Personality disorders

1. Leereenheid 7
Learning unit 7
Persoonlikheidsversteurings
Personality disorders

2. Inleiding / Introduction
• Personality “…is a vital part of what makes us who we are and
how we interact with others”
• Persoonlikheidstrekke = Tipiese manier waarop 'n persoon
dink, voel, optree en in verhouding met die omgewing tree
Personality traits = Typical way a person thinks, feels, behaves,
and relates to their environment.
• Persoonlikheidsversteuring = onbuigbare, onvoorspelbare &
disfunksionele trekke wat betekenisvolle probleme in werk en sosiale
lewe veroorsaak Personality disorder = inflexible,
unpredictable, dysfunctional traits that cause significant difficulty in
work & social life.

3. Ander konsepte: / Other concepts:
• Psig trekke / Psych traits
• waardes, houding, motiewe / values, attitude, motives
• Psig meganisme / Psych mechanism
• Invoer / Input (sensitivity to information)
• Interpretasie & Besluitneming / Interpretation & Decision making
• Uitvoer / Output
• Binne die individu / Within the individual
• Stabiliteit & konsekwentheid / Stability & consistency
• Organisasie / Organization
• Trekke = koherente geheel / Traits are coherent whole
• Invloed / Influence
• Persoon-Omgewing interaksie / Person-Environment
Interaction
• Aanpassing / Adaptation
• Omgewing / Environment

4. Algemene kliniese beeld /
General clinical picture
Sien ook tabel 12.1 / Also see table 12.1
•Swak verhoudinge met ander / Poor relations with others
•Onvermoë om emosies te reguleer / Inability to regulate emotions
•Onbuigbare en onvoorspelbare denke en gedrag / Inflexible &
unpredictable beliefs & behavior
•'Moeilik', nie-samewerkend, weerstandbiedend / 'Difficult',
uncooperative, resistant
•Swak prognose / poor prognosis

5. Classification

6. Kluster A / Cluster A
Kern eienskappe / Core features
• Onttrekking agv vrees en angs; ongeërgdheid
teenoor ander, vreemde en eksentrieke
idees / Withdrawal due to fear and anxiety;
indifference to people, odd & eccentric ideas
• Deel simptome met skisofrenie (sonder
psigotiese simptome) / Shares symptoms with
Schizophrenia (without psychotic symptoms).
paranoied
/ paranoid
skisoied /
schizoid
skisotipies /
schizotypal

7. Paranoiëde PV / Paranoid PD
• Persepsie dat ander vyandiggesind is /
Perception that other people are hostile
• Ekstreme wantroue en hiperwaaksaamheid /
Extreme distrust and hypervigilance
• Koud en verwyderd in persoonlike verhoudinge /
Cold and distant in personal relationships
• Suspisieus oor ander se gedrag / Suspicious
of people’s behaviours
• Openlik of passief vyandiggesind teenoor
ander, lei to verwerping deur, ander wat
wantroue versterk / Overtly or passively hostile
towards people; leads to rejection from others;
reinforces suspicious beliefs

8. Skisoiëde PV / Schizoid PD
• Omvattende verwyderdheid van sosiale verhoudinge / Pervasive
detachment from social relationships
• Beperkte omvang v emosies / Restricted range of emotions
• Ekstreme self-ingekeerdheid / Extreme self-absorption
• Kom voor as ‘koud’, ongeërg, verwyderd / Appear ‘cold’,
‘indifferent’ and ‘aloof’

9. Skisotipiese PV / Schizotypal PD
• Soos skisoiede PV, emosionele verwydering en sosiale isolasie /
Like Schizoid PD, emotional detachment and social isolation
• Idees van verwysing; paranoia / Ideas of reference; paranoia
• Eksentriek: Bygelowing, preokkupasie met paranormale
verskynsels, magiese denke, en rituele / Eccentric: Superstitious;
preoccupied with paranormal phenomena, magical thinking, and
rituals.
Sterk verband met skisofrenie
/ Strong link with schizophrenia

10. Kluster B / Cluster B
Kern eienskappe / Core features
• Dramatiese, impulsiewe gedrag / Dramatic,
impulsive behaviour
• Vyandiggesind, gewelddadig, met min empatie
vir ander / Act in a hostile, violent way, with little
empathy for others
grenslyn /
borderline
histrionies /
histrionic
narsissisties
/ narcissistic
antisisaal /
antisocial

11. Grenslyn PV / Borderline PD
• Onstabiele gemoed / Unstable mood
• Onstabiele selfkonsep / Unstable self-
concept
• Gevoelens van leegheid / Feelings of
emptiness
• Impulsiewe, selfmutilerende &
selfmoordgedrag / Impulsive, self-
mutilating, and suicidal behaviour
• Onstabiele interpersoonlike
verhoudinge / Unstable interpersonal
relationships

