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PERSONALITY DISORDERS

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Introduction

Yet all experience is an arch wherethro' Gleams that untravell'd world, whose margin fades For ever and for ever when I move. Tennyson's Ulysses Personality disorders indicate the presence of chronic rigid and maladjusted personality traits, through which the person's interpersonal or professional functioning is negatively affected, or which lead to personal unhappiness and problems (Louw, 1990). Discuss this statement from a biopsychosocial frame of reference and refer to one personality disorder in any cluster to illustrate your answer. THE BIOPSYCHOSOCIAL MODEL: The biopsychosocial model (Engel, 1980, cited in Paris, 1993) suggests an integrated approach that understands psychopathology in terms of multiple causes, none of which is sufficient on its own for the development of the disorder. These factors could include biological vulnerability, the psychological impacts of life experiences and the influence of the social environment all of which may factor as risk variables or protective variables. The biopsychosocial model differs from more linear cause and effect approaches such as heredity in that it is only the cumulative interactive effects of the multiple variables can produce the overt disorder. PERSONALITY DISORDERS Personality disorders are characterised by inflexible and longstanding maladaptive personality traits that cause significant impairment and subjective distress for the individual. The signs of a personality disorder display in adolescence or early adulthood. Individuals differ to the extent that they possess Personality traits and it may be difficult to decide whether the trait exists to an extent that can be considered pathological. DSM IV criteria are based on a categorical model in which a disorder is diagnosed if "enough of" certain traits are present as opposed to "not enough" traits which indicate a lack of the disorder. The five-factor model (FFM) is one of several personality theories that are used to explain the variance in normal and abnormal personality. The "Big Five" (cited in Klein, 1993; cited in Barlow & Durand, 2002;) ...read more.

Middle

Independent personality disorder would clearly be what is considered "normal" in health ambitious people, but would clearly describe more males than females. Prognosis and Treatment Most people with personality disorders function adequately in spite of their adjustment problems and do not seek help because they do not believe they have a problem. Borderline personalities are more likely to seek treatment as a result of depression or other pathologies like substance abuse. Certain types of disorders such a borderline personality disorder are notoriously difficult to treat and borderlines are more likely that others to deteriorate in treatments and be worse off than had therapy not been undertaken (Carson & Butcher, 1992). In the interest of ethics the clinician should take this into consideration. The course is variable, with chronic instability in early adulthood being the most common pattern. Serious affective disorders and lack of impulse control are prevalent with high levels of use of health and mental health resources. Many borderline patients improve in their thirties and develop more stability in their relationships and career. (DSM IV, 1995) AETIOLOGY The Biopsychosocial model is particularly appropriate to the personality disorders in that the available empirical data maintains that only a combination of biological, psychological and social risk factors is a sufficient combination for the development of these disorders (Paris, 1993). Borderline personality disorder would then be understood as a heritable biological predisposition manifest in personality traits, which are precipitated and amplified by psychosocial variables. The diathesis stress response model explains why an inherited vulnerability may only sometimes precipitate a personality disorder. It is only in combination with psychosocial stressors that a genetic tendency may bring about a borderline personality. BIOLOGICAL FACTORS Gender As has already been mentioned more women are diagnosed with borderline personality disorder than men. Families and Borderline Personality Disorder Family studies indicate that borderline personality disorder is more prevalent in families with the disorder as well as families with mood disorders (Wideger & Trull, 1993, cited in Barlow & Durand, 2002). ...read more.

Conclusion

AN INTEGRATIVE APPROACH It is important to note that various biological, psychological and social factors may contribute to the development of borderline personality disorder and other personality disorders, the biopsychosocial model seems to proffer a more integrative and systemic understanding of the development and maintenance of this disorder. The biopsychosocial model proposes multiple causal factors and would explain why individual risk factors are not strongly associated with specific disorders. The presence of biological variability on its own is not sufficient to bring about borderline personality disorder. It does explain variance in personality, but it only determines the specificity of a personality disorder. Psychological and social risk factors and much stronger determinants of whether a predisposition develops into a disorder (Paris, 1993). REFERENCE LIST: American Psychiatric Association. (1995). Diagnostic and Statistical Manual of Mental Disorders. (4th ed.) USA: American Psychiatric Association Baer, R. (2003, Jul). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, (2), 125-143. Barlow, D.H. & Durand, V.M. (2002). Abnormal psychology: An integrated approach. (3rd ed.). USA: Wadsworth/Thomson Learning. Carson, R. C. & Butcher, J. N (1992). Abnormal psychology and modern life. (9th ed). USA: Harper Collins Publishers Dimidjian, S & Linehan, M. M. (2003, Jul). Defining an agenda for further research on the clinical appliciation of Mindfulness practice. Clinical Psychology: Science and Practice, 10, (2), 166-171. Hayes, S. C & Wilson, K.J. (2003, Jul). Mindfulness: Method and process. Clinical Psychology: Science and Practice, 10, (2), 161-165. Hayes, S. J. (2002, Mar) Acceptance, mindfulness and science. Clinical Psychology: Science and Practice, 9, (1), 101-106. Klein, M.H. (1993, Spring). Issues in the assesment of personality disorders. Journal of Personality Disorders. Supplement 1, 18-33. Morey, L.C. (1993, Spring). Psychological correlates of personality disorder. Journal of Personality Disorders, Supplement 1, 149-166. Paris, J. (1993). Personality disorders: A biopsychosocial model. Journal of Personality Disorders, 7(3), 255-264. Sue, D., Sue, D, W. & Sue, S. (2000). Understanding abnormal behaviour. (6th ed). USA: Houghton Mifflin Vincent, K.R. (1990). The relationship between personality disorders, normality and healthy personality: Personality on a continuum. Social Behavior and Personality, 18(2), 245-250. ...read more.

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