Psych - Personality Disorders

PERSONALITY DISORDERS Dr. Elizabeth Magdalena A. Santos

Clusters of Personality Disorders 

A – odd and eccentric: Paranoid, Schizoid, Schizotypal

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B – dramatic, emotional, and erratic Antisocial, Borderline, Histrionic, Narcissistic

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C – anxious and fearful Avoidant, Dependent, Obsessive-Compulsive NOS (Passive-Aggressive, Depressive)

Etiology GENETIC FACTORS - concordance among monozygotic twins > dizygotic twins - reared apart = reared together - similarities: temperament, interests, social attitudes

Cluster A more common in relatives of schizophrenic patients than in control groups Schizotypal PD occur more in family histories of schizophrenic patients than in control groups Less correlation between Paranoid or Schizoid PD and schizophrenia

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Antisocial PD associated with alcohol use disorders

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Depression common in family backgrounds Borderline PD patients

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Borderline PD have more relatives with mood disorders than do control groups

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Histrionic PD strong association with somatization disorder

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Avoidant PD often have high anxiety levels

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Obsessive-Compulsive traits are more common in monozygotic twins than in dizygotic twins

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OCPD patients show some signs of depression:  

Shortened REM latency period Abnormal DST results

BIOLOGICAL FACTORS  Impulsive traitshigh level of testosterone, 17-estradio, and estrone abnormal DST results with Borderline PD  College students with low platelet MAO levels report spending more time in social activities than students with high platelet MAO levels.  Low platelet MAO levels noted in Schizotypal PD

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Smooth pursuit eye movements are saccadic in: introverted persons, low self-esteem and tend to withdraw Schizotypal PD

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Neurotransmitters Studies show an arousal activating function of dopaminergic and serotonergic systems Raising serotonin levels produce dramatic changes Increased dopamine can induce euphoria

PSYCHOANALYTIC FACTORS 

Sigmund Freud Personality traits are related to a fixation at one psychosexual stage of development oral stage – passive and dependent anal stage – stubborn , highly conscientious

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Wilheim Reich character armor – defensive styles protect from internal impulses and from interpersonal anxiety in significant relationships

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Contemporary concepts of personality and personality disorders unique stamp of personality is largely determined by characteristic defense mechanisms cluster of defenses help psychodynamic clinicians recognize the type of character pathology present effective defense leads to mastery of negative feelings of anxiety, depression, anger, shame, guilt, and other affects