S PERSONALITY DISORDER

Personality is the total quality (characteristic) of an individual's thoughts, feelings, .manner, of acting (behavior or conduct) and his philosophy in life .It may be defined as the person as he known to his friends

:Type of personality :normal or adequate personality.*

There is no fixed dividing of the normal and the abnormal personality, even some . thought that; there are elements of the personality disorders in(all?) of us Whatever the difference between health and pathology may be is one of degree. More .ever, many patients only display their pathology clearly under stress ;But generally speaking adequate personality is one how .a) Plane for his life. c) Sexually mature. e) Can bear responsibility B) Control his emotions D) Bearing criticism

Personality disorders
A personality disorder refers to personality characteristics of a form of a magnitude, that are unchanging, chronic occur in most settings, deviate significantly from cultural norms and cause poor life functioning (significant impairment in social or (occupational functioning or subjective distress

Personality disorders
:Natural history
Most personality disorder develop in childhood and become fixed the early 20s, however, symptoms may become less obvious in late years, yet some occur after organic insults to the brain

Etiology
This may be the result of 1) inherited handicap or 2) faulty upbringing. They are .especially prone to develop mental illnesses

Type of personality disorders

'The general type called inadequate personality or 'mental instability (1 One of the commonest, which display a mixture of several different maladaptive traits (atypical and mixed type), show psychic immaturity and impulsiveness and is the soil from which most cases of mental disorders arise More specific types are the following (2

Cluster A. the odd or eccentric group includes the paranoid, schizoid, and
schizotypal personality disorders

Paranoid P.D
.Aloof, emotionally cold &humorless * Typically display unjustified suspiciousness (mistrust of people, exhibit over * concern for hidden motives and special meanings except to be tricked or harmed) hostility, hyper sensitivity to slights, pathological jealousy, and a fear of intimacy tend to be grandiose, rigid, unforgiving, sarcastic, contentious& litigious and are* .thus isolated and disliked accept criticism poorly (consider him self right and every one else wrong),* blaming others instead Psychotic decompensation some time occurs (usually paranoia), requiring major .tranquilizers .They rarely seek treatment. _therapy, including medication, is of little value

.Schizoid P.D
There are seclusive (loner) people have little wash or capacity to form interpersonal relations, are indifferent to and drive little pleasure from social and sexual contact, and yet prefer and can perform well at solitary activities (e.g. .(,night watchman they have limited emotional range (emotionally cold and aloof, lacking warm &* .(tender feelings), experience little pleasure (anhedonic they daydream excessively and are humorless , absent-minded (dull) and* (detached (seem to be UN related to their surroundings .They are indifferent to praise, criticism and the feelings of others* Loners" are not necessarily schizoid unless they have impaired functioning." .Treatment seems of little help

.Schizotypal P.D
;(In addition to having features of the schizoid (isolated, anhedonic, aloof* These people are "peculiar" having eccentric, strange or odd behavior,* appearance or thinking (ideas of reference & medical beliefs e.g. superstitions, clairvoyance, and telepathy as well as strange speech) yet none of these features reach psychotic proportions (peculiarities are not so severe that they can be termed (schizophrenic .Frequently anxious* It is found in3% of the population commonly occurs with major depression and is .associated with an increase incidence of schizophrenia in family members

Cluster B. The dramatic, emotional and errotic group includes histrionic,

.narcissistic, antisocial, and borderline personality disorders

.Antisocial P.O
Antisocial behavior begins in childhood or early adolescence e.g. .aggressiveness. Fighting. Poor peer relationships, irresponsibility, lying, theft, poor school

performance, runaway, inappropriate, sexual activity, physical cruelty to animal .and drugs & alcohol use

;On adulthood there will be

aggressiveness repeated physical fights or assaults, including parents,* .spouse and child abuse Inability to function as responsible parent malnutrition of a child, poor hygiene,* .lack of medical care or failure to arrange for a caretaker when away they fail at work, change job frequently and receive dishonorable discharges* .from the service .Can't maintain intimate interpersonal relationships* Lacking sensitivity to feeling of others they are egocentric, selfish and* excessively demanding and are usually free of anxiety, remorse, and guilt for .behavior that hurts others Recklessness driving while intoxicated or recurrent speeding* .Self-defeating impulsivity, hedonism, promiscuity, unreliability* Drug and alcohol abuse* (Criminality (50%of prisoners*

