Personality Disorders
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Transcript of Personality Disorders
PERSONALITY
DISORDERS
NARCISSISTICDiagnosis:
1. has a grandiose sense of self-importance
2. preoccupied with fantasies of unlimited
success, power, brilliance, beauty or ideal love
3. believes that he or she is unique and can only
associate with other
special or high-status
people (or institutions).
4. requires excessive
admiration
NARCISSISTICDiagnosis:
5. has a sense of entitlement
6. interpersonally exploitative, i.e., takes advantage of others to achieve his or her
own ends
NARCISSISTICDiagnosis:
7. lacks empathy: unwilling to recognize or identify with the feelings of others
NARCISSISTICDiagnosis:
8. often envious of others or believes that others are envious of him or her
9. shows arrogant, haughty
behaviors or attitudes
NARCISSISTICDiagnosis:
Chronic and
difficult to treat
Aging is handled poorly
NARCISSISTICCourse and Prognosis:
PSYCHOTHERAPY-group therapy so patients can
learn how to share with others and to develop empathic response
PHARMACOTHERAPY-Lithium (Eskalith) for mood swings
and antidepressants—serotonicdrugs—because they’re susceptible
to depression
NARCISSISTICTreatment:
AVOIDANTDiagnosis
1. avoids activities involving interpersonal contact because of fears of criticism, disapproval and rejection
2. unwilling to get involved with people unless certain
of being liked
AVOIDANTDiagnosis
3. restraint within intimate
relationships for fear of being
ashamed or ridiculed
4. preoccupied with being criticized or rejected in social situations
AVOIDANTDiagnosis
5. inhibited in new interpersonal situations because of feelings of inadequacy
6. views self as socially inept, personally
unappealing, or inferior to others
AVOIDANTDiagnosis
7. usually reluctant to take personal risks or engage in any new activities
because they may prove embarrassing
AVOIDANTCourse and Prognosis
Many are able to function in a protected environment.
Should their support system fail, they are subject to
depression, anxiety and anger.
Phobic avoidance in common. Patients may give histories of social phobia.
AVOIDANTTreatment
PSYCHOTHERAPY-solidifying alliance with patients; therapist encourages a patient to move out into the world; assertiveness training- for patient to express needs openly
PHARMACOTHERAPY-serotonic drugs—help rejection sensitivity-dopaminergic drugs—engender novelty-seeking
behavior
DEPENDENTDiagnosis
1. difficulty making decisions without an excessive amount of advice and reassurance from others
2. needs others to assume
responsibility for most major areas of his or her
life
DEPENDENTDiagnosis
3. difficulty expressing disagreement with others because of fear of loss of support or approval
4. difficulty initiating projects or
doing things in his/her own
5. goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering things that are unpleasant
DEPENDENTDiagnosis
6. feels uncomfortable or helpless when alone because of
exaggerated fears of being unable to care for himself or herself
7. urgently seeks another relationship as a source of care and support when a close relationship ends8. unrealistically preoccupied with fears of being left to take care of oneself
DEPENDENTCourse and Prognosis
Occupational functioning tends to be impaired, because persons with
the disorder can’t act independently and without
close supervision.
DEPENDENTTreatment
PSYCHOTHERAPY -the treatment is often successful
-behavioral therapy, assertiveness training, family therapy,
group therapy
PHARMACOTHERAPY-psychostimulants are used for depression and withdrawalsymptoms
OBSESSIVE-COMPULSIVEDiagnosis
1. preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost
2. shows perfectionism that interferes with task completion
3. excessively devoted to work and productivity to the exclusion of activities and friendships
OBSESSIVE-COMPULSIVEDiagnosis
4. overconscientious, scrupulous, inflexible about matters of morality,
ethics or values
5. unable to discard worn-out or
worthless objects even when they have no sentimental value
6. reluctant to delegate tasks or to work with others unless they
submit to exactly his/her way of doing things
OBSESSIVE-COMPULSIVEDiagnosis
7. adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes
8. shows rigidity and
stubborness
OBSESSIVE-COMPULSIVECourse and Prognosis
This personality disorder is variable and unpredictable.
Persons may develop obsessions or compulsions in the course of their disorder.
OBSESSIVE-COMPULSIVETreatment
Group therapy and behavior therapy
occassionally offer certain advantages.
PHARMACOTHERAPYClonazepam
ClomipramineNefazodone
Personality Disorders not
Otherwise Specified
PASSIVE-AGGRESSIVEDiagnosis
• characteristically procrastinate
• resist demands for adequate performance
• find excuses for delays
• find fault with those on whom they depend
PASSIVE-AGGRESSIVEDiagnosis
• lack assertiveness
• not direct about their own needs
• fail to ask needed questions
• become anxious when forced to succeed
PASSIVE-AGGRESSIVEDiff erential Diagnosis
Less flamboyant, dramatic,
affective and openly
aggressive than those with
histrionic and borderline personality
DEPRESSIVEDiagnosis
• lonely, solemn, gloomy, submissive, pessimistic, self-deprecatory
• meticulous, perfectionistic, overconscientious, preoccupied with work
• easily discouraged, fearful of disapproval
• tend to suffer in silence, cry easily• tendency to hesitation, indecision
DEPRESSIVEDiff erential Diagnosis
Patients with avoidant personality disorder are introverted and dependent, but they
tend to be more anxious than
depressed, compared with persons with
depressive personality disorder.
SADOMASOCHISTICDiagnosis
SADISM—desire to cause others pain –either sexually abusive or generally physically or psychologically abusive
MASOCHISM—achievement of sexual gratification by inflicting pain on the self
SADISTICDiagnosis
• pervasive pattern of cruel, demeaning, and aggressive behavior that is directed toward others
• humiliate or demean persons in front of others
• treated or disciplined uncommonly harshly people, especially the children
PERSONALITY CHANGE DUE TO A GENERAL MEDICAL CONDITIONDiagnosis• characterized by a marked change in
personality style and traits from a previous level of functioning
• impaired control on the expression of emotions
• emotions are labile and shallow• damage to the frontal lobe: prominent
indifference and apathy• temporal lobe epilepsy: humorlessness,
hyperreligiosity, marked aggressiveness during seizures
• clear sensorium