Personality disorders; It is a set of mental disorders characterized by disrupted behavior and thought patterns that significantly affect people's social and personal lives. Personality disorders cause distress in individuals' inner and outer worlds and limit their functionality. It upsets the person's balance. In order for the personality traits and behaviors of people to be interpreted as a personality disorder, they must cause serious adaptation problems in the person and significantly restrict/impair their functionality.
A person diagnosed with a personality disorder is very different from normal people in terms of affect. For example, the affect intensity, frequency and variability of someone with Borderline Personality Disorder, which we will talk about later, are different from normal people. It should not be surprising if someone with BPD hates you for no reason one day or is extremely angry at you, and then shows you all the love in the world the next day for no reason or for a very small reason. He/she has difficulty controlling his/her impulses such as anger and sexual desire. While a normal person waits for the appropriate place and time when he gets angry or has sexual desire and can control himself, someone with PD lacks this control. When you least expect it, he may throw a very destructive tantrum over something insignificant. Therefore, they lack social skills. They remain lonely because they create unrest in their social environment and feel uneasy.
General Characteristics
- There is no self-insight (the idea that no problem is created by them) They are not aware of the root cause of the problem.
- Most of them have interpersonal relationship problems
- It is difficult to detect at the first meeting
- They are resistant, difficult to treat and can also pose an obstacle to solving the problems.
- They are shaped in childhood.
- Settles in the early 20s
- Some may be organically caused (trauma)
- Some may be more biological / genetic E.g. Such as Schizotypal, Antisocial and Borderline
Cluster Organization in DSM-IV
1) Cluster A: odd or eccentric nature, prone to loneliness, suspicious, also borderline features
– Paranoid, Schizoid, Schizotypal
2) B Cluster: dramatic, emotional, disorganized, indecisive, impulsive, lacking empathy ability, shows borderline characteristics
– Antisocial, Borderline, Histrionic, Narcissistic
3) Cluster C: anxious, fearful, perfectionist, neurotic.
– Avoidant, Obsessive, Dependent
CLUST A
1- Paranoid PD
The main feature is, It is the interpretation of others' behavior as malicious and a constant distrust and skepticism.
- It generally begins in young adulthood and occurs under different conditions, interpreting the behavior of others as malevolent and a constant distrust and skepticism. are typical features. At least four of the following must be present.
- He suspects others of exploiting him, cheating on him, or harming himself without a sufficient basis.
- He has unjustified suspicions about his spouse's infidelity.
- Has unfounded doubts about the loyalty or reliability of friends or co-workers. A person who is invited to a meeting with friends thinks that he was invited by force, that he was invited to avoid shame.
- He does not want to tell secrets to others because he has unfounded fears that what he says will be used against him with bad intentions.
- He does not trust anyone's sincerity and is close to everyone because he doubts them. He doesn't have any friends.
- He infers from ordinary words and events that he is being humiliated or intimidated.
- He constantly holds a grudge. He perceives the fact that a friend he meets by chance does not see him as an insult to himself and can get angry. He harbors a grudge deep down.
- He judges that his character and reputation have been attacked and makes anger and counter-attacks.
- He cannot take jokes, he is touchy and gets offended immediately and immediately goes to the defense.
2- Schizoid PD
The general features of schizoid personality disorder can be defined as avoiding social relationships and preferring loneliness, emotional neutrality, dullness, indifference to people and what is happening around them. So much so that there is a distance between them even with their family members and they are considered strange and cold by other people. ar. They may experience brief psychoses in response to stress. However, if there is a condition such as accompanying depression, anxiety or substance use, they consult a psychiatrist. There are studies indicating that it is twice as common in men. The prevalence of schizoid personality disorder may be higher in relatives of those with schizophrenia or schizotypal personality disorder.
- Acts as if not part of the family; Does not engage in and does not enjoy close relationships. They spend time alone within the family. They are always in their rooms. They don't care much about what goes on at home and who comes and goes. They are reluctant to participate in family activities.
- Mostly prefer to engage in a single activity. They always engage in one activity that they can do alone. They are interested in activities that do not require humans, such as philosophy, mathematics and reading books.
- They are quite uninterested in having sexual experiences. There is no problem in having sexual desire. The reason why they do not want to have sexual experience is that dating or dating periods require too much activity and responsibility. They avoid sexual life in order to stay away from responsibility and emotional closeness, and to avoid activities such as spending time with their lovers, going to the movies, and eating. Instead, they turn to their inner world.
