Cluster B personality disorders
These are personality disorders characterized by dramatic, overly emotional thinking or behavior and include:1.Antisocial (formerly called sociopathic) personality disorder
Antisocial personality disorder also called dissocial personality disorder pervasive pattern of disregard for and violation of the rights of others. A personality disorder (PD) is a persistent pattern of thoughts, feelings, and behaviors that is significantly different from what is considered normal within the person's own culture.
Individuals with Antisocial Personality Disorder frequently lack empathy and tend to be callous, cynical, and contemptuous of the feelings, rights, and sufferings of others.Lack of empathy, inflated self-appraisal, and superficial charm are features that have been commonly included in traditional conceptions of psychopathy and may be particularly distinguishing of Antisocial Personality Disorder in prison or forensic settings where criminal, delinquent, or aggressive acts are likely to be nonspecific.
Symptoms
- Disregard for others
- Persistent lying or stealing
- Recurring difficulties with the law
- Repeatedly violating the rights of others
- Aggressive, often violent behavior
- Disregard for the safety of self or others
Causes
Most professionals subscribe to a biopsychosocial model of causation -that is, the causes of are likely due to biological and genetic factors, social factors (such as how a person interacts in their early development with their family and friends and other children), and psychological factors (the individual’s personality and temperament, shaped by their environment and learned coping skills to deal with stress). This suggests that no single factor is responsible rather, it is the complex and likely intertwined nature of all three factors that are important.
If a person has this personality disorder, research suggests that there is a slightly increased risk for this disorder to be “passed down” to their children.
Diagnosis
There are no laboratory, blood or genetic tests that are used to diagnose antisocial personality disorder.Many people with antisocial personality disorder don’t seek out treatment. People with personality disorders, in general, do not often seek out treatment until the disorder starts to significantly interfere or otherwise impact a person’s life. This most often happens when a person’s coping resources are stretched too thin to deal with stress or other life events.
A diagnosis for antisocial personality disorder is made by a mental health professional comparing your symptoms and life history with those listed here. They will make a determination whether your symptoms meet the criteria necessary for a personality disorder diagnosis.
Treatment
Treatment of antisocial personality disorder typically involves long-term psychotherapy with a therapist that has experience in treating this kind of personality disorder.
ASPD is considered to be among the most difficult personality disorders to treat. some research on the treatment of ASPD that indicated positive results for therapeutic interventions .Schema Therapy is also being investigated as a treatment for ASPD .Multisystemic therapy (MST) could also potentially improve this imperative issue. However this treatment requires complete cooperation and participation of all family members.Therapeutic techniques should be focused on rational and utilitarian arguments against repeating past mistakes rather than attempt to develop a sense of conscience in these individuals The best treatment or combination of treatments depends on each person's particular situation and severity of symptoms.
Medications
There are no medications specifically approved by the Food and Drug Administration to treat antisocial personality disorder. However, several types of psychiatric medications may help with certain conditions sometimes associated with antisocial personality disorder or with symptoms such as aggression. These medications may include antipsychotic, antidepressant or mood-stabilizing medications. They must be prescribed cautiously because some have the potential for misuse.
2.Borderline personality disorder
Borderline personality disorder is a mental illness that causes intense mood swings, impulsive behaviors, and severe problems with self-worth. It can lead to troubled relationships in every area of a person's life.
Their mood is unpredictable and capricious. There is a liability to outbursts of emotion and an incapacity to control the behavioural explosions. There is a tendency to quarrelsome behaviour and to conflicts with others, especially when impulsive acts are thwarted or censored. Most of the time, signs of the disorder first appear in childhood. But problems often don't start until early adulthood. Treatment can be hard, and getting better can take years.
Sympoms
• Impulsive and risky behavior
• Volatile relationships
• Unstable mood
• Suicidal behavior
• Fear of being alone
Causes
Although there is no specific cause for BPD, like most other mental disorders, it is understood to be the result of a ways of think combination of factors, including temperament, childhood and adolescent experiences. Stressful experiences, such as the break-up of a relationship or the loss of a job, can lead to already present symptoms of BPD getting worse.
