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| '''For patient information click [[Personality disorder (patient information)|here]]''' | | '''For patient information click [[Personality disorder (patient information)|here]]''' |
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| {{Infobox_Disease | | {{Personality disorder}} |
| | Name = Personality disorder
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| | MedlinePlus = 000939
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| {{SI}}
| | ==[[Personality disorder overview|Overview]]== |
| {{CMG}}
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| ==Overview== | | ==[[Personality disorder historical perspective|Historical Perspective]]== |
| {{wikinews|Dr. Joseph Merlino on sexuality, insanity, Freud, fetishes and apathy}}'''Personality disorder''', formerly referred to as a ''Character Disorder'' is a class of mental disorders characterized by rigid and on-going patterns of thought and action ''([[Cognitive module]]s)''. The underlying belief systems informing these patterns are referred to as [[Fixed fantasy|fixed fantasies]]. The inflexibility and pervasiveness of these behavioral patterns often cause serious personal and social difficulties, as well as a general impairment of functioning.
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| ==Background== | | ==[[Personality disorder classification|Classification]]== |
| Personality disorders are defined by the [[American Psychiatric Association]] (APA) as "''an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it''". <ref name = DSM>[[Diagnostic and Statistical Manual of Mental Disorders]]</ref> These patterns, as noted, are inflexible and pervasive across many situations, due in large part to the fact that such behavior is [[ego-syntonic]] (i.e., the patterns are consistent with the [[Ego Integrity|ego integrity]] of the individual), and therefore, perceived to be appropriate by that individual. The onset of these patterns of behavior can typically be traced back to the beginning of adulthood, and, in rare instances, early adolescence. <ref name = DSM/>
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| This definition allows significant [[Deviant behavior|deviance]] from [[Norm (sociology)|societal norms]], such as conscientious objection to a social regime, to be classified as a [[mental disorder]]. In the former [[Soviet Union]] and elsewhere this has been used to justify treatment of [[Political dissent|political dissidents]] as though they were psychologically disturbed.<ref name="PARANOID2002">{{cite journal | title = The labelling of dissent — politics and psychiatry behind the Great Wall | last = Lyons | first = Declan | coauthors = O'Malley, Art | journal = Psychiatric Bulletin | volume = 26 | issue = 12 | pages = 443-444 | year = 2002 | month = December | doi = 10.1192/pb.26.12.443 | issn = 1472-1473 | oclc = 46851972}}</ref>
| | ==[[Personality disorder pathophysiology|Pathophysiology]]== |
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| ==DSM-IV-TR criteria== | | ==[[Personality disorder causes|Causes]]== |
| Personality disorders are noted on [[Axis II (psychology)|Axis II]] of the [[Diagnostic and Statistical Manual of Mental Disorders]], or DSM-IV-TR (fourth edition, text revision), of the [[American Psychiatric Association]].
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| ===General diagnostic criteria=== | | ==[[Personality disorder differential diagnosis|Differentiating Personality disorder from other Diseases]]== |
| Diagnosis of a personality disorder must satisfy the following general criteria in addition to the specific criteria listed under the specific personality disorder under consideration.
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| A. Experience and behavior that deviates markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas:
| | ==[[Personality disorder epidemiology and demographics|Epidemiology and Demographics]]== |
| :# [[cognition]] (perception and interpretation of self, others and events)
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| :# [[affect (psychology)|affect]] (the range, intensity, [[labile affect|lability]], and appropriateness of [[emotion]]al response)
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| :# [[interpersonal functioning]]
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| :# [[impulse control]]
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| B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.
| | ==[[Personality disorder risk factors|Risk Factors]]== |
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| C. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.
| | ==[[Personality disorder natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| D. The pattern is stable and of long duration and its onset can be traced back at least to [[adolescence]] or early [[adulthood]].
| | ==[[Personality change due to another medical condition|Personality Change Due to Another Medical Condition]]== |
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| E. The enduring pattern is not better accounted for as a manifestation or consequence of another [[mental disorder]].
| | ==Diagnosis== |
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| F. The enduring pattern is not due to the direct physiological effects of a [[substance abuse|substance]] or a general medical condition such as [[head injury]].
| | ==Treatment== |
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| People under 18 years old who fit the criteria of a personality disorder are usually not diagnosed with such a disorder, although they may be diagnosed with a related disorder. In order to diagnose an individual under the age of 18 with a personality disorder, symptoms must be present for at least one year. [[Antisocial personality disorder]], by definition, cannot be diagnosed at all in persons under 18.
| | ==[[Personality disorder psychotherapy|Psychotherapy]]== |
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| ==List of personality disorders defined in the DSM== | | ==[[Personality disorder medical therapy|Medical Therapy]]== |
| The [[DSM-IV-TR|DSM-IV]] lists ten personality disorders, grouped into three clusters. The DSM also contains a category for behavioral patterns that do not match these ten disorders, but nevertheless exhibit characteristics of a personality disorder. This category is labeled ''Personality Disorder NOS'' (Not Otherwise Specified).
