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DISORDER
AND MANAGEMENT
Block 2.4
Carla R Marchira
Psychiatry Department
Gadjah Mada Medical School
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Learning Objectives
General : To understand the
magnitude problems of Personality
Disorder
Introduction
Personality: person’s observable behavior and his
or her subjectively reportable inner experience (Sadock &
Sadock, 2003)
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Personality Disorder and Management
Introduction
Type A : impatient, achievement-oriented people
Type B : easy-going, relaxed
Introvert : Quiet, passive, observing
Extrovert: Open, active, action
Sanguin : talkative, make friends, loud
Choleric : ambitious, leader type
Melancholic : idealis, artist, social responsibility
Phlegmatic : consistent, relaxed, observing
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Personality Disorder and Management
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Personality Disorder and Management
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Personality Disorder and Management
Classification
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Personality Disorder and Management
Etiology:
Genetic Factors:
Study of 15,000 twins in US showed among
monozygotic twins the concordance for personality
disorder several times >< dizygotic twins
Biological Factors:
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Personality Disorder and Management
Paranoid Personality Disorder
Clinical Features:
Pervasive and unwarranted tendency to interpret
other person’s action as demeaning and
threatening
Treatment:
Psychotherapy:
Treatment of choice
Straightforward
Do not use overly warm style
Group psychotherapy is not suggested
Pharmacotherapy:
Antianxiety
Small dosage antypsychotic
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Personality Disorder and Management
Schizoid Personality Disorder
Treatment:
Psychotherapy: similar with paranoid pd
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Personality Disorder and Management
Treatment:
Psychoterapy: similar with schizoid pd
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Personality Disorder and Management
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Personality Disorder and Management
Treatment:
Psychotherapy: Self-help group (among peers)
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Personality Disorder and Management
Treatment:
Psychotherapy:
treatment of choice
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Personality Disorder and Management
Treatment:
Psychotherapy: Psychoanalytically oriented
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Personality Disorder and Management
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Personality Disorder and Management
Treatment:
Psychotherapy: remain difficult
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Personality Disorder and Management
Treatment:
Psychotherapy: group therapy
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Personality Disorder and Management
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Personality Disorder and Management
Clinical Features: pervasive pattern of dependent and submissive behavior,
hard to make decision, avoid position and leadership role, pessimism, self-
doubt, passivity, fears of expressing sexual and aggressive feelings
Treatment:
Psychotherapy: treatment of choice with successful outcome
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Personality Disorder and Management
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Personality Disorder and Management
Treatment:
Psychotherapy: group therapy and behavioral therapy
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Personality Disorder and Management
Personality Disorder-Not Otherwise Specified
Passive-Aggressive Personality Disorder
Characterized by: covert obstructionism, procrastination, stubbornness,
inefficiency, negativistic pd
Treatment:
Psychotherapy: supportive psychotherapy
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Personality Disorder and Management
Depressive Personality Disorder
Characterized by: depressive spectrum, pessimistic, anhedonic, duty bound,
self-doubting, chronically unhappy, newly classified, melancholic personality
(20th century)
Course and prognosis: great risk for dysthymic and depression disorder
Treatment:
Psychotherapy: treatment of choice
Pharmacotherapy: antidepressants
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Personality Disorder and Management
Personality Change due to a General Medical
Condition
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Personality Disorder and Management
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