Personality decomposition Wikipedia. Treatment of selected disorders. Antisocial personality disorder

• Consequences of violations
• Types of disorders
• How is the disease treated?

A personality disorder is a long-term and persistent disturbance of various aspects of mental activity. This behavior lacks productive psychosomatics, so the person himself or those around him suffer from these manifestations. These disorders often begin in childhood or adolescence and last throughout life.. The disorder of the personality itself and its behavior is caused by persistent disturbances in thoughts, emotions and actions. Each person has his own mental characteristics, and when someone’s behavior stands out against the general background, it provokes irritation in other people. Certain problems arise that affect the life of the person with disabilities and those around him. If such a condition significantly affects a person’s daily life, it is advisable to talk about the need for qualified help from a psychologist or psychiatrist.

Despite their appearance, mental disorders disrupt a person’s adequate psycho-emotional perception of the world around them and the patient’s ability to adapt socially. Medication-assisted therapy does not change personality traits, but seeing a therapist can be a big help in identifying your problems and changing your behavior.

Mechanism of occurrence of violations

What is a personality disorder? They can be defined as a type of mental disorder that is classified by clinical psychologists and psychiatrists. It is defined as persistent violations that manifest themselves in a person’s actions, emotions and thoughts. In order for such a diagnosis to be made, it is first necessary to exclude organic brain lesions that can provoke similar abnormalities.

Such disorders are more likely to occur in childhood or teenage. The severity of deviations in behavior and the external environment affect the possibility of adaptation with such a diagnosis. Under positive circumstances, adaptation occurs, in unfavorable cases, disadaptation occurs. Factors that provoke decompensation are:

• somatic disease;
• infectious diseases;
• intoxication of the body;

What are the causes of the disease and what influences its development? The onset and progression of psychopathy is strongly influenced by age. The most dangerous age in terms of maladjustment is adolescence and primary school age.

Mental disorders in a person cause an inadequate perception of the world around them, abnormal problem solving and abnormal attitudes towards people. Such people find it difficult to build constructive relationships with their family members. People with disorders tend not to see their inappropriate behavior and attitude towards the world around them. Therefore, they very rarely turn to a specialist on their own initiative.

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Symptoms of disorders and causes of their occurrence

Such people are not satisfied with their lives, they may suffer from substance abuse, disturbances in emotional perception and mood; Eating behavior is disrupted and excessive anxiety occurs.

The main factors that can provoke the occurrence of such a disorder are violence in childhood (infantile personality disorder), neglect of the child in the family, sexual corruption and bullying, raising a child in conditions of alcoholism, complete indifference to his feelings and behavior.

The Manual of Mental Disorders provides its own criteria for assessing behavior and is fundamental in determining a diagnosis such as personality disorder. Each person has his own personality traits that are closely related to other people and events. Some people tend to difficult situations ask for help, while others solve their problems on their own. Some people are condescending when faced with problems, while others tend to exaggerate even small problems.

No matter what a person's response style is, mentally healthy personality will try an alternative approach to solving the problem if the first reaction does not give a positive result.

People with mental and psychological disorders are rigid, they are not prone to adequate reaction to the problems and difficulties that have arisen. They do not know how to properly build relationships with loved ones, friends, and colleagues. Such violations vary in severity.

Since such individuals do not realize that their thoughts and behavior are unacceptable in society, for this reason they rarely turn to specialists. More often, such people present with problems such as chronic tension that occurs due to disorders, anxiety symptoms, or depression. They believe that their problems are caused by other people or circumstances beyond their control. To date, the effectiveness of treating such disorders with the help of psychotherapy and psychoanalysis has been proven.

