Li Meixiu (Ellen)

JMS University
 Chapter 9
Disorders of adult personality & behavior
Personality

• Deeply ingrained pattern of behavior that include

modes of perception ,relating to & thinking about
oneself & the surrounding environment.
Personality

• a complex mix of traits & behaviors.

• personality -- relationship with the world.
• A man’s usual thought process & interaction with
his environment are what makes him “himself.”
 Personality traits
• Normal ,prominent aspects of personality .
• Abnomal ---personality disorder
inflexible & maladaptive
impairment / subjective distress
 Personility disorder
• 5~10%
• Mixed --------comorbidity
• Single --------pure
 Diagnosis
• Diagnosis – subjective
• Conditions not directly attributable to
gross brain damage/disease
another psychiatric disorder
 Personality Disorders
character disorders, are a class of personality styles
which deviate from the contemporary expectations
of a society.
 Personality Disorders
inflexibile & pervasive behavioral patterns –
difficulties / functional impairment.
Rigid & on-going patterns of feeling, thinking &
behavior are said to be caused by underlying belief
systems -- fixed fantasies or "dysfunctional
schemata" (Cognitive modules).
 General diagnostic criteria
A. Experience & behavior that deviates markedly
from the expectations of the individual's culture.
cognition (perception & interpretation of self, others
& events)
– affect (the range, intensity, lability & appropriateness of
emotional response)
– interpersonal functioning
– impulse control
 Cluster A (odd or eccentric disorders)
• Paranoid personality disorder: irrational suspicions &
mistrust of others. 1/3.
• Schizoid personality disorder: lack of interest in
social relationships, seeing no point in sharing time
with others
• Schizotypal personality disorder: odd behavior or
thinking
 Cluster B (dramatic, emotional, or erratic disorders)
• Borderline personality disorder: extreme "black & white"
thinking, instability in relationships, self-image, identity &
behavior 1~2%

• Histrionic personality disorder: " attention-seeking behavior

including inappropriate sexual seductiveness & shallow or
exaggerated emotions"

• Narcissistic personality disorder: grandiosity, need for

admiration & a lack of empathy 疑病
• Antisocial personality disorder: " disregard for the law &
the rights of others."
 Antisocial personality disorder (ASPD)
• Deceit & manipulation are considered essential
features of the disorder.
• 18 or older + conduct disorder history before 15y.
• "sociopaths" & "psychopaths"
 Antisocial Personality Disorder -- Diagnostic criteria
• Failure to conform to social norms with respect to
lawful behaviors : repeatedly performing acts that
are grounds for arrest;
• Deceitfulness: repeatedly lying, aliases, or conning
others for personal profit or pleasure;
• Impulsivity or failure to plan ahead;
• Irritability & aggressiveness: fights or assaults;
• Reckless disregard for safety of self or others;
• irresponsibility: work behavior or honor financial
obligations;
• Lack of remorse 懊悔 : being indifferent to or
rationalizing having hurt, mistreated, or stolen from
another.
 Symptoms
• Persistent lying or stealing
• Superficial charm
• remorse or empathy; hurting others
• jobs / school
• Impulsivity and/or recklessness
• Lack of realistic, long-term goals –
• Friends / relationships such as marriage
• Poor behavioral controls -- irritability, annoyance,
impatience, threats, aggression, abuse
• Narcissism, elevated self- entitlement
• agitated or depressed feeling (dysphoria烦躁 )
• conduct disorders history
• Recurring difficulties with the law
• violate the boundaries & "rights" of others
• Substance abuse
• Aggressive, often violent behavior; fights
• Inability to tolerate boredom
• Disregard for the safety of self or others
• experience difficulties with authority figures.
 Cluster C (anxious or fearful disorders)
• Avoidant personality disorder: social inhibition,
feelings of inadequacy, extreme sensitivity to
negative evaluation & avoidance of social
interaction
• Dependent personality disorder: psychological
dependence on other people.
• Obsessive-compulsive personality disorder 十全十美
(≠obsessive-compulsive disorder): rigid conformity
to rules, moral codes & excessive orderliness
 Enduring personality changes, not
attributable to brain damage & disease
• without previous personality disorder following
exposure to catastrophic or excessive prolonged
stress, or following a severe psychiatric illness.
 Habit & impulse disorders
• Pathological gambling
• Pathological fire-setting [pyromania]
• Pathological stealing [kleptomania]
• Trichotillomania
• Gender identity disorders
• Disorders of sexual preferece
• Psychological & behavioral disorders associated
with sexual development & orientation
• Factitious disorder(munchausen syndrome) 病理谎言
 Disorders of sexual preference
• Fetishism
• Fetishistic transvestism
• Exhibitionism
• Voyeurism
• Paedophilia 童
• Sadomasochism 虐
• Multiple disorders of sexual preference
• Other disorders of sexual preference
• Disorder of sexual preference, unspecified
Psychological & behavioural disorders associated with
sexual development & orientation
• Sexual maturation disorder
• Egodystonic sexual orientation 自我排斥
• Sexual relationship disorder
• Other psychosexual development disorders
• Psychosexual development disorder, unspecified
Chapter 11 Sleep Disorders
 sleep disorder (somnipathy)
• medical disorder of the sleep patterns of a person .
• interfere with normal physical, mental & emotional
functioning.
• polysomnogram.
 COMMON TYPES
• Insomnia:
• Bruxism: grinding or clenching of the teeth
• Delayed sleep phase syndrome (DSPS): awaken &
fall asleep , 能 sleep maintenance, a disorder of
circadian rhythms.
• Hypopnea syndrome: shallow or slow breathing
• Narcolepsy: daytime sleepiness
• Cataplexy, a sudden weakness in the motor
muscles that can result in collapse to the floor.
• nocturnal myoclonus 肌阵挛 .
• Rapid eye movement behavior disorder (RBD):
Acting out violent or dramatic dreams in REM sleep
• Restless legs syndrome (RLS): An irresistible urge
to move legs.
• Situational circadian rhythm :
shift work sleep disorder (SWSD) & jet lag
• Night terror 夜惊
• Parasomnias异态睡眠 : sleep actions - sleep walking &
night-terrors.
• Periodic limb movement disorder (PLMD): Sudden
involuntary movement of arms and/or legs during
sleep ： kicking the legs.
Psychiatry