BEHAVIORAL SCIENCE

Izben C. Williams, MD, MPHInstructor

Other Psychiatric Disorders

PERSONALITY DISORDERS

Personality DisordersWhat is this Personality that may

become disordered?PERSONALITY:

DEF: The set of ingrained characteristics (traits) that define the behavior, thoughts and emotions of an individual

These characteristics allow us to maintain an equilibrium between our internal drives and the world around us, and they dictate our lifestyle (modus operandi)

Personality DisordersA Personality disorder is a chronic or

lifelong pattern of behavior that is characterized by a group of traits that are:Severely dysfunctional in terms of

interpersonal relationshipsUsually more troublesome to others than to

the affected individualRelatively stable over time

Personality DisordersClusters of Personality disorders (DSM V): 1. Cluster A: The odd and eccentric group

(paranoid, schizotypal, schizoid)2. Cluster B: The dramatic, emotional, and erratic

group in which self-preoccupation predominates (narcissistic, histrionic, borderline, antisocial)

3. Cluster C: Anxious and fearful group(obsessive- compulsive, dependent, avoidant)

This grouping into three clusters is based on similarities in symptoms or traits

Personality DisordersEach cluster has its own hallmark

characteristics and genetic or familial associations

Diagnosis depends also on a personality disorder being present by early adulthood

See diagnostic characteristics for individual disorders (Fadem: Table 14.3)

A diagnosis of antisocial personality disorder is not made before age 18, conduct disorder is ascribed instead.

Personality DisordersIndividuals in each cluster have a tendency

to employ particular defense mechanisms :Cluster A: Affected individuals use the defense

mechanisms of projection and fantasy and may have a psychotic tendency

Cluster B: Affected individuals tend to use dissociation, denial, splitting and acting out

Cluster C: Affected individuals tend to use isolation, passive aggression, and hypochondriasis

Personality DisordersTREATMENT:

Individual and, where tolerable, group psychotherapy may be useful for those who seek help

Pharmacotherapy can be useful on treating symptoms of co-morbid conditions such as depression and anxiety

However personality disorders are, by and large, resistive to treatment