Schizophrenia Spectrum & Other Psychotic Disorders for NCMHCE StudyJohn R. Williams
Quick review of the essential points— DSM5 diagnosis criteria, assessments, treatments—of these disorders to better prepare for the National Clinical Mental Health Counseling Exam. This was informed by several exam prep programs, and can be used like flashcards or as a presentation.
Schizophrenia Spectrum & Other Psychotic Disorders for NCMHCE StudyJohn R. Williams
Quick review of the essential points— DSM5 diagnosis criteria, assessments, treatments—of these disorders to better prepare for the National Clinical Mental Health Counseling Exam. This was informed by several exam prep programs, and can be used like flashcards or as a presentation.
THERE ARE LOTS OF DISORDERS IN MENTAL HEALTH ASPECT.THIS PRESENTATION'S FOCUS IS ON PANIC DISORDER AND ITS MANAGEMENT.THIS CLASS IS IN ASPECT OF PSYCHIATRIC NURSING STUDENTS.
Somatic Symptom & Related Disorders for NCMHCE StudyJohn R. Williams
Quick review of the essential points— DSM5 diagnosis criteria, assessments, treatments—of these disorders to better prepare for the National Clinical Mental Health Counseling Exam. This was informed by several exam prep programs, and can be used like flashcards or as a presentation.
Disorders in psychiatry are often described as syndromes, a constellation of signs and symptoms that together make up a recognizable condition. this ppt help in understanding basic sign and symptoms of psychiatry.
Antisocial personality disorder is a mental condition in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others.
Generalized Anxiety Disorder (GAD), Anxiety, Anxiety Disorders, Risk Factors , Signs and Symptoms of GAD, DSM V Diagnostic Criteria for Generalized Anxiety Disorder, ICD 10 CriteriaF41.1 Generalized anxiety disorder, Prevalence and Age of Onset, Treatment, Self-help Strategies For GAD
Classification in Psychiatry
The concept, reliability, validity, advantages and disadvantages of different classification systems, controversies in psychiatry classification
Adjustment disorders are commonly seen in primary care settings in which the 1-year prevalence varies from 11% to 18% of those with any clinical psychiatric disorder. [Casey PR et al., 1984]
A recent study [Maercker A et al., 2012] in the general population found the prevalence of adjustment disorder to be 0.9%,
Persons with histrionic personality disorder are excitable and emotional and behave in a colorful, dramatic, extroverted fashion. Inability to maintain sincere, long-lasting attachments. They are unaware of their true feelings and cannot explain their motivations. With age, the symptoms of histrionic personality disorder will come down. But patients will feel hard to handle it because they lack the energy they had earlier.
Individuals with narcissistic personality disorder have a heightened sense of self-importance, lack of empathy and grandiose feelings of uniqueness. Underneath, however, their self-esteem is fragile and vulnerable to even minor criticism. Narcissistic symptoms diminish after 40 years of age.
Persons with avoidant personality disorder show extreme sensitivity to rejection and may lead socially withdrawn lives. Although shy, they are not asocial and show a great desire for companionship, but they need unusually strong guarantees of uncritical acceptance. We often describe this group as having an inferiority complex. Some marry, have children, and live their lives surrounded only by family members. If their support system fails, however, they are subject to depression, anxiety, and anger.
THERE ARE LOTS OF DISORDERS IN MENTAL HEALTH ASPECT.THIS PRESENTATION'S FOCUS IS ON PANIC DISORDER AND ITS MANAGEMENT.THIS CLASS IS IN ASPECT OF PSYCHIATRIC NURSING STUDENTS.
Somatic Symptom & Related Disorders for NCMHCE StudyJohn R. Williams
Quick review of the essential points— DSM5 diagnosis criteria, assessments, treatments—of these disorders to better prepare for the National Clinical Mental Health Counseling Exam. This was informed by several exam prep programs, and can be used like flashcards or as a presentation.
Disorders in psychiatry are often described as syndromes, a constellation of signs and symptoms that together make up a recognizable condition. this ppt help in understanding basic sign and symptoms of psychiatry.
Antisocial personality disorder is a mental condition in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others.
Generalized Anxiety Disorder (GAD), Anxiety, Anxiety Disorders, Risk Factors , Signs and Symptoms of GAD, DSM V Diagnostic Criteria for Generalized Anxiety Disorder, ICD 10 CriteriaF41.1 Generalized anxiety disorder, Prevalence and Age of Onset, Treatment, Self-help Strategies For GAD
Classification in Psychiatry
The concept, reliability, validity, advantages and disadvantages of different classification systems, controversies in psychiatry classification
Adjustment disorders are commonly seen in primary care settings in which the 1-year prevalence varies from 11% to 18% of those with any clinical psychiatric disorder. [Casey PR et al., 1984]
A recent study [Maercker A et al., 2012] in the general population found the prevalence of adjustment disorder to be 0.9%,
Persons with histrionic personality disorder are excitable and emotional and behave in a colorful, dramatic, extroverted fashion. Inability to maintain sincere, long-lasting attachments. They are unaware of their true feelings and cannot explain their motivations. With age, the symptoms of histrionic personality disorder will come down. But patients will feel hard to handle it because they lack the energy they had earlier.
