Info
🌱 來自: Huppert’s Notes
Personality Disorders🚧 施工中
Personality Disorders
Definitions:
• Personality: Patterns of relating to and perceiving the world and oneself that persist across multiple contexts
• Personality disorder: The presence of traits that are maladaptive and inflexible across enough contexts to cause distress and impaired functioning within an individual’s environment/culture
Cluster A (“weird”)
• Paranoid: Distrust, suspiciousness of others (often directed towards a spouse)
• SchizoiD: Distant, socially withdrawn, has few friends and prefers to be alone (“happy loner”)
• SchizoTypal: Socially withdrawal and eccentric behavior, magical Thinking; 10–20% children with schizotypal personality disorder ultimately develop schizophrenia
Cluster B (“wild”)
• Antisocial: Violates rights of others without remorse; often history of malingering, arrests/incarcerations, and substance use disorder. Must be ≥18 yr (in children, this behavior is instead called conduct disorder). Treatment: Cognitive behavioral therapy (CBT), although two trials have not demonstrated benefit (Psychol Med 2009;39(4):569; Br J Psychiatry 2007;190:307). Other modalities not studied.
• Borderline: Unstable mood, labile intense relationships, poorly defined sense of self, chronic feelings of emptiness, intense fear of abandonment/rejection, black/white thinking, suicidal gestures common. Treatment: dialectical behavior therapy (DBT).
• Histrionic: Attention-seeking, provocative, exaggerated, regression to childlike behavior
• Narcissistic: Grandiose, limited empathy, often conveys a sense of superiority but the individual actually has fragile self-esteem. Desires recognition/admiration.
Cluster C (“worried”)
• Avoidant: Shy and fear of rejection but would prefer to have friends (in contrast to schizoid); very isolated
• Dependent: Need for others to make decisions and/or care for them. Fear rejection/abandonment.
• Obsessive-compulsive personality: Perfectionism, inflexibility, orderliness, ego-syntonic (i.e., behavior does not threaten the ego; patient does not experience behavior as an external force/impulse, in contrast with obsessive-compulsive disorder)