The lecture has been given on Feb. 22nd, 2011 by Dr. Hazhar.

1. PersonalityDisorders Dr.Abdulrahman Othman maroof Facharzt für Psychiatrie & Psychotherapie Germany

2. Personality: the sum of an individual’s emotional, cognitive, and behavioral traits. Relatively stable, leads to predictable behavior. Biopsychosocialdetermened: genetic, development, education, role models, religion, culture, nation,etc..

3. Personality: typically well formed and stable by adolescence or early adulthood. Personality continues to evolve and change throughout life, in response to various biopsychosocial factors. recurrent stress over prolonged periods of time : produce significant long-term personality changes.

4. Personality disorder: stable, long duration. Clinically: significant subjective distress or impairment in social, occupational, or other important areas of functioning. Onset: adolescence or early adulthood.Inflexible,maladaptive and pervasive. Prevalence :10% to 15% in the general population. Borderline personality disorder is the most common, occurring in 2% . ego-dystonicvsego-syntonic

5. PD: Maskedthrough a successful and happy life, then appears later in life by exacerbation after a major stressor or loss, e.g. divorce, Loss of job, etc.. Diagnosis also before 18 th year of age, except antisocial PD. Spontaneous remission with adulthood,daher cautious!

6. DSM classification: Cluster A (odd and eccentric): paranoid, schizoid, and schizotypal. Cluster B (dramatic and emotional): antisocial, borderline, histrionic, and narcissistic. Cluster C (anxious and fearful): avoidant, dependent, and obsessive-compulsive

7. Paranoid PD:globally suspicious. No delusion, no hallucination, no flatening of affect. SchizotypalPD: generally suspicious, paranoid ideation; odd or unusual beliefs, perceptual experiences, odd thinking, speech, and behavior. Schizoid PD: isolated life style without any desire for close interpersonal relationships, indifferent to the praise or criticism of others.

8. Antisocial PD: violate society’s legal & ethical systems. handguns, poverty, lack of education, substance abuse. Lack of parenting skills, physical abuse and family discord, alcoholism in the parents. Men > women. .Intermittent explosive disorder: an impulse control disorder, episodes of loss of control. few or no signs of general impulsiveness or aggressiveness between episodes.

9. Borderline PD: affective instability +intense dysphoria, irritability, or anxiety. Instable self-image in sexuality, occupation or politics. Abandonment fear. Narcissistic PD: typical is a feeling of being “special” & having grandiose fantasies. subtypes: high functioning/exhibitionist , fragile narcissist, the grandiose/malignant narcissist. Avoidant PD: shy, ,anxious and hesitant, very sensitive to criticism or rejection , decreased selfesteem.

10. Obsessive Compulsive PD:a lot of attention to morals, ethics, and values,applies them rigidly. Control themselves and those around them. Sensitive to position and status. course and prognosis of PD: without therapy, less evident or “burn out”, others over time more-or-less constant ,others more marked with age.

11. Management: Psychotherapy: (individual, group, and couples/family). Symptom-targeted pharmacotherapy: neurolepticsin the treatment of thought disorders, anxiolyticsbyanxiety symptoms.; antidepressants and mood stabilizing.

12. No evidence that personality disorders can be “cured.” Treatment of personality disorders is often difficult and may require much time (e.g., years) for significant alterations to occur.