CHAPTER 7 Personality and Personality disorder Zhang Lei SIR RUN RUN SHAW HOSPITAL Good afternoon, everyone! Let’s begin from questions:

Aim Grasp the definitions of personality traits and disorders features to all personality disorders Be familiar with the psychotherapeutic and pharmacologic treatment strategies for patients with personality disorder

Personality What is personality? Personality refers to enduring qualities of an individual that are shown in his ways of behaving in a wide variety of circumstances. Mental disorder: differ from previous behaviour.

The importance of personality Personality as predisposition Personality as pathoplastic factor Personality in relation to treatment

Personality types Sociable and outgoing type vs. solitary and self-conscious type Extraversion-introversion and neuroticism (Eysenck) Fives factors: openness to experience; Conscientiousness, Extraversion-introversion, Agreeableness, Neuroticism(OCEAN)

The origins of personality Genetic influences Childhood temperament Young infants differ in patterns of sleeping and waking, approach or withdrawal from new situations, intensity of emotional responses, and span of attention. Childhood experience

The assessment of personality Personality tests are more reliable in healthy people. Useful in research, seldom used in clinical practice. The current behaviour of an ill person reflects the effects of the illness as well as the personality.

Personality disorder

The concept of abnormal personality Statistical criterion: such as intelligence Social criterion: cause individual suffer or cause suffering to others Personality change Due to organic disease of the brain After psychiatric disorder After a catastrophic experience

Koch(1891) used the term psychopathic inferiority to denote this group of people who have marked abnormalities of behaviour in the absence of mental illness or intellectual impairment. Later the word inferiority was replaced by pesonality to avoid judgemental overtones.

Classification of personality Disoeder ICD-10 DSM-Ⅳ Paranoid Schizoid Dossocial Schizotypal Emotionally unstable Antisocial Impulsive Passive-aggressive Borderline Histrionic Anankastic Obsessive-compulsive Anxious Avoidant Dependent

Classification of personality Disoeder Cluster A personality disorders Paranoid personality disorder Schizoid personality disorder Cluster B personality disorders Antisocial personality disorder Histrionic personality disorder Cluster C personality disorders Obsessive-compulsive personality disorder Dependent personality disorder Avoidant personality disorder

Descriptions and diagnostic criteria Cluster A personality disorders Paranoid personality disorder Suspicious Mistrustful Sensitive Resentful Bears grudges Self-important

Descriptions and diagnostic criteria Cluster A personality disorders Schizoid personality disorder Emotionally cold Detached Aloof Lacking enjoyment Introspective

Descriptions and diagnostic criteria Cluster B personality disorders Antisocial personality disorder Callous Transient relationship Irresponsible Impulsive and irritable Lack guilt and remorse Fail to accept responsibility

Descriptions and diagnostic criteria Cluster B personality disorders Histrionic personality disorder Self-dramatization Suggestibility Shallow, labile affect Seeks attention and excitement Inappropriately seductive Over-concern with physical attractiveness

Descriptions and diagnostic criteria Cluster C personality disorders Obsessive-compulsive personality disorder Preoccupied with details, rules Inhibited by perfectionism Overconscientious and scrupulous Excessively concerned with productivity Rigid and stubborn Expects others to submit to his ways Excessively pedantic and bound by convention Excessively doubting and cautious

Descriptions and diagnostic criteria Cluster C personality disorders Dependent personality disorder Allows others to take responsibility Unduly compliant Unwilling to make reasonable demands Feels unable to care for himself Fear of being left to care for himself Needs excessive help to make decisions

Descriptions and diagnostic criteria Cluster C personality disorders Avoidant personality disorder Feelings of tension Feels socially inferior Preoccupied with rejection Avoids involvement Avoids risk Avoids social activity

The prognosis of personality disorder Personality disorders are defined as lifelong conditions, so little change would be expected with time. There is little reliable evidence about their outcome.

Treatment Drug treatments Psychological treatments

The management of personality disorders Assessment General aims: conflicts less with their character Overall plan Choice of psychotherapy Choice of medication Organization of services progress

Thank you for your attention! 23