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Mental Disorder

Page history last edited by Henry T. Hill 1 year, 8 months ago

Personality Disorders from Cleveland Clinic

 

Personality disorders Mayo Clinic

 

A personality disorder is a mental health condition that involves long-lasting, all-encompassing, disruptive patterns of thinking, behavior, mood and relating to others. There are 10 types of personality disorders, each with different characteristics and symptoms.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Cluster A personality disorders: Paranoid personality disorder, Schizoid personality disorder, Schizotypal personality disorder.

Cluster B personality disorders: Antisocial personality disorder (ASPD), Borderline personality disorder (BPD), Histrionic personality disorder, Narcissistic personality disorder 

Cluster C personality disorders: Avoidant personality disorder, dependent personality disorder, Obsessive-compulsive personality disorder (OCPD)

People might have mixed symptoms of more than one personality disorder. 

 

General list: Paranoid, Narcissistic personality disorder (NPD),  schizophrenia, schizoaffective disorder, anxiety, panic disorder obsessive-compulsive disorder (OCD), phobias, panic disorder, generalized anxiety disorder (GAD), social phobia

 

Narcissistic Personality Disorder

 

What are the characteristics of a person with narcissistic personality disorder? 

Narcissistic personality disorder involves a pattern of self-centered, arrogant thinking and behavior, a lack of empathy and consideration for other people, and an excessive need for admiration. Others often describe people with NPD as cocky, manipulative, selfish, patronizing, and demanding.

Here Are 4 Different Types of Narcissists:

  • 1 — Grandiose Narcissist. “I'm better than you, and I know it” ...
  • 2 — Malignant Narcissist. “I will do whatever it takes to get what I want.” ...
  • 3 — Covert Narcissist. “I'm a great artist but the world never noticed my talent.” ...
  • 4 — Communal Narcissist.

 

Do narcissists lie? 

Narcissists may lie for a variety of reasons which include seeking admiration or to hide their flaws or mistakes. They commonly lie to seek attention. In some cases, a person with this type of personality disorder will lie in order to make the person (s)he is lying to question their own sense of reality.

 

15 Signs You're Dealing With A Narcissist, From A Therapist April 20, 2022 Margalis Fjelstad (Narcissistic Personality Disorder - NPD)

1. Superiority and entitlement

2. Exaggerated need for attention and validation

3. Perfectionism

4. Great need for control

5. Lack of responsibility

6. Lack of boundaries

7. Lack of empathy

8. Perceiving everything as a threat

9. Emotional reasoning

10. Splitting

11. Fear of rejection and ridicule

12. Anxiety

13. Deeply repressed shame

14. An inability to be truly vulnerable

15. An inability to communicate of work as part of a team

 

8 Types OF Narcissists & How to Distinguish Them April 27, 2020 Abby Moore and Kristina Hallett

1. Healthy narcissism

2. Grandiose narcissism

3. Vulnerable narcissism, also known as covert narcissism

4. Malignant narcissism

Malignant narcissists, just like the name implies, are manipulative and malicious. They show signs of sadism and aggression, and according to AJP, are the most severe subtype of narcissistic personality disorder.

"They get pleasure seeing people writhe in pain and discomfort," licensed psychologist Daniel Fox, Ph.D., says. If you know a malignant narcissist, Neo recommends avoiding them completely and cutting off all ties. Any attempts to outsmart them will be unsuccessful and exhausting, she explains: "They've spent their lives perfecting the craft of becoming better narcissists."

5. Sexual narcissism 

6. Somatic narcissism

7. Cerebral narcissist

 8. Spiritual narcissist

 

Narcissistic Personality Disorder from Cleveland Clinic

 

Narcissistic Personality Disorder from Wikipedia

 


Schizoaffective Disorder

 

Schizoaffective Disorder from Cleveland Clinic (very good article)

The 5 As of schizophrenia refer to negative symptoms: affective flattening, alogia, anhedonia, asociality, and avolition. Schizophrenia is a brain disorder that affects how a person thinks, behaves, and feels.

