assignment on personalty disorders


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the question was about conditions under which one may be described as a deviation of personality and clearly identifying the symptoms, occurrence, diagnoses and treatment not more than six pages

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assignment on personalty disorders

  1. 1. Undoubtedly human behaviour is unpredictable most at times; however, there are certainones we could insist from others and others from us. In going about daily activities and tryingto keep a „normal‟ behaviour we try to always behave in a way that will not be termedimproper or „abnormal‟. Although we do not define what a normal behaviour is, whatever wedo that do not warrant any public or any negative reaction from others sometimes are simplytermed as such. However what constitute a normal behaviour varies in terms geographical,cultural and situational. For instance student who applause lecturer after a normal daylectures will attract some few unpleasant stares from her colleagues however her refusal toclap for a fellow mate who answers a question correctly will be seen as bad if the class wasinstructed to do so. Because of this the personality we portray are parchments of expectedbehaviour traits others insist from us. In the inverse, deviations emanates when certainbehaviour trait exhibited contradicts mainstream cultural and societal norms, values andconventions and causes impairment in identity and sense of self in interpersonal functioning.Not necessarily the breaking of rules but rather ranging from simple deviations toconventions.To begin with, people with behaviours such alcoholism show some kind of behaviours oractions that causes either problems to themselves and or others. The magnitudes of suchproblems are different and the effects it brings to either others or the victim him/herself eitherdraws people away or incites negative conception about the victim. Although the behaviourmay not be termed at the beginning as a disorder because at one point we may all drink,however it gains such status when it becomes a consistent or persistent personality trait. Thistrait also causes either massive or a slight discomfort to others and the victim himself indiverse situations. Such conditions could be termed as a deviation from the averagebehaviour.In addition to behaviours, thoughts and ways of perceiving that could be termed as deviationsfrom the average are those actions that are unwarranted by society or those society frownsupon which may be caused by either emotional problems as a results of trauma or otherstimuli from the environment. Because society expects something from us and us fromothers, a smile to a close relative without reciprocation would mean there is an abnormality inthe interaction. This may have been caused by the emotional state of the supposed respondentas at the time of showing the action. But such behaviour is termed deviations. Not deviationas enshrined in any formal convention but because it the expectation of and from the averageperson in such situations. A French novelist Andre Malreaux says that People with behaviour
  2. 2. problems appear “stuck” in their problems their behaviour is so inflexible that they neverseem able to change to a new approach, even when it is obvious that their old strategies arenot working.Notwithstanding, when a behaviour trait results in a negative consequence on the victim himor herself, it could be termed as a deviation from the average. Humans are endowed withcertain instinctual drives according to Thomas Hobbs which are to be satisfied as such whenan action rather points the opposite it could be termed as a deviation. For instance if a personinflicts person pains on his or her body and that rather becomes the means of satisfying adrive, that becomes a deviation in society. The average person is expected to use approvedsocietal means enshrined in the norms and values and without those there is a deviation.With the above mentioned points are what could be considered as deviations from averagebehaviours. Such traits of behaviours when consistent leads to what is termed personalitydisorders. This term could not be used for a behaviour shown once or by accident, for at onepoint or the other all humans deviate, but rather when persistent. What then constitutepersonality disorders is defined in the Diagnostic and Statistics Manual (DSM-III-R) of theAmerican Psychiatric Association in 1987 as “enduring patterns of perceiving, relating to,and thinking about the environment