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Personality Disorders

  • C. Robert Cloninger
  • Dragan M. Svrakic

Abstract

Personality disorder (PD) is the primary psychiatric illness observed in most patients with psychosocial complaints, particularly young adults. PD is present in one-sixth of people in the general population and more than half of all psychiatric patients. Reliable diagnosis of PD can be made in routine clinical practice by brief assessment of two essential features of a person’s character—low self-directedness and low cooperativeness—that indicate reduced ability to work and to get along with other people. Subtypes can be distinguished in terms of configurations of temperament traits measuring a person’s emotional drives for immediate gratification. PD is usually a lifelong disorder but can mature (remit) spontaneously or with treatment. The temperament and character components of PD are all moderately heritable. Neurobiological findings about personality explain the benefit of differential pharmacotherapy and psychotherapy for different subtypes of PD. The treatment of PD often begins with a stabilization phase with medications and simple cognitive-behavioral approaches. Even in cases of severe PD, more advanced stages of therapy can lead to radical transformation of a person’s perspective on life leading to a healthy and stable state of well-being.

Keywords

Personality Personality disorders Temperament Character Pharmacotherapy Psychotherapy Meditation Contemplation Self-awareness Well-being 

References

  1. 1.
    Swann AC, Johnson BA, Cloninger CR, Chen YR. Relationships of plasma tryptophan availability to course of illness and clinical features of alcoholism: a preliminary study. Psychopharmacology (Berl) 1999;143:380–384.CrossRefGoogle Scholar
  2. 2.
    Widiger TA, Simonsen E, Sirovatka P, Regier DA, editors. Dimensional models of personality disorders: refining the research agenda for DSM-V. Arlington, VA: American Psychiatric Association Publishing; 2006.Google Scholar
  3. 3.
    Cloninger CR. A practical way to diagnose personality disorder: a proposal. J Pers Disord 2000;14:99–108.CrossRefPubMedGoogle Scholar
  4. 4.
    Cloninger CR. Feeling good: the science of well being. New York: Oxford University Press; 2004.Google Scholar
  5. 5.
    Cloninger CR. What makes people healthy, happy, and fulfilled in the face of current world challenges? Mens Sana Monogr 2013;11:16–24.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Arch Gen Psychiatry 1993;50:975–990.CrossRefPubMedGoogle Scholar
  7. 7.
    Oldham JM, Gabbard GO, Goin MK, Gunderson J, Soloff P, Spiegel D, Stone M, Phillips KA, editors. Practice guidelines for the treatment of patients with borderline personality disorder. Arlington, VA: American Psychiatric Association Publishing; 2001.Google Scholar
  8. 8.
    Sperry L. Cognitive behavior therapy of DSM-IV-TR personality disorders. New York: Routledge; 2006.Google Scholar
  9. 9.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders, DSM-5. 5th ed. Arlington, VA: American Psychiatric Association Publishing; 2013.Google Scholar
  10. 10.
    Cloninger CR. A systematic method for clinical description and classification of personality variants: a proposal. Arch Gen Psychiatry 1987;44:573–587.CrossRefPubMedGoogle Scholar
  11. 11.
    Mulder RT, Joyce PR. Temperament and the structure of personality disorder symptoms. Psychol Med 1997;27:99–106.CrossRefPubMedGoogle Scholar
  12. 12.
    Teasdale JD, Moore RG, Hayhurst H, Pope M, Williams S, Segal ZV. Metacognitive awareness and prevention of relapse in depression: empirical evidence. J Consult Clin Psychol 2002;70:275–287.CrossRefPubMedGoogle Scholar
  13. 13.
    Moreira-Almeida A, Santos FS editors. Exploring frontiers of the mind-brain relationship. Mindfulness in behavioral health. In: Singh NN, editor. Springer: New York; 2011.Google Scholar
  14. 14.
    Linehan MM. Cognitive-behavioral treatment of Borderline Personality Disorder. New York: Guilford; 1993.Google Scholar
  15. 15.
    Vaillant GE, Milofsky E. Natural history of male psychological health: IX. Empirical evidence for Erikson’s model of the life cycle. Am J Psychiatry 1980;137:1348–1359.CrossRefPubMedGoogle Scholar
  16. 16.
    Cloninger CR, Zohar AH, Cloninger KM. Promotion of well-being in person-centered mental health care. Focus 2010;8:165–179.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Cloninger CR, Cloninger KM. Person-centered therapeutics. Int J Pers Cent Med 2011;1:43–52.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Pezawas L, Meyer-Lindenberg A, Drabant EM, Verchinski BA, Munoz KE, Kolachana BS, Egan MF, Mattay VS, Hariri AR, Weinberger DR. 5-HTTLPR polymorphism impacts human cingulate-amygdala interactions: a genetic susceptibility mechanism for depression. Nat Neurosci 2005;8:828–834.CrossRefPubMedGoogle Scholar
  19. 19.
    Gutknecht L, Jacob C, Strobel A, Kriegebaum C, Müller J, Zeng Y, Markert C, Escher A, Wendland J, Reif A, Mössner R, Gross C, Brocke B, Lesch KP. Tryptophan hydroxylase-2 gene variation influences personality traits and disorders related to emotional dysregulation. Int J Neuropsychopharmacol 2006;19:1–12.Google Scholar
  20. 20.
    Cloninger CR. Antisocial personality disorder: a review. In: Maj M, editor. Personality disorders: evidence and experience in psychiatry, vol. 8. London: Wiley; 2005. p. 125–129.CrossRefGoogle Scholar
  21. 21.
    Cloninger CR. The science of well-being: an integrated approach to mental health and its disorders. World Psychiatry 2006;5:71–76.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Freud S. Civilization and its discontents. New York: Jonathan Cape & Harrison Smith; 1929.Google Scholar
  23. 23.
    Servan-Schreiber D. Healing without Freud or Prozac. London: Rodale International; 2005.Google Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of PsychiatryWashington University School of MedicineSt. LouisUSA

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