestyle, secretiveness, emotional coldness, and apathy. Isolated lifestyle with overt longing for others. Many people with schizoid personality disorder are able to function fairly well, although they tend to choose jobs that allow them to work alone, such as night security officers, library, or lab workers. Diagnosis To be diagnosed with schizoid personality disorder, you must meet criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. Diagnosis of schizoid personality disorder includes four or more of these characteristics: • You neither desire nor enjoy close relationships, including being part of a family.
  3. 3. • You almost always choose solitary activities. • You have little, if any, interest in sexual experiences with another person. • You take pleasure in few, if any, activities. • You don't have any close friends or confidants other than first-degree relatives. • You seem not to care about praise or criticism. • You seem emotionally cold, detached or unexpressive. Symptoms • They do not desire or enjoy close relationships, even with family members. • They take pleasure in few activities, including sex. • They are indifferent to praise or criticism. • They are aloof and show little emotion. • They have no close friends, except first-degree relatives. • They choose solitary jobs and activities. • They have difficulty relating to others. • They might daydream and/or create vivid fantasies of complex inner lives. Treatment • Focus on realtedness and identification of emotions. • Talk therapy (psychotherapy) - A therapist with experience treating schizoid personality disorder is likely to understand your need for personal space and how difficult it is for you to open up about your inner life. • Medications. - For example, if you have symptoms of anxiety or depression, you doctor may prescribe a selective serotonin reuptake inhibitor (SSRI). Schizotypal Personality Disorder A pattern extreme discomfort interacting socially, distorted cognitions and perceptions Multiple oddities and eccentricities of behavior, thought, affect, speech and appearance. Characterized by a need for social isolation, anxiety in social situations, odd behavior and thinking, and often unconventional beliefs People with this disorder feel extreme discomfort with maintaining close relationships with people, and therefore they often do not.
  4. 4. Prognosis: Schizotypal personality disorder is usually a long-term (chronic) illness. The outcome of treatment varies based on the severity of the disorder. Diagnosis Many people with schizotypal personality disorder don’t seek out treatment. People with personality disorders, in general, do not often seek out treatment until the disorder starts to significantly interfere or otherwise impact a person’s life. This most often happens when a person’s coping resources are stretched too thin to deal with stress or other life events. A diagnosis for schizotypal personality disorder is made by a mental health professional comparing your symptoms and life history with those listed here. They will make a determination whether your symptoms meet the criteria necessary for a personality disorder diagnosis. Symptoms • Ideas of reference (excluding delusions of reference) • Unusual perceptual experiences, including bodily illusions • Odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped) • Lack of close friends or confidants other than first-degree relatives • Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self Treatment Treatment of schizotypal personality disorder typically involves long-term psychotherapy with a therapist that has experience in treating this kind of personality disorder. Medications may also be prescribed to help with specific troubling and debilitating symptoms. Antisocial Personality Disorder A pervasive pattern of disregard for the rights of others, lack of empathy. Characterized by a pervasive pattern of disregard for, or violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood. Diagnosis To be diagnosed with antisocial personality disorder, a person must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual, published by the American Psychiatric Association, is used by mental health providers to diagnose mental illnesses and by insurance companies to reimburse for treatment. Symptom criteria required for a diagnosis of antisocial personality disorder include: • Being at least 18 years old • Having had symptoms of conduct disorder before age 15, which may include such acts as stealing, vandalism, violence, cruelty to animals and bullying • Repeatedly breaking the law