Individuals with narcissistic personality disorder have a heightened sense of self-importance, lack of empathy and grandiose feelings of uniqueness. Underneath, however, their self-esteem is fragile and vulnerable to even minor criticism. Narcissistic symptoms diminish after 40 years of age.
Persons with avoidant personality disorder show extreme sensitivity to rejection and may lead socially withdrawn lives. Although shy, they are not asocial and show a great desire for companionship, but they need unusually strong guarantees of uncritical acceptance. We often describe this group as having an inferiority complex. Some marry, have children, and live their lives surrounded only by family members. If their support system fails, however, they are subject to depression, anxiety, and anger.
Personality disorder and mental returdation.pptxiqra osman
Personality disorder
Dr.Iqra Osman
1.CHARACTERISTICS
All personality disorders are characterized by behavior that:
deviates from cultural standards is rigid and pervasive
is consistent over time
causes distress or functional impairment
2.IDENTIFICATION
There are 10 personality disorders that fall into 3 clusters:
Cluster A (Odd/Eccentric)
Paranoid
Schizoid . Schizotypal
Cluster B (Dramatic/Emotional)
Antisocial
Borderline Histrionic Narcissistic
Cluster C (Anxious/Fearful)
Avoidant Dependent
Obsessive-compulsive
3.Cluster A(Odd/Eccentric)
Paranoid Personality Disorder is characterized by distrust and suspiciousness of other people.
Schizoid Personality Disorder describes people with a pervasive detachment from social interaction.
Schizotypal Personality Disorder is characterized by bizarre behavior and ideas and a reduced capacity for social relationships.
4.Cluster B (Dramatic/Emotional)
Antisocial Personality Disorder is diagnosed in people who show a consistent pattern of disregard for the rights of others. The pattern of behavior must have been present since the age of 15.
Borderline Personality Disorder describes people who show a pervasive pattern of (1) unstable relationships, (2) unstable affect, (3) unstable self- image, and (4) unstable impulse control.
Histrionic Personality Disorder describes people who demonstrate excessive emotional expression and attention-seeking behavior.
Narcissistic Personality Disorder is characterized by a heightened sense of entitlement, exaggerated feelings of self-importance, and fragile self-esteem.
5.Cluster C (Anxious/Fearful)
Avoidant Personality Disorder is diagnosed in people who are impaired in social interactions because of feelings of inadequacy and fear of rejection.
Dependent Personality Disorder describes people who have an excessive need to be cared for and a fear of separa-tion.
Obsessive-Compulsive Personality Disorder is characterized by a preoccupation with orderliness and control.
6.REVIEW
Personality disorders are diagnosed on Axis II. They are often referred to as "character disorders" or "Axis II" in general. It is extremely important to distinguish between personality disorders and personality traits. Every person has traits that are consistent with personality disorders. The difference between personality disorders and personality traits lies in symptom severity and the degree of functional impairment.
7.ESSENTIAL FEATURES OF CLUSTER A (ODD/ECCENTRIC)
Paranoid Personality Disorder
These people appear guarded and suspicious and are always afraid of being deceived.
They tend to interpret other people's actions as harmful or threatening.
People with paranoid personality disorder are quick to anger and persistently bear grudges.
Their affect is usually constricted and they tend to lack interpersonal warmth.
They use projection as their defense mechanism,
attributing their own unacceptable thoughts and impulses to o
Personality disorders are a group of mental health conditions characterized by enduring patterns of behavior, cognition, and inner experience that deviate significantly from the expectations of the individual's culture. These patterns are inflexible, pervasive across many contexts, and lead to significant distress or impairment in social, occupational, or other important areas of functioning. Personality disorders are usually categorized into three clusters based on similar characteristics and symptoms:
**Cluster A: Odd or Eccentric Disorders**
1. **Paranoid Personality Disorder**: Characterized by pervasive distrust and suspicion of others. Individuals often believe that others are out to harm, deceive, or exploit them, even without substantial evidence. They may be reluctant to confide in others and often interpret benign remarks or events as personal attacks.
2. **Schizoid Personality Disorder**: Marked by a pervasive pattern of detachment from social relationships and a restricted range of emotional expression. People with this disorder tend to be solitary, have little desire for social interactions, and are indifferent to praise or criticism from others.
3. **Schizotypal Personality Disorder**: Involves acute discomfort in close relationships, cognitive or perceptual distortions, and eccentric behaviors. Individuals may have odd beliefs, magical thinking, or peculiar ways of dressing and speaking. They often have social anxiety and may come across as eccentric or bizarre.
