Psychological Disorder
Disorder’s history/background
Our understanding of personality disorders has existed for quite a long time. There are various classification systems that have been used in description and diagnosis of personality disorders in varying periods of history (Rotgers & Maniacci, 2006). During the 4th century BC, the Hippocrates described the disease as a disparity of the four humors in the body. The fundamental idea here was about the four body fluids which included; blood, phlegm, black bile and yellow bile. Therefore any variations in their levels were referred to cause changes in people’s moods (Rotgers & Maniacci, 2006). Later in the 18th century, it was observed that patients behaved irrationally though they seemed in touch with reality and were aware of their irrationality.
Philippe Pinel in his observations described what we can now call personality disorder. The only types of mental illness that were known then were delirium, mania, delusions and psychoses. In 1835, J.C. Pritchard a British senior Physician published a seminal work that was entitled “Treatise on Insanity and other Disorders of the mind” (Rotgers & Maniacci, 2006). According to him, moral insanity comprised of a morose distortion of one’s natural feelings, inclinations, habits, temper, morals and impulses without defect of the intellect faculties. The European diagnostic systems started describing various temperaments and personality types in the early 1900s (Rotgers & Maniacci, 2006). Due to infancy in the scientific profession of psychiatry during that period, mental conditions and disorders could not be well defined. Between 1920s and 1930s, Sigmund Freud and his team were the first to initiate the categorization of mental disorders. Freud theorized the causes of emotional and behavioral problems (Rotgers & Maniacci, 2006). However, there is advancement in the modern understanding of personality disorders beyond Freud’s theories.
Causes of personality disorders
Despite in the past, when people believed that those with personality disorders were lazy and evil, the new research suggests the potential causes of personality disorders. One of the causes is genetics; researchers have identified possible genetic factors responsible of personality disorder (McCallum, 2001). According to this research, there is a possibility of inheriting a particular personality trait from parents. Personality disorders may also be caused as a result of environmental factors for instance by being exposed to chronic fear in childhood stage, being a victim of physical, emotional and sexual abuse at an early stage, being neglected by parents at an early stage, or growing up with a family member who had a mental disorder.
Attachment theories may also contribute to the cause of personality disorder; this is the relationship between the child and their caregivers. Sensitive care giving will result into a secure attachment which enables the child to grow in a flexible and a confident relationship with others (McCallum, 2001). However, an insecure attachment as a result of abandonment, being ignored, harmful threats will most likely lead to personality disorder. Personality disorder may also be caused by high reactivity; this is characterized by sensitivity to light, texture, noise, and other stimuli. Children who are overly sensitive are more likely to develop timid, shy or anxious personalities.
Treatment of personality disorders
Treating personality disorder involves a course of psychological therapy which lasts for a period of six months or more depending on the severity of the condition. Psychotherapy refers to a treatment that involves discussion of emotions, thoughts and behaviors with a professional (McCallum, 2001). This is aimed at improving one’s ability to regulate emotions and thoughts. There are therapies that focus on dysfunctional thoughts and others that focus on self awareness of how one’s mind works. There are also social therapies that help understand how to socially relate with others. These psychological therapies are usually effective for many personality disorders. They are always conditioned to only be delivered by a professional trained to work with personality disorders. This is because of the dangers associated with personality disorders for example self harm (McCallum, 2001). Psychotherapist are trained to have all the experience to deal with personality disorders for example listening and discussing with the patient, strategies to deal with the problem. A range of psychotherapies are used in treating personality disorders.
Psychodynamic psychotherapy is based on the view that personality disorder is related to negative childhood experience. In this case, metallization-based therapy is recommended in borderline personality disorder. There is cognitive behavioral therapy which is based on the view that our thinking about a situation affects our actions towards that particular situation and this need to change right from the how we think. This condition is being reduced using Dialectical Behavior Therapy (DBT) (McCallum, 2001). We also have interpersonal therapy which is based on the view that our relationship with people around us has a powerful impact to our mental health. There is no licensed medication currently being used in treating personality disorder, however, medications are always prescribed to treat a specific problem like anxiety, depression, etc.
Diagnostic criteria for personality disorders
The following are the diagnostic criteria for a person antisocial personality disorder. There is a pattern of disregard for and defiance of the rights of others that occurs from the age of 15 years as shown by the following; failure to abide with the social norms in relation to lawful behaviors as shown by performing acts that are ground for arrest (Kantor, 2006). Deceitfulness as shown by repeated lies, conning others, use of aliases, failure to plan ahead, recklessly disregarding self safety and others’ safety, lack of remorse which may be signified by being unresponsive to or rationalizing having harmed, mistreated and stolen from another. The other diagnostic criterion is that the individual is at least 18 years of age. There should also be an evidence of conduct disorder previously before 15 years of age (Kantor, 2006). Lastly, the occurrence of antisocial behavior should be excluded in the course of schizophrenia.
A person’s ability to live with antisocial personality disorder
One is able to live with antisocial personality disorder as long as their condition is understood by those around them and they are not threatened because of their state. People with antisocial personality disorder are known not to be empathetic at all and hence e cannot understand others feelings. Therefore to help him or her live with the condition, let them be taken the way they are (Kantor, 2006). They can also be helped by taking them for medications if their conditions worsen. For healthcare professionals, they are recommended to set boundaries for themselves, enforce consequences in case boundaries are violated, debrief after enforcing consequences and when the person is calm, never to engage in arguments with the person and monitoring their communications both verbal and nonverbal.
Origin of antisocial personality disorder, first documented cases, types of treatment, how they work and the most effective ones
This disorder originated from the view that there are people who exploit others and violate society rules for their personal gains as a result of their personality traits. One of the famous cases of antisocial personality disorders is that of David Garry a known criminal from Australia who spent his life in institutions since his adolescence (Kantor, 2006). He is known of mutilating himself as many times as seventy which includes swallowing razor blades, slicing off his nipples, nailing his feet and damaging his penis. He was also imprisoned for 14 years for attempting to murder three people. For all these crimes, he did not express remorse hence diagnosed of borderline antisocial personality disorder. This disorder is known to be the most difficult one to treat. However, antidepressants and antipsychotics are normally used in treating the associated problems and symptoms (Kantor, 2006). Additionally, psychotherapies are used to help patients deal with the disorder.
References
Rotgers, F., & Maniacci, M. P. (2006). Antisocial personality disorder: A practitioner's guide to comparative treatments. New York: Springer Pub.
McCallum, D. (2001). Personality and dangerousness: Genealogies of antisocial personality disorder. New York: Cambridge Univ. Press.
Kantor, M. (2006). The psychopathy of everyday life: How antisocial personality disorder affects all of us. Westport, Conn: Praeger.
