Personality Disorders

Personality Disorders

Personality disorders are severe disturbance of an individual’s behavior and character impacting his actions and overall personality. Generally personality disorders are related to social and personal impairments. Personality disorders involve eccentric behavioral patterns expressed by rigid reactions towards social and personal life. It has been discovered that people having personality disorders related to vast majority of concerned population, notable variations in thought patterns, perception, feeling and associations with others. Consider behavioral patterns are constant and associate to various regions of psychological and behavioral functions. Patients experience personal suffering and marred social relationships and performance.   Many people consider diagnosis of personality disorder under age group of 16-17 years.

Personality disorders are not caused due to brain disorder or any other mental problems, but such problems might co-exist and be related to them. Changes in adulthood are acquired in adulthood due to prolonged stress, severe brain disorders and extreme deprivation. They are grouped based on existing attitudes. Presently, this classification includes a description of categories and sub-categories that are contradictory and there are overlapping features.

Personality disorders are classified entirely based on groups of features which should meet the general behavioral patterns. The sub-types are usually believed to be deviation of personality.

The ICD-10 includes the below personality disorders,

1. First Category –    paranoid personality disorder
2. Second Category –    Delinquent Personality Disorder
3. Third Category – Schizoid personality disorder
4. Fourth Category – Emotionally unbalanced personality disorder: Borderline type + impulsive type
5. Fifth – Histronic personality disorder
6. Sixth category – Anankastic personality disorder
7. Seventh Category    -   Anxious personality disorder
8. Eighth category   –    Dependent personality disorder
9. Ninth – Narcissistic personality disorder and other particular personality disorders

Every personality disorder will include particular diagnostic criteria. The important criteria for all personality disorder are explained below.

As per clinical diagnostic rules laid out by ICD-10, below are some symptoms required to identify and diagnose a personality disorder,

• Considerable disproportion in behavior and attitude in various functional regions like drive, affectivity, general thinking, perception, impulsive control and maintaining relationships with others.
• This dramatic behavior is consistent and uniform and is not restricted to sequences of mental illness.
• This dramatic behavior is fundamental and in many social and personal situations distinctly inappropriate.
• The faults usually start in adolescence or childhood and continue to exist for long period in adults.
• The disorder causes considerable subjective suffering, but in certain cases at late stage.
• It is usually important that limitations of social and professional performance related with.
• For diagnosis of majority of most sub-groups, 3 particular behaviors or properties usually exist.
• Various cultures might have particular criteria for social rules, norms and there will be obligations developed.

After the precise research conditions of ICD-10, below are general criteria needed to diagnose personality disorder,

G1. The characteristic and long-term behavior patterns and interior experience of the impacted vary considerably from culturally accepted and anticipated standards. This deviation will express in terms of below regions,

1. Cognition  (Interpretation of events and people, perception of others and themselves, attitude)
2. Gratification and Impulse control
3. Affectivity (variety, strength and aptness of emotional response to situations)
4. Developing Social relationships with others maintaining them.

G2. The variation is expressed such a way that social and personal situations are maladaptive, inflexible and unfitting (not restricted to particular triggering situations or stimulus).

G3. Personal suffering – Negative impact on social environment and considerably below G2, ascribed to explained behavior.

G4. Proof that there is stable deviation of long duration and starts in adolescence or childhood.

G5. The deviation is not result of consequence or presence of various mental disorders in adults is explained. But it’s chronic or episodic condition photos of Chapter F59-F70-F00-F70 stay with disorder or it is overlapped.

G6. An injury, organic disease or considerable damage of brain have resulted in deviation which can be excluded if the cause can be explained, then F07 categories are used.

F60.0 Paranoid personality disorder

Minimum 4 of below behaviors of categories should exist,

1. Increased sensitive to slights and setbacks.

1. Tendency to permanently have grudges on disrespect, injuries or insults.
2. Mistrust and following tendency to change experienced through friendly or neutral actions of others could misunderstood as contemptuous and hostile.
3. Insistent and Argumentative, misunderstand situations exist on their own rights.
4. Recurrent undue mistrust of sexual faithfulness of sexual partner or spouse
5. Constant self-involvement, particularly in relation with strong assumption
6. Frequent engrossment with thoughts related to baseless conspiracies as explanations for events in further afield.

F60.1 Schizoid personality disorder

At least 4 of below behaviors or characteristics should be present,

1. If anything, just few activies make them happy
2. Always exhibit emotional coldness, flattered affection or detachment from others.
3. Impaired potential to express care or anger over others.
4. Appears apathetic to criticism or praise from others
5. Lack of sexual interests with partners
6. Always prefer to work alone and independently
7. Excessive use of illusion and self-contemplation.
8. Does not have any wish or close relations or friends of trust
9. Lack of sense of social conventions and norms. If they are not followed it is done without any intention.

Delinquent personality disorder F60.2

At least 3 of below behaviors or characteristics should be present,

1. Persistent and considerable irresponsible attitude and neglection of social rules, obligations and norms.
2. Lack of potential to maintain enduring relationships, though it isn’t difficult, it can be understood.
3. Very minimal toleration, aggressive and violent behavior
4. Incompetence or lack of guilt from negative experiences, especially penalty to learn
5. Notable tendency to blame others or provide believable reasons for behavior for which person finds in conflict with society.