.Border line P.O ;They are characterized by

Anxiety, intense and labile affect, intense, inappropriate out bursts of anger and * .sarcasm .unstable and volatile inter personal relations* Identify confusion-uncertainty about self-image, gender and long- term goals* Those are most important features, in stability of mood, interpersonal relationship) .(and image Brief disturbances in consciousness (e.g. depersonalization, dissociation).* Chronic loneliness, boredom and a chronic sense of emptiness Impulsive behavior, including self injury self stimulation; recurrent suicidal* gestures &/ or attempts death by suicide occur in 8% .Hypersensitivity to abandonment* Stress can precipitate transient psychosis*

.Histrionic P.O
Histrionic patient initially seem charming, likeable, lively and attractive but ;gradually become seen as Immature, childish, emotionally, sallow &unstable with easy laughter and tears* Having attendance to over reaction to situations i.e. dramatizing like on actor on* the stage .such over reaction lead to the following two features .high suggestibility i.e. Easy influenced by persons or idea that appeal to himImitation i.e. remarkable capacity for identifying her self with other and imitatingthem they demand attention (&exhibits bored or irritated behavior with depression or* (irritated behavior if not the center of attention Egocentric (inconsiderate of others), dependent, manipulative, excitement * seeking and shallow Present a "caricature of femininity" and is sexually seductive in inappropriate* ways; yet have a limited ability to maintain stable, intimate interpersonal relationship with either sex

.Exhibitionistic and suggestible* This common disorder (2% in general population) is associated with depression, .substance abuse and conversion disorder Suicidal gestures and attempts are common .lesser impaired patient respond to .psychotherapy .Narcissistic P.O Although often symptoms free and well functioning these patients are chronically dissatisfied duo to a constant need for admiration and habitually unrealistic self-expectation They are impulsive and anxious* .Arrogant and envious* Have idea of own importance and of being a "special person" become quickly* dissatisfied with other and maintain superficial, exploitative interpersonal .relationships Under stress and when others are not adequately admiring, they may become* depressed, develop somatic complaints, and have brief psychotic episodes or .display extreme rage .Mixtures with other personality disorder are common .Long- term psychotherapy helps

Cluster C. The anxious and fearful group includes avoidant, dependent,

compulsive and passive aggressive personality disorders .Avoidant P.D The classic presentation as of an exceedingly shy, lonely, hypersensitive individual with low self-esteem who avoid (&is shy )with personal contact & social disapproval or criticism which case great to him, even though wishing to make social relations .((i.e. wish to have friends as opposed to the schizoid person .This affects performance in school, work, and life These patients are troubled by anxiety (especially social phobia) and depression .group therapy may help

Dependant P.O
These are excessively passive, unsure, lacking self confidence and see themselves as helpless, inefficient even stupid so become abnormally dependant on one or more people such aspirants or a spouse (allowing them- if having the right to allow or not? _ to direct their lives and make all of its major decisions _because they are unable to do so themselves-as; where to live, what type of employment to obtain and who to (marry they are overly agreeable with the opinions of others, even when he or she believes* they are wrong and cannot initiate things by their selves Their own needs are placed secondary to those of the people upon whom* . . they depend and will agree to do unpleasant or demeaning tasks just to gain their .approval, to avoid being alone or having to be self reliant They is pessimistic, isolated people who are hyper sensitive to & easily hurt by. .criticism or disapproval

Anxiety and depression are common, particularly if the dependant relationship is* .threatened .Obsessive-compulsive P.D These patient, frequently successful men (M: F = 2:1) are stubborn, judgmental, :perfectionist Insisting that things be done his or her way and displays an unjustified reluctant to delegate work because of fear others will not do it correctly Over conscientious and idealistic with high moral standards (making big demand * (both upon himself and upon other, good junior bad senior .Rigid, inflexible; often appears to others as unduly fussy and over strict * Over careful, indecisive (may appear to be slow owing to the weighing of the pros * and cons that precedes action, gets lost in the rules and details to the extent that the .(ultimate goal of the activity is lost .Excessively neat and tidy * Chronically anxious individuals who avoid intimacy and experience little pleasure * .from life, often perceived as cold .Finally, often much preoccupied with his health, diet and bowels * They are at risk to develop depression and perhaps obsessive-compulsive disorder. .Psychotherapy can effect changes over time