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Personality Disorders of Group B
- DSM-V-TR
By: Letícia Gouveia, undergraduate in Psychology.
GROUP B
Borderline Personality Disorder
Individuals go to great lengths to avoid real or imagined abandonment. They are highly sensitive to environmental circumstances. They can shift quickly from idealizing to devaluing others. They may emphasize and care for others, but usually with the expectation that the other person will be there when called, in a kind of transactional exchange to meet their own needs. Identity disturbance may occur, characterized by a pronounced and persistent instability in self-image or self-perception. Sudden and dramatic changes in self-image are often reflected in fluctuating goals, values, and vocational aspirations. Although they often have a negative self-image, they may also feel as though they do not exist. Impulsivity is evident in at least two potentially self-destructive areas, such as gambling, reckless spending, compulsive eating, substance abuse, unprotected sex, or reckless driving. Recurring suicidal behaviors, gestures, or threats, and self-harming behavior are common. Marked emotional reactivity (episodic dysphoria, irritability, or intense anxiety, typically lasting a few hours and rarely lasting more than one or two days). Chronic feelings of emptiness and painful loneliness.
Frequent expressions of inappropriate and intense anger, or difficulty controlling it. They may show extreme sarcasm, persistent bitterness, or verbal outbursts. Such expressions are often followed by regret and guilt, contributing to the feeling of being "bad." During periods of extreme stress, paranoid thoughts or transient dissociative symptoms (e.g., depersonalization) may occur.
Associated Features of Borderline Personality Disorder
Some individuals develop psychotic-like symptoms during times of stress. Individuals with this disorder may seek comfort in transitional objects (e.g., pets or inanimate objects). Premature death due to suicide is more common, especially in those with co- occurring depressive or substance use disorders. Physical disabilities can result from unsuccessful suicide attempts. Job loss, academic interruptions, and separation or divorce are common.
Development and Course Borderline personality disorder was traditionally thought to emerge in adulthood. However, it has been found that adolescents as young as 12 or 13 can meet all diagnostic criteria for the disorder.
Risk Factors and Prognosis It has been associated with high rates of childhood abuse and emotional neglect.
Genetic and Physiological Factors The disorder is about five times more common in first-degree biological relatives.
Sex and Gender Diagnostic Issues Although it is more common in women in clinical samples, community-based studies show no significant difference in prevalence between men and women.
Comorbidity Common co-occurring disorders include depressive and bipolar disorders, substance use disorders, anxiety disorders, eating disorders, post- traumatic stress disorder PTSD, and ADHD. Borderline personality disorder frequently occurs with other personality disorders.
Histrionic Personality Disorder
Excessive emotionality and attention-seeking behavior.
This sense of entitlement, combined with a lack of sensitivity to others' needs and desires, may lead to the exploitation of others, either intentionally or unintentionally. Some may intentionally exploit others for emotional, social, intellectual, or financial gain.
Antisocial Personality Disorder
Also known as psychopathy or sociopathy, for the diagnosis to be made, the individual must be at least 18 years old and have exhibited symptoms of conduct disorder before the age of 15. Specific behaviors characteristic of conduct disorder include aggression toward people and animals, destruction of property, fraud or theft, and serious rule violations. They fail to conform to social norms regarding lawful behavior. They may repeatedly engage in acts that are grounds for arrest (e.g., harassment, theft, destruction of property). A pattern of impulsivity may manifest as a failure to plan for the future. They may be irritable and aggressive, often engaging in physical fights or committing acts of violence (including against spouses or children). They demonstrate reckless disregard for their own safety and the safety of others (e.g., reckless driving). They show little remorse for the consequences of their actions. They have an inflated and arrogant self-concept. Some may exhibit a disinhibited, superficial charm and may be very talkative and verbally fluent. They are at a higher risk of premature death, both from natural causes and suicide.
Environmental Factors Risk and Prognosis) Childhood abuse or neglect, unstable or erratic parenting, and inconsistent discipline are significant risk factors.
Cultural Diagnostic Issues This disorder may be linked to low socioeconomic conditions, urban environments, childhood maltreatment, or exposure to violence.
Antisocial personality disorder is three times more common in men than in women.
Comorbidity Individuals with this disorder often present with dysphoria, including complaints of tension, an inability to tolerate monotony, and depressed mood.
