Does this sound like anyone we know?

Characteristics common to all personality disorders

Patients with personality disorders share certain characteristics:

1. Except those suffering from the Schizoid or the Avoidant Personality Disorders, they are insistent and demand preferential and privileged treatment. They complain about numerous symptoms, though they frequently second guess the diagnosis and disobey the physician, his treatment recommendations and instructions.

2. They feel unique, are affected with grandiosity and a diminished capacity for empathy. Consequently, they regard the physician as inferior to them, alienate him and bore him with their self-preoccupation.

3. They are manipulative and exploitative, trust no one and find it difficult to love or share. They are socially maladaptive and emotionally labile.

4. Disturbed cognitive and, mainly, emotional development peaks in adolescence.

5. Personality disorders are stable and all-pervasive – not episodic or transient. They affect all the dimensions of the patient’s life: his career, his interpersonal relationships, his social functioning.

6. Though the patient is sometimes depressed and suffers from mood and anxiety disorders – defenses – splitting, projection, projective identification, denial, intellectualization – are so strong, that the patient is unaware of the reasons for his distress. The character problems, behavioral deficits and emotional deficiencies and instability encountered by the patient with personality disorder are, mostly, ego-syntonic. This means that the patient does not, on the whole, find his personality traits or behavior objectionable, unacceptable, disagreeable, or alien to his self.

7. The patient is prone to suffer from other psychiatric disturbances, both personality disorders and Axis I disorders (“co-morbidity”). Substance abuse and reckless behaviors are also common (“dual diagnosis”).

8. Defenses are alloplastic: patients tend to blame the external world for their misfortune and failures. In stressful situations, they try to preempt a (real or imaginary) threat, change the rules of the game, introduce new variables, or otherwise influence the external world to conform to their needs.

9. The personality-disordered are not psychotic. They have no hallucinations, delusions or thought disorders (except those who suffer from a Borderline Personality Disorder and who experience brief psychotic “microepisodes”, mostly during treatment). They are also fully oriented, with clear senses (sensorium), good memory and general fund of knowledge.

[Editor’s note: MW thanks the person that submitted this interesting piece of information.]


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