  5. 5. • Repeatedly conning or lying to others • Being irritable and aggressive, repeatedly engaging in physical fights or assaults • Feeling no remorse — or justifying behavior — after harming others • Having no regard for the safety of self or others • Acting impulsively and not planning ahead • Being irresponsible and repeatedly failing to honor work or financial obligations. Symptoms • Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest. • Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure. • Irritability and aggressiveness, as indicated by repeated physical fights or assaults. • Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations. • Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another. Treatment Psychotherapy, also called talk therapy, is sometimes used to treat antisocial personality disorder. Psychotherapy is not always effective, especially if symptoms are severe and the person can't admit that he or she contributes to problems. Psychotherapy may be provided in individual sessions, in group therapy, or in sessions that include family or even friends. Multisystematic Therapy (MST) that could potentially improve this imperative issue. However this treatment requires complete cooperation and participation of all family members Borderline Personality Disorder A pervasive pattern of instability in relationships, self-image, identity, behavior and affects often leading to selfharm and impulsivity Diagnosis For borderline personality disorder to be diagnosed, at least five of the following signs and symptoms must be present: • Intense fear of abandonment • Pattern of unstable relationships • Unstable self-image or sense of identity • Impulsive and self-destructive behaviors
  6. 6. • Suicidal behavior or self-injury • Wide mood swings • Chronic feelings of emptiness • Anger-related problems, such as frequently losing your temper or having physical fights • Periods of paranoia and loss of contact with reality Symptoms • Impulsive and risky behavior, such as risky driving, unsafe sex, gambling sprees or illegal drug use • Impulsive and risky behavior, such as risky driving, unsafe sex, gambling sprees or illegal drug use • Awareness of destructive behavior, including self-injury, but sometimes feeling unable to change it • Short but intense episodes of anxiety or depression • Inappropriate anger and antagonistic behavior, sometimes escalating into physical fights Treatment • Counseling and therapy. It's important to fnd a counselor you can build a stable relationship with. This can be hard, because your condition may cause you to see your counselor as caring one minute and cruel the next, especially when he or she asks you to try to change a behavior. Try to find a counselor who has special training in treating this disorder. • Medicines, such as antidepressants, mood stabilizers, and antipsychotics. • Healthy habits, such as getting enough sleep, eating healthy foods, getting regular exercise, and avoiding alcohol and drugs. These habits can help reduce stress and anxiety Historionic Personality Disorder Characterized by a pattern of excessive emotionality and attention-seeking, including inappropriately seductive behaviour and an excessive need for approval, usually beginning in early adulthood. People with these disorders have intense, unstable emotions and distorted self-images. For people with histrionic personality disorder, their self-esteem depends on the approval of others and does not arise from a true feeling of self-worth. Diagnosis If signs of this personality disorder are present, the doctor will begin an evaluation by performing a complete medical and psychiatric history. If physical symptoms are present, a physical exam and laboratory tests (such as neuroimaging studies or blood tests) may also be recommended to assure that a physical illness is not causing any symptoms that may be present.
  7. 7. If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder. Symptoms • Dress provocatively and/or exhibit inappropriately seductive or flirtatious behavior • Act very dramatically, as though performing before an audience, with exaggerated emotions and expressions, yet appears to lack sincerity • Have a low tolerance for frustration and be easily bored by routine, often beginning projects without finishing them or skipping from one event to another • Have difficulty maintaining relationships, often seeming fake or shallow in their dealings with others • Be overly concerned with physical appearance Treatment Treatment is often prompted by depression associated with dissolved romantic relationships. Medication does little to affect the personality disorder, but may be helpful with symptoms such as depression.Treatment for HPD itself involves psychotherapy, including cognitive theraphy. Narcissistic Personality Disorder Is a personality disorder in which the individual is described as being excessively preoccupied with issues of personal adequacy, power, prestige and vanity. Diagnosis • Criteria for narcissistic personality disorder to be diagnosed include: • Having an exaggerated sense of self-importance • Being preoccupied with fantasies about success, power or beauty • Believing that you are special and can associate only with equally special people • Requiring constant admiration • Having a sense of entitlement • Taking advantage of others • Having an inability to recognize needs and feelings of others • Being envious of others • Behaving in an arrogant or haughty manner
