Personality Disorders

Personality Disorders

 

Personality disorder is a number of clinically relevant states and behavioral types that tend to sustainability. It deals with the inherent characteristics of an individuals lifestyle and attitudes towards him-/herself and others. Some of these states and behaviors appear very early in the process of individual development as a result of constitutional factors and social experience, while the others are acquired later. Personality disorder is an impaired behavioral individual tendency, which usually covers several psychological areas and is almost always accompanied by personal and social disintegration.

For the classification serves the Diagnostic and Statistical Manual of Mental Disorders. It groups them into three clusters (DSM-IV, 2000). To cluster A belong odd or eccentric disorders, such as paranoid personality (a personality disorder characterized by excessive sensitivity to frustration, suspicion, rancor, resentment constant tendency to treat others and all at his own expense), schizoid personality disorder (a tendency to avoid emotionally charged relationship through excessive theorizing, withdrawal, withdrawal into fantasy; in addition, the schizoid personality often tends to disregard the prevailing social norms), and schizotypal personality disorder (it is not appropriate for the diagnostic criteria for the diagnosis of schizophrenia; it does not have all the necessary symptoms or they are weak). The second is cluster B, which includes dramatic, emotional or erratic disorders. It includes antisocial personality disorder (disregard for social norms, impulsivity, aggression, and a very limited ability to form attachments), borderline personality disorder (emotionally unstable personality disorder characterized by impulsivity, low self-control, emotional instability, unstable connection with reality, high anxiety, and a strong level of de-socialization), histrionic personality disorder (never-ending necessity in getting attention, unstable self-esteem, the importance of gender reassessment, mock behavior, etc; this hysterical, stage, theatrical disorder found the name show personality), and narcissistic personality disorder (belief in ones own uniqueness, special position, superiority over the other human beings, inflated opinion about his or her talents and achievements, seeking to confirm the admiration of others, inability to show empathy, ideas about own freedom from any rules). Cluster C consists of fearful or anxious disorders: avoidant personality disorder (a constant avoidance of social interaction, extreme sensitivity to negative assessments of others; people with anxiety disorder often feel that they are not able to communicate or that their identity is not attractive; they avoid social interaction for fear of being ridiculed, humiliated, rejected; they often present themselves as individualists and talk about feelings of alienation from society), dependent personality disorder (an increased sense of helplessness, incompetence and lack of vitality without the support of others, the need for which is felt most of the time), obsessive-compulsive personality disorder (an excessive tendency to doubt, preoccupation details unnecessary perfectionism, stubbornness, and periodically emerging obsessions and/or compulsions).

All clusters differ, but they also have similar features. First of all, the most common similarity among the types is the de-socialization and reserved character as, for example, in schizoid, antisocial, borderline, and avoidant personality disorders, which belong to different clusters. The types of schizoid, antisocial and narcissistic personality disorders tend to disregard prevailing social norms. Low self-esteem is a sign of paranoid and avoidant disorders. The histrionic type also partly belongs here because of its unstable self-esteem. Suspicions and doubts are a part of paranoid and obsessive-compulsive personality disorders. On the other hand, differences between the clusters are also significant. The disorders of cluster A are mostly self-oriented. Their features tend to the suspension from the society and any social relationship. However, the disorders in cluster B need other people although for different aims. This clusters disorders vary from the aggressive to the dependent on the admiration type. The third cluster has some elements from the previous ones in addition to its own.

Paranoid personality disorder refers to cluster A (unusual or eccentric disorders). A person with this disorder has a global distrust and suspicion towards others, which leads to the interpretation of the peoples motives as malicious (Livesley, 1995). For the diagnosis, in addition to the general criteria of the personality disorders, it is necessary to indicate four or more of following: suspicion without good reason that others are exploiting, harming or deceiving him or her; preoccupation with the unjustified doubts about the loyalty and reliability of friends or associates; reluctance to open up to others because of unwarranted fear that it will be used against him or her; detection of latent or degrading threatening values in favorable words or events; constant hostility towards others, including the refusal to forgive insults, disrespect or harm; recognition of subtle attacks on surrounding him (her) reputation with rapidly emerging response to attack or anger; suspicion of loyalty of a spouse or sexual partner. The diagnosis of these manifestations should be recorded not only in the course of schizophrenia, but mood disorders with psychotic symptoms, other psychotic disorder or even a direct consequence of some other disease or overall physical condition.

Histrionic personality disorder is an example of excessive emotionality and desire to receive attention beginning from the late adolescence, marked in many situations (Livesley, 1995). In addition to the general criteria of personality disorders, histrionic personality disorder must include five or more of the following: a person feels uncomfortable in situations where he or she is a center of attention; interaction with others is often characterized by inappropriate seductive or provocative behavior, namely rapidly changing exhibits, shallow emotions; a person consistently uses his/her looks to attract attention; a person uses different impressionistic style speech to the lack of attention to detail, theatrical and exaggerated emotions; a person is suggestible, that is easily comes under the influence of others or the situation; he or she considers relationships more intimate than they really are.

The obsessive-compulsive personality disorder refers to cluster C. A person with this disorder is characterized by a severe concern to procedure, perfectionism, and control over oneself and others, which reaches sacrificing flexibility, openness and efficiency of their behavior (Livesley, 1995). The diagnosis requires four or more of the following characteristics revealed in the early adulthood in a variety of contexts as well as to meet the general criteria for personality disorder: pay attention to details, rules, lists, order, organization or schedules to the detriment of the basic sense of activity; shows perfectionism that prevents the implementation of tasks; too much attention is paid to work and productivity to the detriment of leisure activities and friendships; overly honest, scrupulous and inflexible in matters of morality, ethics and values (Baer, 1994); unable to get rid of worn-out or worthless objects even when they do not have a subjective emotional value; refusing to transfer the case or to cooperate with other people as they do not do exactly what he or she does; demands from himself and others frugality in spending, money is considered as something that should have been postponed in the event of disaster; shows rigidity and stubbornness.

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Even though all of these three disorders show different behavior problems, they cause significant difficulties in communication with other people. For example, paranoid people are too reserved and suspicious, histrionic are too expressive, obsessive-compulsive are too stubborn and demanding. The paranoid makes people perceive others as enemies, while in the histrionic personality disorder people see the world as the theatre, and in the obsessive-compulsive personality disorder as something that can be corrected.

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