PARANOID SCHIZOID SCHIZOTYPAL

ETIOLOGY
A genetic contribution to paranoid traits and a possible genetic link between this personality disorder and schizophrenia exist. Psychosocial theories implicate projection of negative internal feelings and parental modeling.

TREATMENT
Because of reduced levels of trust, there can be challenges in treating paranoid personality disorder. However, psychotherapy, antidepress ants, antipsychotics and antianxiety medications can play a role when an individual is receptive to intervention.

 ETIOLOGY
There is some evidence to suggest that there is an increased prevalence of schizoid personality disorder in relatives of people with schizophrenia or schizotypal personality disorder. Unloving, intrusive, or neglectful parenting is hypothesized to play a role.There is a strong correlation between sexual abuse experienced in childhood and the later development of Schizoid Personality Disorder, and most personality disorders in general.

TREATMENT
Since schizoid traits are very similar to negative schizophrenic symptoms, atypical antipsychotics may have efficacy in alleviating them. Those who do seek treatment have the option of medication or therapy. For medication, the schizoid personality disorder seems to have similar negative symptoms of schizophrenia such as anhedonia, blunted affect, and low energy. The medication that is most recently used to treat the negative symptoms is risperidone.

 ETIOLOGY

Rates of schizotypal PD are much higher in relatives of individuals with schizophrenia than in the relatives of people with other mental illnesses or in people without mentally ill relatives. Technically speaking, schizotypal PD may also be considered an "extended phenotype" that helps geneticists track the familial or genetic transmission of the genes that are implicated in schizophrenia.

TREATMENT
Medication can be used for treatment of this disorder's more acute phases of psychosis. These phases are likely to manifest themselves during times of extreme stress or life events with which they cannot adequately cope. Psychosis is usually transitory, though, and should effectively resolve with the prescription of an appropriate anti-psychotic.

ANTI-SOCIAL BORDERLINE HISTRIONIC NARCISSISTIC

 ETIOLOGY There are many theories, however, about the possible causes of antisocial personality disorder. Most professionals subscribe to a biopsychosocial model of causation -- that is, the causes of are likely due to biological and genetic factors, social factors (such as how a person interacts in their early development with their family and friends and other children), and psychological factors (the individual's personality and temperament, shaped by their environment and learned coping skills to deal with stress). If a person has this personality disorder, research suggests that there is a slightly increased risk for this disorder to be "passed down" to their children.

 TREATMENT
There has been some research on the treatment of ASPD that showed positive results for therapeutic interventions. Some studies have found that the presence of ASPD does not significantly interfere with treatment for other disorders, such as substance abuse, although others have reported contradictory findings. Schema Therapy is being investigated as a treatment for antisocial personality disorder.

 ETIOLOGY

The causes of BPD are complex and not fully understood. One finding is a history of childhood trauma, abuse or neglect, although researchers have suggested diverse possible causes, such as a genetic predisposition, neurobiological factors, environmental factors, or brain abnormalities.There is evidence that suggests that BPD and post-traumatic stress disorder (PTSD) are closely related. Evidence further suggests that BPD might result from a combination that can involve atraumatic childhood, a vulnerable temperament and stressful maturational events during adolescence or adulthood.

 TREATMENT

Antidepressant and anti-anxiety agents may be appropriate during particular times in the patients treatment, as appropriate. For example, if a client presents with severe suicidal ideation and intent, the clinician may want to seriously consider the prescription of an appropriate antidepressant medication to help combat the ideation. Medication of this type should be avoided for long-term use, though, since most anxiety and depression is directly related to short-term, situational factors that will quickly come and go in the individuals life.

 ETIOLOGY The cause of this disorder is unknown, but childhood events such as deaths in the immediate family, illnesses within the immediate family which present constant anxiety, divorce of parents andgenetics may be involved. Histrionic Personality Disorder is more often diagnosed in women than men; men with some quite similar symptoms are often diagnosed with narcissistic personality disorder.