and oneself, and are exhibited in a wide range ofimportant social and personal contexts. It is only when personality traits are inflexible andmaladaptive and cause either significant functional impairment or subjective distress thatthey constitute Personality Disorders” (page 335). It is imperative to acknowledge the factthat indeed the ways that one perceives, thinks and acts has effect not only on himself but thatof the significant and even insignificant others in society. In addition according to thedefinition, the personality trait should be inflexible as in unbending or almost impossible tochange and also poorly adopted. Then, reason for these features lays in the fact that it mostlysurfaces in the adolescence stage but may have existed in the personality for a long time buthidden and rarely show in late adulthood and old age because there are common ones likeattention deficit and hyperactivity disorders (ADHD) that are in almost all children andbiological. such as Gender identity disorders (GID). This is summarized by the DSM-III-R as“ the manifestation of personality disorders are often recognizable by adolescence orearlier and continue throughout most of adult life, though they often becomes less obviousin middle or old age”. Personality disorders are behavioural patterns that cause personal andsocial difficulties, distress, or problems in functioning and such people have temperamentaldeficiencies or aberrations, rigidity in dealing with life problems and defective perceptions of
  3. 3. self and others. (Sue,Sue & Sue 1990). These behaviours as asserted by Carson and Butcher(1992) to a large extent caused by immature and distorted personality patterns which mayeither be biological or from previous socialization and may not be merely from disablingdefences against anxiety as in a neurotic disorders ( somebody regarded as overanxious,oversensitive or obsessive about everyday things). They further asserted that threeepidemiological studies conducted on one personality trait disorder showed 2.1%, 2.6 % and3.3% from different geographical regions. Accidents such as head injuries and brainpathologies cannot be left out when incomes some causes of the deviations. This accounts forthe ubiquitous nature of personality disorders.There are several personality disorders that occur to humans with some being just slightlydifferent from others but defined with divergent deviational features. Among such disordersare: paranoid, schizoid, obsessive, avoidant, antisocial, borderline, schizotypal, Narcissistic,Histrionic, Dependent, Obsessive-compulsive, Passive-aggressive. The DSM-III-R(American Psychiatric Association) in 1987 has however added two new personalitydisorders named Self-defeating and Sadistic personality disorders.DSM-III-R groups these disorders into clusters on the basis of similarities as Cluster I(paranoid, Schizoid and Schizotypal), Cluster II (Antisocial, Borderline, Histrionic andNarcissistic) and Cluster III (Avoidant, Dependent, Obsessive-compulsive and Passive-aggressive). Sue et al (1990) also renamed these groupings as Odd -Eccentric, Dramatic-emotional- erratic and Anxious- fearful respectfully.To commence with, the definition, occurrence, symptoms as well as diagnosis and treatmentof seven of such disorders would be looked at:PARANOID, with such a personality disorders shows the following signs of unwarrantedsuspicious, hypersensitivity, and restricted affect thus aloofness and lack emotions assymptoms. This sometimes occurs among couples who suspect each other of having extramarital affair (cheating). This could gradually result in the couple not trusting and fellingjealous each other and may even end in break-ups or even physical attacks. Diagnosticallyparanoids have persecutory, grandiose, jealousy and hallucinating delusions and reluctant toconfide in others (Sue et al (1990). For treatment of paranoia a therapist or psychologist isneeded through Dialectical Behaviour Therapy (DBT) usage ( personality disorder are marked basically by social isolation, withdrawn, lack ofdesire or enjoyment of close relationships, almost exclusive preference for solitude. Little