**Cluster B: Dramatic, Emotional, or Erratic Disorders**
1. **Antisocial Personality Disorder**: Characterized by a pervasive pattern of disregard for and violation of the rights of others. Individuals may engage in deceit, manipulation, and impulsivity, and often have a history of criminal behavior. They typically show a lack of remorse for their actions.
2. **Borderline Personality Disorder**: Involves instability in relationships, self-image, and emotions. People with this disorder may experience intense episodes of anger, depression, and anxiety, often lasting a few hours to a few days. They may have a chronic fear of abandonment and may engage in self-harming behaviors or suicidal gestures.
3. **Histrionic Personality Disorder**: Marked by excessive emotionality and attention-seeking behavior. Individuals often feel uncomfortable when they are not the center of attention, and they may use their physical appearance or provocative behavior to draw attention. They tend to be highly suggestible and may consider relationships to be more intimate than they actually are.
4. **Narcissistic Personality Disorder**: Involves a pattern of grandiosity, need for admiration, and lack of empathy for others. People with this disorder often have an inflated sense of their own importance, a deep need for excessive attention and admiration, and a lack of understanding or consideration for the feelings of others. They may exploit relationships for personal gain.
According to the Diagnostic and Statistical Manual (DSM-IV), a personality disorder is an "enduring pattern of inner experience and behavior that deviates markedly from the expectation of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment."
Because these disorders are chronic and pervasive, they can lead to serious impairments in daily life and functioning.
Different Disorders have been discussed.
Seminar presentation by 5th-year medical students under the supervision of in house lecturer. He was previously working as a consultant surgeon in Syria. Reference as mentioned in the slides.
Seminar presentation by 5th year Medical Student under the supervision of a pediatric surgery specialist from HRPZ II. Reference as mentioned in the slide.
Seminar presentation by group C 5th year medical student under supervision Dato Imi, endocrine specialist in HRPZ II.
Reference as mentioned at the end of the slide presentation
4th year medical student's seminar presentation under supervision of orthopedic lecturer. Reference is from Dr. Sameh Doss Textbook of upper and lower limb, and also other multiple websites.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
2. INTRODUCTION
Dynamic organization and configuration of trait within a
person.
This trait determines the characteristics behavior and
thoughts of the person.
The personality of a person allows other to predict how this
person would react, feel or think in a particular situation.
An extreme variant of a normal personality trait.
PERSONALITY
PERSONALITY DISORDERS
3. EPIDEMIOLOGY
Overall prevalence of personality disorder in
community surveys : 5 – 10%
Overall rates are higher in men than women and
decrease with age.
Antisocial personality disorder (1 – 3% in
community surveys) – more common in men
Histrionic personality disorder (2%) &
borderline personality disorder (1 – 2%) – more
common in women.
4. AETIOLOGY
1. GENETICS
2. CHILDHOOD EXPERIENCE
3. INJURY TO BRAIN AT BIRTH
4. ABNORMAL BRAIN DEVELOPMENT
5. ENVIRONMENTAL FACTORS
6. NEUROCHEMISTRY
5. AETIOLOGY
1. Children of parents with
antisocial personality
disorder have greater rates
of antisocial behavior than
children of parents who do
not have this personality.
2. Similar excess has been
reported also among
adopted children whose
biological parents have
antisocial personality
disorder and whose
adoptive parents do not.
GENETICS CHILDHOOD EXPERIENCE
1. Separation from parents in
early childhood is more
frequent among people with
antisocial personality
disorder than among
controls.
1. This association could be
due to:
A. Parental disharmony
preceding separation
B. The separation itself
C. A consequence of
separation such as
upbringing in care rather
6. AETIOLOGY
1. Sometimes
followed by
impulsive and
aggressive
behavior.
2. Such injury has
been suggested
as cause of
personality
1. The only evidence,
which is indirect, is that
some adults with
antisocial personality
have non-specific
features in the
electroencephalogram
(EEG) of a kind found
normally in
adolescents, not
adults.
INJURY TO BRAIN AT BIRTH ABNORMAL BRAIN DEVELOPMENT
7. AETIOLOGY
Low
socioeconomic
status
Social isolation
High levels of
testosterone, oestrone
– associated with
impulsivity in
borderline and
antisocial personality
disorders.
Low level of serotonin
metabolite 5-
hydroxyindoleacetic
acid (5-HIAA) –
ENVIRONMENTAL FACTORS NEUROCHEMISTRY
8. DIFFERENTIAL DIAGNOSIS
DIFFERENCES BETWEEN PERSONALITY DISORDER AND:
SCHIZOPHRENIA: People with personality disorder may
present with psychotic features but have relatively intact
capacity for reality testing, expression of emotion, ability to
distinguish between thoughts of their own and others.
