Personality Disorder

Excerpt

Temperament classification dates back as far as ancient Greece when Hippocrates proposed his humoral theory regarding the classifications of behavior. The postulated temperaments, consisting of sanguine, choleric, melancholic, and phlegmatic, remained in use as recently as the 20th century. Emil Kraepelin classified manic-depressive patients as depressive, hypomanic, or irritable, which in turn correlated with melancholic, sanguine, or choleric dispositions, respectively. These, in turn, evolved into the seven personality disturbances listed by the DSM-1, in 1952. The subsequent DSM II (1968), which was heavily influenced by psychoanalysis, elaborated further to distinctly separate personality disruptions from neuroses of the same name. Psychiatric conceptualization then shifted away from the previously accepted psychoanalytic model to a categorical model strongly correlating with the medical model originally proposed by Kraepelin. This new model was represented by the eleven personality disorders acknowledged in DSM III (1980). Eleven then became ten in the more condensed DSM IV (1994). During the production of DSM 5 (2013), editors considered combining the novel dimensional five-factor model of behavior with psychoanalytic typological models of personality. However, the catalog ultimately remained unchanged. The ensuing ten disorders are classified into three clusters. Cluster A includes paranoid, schizoid, and schizotypal. Cluster B includes antisocial, borderline, histrionic, and narcissistic. Cluster C includes avoidant, dependent, obsessive-compulsive. These disorders are currently described as pervasive, maladaptive, and chronic patterns of behavior, thinking, and feeling, ultimately leading to distress and dysfunction. Patients with personality disorders suffer from distorted perceptions of reality and abnormal affective behavior, manifesting in maladaptive coping mechanisms and distress.