Category: Personality Disorder

Personality Disorder

Personality Disorder

Psychiatry

Personality Disorder

Personality Disorder

Personality disorders are a group of disorders encountered in clinical practice by psychiatrists. It occurs in about 1 in 20 individuals and is difficult to diagnose and needs a lot of information from people who know the client well.

It refers to a collection of characteristics that the individual has developed as he has grown up and includes how he thinks, behaves and feels.  His family members would have noticed these characteristics and usually brought it to the individual notice but he or she is not able to rectify it and learn from their mistakes.

These characteristics cause the individual to have difficulty in maintaining relationships with family and friends, be impulsive and take hasty decisions, have constant crisis in their lives, unable to learn from their past experiences and they are more prone to develop other psychiatry disorders. With time these disorders can gradually burn out and the characteristics can mellow down. It usually occurs at the age of 45 -55 yrs. 

Psychiatrists offer help in the form of medications and therapy for people suffering from personality disorders. Mainstay of treatment is various forms of talk therapy and it usually runs for a long time (even years). Medications are used to treat underlying co-morbidity, mood swings and impulsivity.

Classification of personality Disorders

Cluster A:  Odd and eccentric

Personality Disorder

  1. Paranoid personality disorders
  2. Schizoid personality disorder
  3. Schizotypal personality disorder

Cluster B:  Dramatic, Emotional or Erratic

Personality Disorder

  1. Antisocial personality disorder
  2. Borderline or emotional unstable  personality disorder
  3. Histrionic personality disorder
  4. Narcissistic personality disorder

Cluster C:  Anxious and Fearful

Personality Disorder

  1. Obsessive compulsive personality or anankastic  personality disorder
  2. Anxious avoidant personality disorder
  3. Dependent personality disorder

Each of the personality disorder has definite criteria which have to be fulfilled before a diagnosis of a particular personality is made. 

GO TO INDIVIDUAL PERSONALITY DISORDER TO READ ABOUT THE CRITERIA

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Other Personality Disorders

Other Personality Disorders

Psychiatry

Other Personality Disorders

Personality Change Due to another Medical Condition

Diagnostic Criteria

A) A persistent personality disturbance that represents a change from the individual’s previous characteristic personality pattern.

Note: In children, the disturbance involves a marked deviation from normal development or a significant change in the child’s usual behavior patterns, lasting at least 1 year.

B) There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct patho physiological consequence of another medical condition.

C) The disturbance is not better explained by another mental disorder (including another mental disorder due to another medical condition).

D) The disturbance does not occur exclusively during the course of a delirium.

E) The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify whether:

Labile type: If the predominant feature is affective liability.

Disinherited type: If the predominant feature is poor impulse control as evidenced by sexual indiscretions, etc.

Aggressive type: If the predominant feature is aggressive behavior.

Apathetic type: if the predominant feature is marked apathy and indifference.

Paranoid type: If the predominant feature is suspiciousness or paranoid ideation.

Other type: If the presentation is not characterized by any of the above subtypes.

Combined type: If more than one feature predominates in the clinical picture.

Unspecified type

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Obsessive-Compulsive Personality Disorder

Obsessive-Compulsive Personality Disorder

Psychiatry

Obsessive-Compulsive Personality Disorder

Diagnostic Criteria

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

  1. Is preoccupied with details, rules, lists, order, or schedules to the extent that the major point of the activity is lost.
  2. Shows perfectionism that interferes with task completion (e.g., unable to complete a project because his or her own overly strict standards are not met).
  3. Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).
  4. Is over conscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification).
  5. Is unable to discard worn-out or worthless objects even when they have no sentimental value.
  6. Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.
  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 stubbornness.

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Dependent Personality Disorder

Dependent Personality Disorder

Psychiatry

Dependent Personality Disorder

Diagnostic Criteria

A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Has difficulty making everyday 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.
  3. Has difficulty expressing disagreement with others because of fear of loss of support or approval. (Note: Do not include realistic fears of retribution.)
  4. Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).
  5. Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.
  6. Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for him or her.
  7. Urgently seeks another relationship as a source of care and support when a close relationship ends.
  8. Is unrealistically preoccupied with fears of being left to take care of him or her.

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Avoidant Personality Disorder

Avoidant Personality Disorder

Psychiatry

Avoidant Personality Disorder

Diagnostic Criteria

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

  1. Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection.
  2. Is unwilling to get involved with people unless certain of being liked.
  3. Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.
  4. Is preoccupied with being criticized or rejected in social situations.
  5. Is inhibited in new interpersonal situations because of feelings of inadequacy.
  6. Views self as socially inept, personally unappealing, or inferior to others.

Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing

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Narcissistic Personality Disorder

Narcissistic Personality Disorder

Psychiatry

Narcissistic Personality Disorder

Diagnostic Criteria

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
  2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
  3. Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
  4. Requires excessive admiration.
  5. Has a sense of entitlement ( I. e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).
  6. Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).
  7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
  8. Is often envious of others or believes that others are envious of him or her.
  9. Shows arrogant, haughty behaviors or attitudes.

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