 

Paranoid Personality Disorder (PPD)

 

Paranoid Personality Disorder (PPD) Wikipedia

Mistrustful and Misunderstood: A Review of Paranoid Personality Disorder from National Library of Medicine 2017 with 125 References, PPD often comorbid with BPD (Borderline Personality Disorder)
Paranoid personality disorder (PPD) is a mental illness characterized by paranoid delusions, and a pervasive, long-standing suspiciousness and generalized mistrust of others. People with this personality disorder may be hypersensitive, easily insulted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions that may validate their fears or biases. They are eager observers. They think they are in danger and look for signs and threats of that danger, potentially not appreciating other interpretations or evidence.[2]
They tend to be guarded and suspicious and have quite constricted emotional lives. Their reduced capacity for meaningful emotional involvement and the general pattern of isolated withdrawal often lend a quality of schizoid isolation to their life experience.[3][verification needed] People with PPD may have a tendency to bear grudges, suspiciousness, tendency to interpret others' actions as hostile, persistent tendency to self-reference, or a tenacious sense of personal right.[4] Patients with this disorder can also have significant comorbidity with other personality disorders, such as schizotypal, schizoid, narcissistic, avoidant and borderline.


Paranoid Personality Disorder Diagnosis Wikipedia 

ICD-10[edit]

The World Health Organization's ICD-10 lists paranoid personality disorder under (F60.0). It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria. It is also pointed out that for different cultures it may be necessary to develop specific sets of criteria with regard to social norms, rules and other obligations.[7]

PPD is characterized by at least three of the following symptoms:

  1. excessive sensitivity to setbacks and rebuffs;

  2. tendency to bear grudges persistently (i.e. refusal to forgive insults and injuries or slights);

  3. suspiciousness and a pervasive tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous;

  4. a combative and tenacious sense of self-righteousness out of keeping with the actual situation;

  5. recurrent suspicions, without justification, regarding sexual fidelity of spouse or sexual partner;

  6. tendency to experience excessive self-aggrandizing, manifest in a persistent self-referential attitude;

  7. preoccupation with unsubstantiated "conspiratorial" explanations of events both immediate to the patient and in the world at large.

Includes: expansive paranoid, fanaticquerulant and sensitive paranoid personality disorder.

Excludes: delusional disorder and schizophrenia.

 

Paranoid Personality Disorder Diagnosis Wikipedia 

DSM-5[edit]

The American Psychiatric Association's DSM-5 has similar criteria for paranoid personality disorder. They require in general the presence of lasting distrust and suspicion of others, interpreting their motives as malevolent, from an early adult age, occurring in a range of situations. Four of seven specific issues must be present, which include different types of suspicions or doubt (such as of being exploited, or that remarks have a subtle threatening meaning), in some cases regarding others in general or specifically friends or partners, and in some cases referring to a response of holding grudges or reacting angrily.[8]

PPD is characterized by a pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts. To qualify for a diagnosis, the patient must meet at least four out of the following criteria:[8]

  1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving them.

  2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.

  3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against them.

  4. Reads hidden demeaning or threatening meanings into benign remarks or events.

  5. Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).

  6. Perceives attacks on their character or reputation that are not apparent to others and is quick to react angrily or to counterattack.

  7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

The DSM-5 lists paranoid personality disorder essentially unchanged from the DSM-IV-TR[9] version and lists associated features that describe it in a more quotidian way. These features include suspiciousness, intimacy avoidance, hostility and unusual beliefs/experiences.

 

Differential diagnosis[edit]

Paranoid personality disorder can involve, in response to stress, very brief psychotic episodes (lasting minutes to hours). The paranoid may also be at greater than average risk of experiencing major depressive disorderagoraphobiasocial anxiety disorderobsessive-compulsive disorder and substance-related disorders. Criteria for other personality disorder diagnoses are commonly also met, such as:[11] schizoidschizotypalnarcissisticavoidantborderline and negativistic personality disorder.

 

Paranoid Personality Disorder from Cleveland Clinic

 

Do You Have Paranoid and Controlling Parents? Psychology Today 2020

 

When a Parent Has Paranoid Personality Disorder 2021

 

7 Signs Your Mon May Have A Personality Disorder, According To Experts 2019

 

When Mom Is Emotionally Unstable, Seven Ways To Heal 2021

 

Paranoid Personality Disorder (PPD) 

 

Paranoid Ideation and Violence: Meta-analysis of Individual Data of 7 Population Surveys

Research findings suggest that individual psychotic-like-experiences on the psychosis continuum in the general population are associated with violence;

 

Paranoid Thinking, Suspicion, and Risk for Aggression: A neurodevelopmental Perspective 17 pages, 2012

 

Risk Factors for violence in Serious Mental Illness 

 

Perceived threat mediates the relationship between psychosis proneness and aggressive behavior

 

4 Types of Anger and Their Destructive Impact Psychology Today

 

Living With Paranoid Personality Disorder: How Our Family Survived

 

Controlling Parents Trauma - Eggshell Therapy and Coaching

Table of Contents

 

What medication is used for paranoid personality disorder? 

