PERSONALITY DISORDERSPERSONALITY DISORDERS

FABRICE TOURRE

GOLDMAN SACHS CEO LLOYD BLANKFEIN

BURN THEM !

Senator Carl Levin

CLUSTER A PERSONALITYCLUSTER A PERSONALITY

Also known as the odd and eccentric Also known as the odd and eccentric clustersclusters

These are exemplified by the following:These are exemplified by the following:– Schizotypal personality disorderSchizotypal personality disorder– Schizoid Personality disorderSchizoid Personality disorder– Paranoid personality disorderParanoid personality disorder

Cluster B Personality DisordersCluster B Personality Disorders

Also known as the dramatic, erratic and Also known as the dramatic, erratic and emotionalemotional

These are exemplified by the following These are exemplified by the following groupgroup– Histrionic P.D.Histrionic P.D.– Antisocial P.D.Antisocial P.D.– Narcissistic P.D.Narcissistic P.D.– Borderline P.D.Borderline P.D.

Cluster C personality disordersCluster C personality disorders

Also known as the anxious and fearful Also known as the anxious and fearful cluster cluster

These are exemplified by the following These are exemplified by the following – AvoidantAvoidant– DependentDependent– Obsessive-compulsive Obsessive-compulsive

Genetic FactorsGenetic Factors

All clusters have genetic basisAll clusters have genetic basis

Cluster A are more common in biological relatives Cluster A are more common in biological relatives patients with schizophrenia than in control groupspatients with schizophrenia than in control groups

Cluster B especially the antisocial P.D. is Cluster B especially the antisocial P.D. is associated with alcohol use disorders. In borderline associated with alcohol use disorders. In borderline P.D., depression and mood disorder is common. P.D., depression and mood disorder is common. Histrionic PD with somatization disorder.Histrionic PD with somatization disorder.

Cluster C especially with Avoidant P.D. have high Cluster C especially with Avoidant P.D. have high anxiety levels.anxiety levels.

Psychoanalytic factorsPsychoanalytic factors

Sigmund Freud suggested that personality Sigmund Freud suggested that personality traits are related to a fixation at one traits are related to a fixation at one psychosexual stage of development. e.g. psychosexual stage of development. e.g. those with oral character are passive and those with oral character are passive and dependent. While those of an anal dependent. While those of an anal character are stubborn, parsimonious and character are stubborn, parsimonious and highly conscientious because of struggle highly conscientious because of struggle over toilet training.over toilet training.

PARANOID P.D.PARANOID P.D.

Prevalence rate is 0.5 to 2.5% of the general Prevalence rate is 0.5 to 2.5% of the general population.population.They are characterized by long-standing They are characterized by long-standing suspiciousness and mistrusts of person in general. suspiciousness and mistrusts of person in general. They refuse responsibility of their own feelings and They refuse responsibility of their own feelings and assign responsibility to others. They are often hostile, assign responsibility to others. They are often hostile, irritable, and angry. Bigots, injustice collectors, irritable, and angry. Bigots, injustice collectors, pathologically jealous spouses, and litigious.pathologically jealous spouses, and litigious.They are usually formal in manner, usually serious They are usually formal in manner, usually serious and humorless.and humorless.The essential feature is a pervasive and unwarranted The essential feature is a pervasive and unwarranted tendency to interpret other person’s action as tendency to interpret other person’s action as demeaning or threatening. demeaning or threatening.

PARANOID PDPARANOID PD

They usually dispute friend’s loyalty or They usually dispute friend’s loyalty or trustworthiness.trustworthiness.

This persons are pathologically jealous This persons are pathologically jealous and questions the fidelity of the spouse or and questions the fidelity of the spouse or sexual partners.sexual partners.

Their affect are usually restricted and Their affect are usually restricted and unemotional.unemotional.

SCHIZOTYPAL PDSCHIZOTYPAL PDPersons with this PD are strikingly odd or strange Persons with this PD are strikingly odd or strange even to laymen.even to laymen.

Magical thinking, peculiar notions, ideas of reference, Magical thinking, peculiar notions, ideas of reference, illusions and derealizations are part of his daily world.illusions and derealizations are part of his daily world.