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Consequences of violations

Disturbances in the development of personality and behavior can cause complications such as:

• high risk of alcohol and drug addiction, inappropriate sexual behavior, and manifestations of suicidal tendencies;
• the development of mental disorders in the children of a sick person due to his inadequate upbringing, which is expressed in emotional breakdowns, irresponsible and offensive type of upbringing;
• mental and emotional breakdowns due to frequent stress;
• the appearance of other mental disorders, such as psychosis or anxiety;
• the refusal of a sick person to be responsible for his behavior, as a result of which distrust of everyone around him develops.

The incidence of the disorder is approximately 9% of the population worldwide.

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Types of disorders

All types of personality disorders are divided into the following main categories:

1. Category A: paranoid, schizotypal and schizoid disorders.
2. Group B: borderline, hysterical or histrionic, antisocial, narcissistic disorders.
3. Category C: obsessive-compulsive, avoidant, dependent disorders.

All types of personality disorders differ in their intensity and reasons for their occurrence. As for the classification of personality disorders, it is conditional, since there are often mixed types of disorders that include signs different types disorders.

The paranoid type of disorder causes various manifestations. A sick person experiences suspicions that have no basis in reality. Such people believe that they are being used, deceived, and harmed. They are overly unkind to the people around them, do not know how to show compassion and forgiveness, and may express unfounded suspicions that their significant other is cheating on them. Such individuals are convinced that they are right in any situation; they may be deprived of emotions and warmth towards loved ones. They are influenced only by strength and authority; in opposite cases, they despise those who are weak, sick or inferior to them.

As the disease progresses, the degree of complexity and intensity of the symptoms develop. If such a person feels offended, he can write complaints to government authorities, in which he points out any views or actions that the enemy, as it seems to them, is showing deliberately and with obvious hostility towards them. Such a person may send anonymous threatening letters. The number of people who persecute them is growing, this may include everyone who did not understand them in time and did not take due part in their fate. In such cases, a person may develop overvalued delusions and delusions of jealousy. Individuals with delusions are socially dangerous, so they may have the ability to act aggressively towards their imaginary enemies or towards a spouse who is considered a traitor.

The passive-aggressive type of disorder is expressed in irritability, envy, anger, and threats to commit suicide (which they actually do not intend to commit). The condition is aggravated by a prolonged depressive state, which can occur against the background of alcohol addiction and various somatic disorders.

The narcissistic type is expressed in a strong exaggeration of one’s abilities and merits, attributing non-existent talents and heroic deeds. Such individuals love to be praised and admired; successful people make them jealous.

The dependent type of disorder manifests itself in low self-esteem, self-doubt, and avoidance of responsibility. The main problem of such individuals is the aversion to loneliness. They can endure humiliation and insults.

The anxious type is expressed in fear of various manifestations in the surrounding world. Such individuals experience fear of public speaking, they experience a lot of anxiety, they are very susceptible to criticism, and they need constant support and approval from society.

The anancast type manifests itself in excessive shyness, impressionability, and lack of self-confidence. This syndrome raises doubts, the patient avoids responsibility, and may have obsessive thoughts.

With the histrionic type, signs such as the need for constant attention arise; people are impulsive, prone to sudden changes in their already volatile mood. They try to stand out from the crowd, have a tendency to often lie and fantasize about themselves in order to achieve their own importance, and often lead a double life: they behave friendly in society, but they show real tyranny to their family.

Emotionally unstable disorder is expressed in great excitability, violent reactions and dissatisfaction. Angry manifestations in such people can be accompanied by open violence if they are resisted. Prone to sudden mood swings and impulsive actions.

The dissocial type causes the possibility of impulsive actions, denial of generally accepted moral norms, and failure to accept one’s own responsibilities. Such individuals, unfortunately, are not inclined to commit actions; they regularly deceive, openly manipulate other people, take advantage of their favor, and at the same time they do not experience anxiety or depression.

In the schizoid type, personality and behavior disorder is expressed in the sick person’s desire for loneliness. Such people avoid relationships and contact with people, are indifferent to praise or criticism, and animals often become their only friends. The surrounding society fences itself off from the patient if a person has such a disease.