BIPOLAR DISORDER: People with personality disorder may
complain of mood swings but these range from normal mood
to irritability and should not have hypomanic or manic
episodes.
15. AETIOLOGY
More common among 1st degree relatives of schizophrenia patients
Childhood experience : Lack of protective care and support in
childhood, humiliation
Temperament : Non-adaptability, tendency of hyperactivity
Defense Mechanism : Projection of negative internal feeling onto
other people
Sensory impairment : Impaired vision, impaired hearing, victims of
traumatic brain injury
16. CLINICAL FEATURES
ICD-10 CRITERIA
• Met general criteria for personality disorder and ≥4 symptoms
Behavior :
Tendency to bear grudges persistently
Cognition :
• Excessive sensitivity to setbacks and rebuffs
• Suspiciousness and a pervasive tendency to distort experience
• Combative and tenacious sense of personal rights
• Recurrent suspicious without justification
• Persistent self-referential attitude, associated particularly with
excessive self-importance
17. CLINICAL FEATURES
DSM-5 CRITERIA
Salient Features of DSM-5 :
• Must not occur (schizophrenia,mood disorder with psychotic features
or other psychotic disorder or a pervasive developmental disorder)
Additional affective symptom:
• Angry reaction to perceived attacks on his/her character or reputation
Additional cognitive symptoms includes:
• Unjustified doubts about loyalty or trustworthiness of friends
• Hidden demeaning or threatening meanings
21. SCHIZOID PERSONALITY
Prevalence - 0.5-1.5%
Gender – Male > Female
Heritability – 0.55
DISORDER
EPIDEMIOLOGY
AETIOLOGY
More common among 1st degree relatives of
schizophrenia patients
22. CLINICAL FEATURES
ICD-10 CRITERIA
Affect :
Emotional coldness, detachment or flattened affectivity
Limited capacity to express either warm, tender feelings or anger towards
others
Behavior :
Few, if any, activities provide pleasure
Little interest in having sexual experience with another person
Consistent choice of solitary activities
No desires for possession of any close friends
Cognition :
Excessive preoccupation
Marked insensitivity to prevailing social norms and conventions
23. CLINICAL FEATURES
DSM – 5 CRITERIA
DSM-5 requires ≥ 5 symptoms
Must not occur ( schizophrenia, mood disorder with psychotic
features , other psychotic disorder )
Affective Symptoms :
Limited capacity to express either warm, tender feelings or anger
towards others
Additional Behavior Symptoms :
Lack of close friends or confident
Cognitive symptoms :
Marked insensitivity to prevailing social norms and conventions
24. ‘People with schizoid personality disorder show
restricted affective expression, impoverished social
relationships and avoidance of social activities’
25. DIFFERENTIAL DIAGNOSIS
1. Other Personality Disorders :
People with Schizotypal Personality Disorder
are more eccentric with disturbed and thought
form
People with Paranoid Personality Disorder
are more easily engaged resentful
2. Pervasive development disorder
3. Schizophrenia
26. MANAGEMENT
1. Psychotherapy
Supportive psychotherapy is useful to
establish therapeutic alliance , as trust
increases, the therapist may be able to
access patient’s fantasies
2. Pharmacotherapy
Low dose Anti-Psychotics and Anti-
Depressants have been used with variable
outcomes
29. SCHIZOTYPAL PERSONALITY
Prevalence - 3%
Gender – Male > Female
Heritability – 0.72
DISORDER
EPIDEMIOLOGY
AETIOLOGY
More common among 1st degree relatives of
schizophrenia patients
Link to dopamine dysregulation
31. CLINICAL FEATURES
Psychoticism :
• Eccentricity – odd, unusual or bizarre behaviour or appearance
• Cognitive and perceptual dysregulation – odd or unusual thought
process , odd sensations
• Unusual beliefs and experiences – unusual experiences of reality
Detachment :
• Restricted affectivity – constricted emotional experience and
indifference
• Social withdrawal – avoidance of social contacts and activity
Negative Affectivity :
• Suspiciousness – expectations of and heightened sensitivity to signs
of interpersonal ill-intent or harm, doubts about loyalty and fidelity of
others , feelings of persecutions
32. DIFFERENTIAL DIAGNOSIS
1. Delusional Disorder , Schizophrenia and
Severe Depressive Disorder with
psychotic features
2. Paranoid and Schizoid Personality
Disorder
3. Borderline Personality Disorder
4. Avoidant Personality Disorder
5. Pervasive Development Disorder
33. MANAGEMENT
1. Psychotherapy
Supportive therapy
Social skill training
2. Pharmacotherapy
Antipsychotic drug : May lead to mild
to moderate improvement in psychotic
symptoms
37. EPIDEMIOLOGY
Prevalence:
In the community: 0.6-3.0%
In prison: 75%
More common in urban settings
Gender: M:F = 3:1
Comorbidity: people with onset of substance
misuse younger than 15 years are more likely to
develop
ASPD; Substance abuse is also a comorbidity of
ASPD
38. AETIOLOGY
Parental deprivation and antisocial behaviour: e.g. witnessed abuse
when patients were young, inconsistent or harsh parenting
Frequent moves or migration, large family size and poverty
Children who go on to develop antisocial personality disorder are
innately aggressive, have high reactivity levels and diminished
ability to be consoled
DEVELOPMENTAL CAUSES
PSYCHOLOGICAL CAUSES
Temperament: high novelty seeking, low harm avoidance, low
reward dependence, uncooperativeness.
