![]() ![]() Psychotherapy, however, may be difficult for an individual with a PD because they may be reluctant to build a trusting relationship with the therapist. Psychotherapy (individual, group, or family) is directed towards management of the disorder, including education about the illness, support, and social skills training. Depending on the PD, pharmacological interventions can be targeted at reducing impulsivity ( e.g., olanzapine, neuroleptics) and depression ( e.g., serotonin reuptake inhibitors) antipsychotics may be used in cases of distorted thinking. Overall, there is no cure for a PD, but treatments are available to improve prognosis. ![]() Because onset of PDs is usually in adolescence, a time when the personality stabilizes and matures, individuals with PDs are prone to developing maladaptive coping mechanisms and low self-esteem. 127, 128, 129 Social factors, such as parental neglect, overprotection, or abuse may contribute to personality or other psychiatric problems in children. A genetic vulnerability to developing a PD has also been suggested. Researchers believe that a specific situation or event ( e.g., loss of a parent or friend) can trigger the behaviours common in PDs, particularly events in early childhood that have the potential to influence behaviour in later life. The causes of developing a PD are unknown. 7 PD diagnoses apply only to the completely formed personality, thus, they are rarely made before age 18 and are therefore not usually assessed in children and adolescents. 7 Specific (types of) PDs require their own criteria, which are presented in the DSM-IV manual. The pattern cannot be due to another mental disorder, or due to the physiological effects of a substance or a general medical condition. Evidence of the PD must have been present in at least adolescence or early adulthood, with a stable pattern of long duration. In addition, the pattern must be pervasive and inflexible across a wide range of personal and social situations, and cause clinically significant distress in social, occupational, or other areas of functioning. The DSM-IV diagnoses a PD if an individual exhibits maladaptive behavioural and cognitive patterns which are evident in at least two of the following areas: cognition, affectivity, interpersonal functioning, or impulse control. 7 The course of a PD is relatively stable over time. It is possible for a PD to become exacerbated after the loss of a significant supporting person or situation. 126 PDs typically become recognizable by adolescence or early adulthood, although some individuals may not seek clinical attention until much later. 125, 126 The most common of the PDs are obsessive-compulsive (with a prevalence rate of 7.7% according to DSM-IV criteria), avoidant (6.6%), paranoid (5.6%), borderline (5.4%), and schizotypal (5.2%). PDs affect between 6% and 15% of the population. 7 The functional limitations associated with all personality disorders are similar in terms of attribute levels, therefore only one health state is described for an individual diagnosed with an unspecified personality disorder. ![]() According to the DSM-IV, 7 there are ten PDs that are distinctively diagnosed and are grouped into three clusters based on descriptive similarities: Cluster A includes Paranoid, Schizoid, and Schizotypal PDs-individuals with these disorders likely appear odd or eccentric Cluster B includes Antisocial, Borderline, Histrionic, and Narcissistic PDs-individuals with these PDs often appear dramatic, emotional or unpredictable Cluster C includes Avoidant, Dependent, and Obsessive-Compulsive PDs-individuals with these disorders tend to appear anxious or fearful. Their personality traits ( i.e., attitudes, thoughts, behaviours, temperament) are expressed inappropriately and become maladaptive. 69 Ultimately, individuals with a PD have difficulties with interpersonal relationships, and often demonstrate irritability, hostility, and fearfulness. PDs are considered a major mental health problem because of their prevalence and the disability they produce. ![]() ArchivedĪ personality disorder ( PD) is characterized by a stable pattern of inner experience and behaviour that deviates significantly from the expectations of society, and can lead to marked impairments in social and occupational functioning. Please " contact us" to request a format other than those available. It is not subject to the Government of Canada Web Standards and has not been altered or updated since it was archived. Information identified as archived is provided for reference, research or recordkeeping purposes. ![]()
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