Personality disorders are life-spanning, enduring patterns of behavior that cause significant distress and impairment of functioning. There are 10 separate personality disorders that are grouped into three clusters. Diagnosis is based on clinical data. Treatment uses psychotherapy and sometimes medication.

Personality traits are characteristics of thinking, perceiving, responding, and relating that are relatively stable over time and across situations. Personality traits typically become evident from late adolescence to early adulthood, and while many traits remain the same throughout life, some may decline or change with age. A personality disorder can be identified when these traits become so rigid and maladaptive that they impair functioning. The psychological mechanisms of coping with stress (psychological defense), which everyone unconsciously uses from time to time, are often immature and poorly adaptive in people with personality disorders.

People with personality disorders are often frustrated and may even take their anger out on others (including doctors). Most are worried about their lives, have problems with work and in relationships with people. Personality disorders often co-occur with mood disorders, anxiety, substance abuse, and eating disorders. Patients with severe personality disorders are at high risk for hypochondriasis, violence, and self-destructive behavior. They may have inconsistent, fragmented, overly emotional, abusive, or irresponsible parenting within their families, leading to the development of physical and physical problems in their children.

About 13% of the general population have a personality disorder. Antisocial personality disorder occurs in approximately 2% of the population, with a higher prevalence among men than women (6:1). Borderline personality disorder occurs in approximately 2% of the population, more among women than men (3:1).

Diagnosis and classification of personality disorders

The patient's emotional reactions, his view of the causes of his problems, the attitude of others towards him - all this can provide information about the disorder. Diagnosis is based on observation of recurring patterns of behavior or perception that cause distress and impairment of social functioning. The patient is usually not critical enough to these behavioral features, so it is better to initially begin the assessment with information from people in contact with the patient. Often the suspicion of a personality disorder arises from the doctor's feeling of discomfort, usually if the doctor begins to feel angry or tense.

The general criteria (DSM-IV) of the Statistical and Diagnostic Manual of Mental Disorders, Fourth Edition, emphasize consideration of the possible influence of other mental or physical disorders (eg, depression, substance abuse, hyperthyroidism) on the patient's behavior patterns. The DSM-IV identifies 10 different personality disorders, which are divided into 3 clusters: A - unusual / eccentric; B - impressionable / changeable and C - anxious / fearful.

Coping mechanisms

Cluster A

Patients belonging to cluster A tend to be distant and suspicious.

The paranoid personality has characteristics such as coldness and distance in relationships, with a need to control the situation and a tendency to jealousy if attachment is formed.

People with this disorder are often secretive and distrustful. They tend to be suspicious of change and often see hostile and evil motives in other people's actions. Usually these unfriendly motives are a projection of their own hostility towards other people. Their reactions sometimes surprise or frighten others. They may use the resulting anger and rejection from others (i.e., projective identification) to validate their own perceptions. Paranoid people tend to feel righteous indignation and often take legal action against others. These people can be highly skilled and conscientious, although they usually require relative isolation to work. This disorder must be differentiated from paranoid schizophrenia.

The schizoid personality is characterized by introversion, social withdrawal, isolation, emotional coldness and distancing. Such people are usually absorbed in their own thoughts and feelings and avoid close, intimate relationships with other people. They are silent, prone to daydreaming, and prefer theoretical reasoning to practical action.

The schizotypal personality, like the schizoid personality, includes social withdrawal and emotional coldness, but also unusual thinking, perception and communication, such as magical thinking, clairvoyance, relational ideas or paranoid thinking. These oddities suggest schizophrenia, but are not severe enough to meet its criteria. People with schizotypal personality are thought to have latent expression of genes that cause schizophrenia.

Cluster B

These patients tend to be emotionally unstable, impulsive, and impressionable.