They exhibit disturbed thinking and communicatingThey exhibit disturbed thinking and communicating

They may be superstitious or claim power of They may be superstitious or claim power of clairvoyance and believe they have special powers of clairvoyance and believe they have special powers of thought and insight. This is the premorbid personality thought and insight. This is the premorbid personality of patient with schizophrenia.of patient with schizophrenia.

SCHIZOID PDSCHIZOID PDPatients display a lifelong pattern of social Patients display a lifelong pattern of social withdrawalwithdrawal

They are introvert with constricted affect.They are introvert with constricted affect.

They are often seen as eccentric, isolated or lonely.They are often seen as eccentric, isolated or lonely.

Prevalence rate is about 7.5% of the general Prevalence rate is about 7.5% of the general population.population.

Always cold and aloof; they display a remote reserve Always cold and aloof; they display a remote reserve and show no involvement with everyday events and and show no involvement with everyday events and the concerns of the others.the concerns of the others.

They are quiet, distant, seclusive, and unsociableThey are quiet, distant, seclusive, and unsociable

They are the last to be aware of the social fashion.They are the last to be aware of the social fashion.

SCHIZOID PDSCHIZOID PD

The life histories of such persons reflect The life histories of such persons reflect solitary interests and success at solitary interests and success at noncompetitive levelsnoncompetitive levels

Their sexual lives may exist exclusively at Their sexual lives may exist exclusively at fantasy levelsfantasy levels

They are usually involved in nonhuman They are usually involved in nonhuman interests such as astronomy and interests such as astronomy and mathematics mathematics

ANTISOCIAL PDANTISOCIAL PD

Is an inability to conform to the social norms that Is an inability to conform to the social norms that ordinarily govern many aspects of adolescents and adult ordinarily govern many aspects of adolescents and adult behavior.behavior.Constitute about 75% of the prison populationConstitute about 75% of the prison populationPatients usually appear composed and crediblePatients usually appear composed and credibleThere is usually tension, hostility, irritability and rage.There is usually tension, hostility, irritability and rage.They are usually charming and ingratiatingThey are usually charming and ingratiatingThey life histories revealed many areas of life functioning They life histories revealed many areas of life functioning such as lying, truancy, running away from home, thefts, such as lying, truancy, running away from home, thefts, fights, substance abuse and illegal activitiesfights, substance abuse and illegal activitiesPromiscuity, spousal abuse, child abuse and animal Promiscuity, spousal abuse, child abuse and animal cruelty is common. cruelty is common.

ANTISOCIAL PDANTISOCIAL PDDiagnostic CriteriaDiagnostic Criteria

Failure to conform with the social norms with respect to Failure to conform with the social norms with respect to lawful behaviorslawful behaviorsDeceitfulness as indicated by repeated lying, use of Deceitfulness as indicated by repeated lying, use of aliases or conning others for personal profitaliases or conning others for personal profitImpulsivity or failure to plan ahead.Impulsivity or failure to plan ahead.Irritability and aggressiveness by repeated physical fightsIrritability and aggressiveness by repeated physical fightsReckless disregard of safety of self or othersReckless disregard of safety of self or othersConsistent irresponsibilityConsistent irresponsibilityLack of remorseLack of remorseAt least 18 years oldAt least 18 years oldPresence of conduct disorder before age 15.Presence of conduct disorder before age 15.

BORDERLINE PDBORDERLINE PD

This PD stands on border between neurosis and This PD stands on border between neurosis and psychosis.psychosis.

Almost always appear in the state of crisis.Almost always appear in the state of crisis.

Patients may have micropsychotic episodesPatients may have micropsychotic episodes

They cannot tolerate being aloneThey cannot tolerate being alone

They consider each person as either all good or They consider each person as either all good or all bad.all bad.

The defense mechanism is projective identification The defense mechanism is projective identification wherein the intolerable aspects of self are wherein the intolerable aspects of self are projected onto another.projected onto another.

