Basic understanding about personality disorder

1. Dr.Sujit Kumar Kar
Assistant Professor in Psychiatry
King George’s Medical University,
Lucknow, UP

2. An enduring
pattern of inner
experience and
behaviour as per
the expectations
of the individual’s
culture

3. Structural Theory
Id
Ego
Superego
Arlow JA, Brenner C. Psychoanalytic concepts and

4. Topographic Theory
Conscious
Preconscious
Unconscious
Arlow JA, Brenner C. Psychoanalytic concepts and

5. Psycho-sexual development
Oral
phase
Anal
phase
Phalic
phase
Latency
phase
Genital
phase

7. Factors influencing personality
Biological
PsychologicalSocio-cultural

8. Deviation
from the
expected
norms
Pattern is manifested in two (or more) of the following areas
• Cognition [Ways of perceiving and interpreting self, people and events]
• Affectivity [Range, intensity, lability and appropriateness of emotional
response]
• Interpersonal functioning
• Impulse control

9. • Enduring pattern is inflexible and
pervasive across various domains of
life
• Enduring pattern leads to clinically
significant distress or impairment
• Pattern is stable and of long
duration
• Onset – Adolescence to young
adulthood
• The pattern of behaviour is
unexplainable by any other
psychiatric disorder or substance
use disorder

13. Assessment of Personality
• History
• Clinical interview: IPDE, SCID-II, 16-PF, EPI
• Projective tests: Rorschach Inkblot Test, TAT,
SCT, DAPT, HTP
It is often underdiagnosed or misdiagnosed

14. Approach & Management
• Pharmacological (limited role)
– Border-line personality disorder
• Micro-psychotic episode
• Impulsive behaviour (role of SSRIs, low dose antipsychotics)
– Co-morbid psychiatric illness
• Psycho-social
– CBT
– Psychodynamic psychotherapy
– Social skill training
– Coping skill
– Anger management
– DBT