12. Histrioniese PV / Histrionic PD
• Oordrewe emosionaliteit en
aandagsoekende gedrag / Excessive
emotionality and attention seeking.
• Oordrewe dramaties, entoesiasties en
vlerkslepend /Overly dramatic,
enthusiastic, and flirtatious
• Soek gedurig erkenning en versekering /
Seek approval and reassurance
• Baie besorg oor fisiese voorkoms / Very
concerned about physical appearance
• Dramatiseer alles / Exaggerate everything
• Oppervlakkig, selfgesentreer, veeleisend
en afhanklik / Shallow, self-centred,
demanding and dependent

13. Narsissistiese / Narcissistic PD
• Gepreokkuppeer met selfbelangrikheid en
fantasieë van mag en sukses / Preoccupied with
self-importance and fantasies of power and
success
• Min empatie / Little empathy
• Buit ander uit, arrogant / Exploit others, arrogant
• Vereis baie aandag / Require and expect a great
deal of attention.
• Jaloers op ander se sukses / Envious of
successful people.
• Spog oor eie talente / Boastful and exaggerate
their own talents.

14. Storietyd! - Story time!

15. Antisosiale PV / Antisocial PD
• Psigopatie & sosiopatie / Psychopathy’ &
sociopathy
• Miskenning v regte sonder skuldgevoel of
spyt / Violation of, and disregard for, rights
of others without showing guilt or remorse.
• Impulsief / Impulsive
• Totale miskenning v eie, en ander se
veiligheid / Total disregard for safety of self
and others
• Manipulerend en misleidend / Manipulative
and deceitful
• Finansieel & beroeps-onverantwoordelikheid
/ Financial and occupational irresponsibility
• Opgeblase & onrealistiese selfagting /
Inflated and unrealistic self-appraisal.

16. Kluster C / Cluster C
Kerneienskappe / Core features
• Angs en vrees / Anxiety & fearfulness.
• Moeilik om van as 1 versteurings te onderskei,
en het hoë ko-morbiditeit met angsversteurings /
Difficult to distinguish from Axis 1 disorders, and
have high co-morbidity with anxiety-rlated
disorders.
vermydend /
avoidant
afhanklik /
dependent
obsessief-
kompulsief /
obsessive-
compulsive

17. Vermydings PV / Avoidant PD
• Angstig, swak selfbeeld, hipersensitief teenoor
kritiek / Anxiety, low self-esteem, and
hypersensitivity to criticism.
• Vermy sosiale interaksies omdat bang vir
verwerping en kritiek / Avoid social interactions
because they are scared of rejection, humiliation,
or criticism.

18. Afhanklike PV / Dependent PD
• Oorafhanklik van andere om besluite te
neem / Overly dependent on others to
make decisions for them
• Passief en besluiteloos / Passive and
indecisive
• Ontken eie gevoelens & behoeftes om
ander nie te ontstel / Deny own
thoughts, feelings, and needs in case
they upset others.
• Vermy verantwoordelikheid / Avoid
responsibility.

19. Obsessief-kompulsiewe PV /
Obsessive-Compulsive PD
• Preokkupasie met orde, perfeksie, detail, reels
en beheer / Marked preoccupation with order,
perfection, attention to detail, rules, and
control.
• Onbuigbaar/rigied en gebrek aan openheid /
Inflexible and lack openness  poor
interpersonal relationships.
• Oorgekontroleerde emosies / Overly
controlled emotions; lack spontaneity.
• Hardkoppig, suinig, besitlik, moralisties /
Stubborn, stingy, possessive, & moralistic

20. Psigoanalitiese teorie / Psychoanalytic theory
• Psigologiese verdedigings [onbewuste breinprosesse wat ego
gebruik om interne konflik te hanteer ] / Psychological defences
[unconscious mental processes the ego uses to resolve inner conflict]
• Verdedigings as funksionele meganismes / defenses as functional
mechanisms
• In PV, intense onderliggende angs, onsekerheid, & depressie agv
onverwerkte kinderjare-trauma & disfunksionele psigologiese
ontwikkeling / In PD, intense anxiety, uncertainty & depression due to
unresolved childhood trauma & dysfunctional psychological
development
• Verdedigingsmeganismes in PV is daarom intens, maar ook
onvolwasse, onbuigbaar, wanaanpassend & self-destruktief / In PD,
defense mechanisms therefore intense, but also immature, inflexible,
maladaptive & self-destructive

21. Kindertrauma / Childhood
trauma
veral in gesinskonteks / especially in
family context:
- mishandeling / abuse
- verkragting / rape
- aggressie / aggression
- afwesigheid v positiewe rol-
modelle / lack of positive role
models
Kompensering deur destruktiewe
verd. meg / Compensation through
destructive defense mechanisms
projeksie / projection (paranoid/schizotypal)
splyting / splitting (borderline)
uitreageer / acting out (histrionic, antisocial)
selfgerigte aggressie / self-directed aggression
(borderline)
fantasiëring / fantasizing (schizotypal)
hipochondriase / hypochondriasis (dependent)
manipulering / manipulation (antisocial)
vermyding / avoidance (avoidant)
Verwerp deur ander /
Rejected by others
Versteurde selfbeeld, ander-
beeld, woede, vyandig-
gesindheid, angs & depressie
/ Disturbed self-image, other-
image, anger, hostility,
anxiety & depression