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| ''Cluster A'' (odd or eccentric disorders)
| | == Case Studies == |
| :* [[Paranoid personality disorder]]
| | [[Personality disorder case study one|Case #1]] |
| :* [[Schizoid personality disorder]]
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| :* [[Schizotypal personality disorder]]
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| ''Cluster B'' (dramatic, emotional, or erratic disorders)
| | ==Related Chapters== |
| :* [[Antisocial personality disorder]]
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| :* [[Borderline personality disorder]]
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| :* [[Histrionic personality disorder]]
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| :* [[Narcissistic personality disorder]]
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| ''Cluster C'' (anxious or fearful disorders)
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| :* [[Avoidant personality disorder]]
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| :* [[Dependent personality disorder]] (''not'' the same as [[Dysthymia]])
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| :* [[Obsessive-compulsive personality disorder]] (''not'' the same as [[Obsessive-compulsive disorder]])
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| ==Revisions and exclusions from past DSM editions== | |
| The revision of the previous edition of the DSM, DSM-III-R, also contained the ''Passive-Aggressive Personality Disorder'', the ''Self-Defeating Personality Disorder'', and the ''Sadistic Personality Disorder''. [[Passive-aggressive behavior|Passive-Aggressive Personality Disorder]] is a pattern of negative attitudes and passive resistance in interpersonal situations. [[Self-defeating personality disorder]] is characterised by behaviour that consequently undermines the person's pleasure and goals. [[Sadistic Personality Disorder]] is a pervasive pattern of cruel, demeaning, and aggressive behavior. These categories were removed in the current version of the DSM, because it is questionable whether these are separate disorders. Passive-Aggressive Personality Disorder and [[Depressive personality disorder]] were placed in an appendix of DSM-IV for research purposes.
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| ==Etiological studies==
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| A study of almost 600 male college students, averaging almost 30 years of age and who were not drawn from a clinical sample, examined the relationship between childhood experiences of sexual and physical abuse and presently reported personality disorder symptoms. Childhood abuse histories were found to be definitively associated with greater levels of symptomatology. Severity of abuse was found to be statistically significant, but clinically negligible, in symptomatology variance spread over Cluster A, B and C scales. [http://www.ingentaselect.com/vl=2446665/cl=50/nw=1/rpsv/cw/sage/08862605/contp1.htm Miller and Lisak. Journal of Interpersonal Violence. June 1999]
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| Child abuse and neglect consistently evidence themselves as antecedent risks to the development of personality disorders in adulthood. In this particular study, efforts were taken to match retrospective reports of abuse with a clinical population that had demonstrated psychopathology from childhood to adulthood who were later found to have experienced abuse and neglect. The sexually abused group demonstrated the most consistently elevated patterns of psychopathology. Officially verified physical abuse showed an extremely strong role in the development of antisocial and impulsive behavior. On the other hand, cases of abuse of the neglectful type that created childhood pathology were found to be subject to partial remission in adulthood. Cohen, Patricia, Brown, Jocelyn, Smailes, Elizabeth. "Child Abuse and Neglect and the Development of Mental Disorders in the General Population" Development and Psychopathology. 2001. Vol 13, No 4, pp981-999. ISSN 0954-5794
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| In 2005, psychologists Belinda Board and Katarina Fritzon at the [[University of Surrey]], UK, interviewed and gave personality tests to high-level British executives and compared their profiles with those of criminal psychiatric patients at [[Broadmoor Hospital]] in the UK. They found that three out of eleven [[personality disorders]] were actually more common in managers than in the disturbed criminals:
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| * [[histrionic personality disorder]]: including superficial charm, insincerity, egocentricity and manipulation
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| * [[narcissistic personality disorder]]: including grandiosity, self-focused lack of empathy for others, exploitativeness and independence.
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| They described the business people as successful [[psychopaths]] and the criminals as unsuccessful psychopaths. <ref>Board, B.J. & Fritzon, Katarina, F. (2005). Disordered personalities at work. Psychology, Crime and Law, 11, 17-32</ref>
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| ==References==
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| {{reflist|2}}
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| ==Further reading==
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| * American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders. 4th ed. (text revision). (DSM-IV-TR). Arlington, VA.
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| * Häcker, H. O. Stapf (2004). Dorsch Psychologisches Wörterbuch, Verlag Hans Huber, Bern
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| * Klausch, Tasja (2006). [http://web4health.info/en/answers/border-menu.htm ''Articles about personality disorders.''] Web4Health 2006.
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| * Marshall, W. & Serin, R. (1997) Personality Disorders. In Sm.M. Turner & R. Hersen (Eds.) Adult Psychopathology and Diagnosis. New York: Wiley. 508-541
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| * Millon, Theodore (and Roger D. Davis, contributor) - ''Disorders of Personality: DSM IV and Beyond'' - 2nd ed. - New York, John Wiley and Sons, 1995 ISBN 0-471-01186-X
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| * [http://appi.org/book.cfm?id=62214 Fatal Flaws: Navigating Destructive Relationships With People With Disorders of Personality and Character], by Stuart C. Yudofsky, M.D. ISBN 1-58562-214-1
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| ==See also==
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| * [[Anxiety disorder]] | | * [[Anxiety disorder]] |
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| * [[Personality psychology]] | | * [[Personality psychology]] |
| * [[Psychopathy]] | | * [[Psychopathy]] |
| * [[Eccentricity (behavior)|Eccentricity]]
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| * [[clinical depression|Depression]] | | * [[clinical depression|Depression]] |
| * [[List of Personality disorders]]
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| {{Mental and behavioural disorders}} | | {{Mental and behavioural disorders}} |
| {{DSM_personality_disorders}} | | {{DSM_personality_disorders}} |
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| [[Category:Overview complete]]
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| [[Category:Psychiatry]]
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| [[Category:Personality disorders]]
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| [[Category:Mental illness diagnosis by DSM and ICD]]
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| [[bar:Persönlichkeitsstörung]] | | [[bar:Persönlichkeitsstörung]] |
| [[da:Personlighedsforstyrrelse]] | | [[da:Personlighedsforstyrrelse]] |
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| [[sv:Personlighetsstörning]] | | [[sv:Personlighetsstörning]] |
| [[zh:人格違常]] | | [[zh:人格違常]] |
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| | [[Category:Psychiatry]] |
| | [[Category:Personality disorders]] |
| | [[Category:Mental illness diagnosis by DSM and ICD]] |