More recently, however, researchers have found that atypical antipsychotics like risperidone (Risperdal) and olanzapine (Zyprexa) can alleviate symptoms of paranoid personality disorder.

 

Although biological data regarding the mechanism of PPD are scarce, what is known so far supports the potentially enormous value of the NIMH rDOC approach, which organizes PPD symptoms under the negatively valenced emotion and social processes categories. Anchoring the clinical and psychological approach to PPD in brain-based systems of negative affect and social processes could substantially accelerate the progress of research. There is an enormous body of neuroscience regarding the neural circuits mediating normal emotional and social behavior that can be applied to PPD. 

 

Dangerously Paranoid? Overview and Strategies for a Psychiatric Evaluation of a Highly Prevalent Syndrome  with 28 references in Psychiatric Times 

1. The prevalence of paranoid personality disorder is 0.5% to 2.5%; this condition accounts for 10% to 30% of psychiatric admissions.

2. For instance, the MacArthur Violence Risk Assessment Study demonstrated that fear and anger are 2 of the strongest predictors of violence, which suggests that perceived threat or a feeling of being wronged by another are at issue in the individual’s violent behavior.

3. Appelbaum and colleagues10 propose that suspiciousness may be a more relevant predictor of violence than delusions.

4. Threat/control-override (TCO) de­lusions, which can be conceptualized as a form of paranoia, involve the belief that one is being threatened or controlled by forces outside oneself. These delusions have been generally found to be associated with increased violence.

5. Current conceptualizations of attribution style diverge from this psychoanalytic formulation of projection, and divide the phenomenon into 4 classes of explanations for paranoid behavior in the context of persecutory delusions:

1. Heightened perception of threat from the content of delusions, particularly TCO delusions
2. Theory of mind abnormalities, which involve the ability to envision the minds of others but without empathy
3. Attributional bias, which is characterized by a hostile and threatening outlook regarding others and external stimuli
4. Early adverse experience

Also described as a paranoid cognitive personality style, attribution bias involves distortions in the interpretation of innocuous events.

The detection of discreet delusions with nonbizarre content essentially requires a high index of suspicion. Because of the plausible nature of the delusion and the reticence of the individual, detailed serial examination is sometimes required. Attention should be given to the presence of a delusion that may appear to be an overvalued idea that is particularly intense in the context of anxiety or depression. Nonbizarre delusions require assessment of the reasoning process in addition to the elaboration of thought content.

A tendency to jump to conclusions and extrapolate from improbable features of the story may indicate a lack of flexibility in internal logic that is fundamentally impervious to counterexample. 

 

Some general strategies may help the clinician exercise appropriate judgment in the interview and maintain safety when speaking with an acutely paranoid patient. The following includes key points elaborated on by McWilliams26 and Gabbard27 regarding patients with paranoid personality disorder, grouped into 5 main principles:

 

Establish a therapeutic alliance, without expecting trust. Paranoid patients are by definition distrustful. To promote a constructive clinical encounter, the interviewer often must tolerate the patient’s suspicion and reticence. Acknowledgment of the patient’s hostile attitude may be reassuring to him, in that the interviewer thereby conveys an acceptance of the patient’s psychic reality centered on fear. Paranoid patients may require a sense of control over the interview and over treatment decisions, when this is possible. Efforts of the interviewer to ensure the personal safety of both parties may provide additional comfort for the patient, who often fears his own destructive impulses arising from paranoid ideas.