  8. 8. • Are self-centered and boastful • Seek constant attention and admiration • Seek constant attention and admiration • Consider themselves better than others • Exaggerate their talents and achievements • Believe that they are entitled to special treatment Treatment Group treatment has its benefits as the effectiveness of receiving peer feedback rather than the clinician’s may be more accepted, but group therapy can also contradict itself as the patient may show "demandingness, egocentrism, social isolation and withdrawal, and socially deviant behavior." Relationship therapy stresses the importance of learning and applying four basic interpersonal skills: "effective expression, empathy, discussion and problem solving/conflict resolution." Marital/relationship therapy is most beneficial when both partners participate. Obsessive-Compulsive Personality Disorder Also called anankastic personality disorder. Is a personality disorder characterized by a pervasive pattern of preoccupation with orderliness, perfectionism, mental and interpersonal control at the expense of flexibility, openness, and efficiency. Symptoms • Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost • Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met) • Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity) • Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes • Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things Treatment Treatment for OCPD includes pyschotherapy, cognitive behavioral therapy, behavior therapy or self-help. Medication may be prescribed. In behavior therapy, a patient discusses with a psychotherapist ways of changing compulsions into healthier, productive behaviors. Cognitive analytical theraphy is an effective form of behavior therapy Avoidant Personality Disorder
  9. 9. Also known as Anxious personality disorder. Is a Cluster C personality disorder recognized in the DSM handbook as afflicting a person when they display a pervasive pattern of social inhibitions, feelings of inadequacy, extreme sensitivity to negative evaluation, and avoidance of social interactions. Diagnosis Many people with avoidant personality disorder don’t seek out treatment. People with personality disorders, in general, do not often seek out treatment until the disorder starts to significantly interfere or otherwise impact a person’s life. This most often happens when a person’s coping resources are stretched too thin to deal with stress or other life events. Symptoms • Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection • Is unwilling to get involved with people unless certain of being liked • Shows restraint within intimate relationships because of the fear of being shamed or ridiculed • Is inhibited in new interpersonal situations because of feelings of inadequacy • Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing Treatment Talk therapy is considered to be the most effective treatment for this condition. It helps persons with this disorder be less sensitive to rejection. Antidepressant drugs may be used in addition. Other Personality Disorder: Dependent (DPD), formerly known as asthenic personality disorder, is a personality disorder that is characterized by a pervasive psychological dependence on other people. This personality disorder is a long-term (chronic) condition in which people depend on others to meet their emotional and physical needs, with only a minority achieving normal levels of independence. Diagnosis A diagnosis of DPD must be distinguished from borderline personality disorder, as the two share common symptoms. In borderline personality disorder, the person responds to fears of abandonment with feelings of rage and emptiness. With DPD, the person responds to the fear with submissiveness and seeks another relationship to maintain his or her dependency. Symptoms
  10. 10. People with DPD become emotionally dependent on other people and spend great effort trying to please others. People with DPD tend to display needy, passive, and clinging behavior, and have a fear of separation. Other common characteristics of this personality disorder include: Inability to make decisions, even everyday decisions like what to wear, without the advice and reassurance of others. Avoidance of adult responsibilities by acting passive and helpless. *Dependence on a spouse or friend to make decisions like where to work and live.Intense fear of abandonment and a sense of devastation or helplessness when relationships end. A person with DPD often moves right into another relationship when one ends. Oversensitivity to criticism. Pessimism and lack of self-confidence, including a belief that they are unable to care for themselves. Treatment Psychotherapy (a type of counseling) is the main