Borderline personality is characterized by unstable self-perception, mood, behavior and relationships with others. Such people tend to believe that they did not receive adequate care in childhood, and, as a result, feel emptiness, anger and complain about their upbringing. As a result, they are constantly looking for care and are sensitive to the feeling of its absence. Their relationships with people tend to be dramatic and intense. When they feel cared for, they appear to be lonely drifters seeking help for depression, substance abuse, eating disorders, or past abuse. When they are afraid of losing the person who cares about them, they often show inappropriate, expressed anger. Such mood swings are usually accompanied by extreme changes in their views of the world, themselves and others, such as from bad to good, from hatred to love. When they feel lonely, they experience dissociation or severe impulsivity. Their concept of reality is so weak that they may develop short episodes of psychotic disorders such as paranoid delusions or hallucinations. They often become self-destructive and may self-harm and attempt suicide. They initially tend to demand special attention, but after repeated crises, vague unfounded complaints and failure to follow therapeutic recommendations, they are perceived as complainers who avoid help. Borderline personality disorder tends to become less severe and stabilize with age.

An antisocial personality is characterized by a gross disregard for the rights and feelings of other people. People with antisocial personality disorder exploit other people for material gain or personal pleasure. They are easily frustrated and do not tolerate stress well. They are characterized by impulsive and irresponsible external manifestations of their conflicts, sometimes accompanied by aggression and violence. They cannot foresee the consequences of their behavior and usually do not subsequently experience guilt or remorse. Many of them have a well-developed ability to actively rationalize their behavior and condemn it in other people. Fraud and deceit permeate their relationships with others. Punishment rarely leads to changes in their behavior and improvement in law-abiding behavior. Antisocial personality disorder often leads to alcoholism, drug use, promiscuity, failure to fulfill obligations, frequent movement, and difficulty obeying the law. Life expectancy is reduced, but the disorder becomes less intense and may stabilize with age.

The narcissistic personality is characterized by grandiosity. Such people have an exaggerated sense of their own superiority and expect to be treated with deference. Their relationships are characterized by the need for admiration from others, they are extremely sensitive to criticism, failures and losses. If such people are faced with an inability to live up to a high opinion of themselves, they may become angry or deeply depressed and suicidal. They often believe that others are jealous of them. They may exploit others because they believe their superiority justifies it.

The histrionic (hysterical) personality is characterized by a conspicuous search for attention. Such people also attach excessive importance to their appearance and behave theatrically. Their expressions of emotion often seem exaggerated, immature, and superficial. In addition, they often require friendly and erotic attention from others. Relationships with other people are usually easy to establish, too much importance is attached to sexuality, but there is a tendency for contacts to be superficial and short-lived. Behind their seductive behavior and tendency to exaggerate physical problems [i.e. e. hypochondria] often hides basic desires for dependence and protection.

Cluster C

Such patients tend to be nervous and passive or rigid and preoccupied.

A dependent personality is characterized by shifting responsibility to others. Such people may submit to others in order to gain their support. For example, they allow the needs of the people they depend on to dominate their own. They lack self-confidence and express a feeling that they cannot adequately take care of themselves. They believe that other people are more capable and are reluctant to voice their concerns that their enterprising ways will offend the people on whom they depend. Addiction in other personality disorders may be hidden behind overt behavioral disturbances; for example, hysterical or borderline behavior masks an underlying addiction.

An avoidant personality is characterized by hypersensitivity to rejection and a fear of starting a new relationship or doing anything new due to the risk of failure or disappointment. Because of their strong conscious desire for affection and approval, such individuals often experience distress due to isolation and an inability to maintain comfortable relationships with others. They react with distance even to small hints of rejection.

The obsessive-compulsive personality is characterized by conscientiousness, orderliness, and reliability, but their lack of flexibility often makes them unable to adapt to change. They take responsibility seriously, but since such people hate mistakes and incompleteness, they get bogged down in details and forget the goal. As a result, they have problems making decisions and completing tasks. Such problems make responsibility a source of anxiety, and such patients rarely receive much satisfaction from their successes. Most obsessive-compulsive traits are adaptive when severe. People with such personality traits can achieve a lot, especially in the sciences and other academic fields where order, perfectionism and persistence are desirable. However, they may feel uncomfortable when feelings, interpersonal relationships, and situations become out of control, or when they must rely on other people, or when events are unpredictable.