 

Let the patient recount his theory-and listen. Whether delusional or a set of overvalued ideas, paranoid thinking is an attempt to create meaning that serves a purpose for the patient. The patient has an explanatory theory of events that surround him, an account that is impervious to ordinary reason or reassurance. Attempts to reassure the patient or correct delusional beliefs may lead him to feel humiliated or result in the incorporation of the interviewer into the delusional system.26

 

Lacan28 described the listener’s stance as that of being “a secretary to the madman,” learning, registering the patient’s account, and helping shape the thought content into a form that is more tolerable to the patient. Interpretations by the clinician are likely to be experienced by the patient as destabilizing or invasive, and result in an increase in persecutory ideation. Conversely, simply naming the emotions that are close to the surface of the patient’s discourse (for example, fear and anger) may attenuate the intensity of persecution. In general, allow the patient to speak of the paranoid ideas, to the extent that this is not disorganizing, and focus on his experience, without expressing an opinion on the ideas themselves.5

 

Maintain optimal distance. Readily threatened or invaded by the presence of another person, paranoid patients tend to benefit from having greater physical space between themselves and the interviewer than would ordinarily seem appropriate. Physical movements should not be sudden or unexpected, and any movements, such as reaching into a desk drawer, should be explained beforehand.27

Although empathy and recognition of the patient’s expressed feelings is generally beneficial, clinicians should exercise caution by maintaining careful emotional distance. Levels of empathy that are appropriate for other patients may be felt by the paranoid person as intrusive or humiliating.

 

Separate thoughts and speech from actions. Paranoid patients who experience the urge to act on persecutory ideas often fear their own impulses and are reassured when the clinician reminds them of the distinction between thoughts, fantasies, and speech, on the one hand, and action on the other.26 Verbalization of feelings and thoughts is often constructive, and patients should be encouraged to express themselves in words rather than action. Verbalization may also allow the individual to identify stressors and triggers of violence that he may then choose to avoid, as well as to clarify strategies for managing overwhelming anxiety or impulses.

Maintain a position of ethical integrity. Patients with paranoid ideas and attribution bias are particularly observant of and sensitive to the re­actions of others. The interviewer should strive to be fair and consistent, as well as straightforward. Equivocal or hesitant statements may be interpreted in a persecutory manner. Countertransference issues may pose significant obstacles, leading the clinician to avoid asking about topics that may be uncomfortable for the patient but that require assessment, such as a history of violence.26

 

The interviewer may feel afraid or angry in the patient’s presence, and should be attentive to excessive fear that may accompany the escalation of the patient’s hostile or threatening attitude. Careful observation of boundaries along with the clinician’s willingness to honestly acknowledge his or her own mistakes (when these occur) allow the paranoid patient to feel safe and in the presence of a clinician with credible authority who will not abuse the power he has over the patient. It is essential to maintain a nonjudgmental attitude, to treat the patient respectfully, and to take his paranoid ideas seriously to the extent that they are a central feature of his subjective reality.

 

 

Mental Illness and Mental Health 

 

Johns Hopkins Medicine Mental Health Disorder Statistics  

The following are the latest statistics available from the National Institute of Mental Health Disorders, part of the National Institutes of Health:

  • Mental health disorders account for several of the top causes of disability in established market economies, such as the U.S., worldwide, and include: major depression (also called clinical depression), manic depression (also called bipolar disorder), schizophrenia, and obsessive-compulsive disorder.

  • An estimated 26% of Americans ages 18 and older -- about 1 in 4 adults -- suffers from a diagnosable mental disorder in a given year.

  • Many people suffer from more than one mental disorder at a given time. In particular, depressive illnesses tend to co-occur with substance abuse and anxiety disorders.

  • Approximately 9.5% of American adults ages 18 and over, will suffer from a depressive illness (major depression, bipolar disorder, or dysthymia) each year.

    • Women are nearly twice as likely to suffer from major depression than men. However, men and women are equally likely to develop bipolar disorder.
    • While major depression can develop at any age, the average age at onset is the mid-20s.
    • With bipolar disorder, which affects approximately 2.6% of Americans age 18 and older in a given year -- the average age at onset for a first manic episode is during the early 20s.