39. CLINICAL FEATURES
ICD 10
Affect:
Very low tolerance to frustration and a low threshold for discharge of
aggression, including violence.
Incapacity to experience guilt, or to profit from adverse experience,
particularly punishment.
Behavior:
Incapacity to maintain enduring relationships, though no difficulty in
establishing them.
Marked proneness to blame others, or to offer plausible rationalizations for
the behavior that has brought the individual into conflict with society.
Cognition:
Callous unconcern for feelings of others
Gross and persistent attitude of irresponsibility and disregard for social
norms, rules and obligations.
40. DIAGNOSTIC STATISTIC
MANUAL-5 CRITERIA
Antagonism:
Manipulativeness: frequent use of subterfuge to influence or control others
Deceitfulness: dishonesty and fraudulence or misrepresentation of self
Callousness: lack of concern for feelings or problems of others; lack of guilt or
remorse
Hostility: persistent or frequent angry feelings; anger or irritability in response
to minor insults
Disinhibition:
Irresponsibility: Failure to honor obligations or commitments and lack of
follow through on agreements and promises.
Impulsivity: Acting on the spur of the moment in response to immediate
stimuli; acting on a momentary basis without a plan or consideration of
outcomes; difficulty establishing and following plans.
Risk taking: Engagement in dangerous, risky, and potentially self-damaging
activities, unnecessarily and without regard or consequences; boredom
proneness and thoughtless initiation of activities to counter boredom; lack of
concern for one‘s limitations and denial of the reality of personal danger.
41.
42. DIFFERENTIAL DIAGNOSIS
1. Temporary antisocial behavior:
focal behavior (e.g. vandalism or riot),
not exploitive and with conscience
preserved
1. Mania/hypomania: antisocial
behavior (e.g. reckless driving or
violence) as a result of impaired
judgement and irritability
43. MANAGEMENT
Management (NICE Guidelines Recommendations)
Psychotherapy:
– Cognitive and behavioral interventions: Address impulsivity,
interpersonal difficulties and antisocial behavior; for people with forensic
history, the CBT should focus on reducing offending and other antisocial
behavior
– Important to assess risk regularly and adjust the duration and intensity of
the program accordingly
Pharmacotherapy:
– Should not be routinely used for the treatment of dissocial personality
disorder
– May be considered in the treatment of comorbid disorders such as
depression and anxiety (e.g. SSRIs) and aggression (e.g. low dose
antipsychotics or mood stabilizers)
44. COURSE AND PROGNOSIS
Positive prognostic factors include:
Showing more concern and guilt with regard to
antisocial behavior
Ability to form therapeutic alliance
Positive occupational and relationship record
46. INTRODUCTION
Prevalence: 2-3%
Gender: M = F
Usually begins by late teens or early 20s (adolescent or
early adulthood)
Comorbidity: Somatisation disorder, alcohol misuse
The word histrionic means "dramatic or theatrical."
