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Personality Disorder

Paranoid Personality Disorder

   The characteristic is a highly pervasive and long-standing pattern of suspiciousness and mistrust. They are hypersensitive in their relationships w other ppl.
As a result, their emotional and social life is apt to be highly restrictive, since its difficult for 'em to enter or maintain a mutually trusting relationship w others.
Paranoid personality disorder does not as a rule involve the sharp break w reality found in delusions of paranoid schizophrenia and other paranoid froms of psychoses.
   Indeed, individuals who suffer from this kind of disorder may be highly competent intelectually.
Nevertheless, because their paranoid approach to presonal and social life prevents their maintaining satisfactory relationships w other ppl, they often fail to achieve the goals that their intelligence would allow.
Psychoteraphy is the basic approach of helping 'em w their problems.

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Schizoid Personality Disorder

   Seclusiveness and lack of desire for social involvement mark "schizoid personality disorder". Schizoid individuals tend to be cold, aloof loners.
They often seem indecisive and somewhat detached from their surroundings, but their remoteness does not take the extreme form of retreat one often finds in schizophrenics.
   The primary defense mechanism used by schizoid ppl is "intellectualization" -- thinking about one's interpersonal experience in highly objective, almost mechanical terms.
Such ppl regard displays of emotion as a sign of immaturity. In this way, they maintain their detached perspective on the human world and thus feel safe.
   Traditional psychodynamic therapies, which emphasize the uncovering of deeply unconscious conflicts, are extremely difficult to manage in schizoid personality disorders.
The most important goal in psychotherapy is probably the consistent use of emotional support. Medication is sometimes useful, but only as a temporary aid for reducing extreme distress.

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Schizotypal Personality Disorder

   Ppl w "schizotypal personality disorders" resemble schizophrenics, but they usually do not reveal sharp breaks w reality, such as delusions and hallucinations.
   Research offers slight support to the possibility of genetic influences in the development of schizotypal personality disorders.
For example, in Torgersen's (1984) study of co-twins, 7 out of 21 pairs of monozygotic (identical) twins were schizotypal, but only one pair out of 23 dizygotic co-twins was so diagnosed.
Schizotypal individuals have strange ways of communicating ideas, but they are not incoherent. They have great difficulty in meeting and talking w ppl. Because of their eccentric convictions, they often alienate other ppl.
   Schizotypal behavior often involves the defense mechanism of "undoing", a form of atonement in which the individual engages in various acts as repentance for undesirable and even evil motives and behavior.
In its more extreme forms, undoing may include bizarre rituals or magical arts. There are similar to the behavior that often occurs in obsessive compulsive disorder.
In this way, schizotypal individuals hope to be cleansed of unworthy motives and thoughts. Altho' they may consciously admit that their behavior is foolish, they often reach the point where they cannot control or suppress it.
   The basic approach in psychotherapy for schizotypal personality disorders is similar to that for schizoid disorder. The emphasis is on emotional support.
However, symptoms are more apt to move toward a greater distortion of reality than in the case of schizoid disorder, so antipsychotic medication may become necessary.

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Histrionic Personality Disorder

   Traditionally, "histrionic personality disorder" has been called 'hysterical personality disorder', but 'histrionic' which means "acting," "deliberately affected," and "theatrical," is a more appropriate term.
DSM-III-R specifies the following diagnostic criteria. At least four should be present to justify a diagnosis of histrionic personality disorder.
- exaggerated expression of emotion (self-dramatization)
- overconcern w physical attractiveness
- constant seeking of approval, reassurance, or praise
- inappropriately sexual seductiveness in appearance or behavior
- discomfort in situations where the person is not the center of attention
- shallow and rapidly shifting expression of emotions
- extreme self-centeredness, w no tolerance for delayed gratification
- style of speech excessively impressionistic, lacking appropriate details
   One feature of histrionic personality disorder is the strong fear of expressing sexuality. In response, histrionic individuals may employ the defense mechanism of "reaction formation", behaving in ways that are opposite from what they fear.
   Many victims of histrionic personality disorder respond well to supportive psychotherapy. The terapist must be alert to suicide threats, however, even though the majority of 'em are made for dramatic purposes.
In general, medication is not recommended, except for very short periods and in low doses, as in the case of temporary depression.

