Personality Diagnosis

The Disease Entity Approach

Middle Ages

• Physicians slowly conveyed that the notion that bizarre behaviors were of people should be regarded as sick rather than damned.

• As for other kinds of diseases, it was first assumed that each individual suffering from some specific disorder which was revealed by observable behavior.

19th Century

Emil Kraepelin

He found a new way of looking at mental illness, referring to the traditional view as "symptomatic" and to his view as "clinical".

• He made a thorough and systematic classification of the mental disorders.

• His scheme was sometimes reffered to as the psychiatric classification system or psychiatric nosology.

Emil Kraepelin

• His first classificatory breakdown was into organic (endegenous) disorders and functional (exegenous) disorders.

• Some disorders are identified not so much from their symptoms, causes, systems nor by prognosis. In this case, the duration of time itself is used as one of the bases for his classification.

Emil Kraepelin

The terms neurotic and psychotic are both used to describe conditions or illnesses that affect mental health. Though neurotic and psychotic are both relative to mental health, there are differences between neurotic and psychotic conditions.

The terms neurosis and psychosis are sometimes used interchangeably with neurotic and psychotic disorders.

A neurotic disorder can be any mental imbalance that causes or results in distress. In general, neurotic conditions do not impair or interfere with normal day to day functions, but rather create the very common symptoms of depression, anxiety, or stress. It is believed that most people suffer from some sort of neurosis as a part of human nature.

As an example, some people are afraid or unable to speak in front of large crowds. As a result, any situation that might warrant public speaking can cause symptoms from nervous nausea to vomiting, or from trembling to excessive perspiration. Some people suffer more severe symptoms of neurosis than others, and some forms of neurosis are more marked, such as obsessive-compulsive disorder.

Psychosis - severe mental disorder characterized by:

1. Disorganization of thought disorders2. Disturbances of emotionality3. Disorientation of time, place and

person4. Hallucination and delusion

Organic Disorders• These are disturbances in thinking and

action associated with physiological abnormalities such as tumors, deteriorative brain disorders, drug intoxication attacks.

• Symptoms of these disorders include delusion and sometimes bizarre thinking processes.

Functional Disorders

Divided into three major groupings:1. Psychosis- equivalent to insanity.

Schizophrenia - functional psychotic disorder presumably occurs in our culture often.

- characterized by loss of contact with reality, marked with disturbances of thought, perception and bizarre behavior.

Functional Disorders

Manic-depressive - heightened by excitement and inappropriate sadness or discouragement.

Paranoia Depression

Functional Disorders

2. Psychoneuroses -unhappy, maladjusted and sometimes peculiar in behavior. The individual is able to cope with the various aspects of its environment.

-exaggerated fears, obsessive thoughts that recur with great persistence, specific ideas regarding sexual behavior that interferes with normal sexual adjustment and the

presence physical complaints that have no apparent physiological basis.

- Other symptoms include exaggerated feelings of inadequacy, extreme shyness, anxiety, and feelings of being under continuous tensions.

Functional Disorders

3. Psychopathic - primarily hereditary in nature.

-characterized by behavior that is amoral or in opposition to the standards of society.

-included here are the habitual criminals, chronic alcoholic, drug addicts and sexual deviates.

Approaching personality description or diagnosis via such a classification scheme necessarily involves measuring the characteristics, or symptoms, predominant in the various disorders. The outcomes of such observations would facilitate diagnosis.

DO YOU KNOW A PSYCHOPATH?

1. When you first met this person what characteristic best described him/her?

a) Insecure, shyb) Charismatic, charmingc) Secretive, unresponsived) Humorous, easy going

2. Which word best describes how this person most often presents himself?

a) Naïveb) Moralisticc) Street wised) Intellectual

3. Have you ever suspected or caught this person lying?

e) Rarely if everf) Sometimes - to avoid hurting feelingsg) Often - to keep from getting in trouble.h) Habitually - often about silly things.

4. What best describes this person's employment history?

a) White collar executiveb) Manual laborerc) Educatord) Middle management

5. When dealing with people in positions of authority which best describes how the person reacts?

e) Resentful of people in authorityf) Tends to suck up to authorityg) Respectful of authorityh) Afraid of authority

6. Which best describes this person's financial situation?

a) Responsible, pays his way in lifeb) Rarely holds the same job for long, lets others

support him and complains of bill collectorsc) Struggling along, sometimes shows

irresponsible behaviourd) Wealthy, sometimes flamboyant, rarely speaks

about being over his head.

7. When dealing with his failures such as a loss of a job, bypassed for promotion or failure in school this person reacts...

a) Angrily and always blames the person who made the decision.

b) Overly hard on himself and beats himself down for his failures.

c) Depressed but eventually shakes it off and moves on.

d) Learns from his mistakes and shows personal growth from the experience.

8. When speaking about childhood memories this person appears...a) Reflective and generally speaks positively

about his childhood.b) Avoids discussing it and seems vague if asked

pointed questions.c) Remembers the good times and doesn't

dwell on the bad times such as parents divorcing.

d) Extremely specific with details most people would forget.

9. Select the phrase which best describes how this person is in his intimate relationships such as marriage.

a) Shows respectful toward his mate.b) Seems to have the ability to share deep

emotional ties with his mate.c) Seems to love his mate, but has had

occassional flings.d) Has no regard or respect for his mate and

has regular flings.

10. You have observed this person...a) Directly point out a potentially unsafe

situation to others.b) Observe a potentially unsafe situation, but

did not say anything about it.c) Appear generally unobservant and usually

fails to notice unsafe situations.d) Overreacts to potentially unsafe situations

demanding they be rectified immediately.

11. Which best describes the person?a) Takes good care of himself by exercising

and watching his diet.b) Is moderately careful about his health, an

occasional drinker.c) Drinks often and enjoys drugs such as

meth and cocaine.d) Warns others against the use of alcohol

and drugs.

12. Choose which best describes this person after you got to know him.

a) Nice, honest, caring, responsibleb) Arrogant, liar, lazy, irresponsiblec) Often charming, deceptive, manipulative,

void of emotiond) Hard, isolated, uncommutative, private

Limitations of the Diagnostic Scheme

1. As a general approach to personality descriptions it does not account for the individual differences in the large group of people who are “normal”.

Limitations of the Diagnostic Scheme

2. The clear-cut facts are that the symptom pictures do no fail into neat patterns or clusters. There is considerable overlap in the symptoms of different disorders, and many people seem to as much mixtures of

Limitations of the Diagnostic Scheme

different disorders as representatives of a single one.

As a result, diagnosis is highly unreliable, frequently changes with time, and can differ markedly with the diagnostician.

Limitations of the Diagnostic Scheme

3. Different individuals may develop the same symptoms for different reasons and that, equally individuals with similar difficulties may develop different symptoms.

Limitations of the Diagnostic Scheme

4. In the hundred years or so since these diagnostic entities presumably have been identified and described, it has been extremely difficult, particularly in the functional discorders, to find any treatment that follow from the diagnosis.