F60.30 Emotionally Unbalanced Personality Disorder – Patients of Impulsive type

The emotionally uneven personality disorder includes 2 types – Borderline type (F60.31) and impulsive type (F60.30).

The important characteristics of impulsive type are lack of impulse control and emotional imbalance. Outbreaks of threatening or violent behavior are usually, particularly when criticized by others.

At least 3 of below behavior or characteristics should be present which includes,

1. Notable tendency to act in unanticipated way without thinking about consequences.
2. Clear tendency to conflicts and quarrels with others, particularly when impulsive acts are blamed or prevented.
3. Tendency to express violence or anger with lack of potential to control violent behavior.
4. Unpredictable or unstable mood
5. Tough to maintain acts which are not rewarded directly.

F60.31 Borderline Type – Emotionally unbalanced Personality Disorder

At least 3 among 5 criteria which were mentioned for impulsive type disorder should also be present for emotionally unstable borderline type along with 3 below behavior or characteristics,

1. Uncertainty and disturbance about goals, self-image and internal tastes
2. Tendency to involve in unstable and intense relationships, usually results in emotional crises.
3. Inordinate attempts to prevent abandonment
4. Repeated acts or threats of self-harm
5. Persistent impressions of emptiness.

F60.4 Histrionic personality disorder

There should be minimum 4 of below behaviors or characteristics,

Theatrical appearance, dramatic self-presentation or a high lightened expression of emotions,

1. Susceptibility easily changed by events or by other people.
2. unstable and superficial emotions;

1. Persistent search for exciting and activities where nominees are center of attention.
2. Inappropriately seductive in behavior or appearance.
3. Preoccupation to appear attractive externally
4. Selfishness, egocentricity, persistent desire for recognition, vulnerable to situations, lack of mention to others, consistent manipulative nature and not proposed to diagnose, but essential.

F60.5 Compulsive Anankastic personality disorder

At least 4 of below behaviors or characteristics should be present,

1. Strong feelings of doubt and increased caution

1. Pre-occupation with rules, details, schedules or organization, orders, lists etc.
2. Perfectionism which matches with task completion.
3. Unreasonable conscientiousness
4. Inconsistent approach related to performance, missing to discharge of social relationships.
5. Obstinacy and rigidity
6. Excessive pedantry and devotion to social conventions.
7. Baseless imperativeness which others submit to meet their own habits or excessive hesitancy to permit others for doing certain things.

F60.6 Anxiety personality disorder or Avoidant personality disorder

At least 4 of below characteristics should be present,

1. Comprehensive feelings of anxiety and tension
2. To worry excessively when rejected or criticized in public.
3. They have personal contacts in case of security requirements.
4. Restricted lifestyle due to requirement of physical security.
5. Avoid social contacts with others or occupational activates which demand intensive human contact, due to fear of rejection or disapproval.

F60.7- Related personality disorder

It should meet with at least 4 of below behavioral traits or characteristics,

1. Encouragement to others or permission to make important decisions for own lives.

1. Subordination of their own requirements to other people in order to balance the dependence on others and yield to their wishes.
2. Lack of willingness to submit to reasonable claims against people whom they are dependent.
3. Feeling uncomfortable when staying alone due to high lightened fear of caring for them selves alone.
4. Leave frequent engrossment with fear of remaining alone
5. Lack of potential to take decisions on their own without getting advice from others.

Apart from that, persons who are concerned feel helpless and incompetent when they are on their own.

F60.8 Narcissistic Personality Disorder

They should have at least 5 of below characteristics,

1. Size feeling regarding their own importance (Victims exaggerate their talents and achievements anticipated to be considered material without associated benefits).
2. Engrossment with illusions of unrestricted success, subtlety, power, ideal love or beauty
3. Desire for lot of admiration from others
4. Conviction particularly to be unique and special and understood only by people of high status.

1. Undue expectations for favorable treatment from others and automatic compliance with expectations.
2. Manipulating others for selfish reasons to achieve their own targets.
3. Lack of sympathy and understanding of feelings and requirements of other people.
4. Often feel jealous about others and believe that others are also envious on them.
5. Arrogant attitude and swaggering behavior

People who have anxiety disorder & one or more of the personality disorders below will have lower success rate to cognitive and confrontational theraphy strategies, compared to other patients with anxiety disorder.

• Anxious or Avoidant personality disorder. They have fears and worries often, consistent avoidance of reactions to situations, inferiority complex, fears of social rejection due to continuous psychotherapy and is tough to change them.
• Dependent personality disorder. As a person who depends other people, if they are not able to own 2 feet, but wish to lean on constantly towards others.
• Avoidant personality disorder.  These parties are uncertain towards themselves.
• Obsessive-compulsive personality disorder. They have compulsive behavior to act like perfectionist without rituals.
• Borderline personality disorder.  It has serious impact in person’s emotions, inner experience, impulse control, identity and self-image, general social behavior and social relationship skills.
• Lasting change in personality after a horrific life experience. If the patients experience post traumatic stress disorder for 2 years, it could result to personality disorders and change in behavior.

Tags: Personality Disorders