Biologically, individuals with BPD are more likely to have abnormalities in the size of the hippocampus, in the size and functioning of the amygdala, and in the functioning of the frontal lobes, which are the areas of the brain that are understood to regulate emotions and integrate thoughts with emotions. Although some research asserts that people with BPD seem to have areas of the brain that are more and less active compared to individuals who do not have the disorder, other.Psychologically, BPD seems to make a person more vulnerable to difficulty managing their emotions, particularly impulsive aggression. Socially, this disorder predisposes sufferers to be more likely to excessively expect to be criticized or rejected and negatively personalize disinterest or inattention from others.
Diagnois:
A person with a borderline personality disorder often experiences a repetitive pattern of disorganization and instability in self-image, mood, behavior and close personal relationships. This can cause significant distress or impairment in friendships and work.
The best method is to present the criteria of the disorder to patients and to ask them if they feel that these characteristics accurately describe them.It is usually helpful for patients with BPD to know their diagnosis.
This helps them know that others have had similar experiences and can point them toward effective treatments.
In general, the psychological evaluation includes asking the client about the beginning and severity of symptoms, as well as other questions about how symptoms impact the client's quality of life. Issues of particular note are suicidal ideations, experiences with self-harm, and thoughts about harming others. Diagnosis is based both on the client's report of his or her symptoms and on the clinician's own observations. Additional tests for BPD can include a physical exam and laboratory tests to rule out other possible triggers for symptoms, such as thyroid conditions or substance abuse.
Treatment
many people with the disorder have troubled relationships with their counselors and doctors.
Treatment includes Counseling and therapy. It's important to fnd a counselor you can build a stable relationship with. This can be hard, because your condition may cause you to see your counselor as caring one minute and cruel the next, especially when he or she asks you to try to change a behavior. Try to find a counselor who has special training in treating this disorder.
Problems with emotions and behaviors are hard to improve. But with treatment, most people with severe symptoms do get better over time.
Medications:
The use of psychiatric medications, like antidepressants may be useful in addressing some of the symptoms of BPD but do not manage the illness in its entirety. On the positive side, some women who suffer from both BPD and bipolar disorder may experience a decrease in how irritable and angry they feel. On the other hand, the use of medications in the treatment of symptoms in individuals with BPD may sometimes cause more harm than good. For example, while people with BPD may experience suicidal behaviors no more often than other individuals with a severe mental illness,and therefore great care is taken to avoid the medications that can be dangerous in overdose.
3.Histrionic personality disorder
HPD has a unique position among the personality disorders in that it is the only personality disorder explicitly connected to a patient's physical appearance. Both women and men with HPD express a strong need to be the center of attention. They have an overwhelming desire to be noticed, and often behave dramatically or inappropriately to get attention. The word histrionic means "dramatic or theatrical."
People with these disorders have intense, unstable emotions and distorted self-images. For people with histrionic personality disorder, their self-esteem depends on the approval of others and does not arise from a true feeling of self-worth. Individuals with HPD are highly emotional, charming, energetic, manipulative, seductive, impulsive, erratic, and demanding.
This disorder is more common in women than in men and usually is evident by adolescence or early adulthood.
Symptoms:
- Constantly seeking attention
- Excessively emotional
- Extreme sensitivity to others' approval
- Unstable mood
- Excessive concern with physical appearance
Causes
The exact cause of histrionic personality disorder is not known, but many mental health professionals believe that both learned and inherited factors play a role in its development. ed. However, the child of a parent with this disorder might simply be repeating learned behavior. Other environmental factors that might be involved include a lack of criticism or punishment as a child, positive reinforcement that is given only when a child completes certain approved behaviors, and unpredictable attention given to a child by his or her parent(s), all leading to confusion about what types of behavior earn parental approval. Personality disorders also usually develop in relation to individual temperament and psychological styles and ways people learn to cope with stress while growing up.Histrionic personality disorder usually begins in early adulthood.
Diagnosis
The diagnosis of HPD is complicated because it may seem like many other disorders, and also because it commonly occurs simultaneously with other personality disorders.