47. AETIOLOGY
PSYCHOLOGICAL
CAUSE
DEFENCE
MECHANISM
DEVELOPMENTAL CAUSE
Significant separations in the 1st 4
years of life
Assoc. with authoritarian or seductive
paternal attitudes during childhood
Favouritism towards male gender in a
family (if patient is a woman) causing
power imbalance
Childhood: traumatic, deprivation,
chronic physical illness
Absence of meaningful relationship
May have families high in control,
intellectual orientation, low in cohesion
Extreme variant of
temperamental disposition
Emotionality, extraversion
& reward dependence
Tendency towards overly
generalized cognitive
processing
Dissociation
Denial
48. CLINICAL FEATURES
I Inappropriate behaviour – seductive or
provocative
C Centre of attention
R Relationship are seen as closer than
they really are
A Appearance is most important
V Vulnerable to others’ suggestions
E Emotional expression is exaggerated
S Shifting emotions, Shallow
I Impressionistic manner of speaking
(lacks detail)
N Novelty is craved
“I CRAVE SIN”
50. CLINICAL FEATURES
ICD-10 DSM-5
Affect
Self-dramatization, theatricality or exaggerated
expression of emotions
Shallow and labile affectivity
Salient features
DSM-5 requires a fulfilment of 5 symptoms
Additional affective symptoms
Discomfort in situations in which he/she is not
the centre of attention
Behaviour
Suggestibility (he/she is easily influenced by
others or circumstances)
Continual seeking for excitement & activities in
which the individual is the centre of attention
Inappropriate seductiveness in appearance or
behaviour
Additional behaviour symptoms
Consistent use of physical appearance to draw
attention to self
Excessively impressionistic style of speech
Cognition
Over concern with physical attractiveness
People with histrionic personality disorder feel
comfortable in situations where they are the
centre of attention
Additional behaviour symptoms
Consideration of relationships to be more
intimate than they actually are
51. ‘People with histrionic personality disorder feel
comfortable in situations where they are the center of
attention’
52. DIFFERENTIAL DIAGNOSIS
AXIS I DISORDERS AXIS II DISORDERS
Hypomania/mania
Characterized by episodic mood
disturbances with grandiosity and
elated mood
Borderline Personality Disorder
More self-harm, chaotic relations
& identity confuse
Somatisation/conversion disorder
People with histrionic personality
are more dramatic and attention
seeking
Dependent Personality Disorder
More impairment in making
important decisions
Substance misused Narcissistic Personality Disorder
Need attention by being praised
They are very sensitive to
humiliation when they are the
centre of attention
53. MANAGEMENT
Psychotherapy
Patient may see power and strength as a male attribute based
on their childhood experience & feel inferior about own gender
and need to seek attention.
Dynamic Psychotherapy – May be useful to help patients
analyse their deep seated views & understand how childhood
experiences affect perception & personality development;
therapist should help patient to build self-esteem
Cognitive Psychotherapy – Challenge cognitive distortions,
reduce emotional reasoning
Pharmacotherapy
SSRIs target depressive symptoms
56. INTRODUCTION
Borderline personality disorder (BPD) is a
serious mental disorder marked by a pattern of
ongoing instability in moods, behaviour,
self-image, and functioning. These
experiences often result in impulsive actions
and unstable relationships.
A person with BPD may experience intense
episodes of anger, depression, and anxiety that
may last from only a few hours to days.
57. EPIDEMIOLOGY
Prevalence : 1-2%
Gender : 1:2
Age of onset : Adolescence
or early adulthood
Suicide rate : 9%
Comorbidity : Depression,
PTSD, Substance misuse,
bulimia nervosa
http://www.newhealthguide.org/Famous-
People-With-Borderline-Personality-
Disorder.html
59. EARLY DEVELOPMENT
Early Separation/loss : early insecure attachment results in fear of
abandonment
Family Environment : high conflict, unpredictability, dysfunction, divorce
Parental Factors : Alcohol/drugs misuse, forensic history, mother not
emotionally available
Emotionally vulnerable temperament interacts with an invalidating
environment
PAST TRAUMA AND ABUSE
Childhood trauma
Physical/sexual abuse, neglect
ATTACHMENT
All infants possess a basic instinct towards attachment; if attachment is not
formed, the child’s ability to develop a stable and realistic concept of self is
impaired; the child will have limited mentalisation (capacity) to depict
feelings & thought in self & other people.
AETIOLOGY
60. DEFENCE MECHANISM
Splitting: Adopting a polarised or extreme view of the world where people
are either all good or bad and failing to see that each person has good and
bad aspects
Projective Identifications: The patient unconsciously projects a bad figure
onto the male doctor (projection) and accuses the doctor to be a non-caring
individual; due to counter-transference, the male doctor tries to avoid the
patient as if he does not care about the patient (identification)
AETIOLOGY
BIOLOGICAL FACTORS
Risk of relatives of borderline personality disorder to develop such disorder is 5x
higher as compared to general population (More common in 1st degree relatives of
patients with depression)
Abnormal dexamethasone suppression test results, REM latency, thyrotrophic
response, abnormal sensitivity to amphetamine in BPD patients
Specific marker for impulsivity : CSF 5HIAA (metabolic serotonin)
Chronic Trauma: leads to decreased hippocampal volume, decrease hemispheric
integration & hyperactive HPA axis
Increased bilateral activity in amygdala with emotionally aversive stimuli
Orbitofrontal cortex abnormalities
63. Negative affectivity
1. Emotional liability:
• Unstable emotional and frequent mood changes
2. Anxiousness:
• Intense feelings
• Panic in reaction
• Fears of losing control
3. Separation insecurity:
• Fears of rejection
4. Depression:
• Feeling down, miserable and hopelessness
DIAGNOSTIC STATISTIC
MANUAL-5 CRITERIA
64. Disinhibition
1. Impulsivity:
• Acting on momentary basis w/o plan or consideration
• Difficulty following the plans
• Self harming under emotional distress
2. Risk taking:
• Engagement in dangerous, risky and self damaging
activities
Antagonism
1. Hotility:
• Frequent angry feelings
• Anger or irritability
DIAGNOSTIC STATISTIC
MANUAL-5 CRITERIA
65. ‘People with borderline personality disorder present
with recurrent acts of self-harm usually in the form of
self-laceration. They often report chronic feelings of
emptiness and unstable emotion’
68. WHAT IS NPD?
Narcissistic personality
disorder is a condition
characterized by an inflated
sense of self-importance,
need for admiration, extreme
self-involvement, and lack of
empathy for others.
