Personality Disorders

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Abstract

            There exist different disorders that affect the lives of many individuals across the world. Among the disorders, include a personality disorder described as an enduring pattern of inner experience as well as behaviors that differ significantly from the expectations of an individual's culture. Besides, the experience and behavior is often pervasive and inflexible and lead to distress or impairment. Notably, the most common etiologies of personality disorders are multifactorial. Nevertheless, the conditions may at times be secondary to biologic, genetic abnormalities or developmental. Some individuals may be engaged in stressful situations based on different health or social variables, which may, in turn, result in decompensation hence revealing an unrecognized personality disorder. Stressors, external or self-induced factors may aggravate personality disorders, and some individuals may have more than one personality disorder. The types of personality disorders depend on the causes and manifestations of a particular disorder. Therefore, this paper looks into different aspects of personality disorders ranging from definition to treatment mechanisms.

Personality Disorders

            Personality disorders are a set of mental illness that characterizes enduring patterns of behavior, inner experience, and cognition, demonstrated through many frameworks and deviating evidently from the ones that an individual’s culture accepts. The disorder is a new diagnosis in mental health field and links to a person’s personality. The current health care systems recognize the disorders in the spectrum of mental health diagnosis and as treatable conditions. Individuals have a unique personality that characterizes different traits that determine what they are as well as their interactions with other people. An individual personality disorder may relate to his/her pattern of behavior, impulsiveness, moods or social interaction. Those with the conditions may find it difficult to maintain close relationships, experience chronic interpersonal problems and find it difficult to establish a coherent sense identity or self. Personality disorder accompanies self-harm, drug use, eating disorders, sexual problems, suicidal attempts and mood disorders among others.

Diagnosis Criterion of Personality Disorders

            The diagnosis of personality disorders can help in preventing series of difficulties relating to the disorder. The diagnosis may be controversial given the nature of the disorders. The stigma surrounding the condition as well as the extent of discrimination against those suffering from the disorders characterize such difficulties. The diagnosis reflects ways of understanding emotional distress as well as various strategies for coping and symptoms within the context of an individual rather than a wider social context. As such, the diagnosis of personality disorders should be based on the DSM-IV and CD-10 Classification of Mental and Behavioral Disorders (Bender et al., 2011)

History of Personality Disorders

            The history of PD traced to Hippocrates who outlined four essential body fluids associated with particular personality patterns such as black bile indicating melancholia (Vaknin, 2009). The theory was physiological with some association of environmental variables such as temperature and climate. The only type of mental illness, delirium during the 18th centuries included psychoses, depression, and delusions. The beginning of the 19th century saw the emergence of insanity without delusions characterizing patients with no impulse control being prone to outbursts of violence hence psychopaths (Vaknin, 2009). In 1835, researchers such as J. C. Pritchard described different ideas of antisocial behaviors and moral insanity. After many years, there was an emergence of a system of classification, which provided a differential diagnosis of mental illness without delusions (Vaknin, 2009). The modern history of PD links the work of Pritchard describing the disorder as a moral insanity.

Causes of Personality Disorders

            There are different causes of personality disorders. Various research studies outline that genetics, abuse, as well as other factors, contribute to the development of narcissistic, obsessive-compulsive or other personality disorders. New medical research practices recognize and explore potential causes of personality disorders such as genetics, peer influences, and parenting. Based on individual’s genes, some personality traits may be passed on by parents through inherited genes. On the other hand, the environment where one grows in, occurring events and relationships with family members among others may also lead to the development of personality disorders. The combination of genetic and environmental influences causes the disorders. Other causes of personality disorders include verbal abuse, high reactivity, and childhood trauma.

Symptoms of Personality Disorders

            There are various types of personality disorders, and they are grouped into three clusters, which differ in characteristics and symptoms. An individual with a particular personality disorder may also experience signs and symptoms of at least another disorder. Personality disorders in cluster A include paranoid personality, schizotypal personality and schizoid personality disorders (Skodol et al., 2011). Their symptoms include pervasive distrust, beliefs that some people wants to harm an individual, hostile reactions, tendency to hold grudges among others; flat emotions, magical thinking, indifferent or suspicious response to others, peculiar dress, speech or behavior and social anxiety among others.  Little or no interest in sexual activities, cold appearances, limited emotional expressions and preference to being alone also depict the symptoms.