  4. 4. interest in sex with others. Few if any pleasures, lack of friends, indifference to praise orcriticism from others, emotional detachment as symptoms. Occur when there is lack of closefriends or confidants other than first-degree relatives. Found in persons diagnosed withisolation and emotionally cold. This can also be treated by clinical psychologist and therapistover time and regular practice of newly introduced behaviour by using Cognition AnalyticalTherapy (CAT). Thus ways of perceiving and interpreting self, other people, and events(DSM-IV and DSM-5, revised 2011).The next under cluster I is SCHIZOTYPAL, such people show oddities in various aspects oftheir thinking and behaviour and may even believe that they possess magical thinkingabilities, illusions and cognition problems. They could say “I can predict what people will saynext or I feel my dead father is watching me” They may lack close friends, extreme anxietyaround other people with the occurrence which may be genetic, (Sue et al, 1990). Belief inextrasensory perception, extreme suspiciousness, paranoia, extreme discomfort aresymptoms. This warrants diagnoses of withdrawal, restricted affectivity, cognitive andperceptual dysregualtion, and impairment in identity, self-direction and empathy (Tundy,1994). For treatment, the cognition is seen as the target with psychotherapy by qualifiedpersons.The next is cluster II and ANTISOCIAL would be tackled. The individual is at least age 18years People with antisocial are constantly violating rights of others; callous, manipulative,dishonest, does not feel guilt. Low agreeableness and low conscientiousness symptoms. Thiscomes with the following diagnoses antagonism, manipulativeness, deceitfulness,callousness, hostility, disinhibition, and irresponsibility. Occurs when victim shows persistentor frequent angry feelings, anger or irritability in response to minor slights and insults, mean,nasty, or vengeful behaviour and reckless disregard for safety of self or others. Such disordersmay be treated through a therapist advising and under taken a series of activities and makingvictim derive other source of interest from significance others in society and also with thehelp of a psychopathologist through re-socialization. (APA, 2011).AVOIDANCE as a personality disorder has the following symptoms and occurrence.Avoidance of interpersonal contacts because of fear of criticism or rejection. Unwilling to getinvolved with others unless certain of being liked. Restraint in intimate relationships for fearof being shame or ridiculed, Feelings of inadequacy and inferiority, Extreme reluctance to trynew things for fear of being embarrassed. Such victims are diagnosed as being anhedonia,detachment, anxious and depressed. Treatment is through focusing on affectivity thus the
  5. 5. range, intensity, liability, and appropriateness of emotional response and developinginterpersonal functioning and medication thus anti-depressants (APA, 1994).BORDERLINE personality disorder patterns derives its name from the fact that thebehaviour lays in between psychosis and neurosis thus more extreme mood disorders andschizophrenia because the latter may be aware of the disorder but may choose to seektreatment or not. (Carson and Butcher, 1992). Borderline disorder has symptoms such asfrequent impulsive, unpredictable, angry, empty and unstable with chronic feelings ofboredom, low tolerance for frustration. They occur with drastic mood shifts and erratic. Theyare diagnosed of self destructive behaviours like binges of gambling, sex, alcohol use, eating,shoplifting and self-mutilation and diagnosed with emotional liability and separationinsecurity. According to Gundersons & Singer (1986) as quoted by Carson and Butcher(1992), borderline disorders comes with history of intense but stormy relationships, typicallyinvolving over-idealization of friends or lovers that later end in disappointments. Referrals topsychotherapist who could offer more sessions, sometimes two in a day and trying to dispose-off the causal factors helps victim to achieve or develop another self image and purposetermed dialectic behaviour therapy (DBT) as treatments.OBSESSIVE-COMPULSIVE personality disorder is the last that would be discussed herein this work though not the last one under cluster III. Such persons show inability to expresswarmth or warm feelings coupled with excessive perfectionism, stubbornness, indecision anddevotions to details as diagnosis. Colleague workers may find the compulsive individual toodemanding and perfectionist with such occurrence. (Sue et al 1990). Victims with such adisorder may be adamant to seek help but with the help of psychologist, they are able toendure and also have good impulse control through mood stabilizers. They may be medicallyadvised not to overdo or over stressed themselves just to please others, spend less hours underpressure and take frequent breaks whiles working or when such behaviour disorder shows astreatment.The major clusters and their subdivision are shown as in the table below with a detail of symptoms,occurrence, diagnoses and treatment.Clusters/major class Types Diagnoses TreatmentCluster IOdd Eccentricparanoid, Schizoid andSchizotypalParanoid: Suspicious,hypersensitivity,persecutory, grandiose,jealousy andhallucinationSchizoid: sociallyisolated, emotionally coldSchizotypal: peculiarthoughts, poorinterpersonal relationsLong period of sessionsspent with psychologistand pathologist andDialectical BehaviourTherapy (DBT) ,Cognition AnalyticalTherapy (CAT)