Other personality types. Some personality types are described but not classified as disorders in the DSM-IV.

The passive-aggressive (negative) personality usually comes across as stupid or passive, but behind this behavior lies a desire to avoid responsibility, control, or punishment from others. Passive-aggressive behavior is evidenced by procrastination, ineptitude, and unrealistic statements of helplessness. Often such people, after agreeing to complete a task, do not want to complete it and then subtly sabotage the completion of the task. This behavior usually indicates denial, or hidden hostility, or disagreement.

The cyclothymic personality fluctuates between ardent cheerfulness and despondency and pessimism; each mood variant lasts a week or more. It is characteristic that rhythmic mood changes are regular and observed without a reliable external cause. If these features do not interfere with social adaptation, cyclothymia is considered a temperament and is present in many gifted and creative people.

A depressed person is characterized by constant moodiness, anxiety and shyness. Such people have a pessimistic worldview, which disrupts their initiative and discourages others. Self-satisfaction seems undeserved and sinful. They unconsciously regard their suffering as an emblem of virtue, necessary to earn the love or favor of others.

Treatment of personality disorders

Although treatment varies depending on the type of personality disorder, there are some general principles. Family and friends may act in ways that either increase or decrease the patient's problematic behavior or thoughts, so their involvement is helpful and often key. Early efforts must be made to help the patient see that the problem lies within himself. Another principle is that treating personality disorders takes a long time. In order for a person to become aware of his psychological defenses, beliefs and characteristics of maladaptive behavior, repeated confrontation in long-term psychotherapy or in encounters with other people is usually necessary.

Because personality disorders are extremely difficult to treat, it is important that the therapist has experience, enthusiasm, and an understanding of the patient's expected areas of emotional sensitivity and habitual coping mechanisms. A friendly attitude and recommendations in isolation do not affect personality disorders. Treatment for personality disorders may include a combination of psychotherapy and medication. However, symptoms usually do not respond well to medication.

Relieving anxiety and depression is a top priority, and drug therapy can help. Reducing external stress can also quickly reduce these symptoms. Maladaptive behavior, characterized by recklessness, social withdrawal, lack of confidence, and emotional outbursts, can change over months. Sometimes group therapy and behavior correction carried out at home or in a day hospital are effective. Participation in self-help groups or family therapy can also help in social change. unwanted behavior. Changes in behavior are most important for patients with borderline, antisocial, or avoidant personality disorder. Dialectical behavior therapy (DBT) has proven effective for borderline personality disorder. DBT, which includes weekly individual psychotherapy and group therapy, as well as telephone contact with a therapist between scheduled sessions, helps the patient seek understanding of his or her behavior and teaches problem-solving skills and adaptive behavior. Psychodynamic therapy is also highly effective for patients with borderline and avoidant personality disorders. An important component of such therapy is to help the patient with a personality disorder to transform his emotional state and think about the impact of his behavior on others.

Solving problems of interpersonal relationships, such as dependence, mistrust, arrogance, manipulativeness, usually takes more than 1 year. The basis for effective changes in interpersonal relationships consists of individual psychotherapy, which helps the patient understand the sources of his problems in relationships with people. The physician must repeatedly point out the undesirable consequences of the patient's thoughts and behavior patterns, and also periodically set limits on the patient's behavior. Such therapy is necessary for patients with hysterical, dependent or passive-aggressive personality disorder. For some patients with personality disorders involving varying preferences, expectations, and beliefs (ie, narcissistic or obsessive-compulsive type), psychoanalysis is recommended, usually for 3 years or more.