            Cluster B personality disorders include antisocial personality disorder with symptoms such as disregard for the needs and feelings of others, breaking the law, recurring violations of the rights of other people, aggressiveness, impulsive behavior and lack of remorse (Skodol et al., 2011). The cluster also entails borderline, histrionic and narcissistic personality disorders. Borderline symptoms encompass stress, many display of anger, fragile self-image, intense fear and suicidal behaviors. Besides, Histrionic symptoms include rapid changing emotions, strong opinions, seeking attentions, and being at high risk of others’ influences. On the other hand, Narcissistic symptoms include arrogance, belief of being special, increased fantasies about power, the envy of others and failure to recognize the feelings and needs of others. Cluster C personality disorders include dependent personality, avoidant personality and obsessive-compulsive personality disorders (Skodol et al., 2011). The symptoms of the disorders include being sensitive to criticism, fear of disapproval, feeling inferior, excessive dependence, clingy behavior, tolerance of abusive treatment, rigid, being in control of others and extreme perfectionism among others.

Types of Personality Disorders

            Personality disorders manifest in different ways. The American system of diagnosis identifies ten various types of personality disorders grouped in 3 clusters as shown in the table below.

Suspicious

Emotional and Impulsive

Anxious

Paranoid

Schizotypal

Schizotypal

 

Antisocial

Borderline

Histrionic

Narcissistic

Dependent

Avoidant

Obsessive-compulsive

 

 

Preventions of Personality Disorders

            Early intervention and preventions of personality disorders aim at altering the life-course trajectory of individuals who suffer from different types of the disorders. The prevention should focus on early diagnosis and medical examinations. The prevention should demarcate a particular group of people with high level of current as well as future morbidity. Other preventive measures include early treatments and participating in family therapy to help in learning healthy ways to cope with conflicts and emotional distress (Bateman & Tyrer, 2004). Notably, various preventive plans depend on the type of personality disorder.

Treatment Plan for Short-Term Goals and Long-Term Goals

            It is hard to treat personality disorders given the existence of self-denial about the presence of the condition as well as the pessimism of health professionals given the availability of previous efforts to base their diagnosis and treatment plan (Bateman & Tyrer, 2004). Group psychotherapy with a combination of mood stabilizers and anti-depressants can be effective for some individuals. Nevertheless, the persistence of the symptoms of personality disorders and their negative impacts on therapeutic relationships adversely affect the treatment plan (Bateman & Tyrer, 2004). Notably, people with borderline personality disorders often engage in more hospital visits, the use of outpatient psychotherapy and emergency visits than those having other forms of personality disorders. The treatment plan entails both short-term and long-term goals.

Suggestions for Overcoming Personality Disorders

            An individual may feel defensive about the treatment or rather think that the treatments are unnecessary. The nature of personality disorders can leave one feeling that therapy is not worth his/her attention and time (Anderson, 2006). Nevertheless, there are different strategies that an individual may employ to overcome the disorders. As such, there is a need to keep an open mind while focusing on the benefits of treatment, stick to the treatment plan by attending scheduled therapy sessions and learn more about the disorder to understand its symptoms, treatments and risk factors. Besides, one should get treatment for other mental health problems, learn relaxation, and stress management techniques to help in calming down, and stay focused on the preventive and treatment goals.

Parenting Skills to Help Individuals

            Parenting skills to help individuals with personality disorders should focus on advising and helping those affected to seek appropriate treatment plans and diagnosis (Anderson, 2006). When there are signs of improvements in an individual’s status, parenting skills should help family members reduce the risk of relapse.

Evidence-Based Therapies for Personality Disorders

            Evidence-based psychological interventions entail a complex combination of technical and relational skills as well as research sources of evidence to help in identifying treatment efficacy. It calls for the application of empirical principles and systematic observations to carry out accurate assessments of personality disorder and as such, develop diagnostic formulations and select adequate treatment therapies based on a patient’s unique requirements (The Australian Psychological Society, 2010). The therapies include cognitive behavior therapy to help change behavior, interpersonal psychotherapy to help address interpersonal issues, narrative therapies, family therapy and acceptance and commitment therapy among others (The Australian Psychological Society, 2010).

Conclusion

            Personality disorders are a set of mental illness that characterizes enduring patterns of behavior, inner experience, and cognition demonstrated through many frameworks. Its history traced to Hippocrates who outlined four essential body fluids associated with particular personality patterns such as black bile indicating melancholia and deviating evidently from the ones that an individual’s culture accepts. The diagnosis of personality disorders help in preventing difficulties relating to the disorder, and it may be controversial given the nature of the disorders. It should be based on the DSM-IV and CD-10 Classification of Mental and Behavioral Disorders.

            Genetics, abuse and other factors, contribute to the development of narcissistic, obsessive-compulsive or other personality disorders hence among the causes of personality disorders. The symptoms of personality disorders depend on the type of the disorder in questioned. The types are shown in the table above. Early intervention and preventions of personality disorders help in altering the life-course trajectory of individuals who suffer from different kinds of the disorders. They should focus on early diagnosis and medical examinations. Among another preventive measure, include early treatments and participating in family therapy. Parenting skills, adequate treatment plans, and evidence-based treatments also help in addressing the disorders. It is therefore essential to take sufficient and appropriate care to help those suffering from personality disorders.

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