Individuals with this disorder
are usually arrogantly self-
assured and confident.
69. WHAT IS NARCISSISM?
The word “narcissism” meaning self-love or
admiration for ones self, is derived from the story
of Narcissus in Greek Mythology. Narcissus was
a handsome young man who loved no one but
his own reflection.
71. PARENTAL
• Pampering and spoiling
• Parental disdain for fears and needs expressed during childhood
• Lack of affection and praise during childhood
• Neglect and emotional abuse in childhood
• Excessive praise and over- indulgence
• Unpredictable or unreliable care giving from parents
• Learning manipulative behaviours from parents
TEMPERAMENT
• High novelty seeking and reward dependence
DEFENCE MECHANISM
• Low self-esteem
AETIOLOGY
72. CLINICAL FEATURES
Exaggerated sense of self-importance
Expecting to be recognized as superior even without achievements that
warrant it
Exaggerating your achievements and talents
Being preoccupied with fantasies about success, power, brilliance, beauty
or the perfect mate
Believing that you are superior and can only be understood by or associate
with equally special people
Requiring constant admiration
Having a sense of entitlement
Expecting special favours and unquestioning compliance with your
expectations
Taking advantage of others to get what you want
Having an inability or unwillingness to recognize the needs and feelings of
others
Being envious of others and believing others envy you
Behaving in an arrogant or haughty manner
73. DIAGNOSTIC STATISTIC
MANUAL-5 CRITERIA
1. GRANDIOSITY
– Feelings of entitlement
– Overt or covert
– Self-centeredness
– Strongly beliefs that, One is better than others
– Condescending toward others
2. ATTENTION SEEKING
– Excessive attempts to attract and be the focus of the attention
– Admiration seeking
78. AVOIDANT PERSONALITY
Prevalence: 0.8-5.0% in the community
Gender: M = F
Heritability: 0.28 (estimated)
Comorbidity: Social phobia
DISORDER
EPIDEMIOLOGY
AETIOLOGY
TEMPERAMENT
Neuroticism and introversion are vulnerabilities which seem to be shared with
social phobia.
PARENTING
Inconsistent, absent, less demonstration of parental love
Discouraging, rarely show pride in children
Higher rates of rejection and isolation
Maladaptive avoidance develops as a defence against shame, embarrassment,
failure
79. CLINICAL FEATURES
ICD-10
Affect:
1. Persistent, pervasive tension and apprehension
Behaviour:
1. Unwilling to be involved with people unless certain of being liked
2. Restricted lifestyle due to need for physical security
3. Avoidance of social oroccupational activities involving significant
interpersonal contact because of fear of criticism, disapproval or rejection
Cognition
1. Belief that one is socially inept, personally unappealing or inferior to others
2. Excessive preoccupation with being criticised or rejected in social situations
People with anxious (avoidant) personality disorder exhibit persistent,
pervasive tension and apprehension, characterised by avoidance of
interpersonal contact due to fear of criticism or rejection.
80. Additional behavioural symptoms:
1. Showing restraint in intimate relationships
because of the fear of being ashamed,
ridiculed, or rejected due to severe low
self-worth
2. Inhibition in new interpersonal situations
because of feelings of inadequacy
DIAGNOSTIC STATISTIC
MANUAL-5 CRITERIA
81. ‘People with anxious (avoidant) personality disorder
exhibit persistent, pervasive tension and apprehension,
characterized by avoidance of interpersonal contact due
to fear of criticism or rejection’
82. DIFFERENTIAL DIAGNOSIS
AXIS I DISORDERS AXIS II DISORDERS
1 Social phobia: People with social
phobia show more impairment and
distress in social situations; their
selfesteem is lower compared to
people with avoidant personality
disorder.
2 Agoraphobia: People with
agoraphobia may have more
frequent panic attacks.
3 Depressive disorder: Negative self
evaluation is related to low mood.
1. Dependent personality disorder:
People with avoidant personality
disorder avoid contact while people
with dependent personality disorder
focus on being cared for
1. Schizoid personality disorder:
Isolated but emotionally cold
2. Paranoid personality disorder:
People with paranoid personality
disorder are isolated due to lack of
trust in other people
83. MANAGEMENT
Cognitive Behaviour Therapy: May be more
useful and effective compared to brief dynamic
psychotherapy to overcome avoidance.