 

Personal boundaries Wikipedia 

Borderline personality disorder (BPD): There is a tendency for loved ones of people with BPD to slip into caretaker roles, giving priority and focus to problems in the life of the person with BPD rather than to issues in their own lives. Too often in these relationships, the codependent will gain a sense of worth by being "the sane one" or "the responsible one".[35] Often, this shows up prominently in families with strong Asian cultures because of beliefs tied to the cultures.[36]
Narcissistic personality disorder (NPD): For those involved with a person with NPD, values and boundaries are often challenged as narcissists have a poor sense of self and often do not recognize that others are fully separate and not extensions of themselves. Those who meet their needs and those who provide gratification may be treated as if they are part of the narcissist and expected to live up to their expectations.[37]
Approximately 9% of adults in the U.S. have some type of personality disorder, and about 6% of the global population has a personality disorder. Cleveland Clinic

Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5, and the National Institute of Mental Health’s Research Domain Criteria (RDoC)

 

Pharmacotherapy of mental illness--a historical analysis.

 

Madness or Mental Illness? Revisiting Historians of Psychiatry Download PDF

 

Patient Experiences of Depression and Anxiety with Chronic Disease

 

What percentage of adults have optimal mental health?

 

Adults. It is estimated that only about 17% of U.S. adults are considered to be in a state of optimal mental health. An estimated 26% of Americans age 18 and older are living with a mental health disorder in any given year, and 46% will have a mental health disorder over the course of their lifetime.Feb 6, 2022

 

Anxiety disorders, the most common mental health condition in the U.S., affect about 40 million Americans. and happen to nealy 30% of adults at some point. Anxiety disorders most ofter begin in childhood, adolescence or early adulthood.  Cleveland Clinic

 

Prevalence of Serious Mental Illness (SMI)
In 2020, there were an estimated 14.2 million adults aged 18 or older in the United States with SMI. This number represented 5.6% of all U.S. adults. The prevalence of SMI was higher among females (7.0%) than males (4.2%).

NIMH » Mental Illness


References

Parenting behaviors associated with risk for offspring personality disorder during adulthood

 

Anxiety Disorders from Cleveland Clinic

 

Obsessive-Compulsive Disorder  (OCD) from Cleveland Clinic

 

Woman and psychosis An information guide pdf 46 pages, 2015 Center for Addiction and Mental Health

 

Schizophrenia An information guide pdf 79 pages 2017 Center for Addiction and Mental Health

 

First episode psychosis An information guide pdf 38 pages 2015 Center for Addiction and Mental Health

 

When a Parent Has Experienced Psychosis What kids want to know

 

What is Paranoid Personality Disorder? from Harmony United Psychiatric Care (has Telepsychiatry/ Telehealth Service) https://hupcfl.com/telepsychiatry-in-florida/

 

Personality disorders Mayo Clinic

 

Psychiatric Care in the US: Are We Facing a Crisis?

 

 

Exodus 20 King James Version 

 

1 And God spake all these words, saying,

2 I am the Lord thy God, which have brought thee out of the land of Egypt, out of the house of bondage.

3 Thou shalt have no other gods before me.

4 Thou shalt not make unto thee any graven image, or any likeness of any thing that is in heaven above, or that is in the earth beneath, or that is in the water under the earth.

5 Thou shalt not bow down thyself to them, nor serve them: for I the Lord thy God am a jealous God, visiting the iniquity of the fathers upon the children unto the third and fourth generation of them that hate me;

6 And shewing mercy unto thousands of them that love me, and keep my commandments.

7 Thou shalt not take the name of the Lord thy God in vain; for the Lord will not hold him guiltless that taketh his name in vain.

8 Remember the sabbath day, to keep it holy.

9 Six days shalt thou labour, and do all thy work:

10 But the seventh day is the sabbath of the Lord thy God: in it thou shalt not do any work, thou, nor thy son, nor thy daughter, thy manservant, nor thy maidservant, nor thy cattle, nor thy stranger that is within thy gates:

11 For in six days the Lord made heaven and earth, the sea, and all that in them is, and rested the seventh day: wherefore the Lord blessed the sabbath day, and hallowed it.

12 Honour thy father and thy mother: that thy days may be long upon the land which the Lord thy God giveth thee.

13 Thou shalt not kill.

14 Thou shalt not commit adultery.

15 Thou shalt not steal.

16 Thou shalt not bear false witness against thy neighbour.

17 Thou shalt not covet thy neighbour's house, thou shalt not covet thy neighbour's wife, nor his manservant, nor his maidservant, nor his ox, nor his ass, nor any thing that is thy neighbour's.

 

 

 

 
 

 

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