- Enjoys very few activities. They enjoy activities that they can do alone and that do not require a second person. They prefer to lie in bed at home and think rather than going to the cinema.
- They have no close friends or confidants. Since close friends are about spending time together, they do not have close friends at work or at school.
- He remains indifferent to praise and criticism. It doesn't matter what people say about them. They remain indifferent to good or bad comments.
- Shows emotional coldness, detachment or monotonous affect. People with Schizoid Personality Disorder are not overly cheerful or depressed. They exhibit a monotonous affect. They do not give extreme reactions; Getting angry is like fighting. They may remain unresponsive to what is happening. They are as if they are not in this world.
3-Schizotypal PD
The general characteristics are sudden discomfort in close relationships and a decrease in the ability to enter into close relationships, as well as social and interpersonal inadequacy. In addition to these, there is a widespread pattern of perceptual and cognitive distortions and unusual behavior. Sometimes they may experience psychotic episodes that last for hours. Although rare, schizophrenia or a psychotic disorder may develop.
- They have reference ideas. They attribute events that are independent of them to themselves, think that they are connected to themselves, and present various events and objects as evidence of this. They can derive meanings from letters and numbers and show them as evidence for their beliefs.
- They have strange beliefs and magical thoughts that affect behavior and are not compatible with their culture. They may claim that they have met with the Creator, that they are the Creator himself or that they are prophets.
- They have unusual perceptual experiences and physical illusions. Hallucinations and misperceptions are common. They may claim that ants are crawling in their veins, that they have sores on their face or certain parts of their body, that they have seen or touched extraordinary beings. Most of the time, these perceptual experiences are supportive of reference ideas. It is almost impossible to convince them otherwise.
- They have strange ways of thinking and speaking. They cannot establish a proper dialogue. There are four types of communication methods: Frame, over-elaboration, boilerplate, and metaphorical. When speaking, they either speak in very general terms and do not even touch upon the main topic (framewise), either they explain everything necessary and unnecessary but do not express their real thoughts, or they try to add a mystical atmosphere by responding to everything with irrelevant clichés and proverbs. At the end of the dialogue, they think that although they did not express their actual thoughts, they did what they did and the other party approved it.
- Skepticism or paranoid thoughts may be seen. People with Schizotypal Personality Disorder may show features of Paranoid Personality Disorder. They do not trust or trust anyone or anything.
- They experience inappropriate or restricted emotions. They may give inappropriate emotional reactions. They may laugh at a relative's funeral or get angry at a very normal comment.
- They have strange, unique behaviors or appearances. In general, people's clothing styles It reflects their sweat and identity. People with Schizotypal Personality Disorder are excluded from this. They can have long black hair, wear piercings, dress like metalsmiths and engage in very religious conversations. They also like to dress contrary to the general fashion perception, make strange combinations, and be unique. Wearing a classic blouse while wearing tracksuits underneath is a good example of this. Another example is not dressing appropriately for the season and occasion. While they wear shorts in winter, they can wear coats in summer.
- They do not have close friends and confidants. Not having close friends or confidants is also seen in people with Schizoid Personality Disorder, but the difference with Schizoid Personality Disorder is that Schizoids become uncomfortable with closeness after a while, while Schizotypals are insensitive to closeness and socialization. They don't mind.
- They have extreme social anxiety and paranoid fears that do not decrease. They are constantly in fear in society because of their paranoid thoughts. They are on edge because they have the feeling that danger will come at any moment. These fears are not directly proportional to their knowledge of the people they are with. No matter how well they know each other, they can never feel comfortable because their paranoid fears follow them. For this reason, they generally avoid being in social environments.
CLUSTER B
1- Borderline Personality Disorder
Their basic characteristics are in interpersonal relationships, sense of identity and They have emotional inconsistencies and difficulty controlling their impulses.
- There is a situation of making frantic efforts to avoid real or imagined abandonment. Because they are extremely afraid of abandonment, they try various ways to keep their loved ones. Extreme actions such as suicide attempts, suicide threats, and emotional exploitation are examples of this type of behavior.
- He or she has tense and inconsistent interpersonal relationships, oscillating between extremes of exaggeration and disdain. While they deify someone who has once done them a favor, a disappointment with the same person may cause the person to be hated and despised.
- Identity confusion: They may experience a distinctly and constantly inconsistent sense of self or identity. They have trouble recognizing themselves.
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