Assertiveness and social skill training: Useful
To help patients make and refuse requests.
Distress tolerance skill: Important to help
patients to handle anticipatory anxiety in social
situations.
84. PROGNOSIS
May do well in familiar environments
with known people.
Shyness tends to decrease as people
get older.
High drop-out rates in treatment.
87. CLINICAL FEATURES
ICD -10
1. AFFECT
Uncomfortable or helpless when alone due to exaggerated fear of inability
to self care
2. BEHAVIOR
Encourage or allow others to make most of one’s important life decision
Subordination of own needs to those of others on whom one is
dependent
Unwilling to make reasonable demands on the people one depends on.
3. COGNITION
Preoccupation with fears of being left to care for oneself
Limited capacity to take everyday decisions without an excessive
amount of advice and reassurance from others.
88. DIAGNOSTIC STATISTIC
MANUAL-5 CRITERIA
DSM-5
1. Additional criteria of disorder beginning in
adulthood
2. Require a fulfillment of >5 symptoms
3. Additional behavioral symptoms:
Difficulty in initiating projects or doing things
on his /her own goes to excessive length to
obtain nurturance and support from others.
Urgently seeks another relationship for care
and
Support when close relationship ends.
89. ‘People with dependent personality disorder may have self-effacing
diffidence, eagerness to please and importuning. They may adopt a
helpless or ingratiating posture, escalating demands for medication,
distress on separation and difficulty in termination of psychotherapy’
91. MANAGEMENT
1. Cognitive behavior therapy and social skills
training
1. Therapy targeted at including self esteem,
self confidence, sense of efficacy,
assertiveness and exploring fear of
autonomy
93. OBSESSIVE COMPULSIVE
Prevalence : 1.7 – 2-2 %
Gender: M > F
PERSONALITYDISORDER
EPIDEMIOLOGY
AETIOLOGY
1. Early development
Excessive parental control and criticism result in
perfectionism, orderliness and control.
2. Hereditary trait
1st degree relative with OCPD
94. CLINICAL FEATURES
ICD -10
1. Affect :
Feeling of excessive doubt and caution
2. Behavior :
Perfectionism that interfere with task completion
Excessive conscientiousness and scrupulousness (
extremely careful)
Excessive pedantry (rules) & adherence to social
convention
3. Cognition:
Rigidity & stubbornness
Undue preoccupation with productivity to the exclusion of
pleasure and interpersonal relationship
95. DIAGNOSTIC STATISTIC
MANUAL-5 CRITERIA
DSM-5
1. COMPULSIVITY
Rigid perfectionism on everything being flawless, perfect,
without errors or faults including one’s own and other’s
Sacrificing of timeliness to ensure correctness in every
detail
Believing that there is only one right way to do things
Difficulty in changing ideas
Preoccupation with details, organization, & order
2. NEGATIVE AFFECTIVITY
Perseveration at task
Continuation of same behavior despite repeated failures
96. ‘People with anankastic personality disorder may have
excessive adherence to rules and are rigid with routine. For
example, they may park in the same parking lot every day
and become distress if it’s taken by others”
100. IMPULSE CONTROL
These disorders are characterized by an impulse
(e.g. Gambling or fire-setting) which the person finds
difficult to resist. Prior to the act, there is a build-up of
tension and the person seeks pleasure, gratification,
or relief at the time of performing the act.
CLASSIFICATION
1. Pyromania
2. Kleptomania
DISORDER
101. IMPULSE CONTROL
DISORDER
DISORDER ICD-10 DIAGNOSTIC CRITERIA DSM-5 DIAGNOSTIC CRITERIA
Pyromania
(pathological fire-
setting)
1. There are two or more acts of
fire-setting without apparent
motive.
2. The I visual describes an
intense urge to set fire to
objects,neither a feeling of
tension before the act and
subsequent relief
3. The in ideal is preoccupied with
thoughts, mental images and
related matters such as an
abnormal interest in fire-
engines, fire station and the fire
service.
Similar to ICD-10 diagnostic criteria
Emphasis: fire setting is not done for monetary
gain,expression of political views or anger,riot,to conceal
criminal activity, false insurance of delusion or hallucination
or as a result of impaired judgement (e.g. In dementia or
intellectual disability.
Exclusion: fire setting is not in the context of conduct
disorder, manic episode or antisocial personality disorder
Kleptomania
(pathological stealing)
1. There are 2 or more thefts in
which the individual steals
without any apparent motive of
personal gain or gain for
another person
1. The individual describes an
intense urge to steal, with a
feeling of tension before the act
and subsequent relief.
Similar to the ICD-10 diagnostic criteria
Emphasis: stealing is not committed to express anger and
the theft is not a response to a delusion or a hallucination.
Exclusion:theft is not in the context of conduct disorder,
manic episodes or antisocial personality disorder.