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Narcissistic Personality Disorder

   The central features of "narcissistic personality disorder" are a consistent exaggeration of self-importance and an intense preoccupation w fantasies of power and success.
Narcissistic individuals often demand a great deal of attention, provided it is completely supportive. They find it very difficult to accept criticism, often reacting w "feeling os rage, shame, humiliation, or emptiness".
Such egocentricity is also a characteristic of antisocial personality disorder.
   The exaggerated self-esteem of narcissistic individuals is reflected in their frequent use of "rationalization" to defend 'emselves against conflict, frustation, and anxiety.
   As a practical matter, many clinicians treat narcissistic individuals for specific crises reflecting a sudden loss of self-esteem rather than for the basic disorder itself.
Thus, the goals of psychotherapy are often limited, aimed mostly at bolstering self-esteem. Some therapists have found group therapy helpful. In cases where symptoms are especially severe, hospitalization and a limited use of medication may become necessary.

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Borderline Personality Disorder

   The disturbances in "borderline personality disorder" are also found in schizophrenia, which has various psychotic symptoms identically.
In psychiatric diagnosis, the concept of borderline was developed as a serious psychopathology and there are criterias to place various symptoms of borderline category.
   DSM-III-R offers the following diagnostic criteria. In Frank Costin and Juris G. Draguns's book, there are 8 characteristic of the individual's long-term behavior.
 1) Impulsivity in at least two areas of potentially self-damaging activity (for example, spending, sexual activities, gambling, drug or alcohol use, shoplifting, overeating, self-damaging behavior)
 2) Unstable interpersonal relationship -- for example, intense shifts in attitudes or self-concept or exploitation of other ppl
 3) Inappropriate expression of feelings or lack of control -- for example, frequent loss of temper or chronic feelings of anger
 4) Identify problems such as self-image, gender identity, career goals, friendships, values and loyalties
 5) Extreme shifts in mood, especially in the direction of depression, irritability, or anxiety; shifts may last from a few hours to a few days
 6) Problems w being alone -- for example, extreme fear about being alone
 7) Carrying out physically self-damaging acts, such as mutilation, involvement in frequent accidents or fights, or suicidal gestures
 8) Chronic feelings of boredom or emptiness

   A central difficulty in treatments is the acting out of problems, which may disrupt the therapeutic process. Group empathy, w emphasis on group support can be helpful.
The temporary use of various antipsychotic drugs may be necessary, especially when symptoms are acute.

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Avoidant Personality Disorder

   The central feature of "avoidant personality disorder" is an extreme hypersensitivity to being rejected. Any slight sign of disapproval is interpreted as calamitous.
Even innocuous remarks may provoke strong feelings of rejection. Individuals w long-term feelings of rejection are often reluctant to enter relationships unless they feel sure of being completely accepted.
As a defense, they may become socially withdrawn and refrain from choosing social and occupational goals that are likely to bring criticism.
Typically, their fear of rejection and their social withdrawal are coupled w the feelings of low-esteem and an exaggeration of personal shortcomings.
   A basic goal in helping individuals w an avoidant personality disorder is improving their self-image and increasing their positive relationships w other ppl.
Group psycotherapy can be especially helpful, since the setting offers a protective environment for exploring directions that are feared in everyday life.

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Dependent Personality Disorder

   The chief characteristic of "dependent personality disorder" is the imputing to others a responsibility for one's own decision and way of life.
Passivity and fear of accepting responsibility are often coupled w acquiscence to other ppl's actions that may be detrimental.
For example, the dependent person may tolerate beyond reason an extremely abusive spouse, friend, or supervisor.
   By handing responsibility to others, dependent ppl defend 'emselves against conscious recognition of their negative self-image.
Thus, they avoid the conflicts and present their basic problem.
Within this context, psychotherapy can gradually aim toward helping 'em gain insight into the basic reasons for their immediate problems. Group psychotherapy can also help dependent individuals.

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Source : ABNORMAL PSYCHOLOGY Patterns, Issues, Interventions by Frank Costin & Juris G. Draguns
Sincerely,
Devilsspeak, ARA

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