If signs of this personality disorder are present, the doctor will begin an evaluation by performing a complete medical and psychiatric history. If physical symptoms are present, a physical exam and laboratory tests (such as neuroimaging studies or blood tests) may also be recommended to assure that a physical illness is not causing any symptoms that may be present.psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder. The diagnosis of HPD is frequently made on the basis of an individual's history and results from unstructured and semi-structured interviews.
Treatment:
Psychotherapy (a type of counseling) is generally the treatment of choice for histrionic personality disorder. The goal of treatment is to help the individual uncover the motivations and fears associated with his or her thoughts and behavior, and to help the person learn to relate to others in a more positive way.
family therapy can support family members to meet their own needs without supporting the histrionic behavior of the individual with HPD who uses dramatic crises to keep the family closely connected.
Cognitive-behavioral therapy teaches individuals with HPD to identify automatic thoughts, to work on impulsive behavior, and to develop better problem-solving skills. Medication might sometimes be used as supplemental treatment for distressing symptoms that might occur with this disorder, such as depression and anxiety.
Medications
Medication might sometimes be used as supplemental treatment for distressing symptoms that might occur with this disorder, such as depression and anxiety.
Pharmacotherapy is not a treatment of choice for individuals with HPD unless HPD occurs with another disorder. For example, if HPD occurs with depression, antidepressants may be prescribed. Medication needs to be monitored for abuse.
4.Narcissistic personality disorder
Narcissistic personality disorder is thought to be less common than other personality disorders .As with other personality disorders, this disorder is an enduring and persistent pattern of behavior that negatively impacts many different life areas including social, family, and work relationships.
People with narcissistic personality disorder are frequently perfectionists and need to be the center of attention, receiving affection and admiration, and controlling the situation. To get the attention he craves, he may try to create crises that return the focus to him. He feels that the world owes him, regardless of whether he makes a contribution.
A patient with a personality disorder frequently uses AODs to relieve her symptoms: to raise self-esteem, decrease feelings of guilt and amplify feelings of diminished individuality use of drugs, particularly stimulants. As a disinhibitor, alcohol may help lower anxiety and alleviate depression. A shy person with narcissistic personality disorder may depend on marijuana to relieve her social anxiety, while others use. In a crisis, she may become severely depressed.
Symptoms:
- Believing that you're better than others
- Fantasizing about power, success and attractiveness
- Exaggerating your achievements or talents
- Expecting constant praise and admiration
- Failing to recognize other people's emotions and feelings
Causes
Although onset of the disorder is usually early adulthood, it is likely to be in response to childhood experiences.Childhood experiences such as parental overindulgence, excessive praise, unreliable parenting, and a lack of realistic responses are thought to contribute to narcissistic personality disorder.
Diagnosis:
Narcissistic personality disorder are typically diagnosed by a trained mental health professional, such as a psychologist or psychiatrist.
It explores thoughts, feelings, relationships, behavior patterns and family history, which may include psychological tests about personality. He or she asks about symptoms, including when they started, how severe they are, how they affect daily life and whether similar episodes have occurred in the past. The doctor also asks about thoughts of suicide, self-injury or harming others.
There are no laboratory, blood or genetic tests that are used to diagnose personality disorder.
A diagnosis for narcissistic personality disorder is made by comparing your symptoms and life history
Treatment
People with this disorder rarely seek out treatment. Individuals often begin therapy at the urging of family members or to treat symptoms that result from the disorder.
Therapy can be especially difficult because clients are often unwilling to acknowledge the disorder. Psychotherapy may be useful in getting the individual with narcissistic personality disorder to relate to others in a less maladaptive manner. The following guidelines may help therapists working with these patients, especially those who are also AOD-dependant.
Cognitive-behavioral therapy is often effective to help individual's change destructive thinking and behavior patterns. The goal of treatment is to alter distorted thoughts and create a more realistic self-image. Psychotropic medications are generally ineffective for long-term change, but are sometimes used to treat symptoms of anxiety or depression.
Medications
Patients with narcissistic personality disorder often benefit from the use of psychiatric medications to help alleviate certain symptoms associated with the disorder, such as depression, anxiety, transient psychosis, mood lability, and poor impulse control. In addition, many patients with narcissistic personality disorder have concomitant Axis I diagnoses for which they are taking regular psychiatric medication.
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