method of treatment for DPD. The goal of therapy is to help the person with DPD become more active and independent, and to learn to form healthy relationships. Short-term therapy with specific goals is preferred. It is often useful for the therapist and patient together to pay attention to the role of therapist in order to recognize and address ways in which the patient may form the same kind of passive reliance in the treatment relationship that happens outside of treatment. Specific strategies might include assertiveness training to help the person with DPD develop self-confidence and cognitive-behavioral therapy (CBT) to help someone develop new attitudes and perspectives about themselves relative to other people and experiences. Medication might be used to treat people with DPD who also suffer from depression or anxiety. However, medication therapy must be carefully monitored because the person might become dependent on or abuse the drugs. Passive-Aggressive Behavior Passive-aggressive behavior is the indirect expression of hostility, such as through procrastination, hostile jokes, stubbornness, resentment, sullenness, or deliberate/repeated failure to accomplish requested tasks for which one is (often explicitly) responsible. For research purposes, the DSM-IV describes passive-aggressive personality disorder as a "pervasive pattern of negativistic attitudes and passive resistance to demands for adequate performance in social and occupational situations". Diagnosis DSM-IV psychiatric disorder characterized by the indirect expression of resistance to occupational or social demands. It results in persistent pervasive ineffectiveness, lack of self-confidence, poor interpersonal relationships, and pessimism that can lead in severe cases to major depression, alcoholism, or drug dependence. The behavior often reflects an unexpressed hostility or resentment stemming from a frustrating interpersonal or institutional relationship on which an individual is overly dependent. Treatment may consist of behavior therapy or any of the various psychotherapeutic procedures, depending on the individual and the severity of the condition. Symptoms A personality trait marked by a pervasive pattern of negative attitudes and characterised by passive, sometimes obstructionist resistance to complying with expectations in interpersonal or occupational situations. Behaviours Learned
  11. 11. helplessness, procrastination, stubbornness, resentment, sullenness, or deliberate/repeated failure to accomplish requested tasks for which one is (often explicitly) responsible. Treatment Psychiatrist Kantor suggests a treatment approach using psychodynamic, supportive, cognitive, behavioral and interpersonal therapeutic methods. These methods apply to both the passive-aggressive person and their target victim. Depressive Depressive personality disorder (also known as melancholic personality disorder) is a controversial psychiatric diagnosis that denotes a personality disorder with depressive features. Originally included in the American Psychiatric Association's DSM-II, depressive personality disorder was removed from the DSM-III and DSM-III-R. Recently, it has been reconsidered for reinstatement as a diagnosis. Diagnosis The DSM-IV defines depressive personality disorder as "a pervasive pattern of depressive cognitions and behaviors beginning by early adulthood and occurring in a variety of contexts." Depressive personality disorder occurs before, during, and after major depressive episodes, making it a distinct diagnosis not included in the definition of either major depressive episodes or dysthymic disorder. Specifically, five or more of the following must be present most days for at least two years in order for a diagnosis of depressive personality disorder to be made: Usual mood is dominated by dejection, gloominess, cheerlessness, joylessness and unhappiness Self-concept centres around beliefs of inadequacy, worthlessness and *low self-esteem Is critical, blaming and derogatory towards the self Is brooding and given to worry Is negativistic, critical and judgmental toward others Is pessimistic Is prone to feeling guilty or remorseful Symptoms persistently depressed or irritable mood diminished interest or pleasure in activities significant decrease or increase in appetite, or weight loss or weight gain increased or decreased sleep decreased mental and physical activity, or increase in such activity as *demonstrated by excessive worrying and agitated behavior fatigue, or loss of energy Recurrent thoughts of death and dying, recurrent suicidal thoughts with a specific plan, or a suicide attempt Treatment If you think you have the symptoms of either type of depression, immediately alert your psychiatrist. If appropriate, the treatment for depression frequently involves the addition of an antidepressant, an increase in dosage if one is already being used, and/or the use of behavioral techniques.