BORDERLINE PDBORDERLINE PDDiagnostic CriteriaDiagnostic Criteria

Frantic efforts to avoid real or imagined abandonmentFrantic efforts to avoid real or imagined abandonmentUnstable and intense interpersonal relationship.Unstable and intense interpersonal relationship.Identity disturbance markedly and persistently unstable Identity disturbance markedly and persistently unstable self image or sense of self.self image or sense of self.Impulsivity that are potentially self damagingImpulsivity that are potentially self damagingRecurrent suicidal behavior or threats or self mutilating Recurrent suicidal behavior or threats or self mutilating behaviorsbehaviorsAffective instability due to marked reactivity of moodAffective instability due to marked reactivity of moodChronic feeling of emptinessChronic feeling of emptinessInappropriate, intense anger or difficulty in controlling Inappropriate, intense anger or difficulty in controlling anger.anger.Transient stress related paranoid ideationTransient stress related paranoid ideation

HISTRIONIC PDHISTRIONIC PDThey are excitable and emotional and behave in a They are excitable and emotional and behave in a colorful, dramatic, extroverted fashion but unable colorful, dramatic, extroverted fashion but unable to maintain deep, long lasting attachments.to maintain deep, long lasting attachments.Usually cooperative and eager to give a detailed Usually cooperative and eager to give a detailed history. Gestures and dramatic punctuations in history. Gestures and dramatic punctuations in their conversationstheir conversationsThey make frequent slips of the tongue and use They make frequent slips of the tongue and use colorful languagecolorful languageThey show a high degree of attention-seeking They show a high degree of attention-seeking behavior.behavior.They display temper tantrums, tears and They display temper tantrums, tears and accusations when they are not the center of accusations when they are not the center of attraction.attraction.

HISTRIONIC PDHISTRIONIC PD

Seductive behavior is common on both Seductive behavior is common on both sexessexes

Woman maybe anorgasmic while men are Woman maybe anorgasmic while men are impotentimpotent

Their need for reassurance is endlessTheir need for reassurance is endless

They may act on their sexual impulses to They may act on their sexual impulses to reassure themselves that they are reassure themselves that they are attractive to other sex.attractive to other sex.

NARCISSISTIC PDNARCISSISTIC PD

They are characterized by heightened self-They are characterized by heightened self-importance and grandiose feelings of importance and grandiose feelings of uniqueness.uniqueness.They have a grandiose sense of self-They have a grandiose sense of self-importanceimportanceThey consider themselves as special and They consider themselves as special and expect special treatmentexpect special treatmentThey become enraged when criticizedThey become enraged when criticizedThey can make other furious by their refusal They can make other furious by their refusal to obey conventional rules of behavior.to obey conventional rules of behavior.

AVOIDANT PDAVOIDANT PD

Commonly described as persons with inferiority Commonly described as persons with inferiority complex.complex.They show extreme sensitivity to rejection and They show extreme sensitivity to rejection and may lead to a socially withdrawn life.may lead to a socially withdrawn life.Hypersensitivity to rejection by others Hypersensitivity to rejection by others is the is the central feature.central feature.Their main personality trait is Their main personality trait is timiditytimidityWhen talking with someone, they expect When talking with someone, they expect uncertainty, show a lack of self-confidence, and uncertainty, show a lack of self-confidence, and may speak in self-effacing manner.may speak in self-effacing manner.

DEPENDENT PDDEPENDENT PD

They subordinate their own needs to those of others. They subordinate their own needs to those of others. Get others to assume responsibility for major areas of Get others to assume responsibility for major areas of their lives. Lack self-confidencetheir lives. Lack self-confidencePessimistPessimistFear of sexualityFear of sexualitySelf doubtSelf doubtPassivityPassivitySuggestibilitySuggestibilityLack of perseveranceLack of perseverancePersons with this disorder cannot make decisions Persons with this disorder cannot make decisions without an excessive amount of assurance or advicewithout an excessive amount of assurance or advice

OBSESSIVE-COMPULSIVE PDOBSESSIVE-COMPULSIVE PD

This is characterized by emotional This is characterized by emotional constriction, orderliness, perseverance, constriction, orderliness, perseverance, stubbornness and indecisiveness.stubbornness and indecisiveness.

A pervasive pattern of perfectionism and A pervasive pattern of perfectionism and inflexibility.inflexibility.

They are preoccupied with rules, They are preoccupied with rules, regulations, orderliness, neatness and regulations, orderliness, neatness and details.details.

They cannot tolerate infractionsThey cannot tolerate infractions

So, what is your personality So, what is your personality disorder?disorder?