 TREATMENT
Group therapy can assist individuals with HPD to learn to decrease the display of excessively dramatic behaviors, but must be closely monitored because it may provide the person with an audience to play to (perform for), thus giving opportunity to perpetuate histrionic behavior. Psychoanalytic psychotherapy Family therapy Medications Alternative therapies Cognitive behavioral therapy

 ETIOLOGY

The following factors identified by various researchers as possibilities: An oversensitive temperament at birth Excessive admiration that is never balanced with realistic feedback Excessive praise for good behaviors or excessive criticism for bad behaviors in childhood Overindulgence and overvaluation by parents Being praised for perceived exceptional looks or abilities by adults Severe emotional abuse in childhood Unpredictable or unreliable caregiving from parents Valued by parents as a means to regulate their own self-esteem

 TREATMENT
Schema Therapy, a form of therapy developed by Jeffrey Young that integrates several therapeutic approaches (psychodynamic, cognitive, behavioral etc.), also offers an approach for the treatment of NPD.It is unusual for people to seek therapy for NPD. Unconscious fears of exposure or inadequacy often cause defensive disdain of therapeutic processes. Pharmacotherapy is rarely effective.

AVOIDANT DEPENDENT OBSESSIVE-COMPULSIVE

 ETIOLOGY
The disorder may be related to temperamental factors that are inherited. Specifically, various anxiety disorders in childhood and adolescence have been associated with a temperament characterized by behavioral inhibition, including features of being shy, fearful, and withdrawn in new situations. These inherited characteristics may give an individual a genetic predisposition towards AvPD. Childhood emotional neglect and peer group rejection are both associated with an increased risk for the development of AvPD

 TREATMENT

Treatment of avoidant personality disorder can employ various techniques, such as social skills training, cognitive therapy, exposure treatment to gradually increase social contacts, group therapy for practicing social skills, and sometimes drug therapy. A key issue in treatment is gaining and keeping the patient's trust, since people with avoidant personality disorder will often start to avoid treatment sessions if they distrust the therapist or fear rejection. The primary purpose of both individual therapy and social skills group training is for individuals with avoidant personality disorder to begin challenging their exaggerated negative beliefs about themselves.

 ETIOLOGY

No studies of genetics or of biological traits for dependents have been conducted. Central to their psychodynamic constellation is an insecure form of attachment to others, which may be the result of clinging parental behavior.

 TREATMENT
They can work toward a more functional version of those characteristics that are intrinsic to their style. Oldham suggests seven traits and behaviors of the "devoted personality style," i.e., the nonpersonality-disordered version of DPD: ability to make commitments; enjoyment of intimacy; skills as a team playerwithout need to compete with the leader; willingness to seek the opinions and advice of others; ability to promote interpersonal harmony; thoughtfulness and consideration for others; and, willingness to self-correct in response to criticism.

 ETIOLOGY

Research into the familial tendency of OCPD may be illuminated by DNA studies. Two studies suggest that people with a particular form of the DRD3 gene are highly likely to develop OCPD and depression, particularly if they are male. Genetic concomitants, however, may lie dormant until triggered by events in the lives of those who are predisposed to OCPD. These events could include trauma faced during childhood, such as physical, emotional or sexual abuse, or other types of psychological trauma.

 TREATMENT

Medication in isolation is generally not indicated for this personality disorder, but fluoxetine has been prescribed with success. Anti-anxiety medication may reduce feelings of fear while SSRIs (antidepressants) can ease frustration, reducing stubbornness and negative rumination. Psychotherapy Cognitive behavioral therapy Behavior therapy: Discussing with a psychotherapist ways of changing compulsions into healthier, productive behaviors. An effective form of this therapy has been found to be cognitive analytic therapy. Psychotherapy: Discussion with a trained counselor or psychotherapist who understands the condition. Psychopharmacology: A psychiatrist may be able to prescribe medication to facilitate self-management and also enable more productive participation in other therapies.

Andrade, Charlene Bernal, Janete Gamboa, Dohn Consuelo Libed, Ma. Eloyza Velas, Ada