  6. 6. Cluster IIDramatic emotionalErraticAntisocial, Borderline,Histrionic andNarcissisticAntisocial: failure toconform to legal rules,codes, anxiety, guiltBorderline: intensefluctuations in moods,self-image.Histrionic: selfdramatization.Exaggeration, attentionNarcissitic:hypersensitivity, lack ofsympathy.Psychological treatmentby learning new methodsof interaction and relatingto others for over a longperiod of time andmeeting new persons,dialectic behaviourtherapy (DBT)Cluster IIIAnxious fearful(Avoidant, Dependent,Obsessive-compulsiveand Passive- aggressiveAvoidant: anhedonia,detachment, anxious anddepressedDependent,irresponsibilityObsessive- compulsion:perfectionism, indecisionPassive-aggressive:inefficiency,procrastination.Re socialization andlearning of new selfthrough therapy andpsychological advice ofstress free methods ofliving. Medication thusanti-depressants.Clusters adopted from Sue, Sue and Sue 1990 and the DSM-III-R 2011.To conclude, it is very important for each and every person to develop a positivepersonality throughout his /her life but because all humans are born and raised in diversecultural background, different types exist. This would be a reason for major differences inconditions that constitute a deviation from the average behaviour. Different expectations ofeach other making behaviour deviations socially defined. However a research has shown thatsex is not only defined by what is seen in the physical but right from the biological make upof humans. This has risen concerned about whether or not the behaviours expected of thevarious sexes could have anything to do with personality disorders. Where there are what istermed Sexual Ambiguity or Disorders of Sexual Development (DSD). Thus one may bemale in the outside but female and vice versa in the inside because of malformation andinadequacy of hormones such as testosterone, estrogens or progesterone. This may lead to apersonality disorder but rarely noticed. Such occurrence makes the disorder rather biologicalthan social. However the American Psychological associations have come out with clusters ofpersonality disorders that can either be managed if not totally eliminated though they are nothighly distinguished and exhaustive. According to sue et al (1990) though some disorderslike psychopath can be resolved by use of drugs such as tranquilizers( phenothiazines anddilantin), Carson & Butcher ( 1992) asserted that not all disorders of personality can beresolved with some taking years and others just a meeting with psychotherapist. Others alsoaccept that punishments may also help in extinguishing such behaviours but more effectivemethods such as therapy, psychotherapy and re-socialization has been more yielding.
  7. 7. ReferencesAmerican Psychiatric Association; Diagnostic and Statistical Manual of Mental Disorders,(1994), Fourth Edition. Washington, DC.American Psychiatric Association; Diagnostic and Statistical Manual of Mental Disorders,(1980), Third edition. Washington, DC.Bundy T. (1994), Personality Disorders,Library of congress. USA.Carson, R. C and Butcher , J. N. ( 1992) 9thEdition. Abnormal psychology and modern lifeHarper Collins publishers. New York, USA.Sue, D., Sue, D., Sue, S. (1990), Understanding Abnormal BehaviourHoughton Mifflin company , NY. USA.ASSIGNMENT
  8. 8. SOWK 316 (PERSONALITY DEVELOPMENT ANDBEHAVIOUR DISORDER)LECTURER: DR. SAYRAM EMMA HAMINOOSTUDENT ID: 10335243Question:Which condition in your opinion do you consider as a deviation from the average person‟sbehaviour? Clearly identify them, giving details definition of each, their occurrence,symptoms, diagnoses and treatment.CLUSTER OF PERSONALITY DISORDERS ACCORDING TO AmericanPsychological Association (Diagnostic and Statistical Manual-III-R 2011)CLUSTER I (paranoid, Schizoid and Schizotypal),CLUSTER II (Antisocial, Borderline, Histrionic and Narcissistic)CLUSTER III (Avoidant, Dependent, Obsessive-compulsive andPassive- aggressive).Also added by APA in 1987 are:Self-defeating and Sadistic Personality disorders.