  12. 12. There are no controlled studies on the relative effectiveness of different antidepressants for the treatment for depression in people with borderline disorder. Sadistic Sadistic personality disorder was a personality disorder diagnosis involving sadism which appeared only in an appendix of the revised third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental [1] Disorders (DSM-III-R), The version of the DSM (DSM-IV) does not include it, nor does the most recent version DSM-5 so it is no longer considered a valid diagnostic category. Sadism is a behavioral disorder characterized by a callous, vicious, manipulative, and degrading behavior expressed towards other people. To date, the exact cause of sadism is not known. However, many theories have been given to explain the possible reasons underlying the development of a sadistic personality in an individual Diagnosis This disorder is characterized by cruel, aggressive, manipulative, and demeaning behavior directed towards others. Abusiveness and violence are common in the sadist's social relationships, because the sadist lacks concern for people and derives pleasure from harming or humiliating others. There are similarities between sadistic PD and the more aggressive antisocial PD, however, the antisocial person does not generally hurt others just for pleasure. There may also be an association between sadistic PD and sexual sadism, in which the person derives sexual arousal and satisfaction from sadistic acts like beating and humiliating someone. Symptoms Has used physical cruelty or violence for the purpose of establishing dominance in a relationship (not merely to achieve some noninterpersonal goal, such as striking someone in order to rob him or her). Is fascinated by violence, weapons, martial arts, injury, or torture Humiliates or demeans people in the presence of others, Has treated or disciplined someone under his or her control unusually harshly, e.g., a child, student, prisoner, or patient, Is amused by, or takes pleasure in, the psychological or physical suffering of others (including animals), Has lied for the purpose of harming or inflicting pain on others (not merely to achieve some other goal) Treatment Counseling and Psychotherapy Although treatment differs according to the type of personality disorder, some general principles apply to all. Family members can act in ways that either reinforce or diminish the patient's problematic behavior or thoughts, so their involvement is helpful and often essential. Pharmacotherapy
  13. 13. Drugs have limited effects. They can be misused or used in suicide attempts. When anxiety and depression result from a personality disorder, drugs are only moderately effective. For persons with personality disorders, anxiety and depression may have positive significance, ie, that the person is experiencing unwanted consequences of his disorder or is undertaking some needed self-examination. Self-Defeating Self-defeating personality disorder (also known as masochistic personality disorder) is a proposed personality disorder. A pervasive pattern of self-defeating behavior, beginning by early adulthood and present in a variety of contexts. The person may often avoid or undermine pleasurable experiences, be drawn to situations or relationships in which he or she will suffer, and prevent others from helping him. Diagnosis Some disorders have similar or even overlapping symptoms. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. People with selfdefeating personalities are drawn to situations and relationships in which they are subject to failure, humiliation, suffering, and distress. Although sexual masochism may be present, it has no necessary connection with this disorder. Symptoms Chooses people and situations that lead to disappointment, failure, or mistreatment even when better options are clearly available. Rejects or renders ineffective the attempts of others to help him of her. Following positive personal events (e.g., new achievement), responds with depression, guilt, or a behavior that produces pain ( e.g., an accident). Incites angry or rejecting responses from others and then feels hurt, defeated, or humiliated (e.g., makes fun of spouse in public, provoking an angry retort, then feels devastated). Rejects opportunities for pleasure, or is reluctant to acknowledge enjoying himself or herself (despite having adequate social skills and the capacity for pleasure). Fails to accomplish tasks crucial to his or her personal objectives despite demonstrated ability to do so, (e.g., helps fellow students write papers , but is unable to write his or her own). Is uninterested in or rejects people who consistently treat him or her well, (e.g., is not attracted to caring sexual partners). Treatment Treating a personality disorder takes a long time. Personality traits such as coping mechanisms, beliefs, and behavior patterns take many years to develop, and they change slowly. Changes usually occur in a predictable sequence, and different treatment modalities are needed to facilitate them. Reducing environmental stress can quickly relieve symptoms such as anxiety or depression. Behaviors, such as recklessness, social isolation, lack of assertiveness, or temper outbursts, can be changed in months. Group therapy and behavior modification, sometimes within day care or designed residential settings, are effective. Participation in self-help groups or family therapy can also help change socially undesirable behaviors.

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