I- DEFINITION :
The personality according to the WHO is a structured mode of thought, feeling or behavior that characterizes the type of adaptation and lifestyle of a subject and that results from constitutional factors of its development and its social experience .
Definition of pathological personality (selon DSM IV.R) :
A- sustainable modality of lived experience and behavior that deviates markedly from what is expected in the culture of the individual.
This deviation is evident in at least two of the following :
1- La cognition.
3- Interpersonal functioning.
4- Impulse control.
B- These enduring pattern is inflexible and envahisent personal situations and very different social.
C- The enduring pattern leads to clinically significant distress or impairment in social functioning , occupational, or other important areas.
D- This mode is stable and extended and its first manifestations are detectable in later adolescence or early adult age.
E- This table is not better explained by events or consequences of another mental disorder.
F- The enduring pattern is not the direct physiological effects of a substance (eg a drug of abuse or a medication) or a general medical condition (eg head injury).
The disorders are classified by DSM IVr number ten in three main groups defined on the basis of common characteristics :
II- MAIN PATHOLOGICAL PERSONALITIES :
A- group A :
1- paranoid and sensitive personality :
- Hypertrophy of the Self.
- Falsity of judgment and the & rsquo; & rsquo absence; self-criticism.
- Mistrust towards others and susceptibility
- sensitive : hyperesthesia social contacts permanent introspection, ruminations on true or imagined humiliation
2- schizoid and schizotypal personality :
– schizoid personality Disorder : rich imaginary withdrawal life, poverty and oddity contact downtrend in , Poverty affects with apparent coldness , reduced interest in sex , trend conscious reverie , taste for abstract thoughts membership of mystical beliefs , bizarre metaphysical or philosophical.
– schizotypal : entity may precede the development of chronic psychosis.
B- Group B :
1- histrionic :
histrionics : theatricality (clothing, makeup, finery) hyper expressive facial expressions .
Hyperresponsiveness and emotional control default accented by the frustrations and disappointments, avoidance of sexuality or otherwise apparent hypersexuality masking fear, disgust and frigidity.
2- narcissistic personality :
Fashion general operating Grandiose Type (in fantasies or behavior) characterized by a lack of empathy and an exaggerated sensitivity to the judgment of others.
3- borderline personality (Borderline) :
Pathology of the relationship : Failure to take account of ego boundaries and the other leading to chaotic interpersonal relationships marked by alternating idealization and dependence dévaloralosation and hostility , and agonizing fear of being abandoned ,chronic feelings of emptiness and bored and impulsivity is often most .
The progressive complications :
→ Depressive episodes with shift to self-injurious act repeated (automutilations ; TS…)
→ of existential feeling bored, vacuum and abandonment.
→ Eating Disorders (bulimic episodes) and sexual(risky sexual behavior)
→ Episode acute psychotic.
4- antisocial personality Disorder : characterized by :
→ Intolerance to frustration.
→ Switching to easy act (Stirring crisis,TS, self harm, heteroaggressive gesture) without anticipating the consequences or guilt feelings.
→ addictive behavior (alcoholism, substance addiction, drug abuse. )
C- Group C :
1- Obsessive compulsive personality : with
→ excessive order needs (excessive attachment to objects, worries exaggerated cleanliness, conscientiousness, loyalty, perfectionism)
→ Obstinacy and stubbornness :
→ Reasons of economy and collecting.
2- avoidant personality : characterized by :
→ Sensitivity rejection, avoidance of social contact for fear of being rejected, exaggerated timidity, inhibition sociale.
The progressive complications : pathological shyness and social phobia, depression , anxiety disorders , substance abuse .
3- dependent personality : characterized by :
S abnormally subjected Topic, needs reassurance, living in fear of being abandoned, can tolerate difficult situations or dependent to avoid being confronted has autonomy (Ex : about supporting violence by their spouse to avoid losing the
III- THE MAIN EVALUATION INSTRUMENTS :
The tests psvchométriques :
→ MMPI (Inventory Minnesota Multiphasic Personality)
Projective Tests :
→ Le test Rorschach
→ T AT (Thematic Apperception Test).
→ The frustration Rosenziveig test
IV- THERAPEUTIC PRINCIPLES :
→ Chemotherapy : target symptomatic treatment (anxiety attack, depressive reaction, delirious emergence, impulsiveness )
→ antidepressants : la fluoxetine.
Atypical antipsychotics at low doses : Amisulpride 50 mg
Prof. O's course. BENELMOULOUD – Faculty of Constantine