Personality and behavior disorders in adolescent girls. Schizoid personality disorder in children

Personality disorder refers to a wide range of disorders mental functions, manifested mainly by deviations in the formation of character and behavior, including features of lifestyle and way of relating to oneself and others.
Both character anomalies and deviant behavior can have different origins and do not always represent a painful disorder. Most often they are caused by socio-pedagogical neglect and unfavorable environmental influences. Undoubtedly painful and, therefore, within the competence of medicine should be considered such deviations in the development of character and behavior, which are based on a combination of pathogenic social and biological factors, including dysontogenesis of the central
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nervous system and gross defects in upbringing in the first years of a child’s life, when the formation of the basic properties of a person’s personality occurs. The combined effect of these factors leads to the fact that deviations in character and behavior are persistent and appear at subsequent stages of life, even if its conditions turn out to be quite favorable. A subject with abnormal character traits is limited in the freedom to choose one or another behavior, one or another action; he is poorly aware of their motives and does not know how to judiciously plan and manage his actions. In such cases we are talking about so-called psychopathies. In ICD-10 they refer to. The criteria for their diagnosis, which make it possible to distinguish them from non-pathological forms of deviant character and behavior, are as follows:
a) abnormal character traits and behavior appear from early childhood and persist throughout the subject’s life, intensifying under the influence of difficult life circumstances and somewhat smoothing out under favorable conditions;
b) disharmony mental life manifests itself in almost all its spheres, and not just in affective reactions and behavior. Thus, a psychopathic subject may have an unusual, original image thinking in which romantic views and selflessness coexist with outright cynicism and contempt for people; wealth of knowledge and developed speech are combined with weakness of constructive thinking and undeveloped practical skills, due to which in experimental psychological research the level of intelligence is underestimated; there is a selective decrease in memory for faces, names and surnames of people with very good memory for abstract objects and theoretical knowledge; the gait can be angular, facial expressions and gestures can be strange, mannered, etc.;
c) under the influence of psychogenicity, decompensations occur repeatedly throughout life, manifesting as neurotic or psychotic stress disorders with the same type of manifestations. So, for example, every time a criminal subject is arrested, the same type of hysterical reaction occurs in the form of Ganser syndrome with demonstratively ridiculous behavior.
The indicated diagnostic criteria still do not exclude difficulties in recognizing pathological and non-pathological abnormal properties of character and behavior. In the mind of a diagnostician, there is always a certain average standard of personality with regional and ethnic characteristics characteristic of a given culture. A sharp deviation from this standard, for example, the desire to live solely on pleasure and avoidance of any work, the absence of related feelings, especially daring hooligan acts and cruelty, can raise doubts about them (a normal person would not behave like that!); but such subjective assessments do not always coincide with clinical reality. Therefore, the diagnosis of psychopathy requires additional criteria. These include genetic research data, as well as obstetric history data that can identify possible lesions of the central nervous system as one of the manifestations perinatal pathology. Genetic factor plays a special role in the origin of personality disorders. This is supported by data from twin studies, which show that concordance for psychopathy in identical twins is several times higher than in fraternal twins. This relationship also persists when identical twins are raised in different families from birth.
Naturally, it is not inherited pathological behavior, and anomalous biological properties the brain, which is the organ of mental activity. This is confirmed by the high frequency of pathological slow waves detected during EEG studies of patients with psychopathy. Developmental anomalies are often observed in other organs: patients are characterized by a diplastic physique, disproportionately long
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limbs, short neck, abnormal structure of the skull and dental system, deformities of internal organs, disorders hormonal regulation. Symptoms of vegetative-vascular dystonia occur with great consistency. All these somatic changes, of course, do not serve as a direct cause of the pathological formation of character, but are indirect sign(markers) that developmental anomalies could also occur in the central nervous system. Taking them into account is useful when establishing a diagnosis of psychopathy.
The group of psychopathy, the occurrence of which is associated with the influence of not only social-environmental, but also biological factors, is relatively small and makes up approximately 25-30% of the total number of people for whom, at the present stage of development of psychiatry, it is customary to diagnose personality disorders (V. Ya. Gindikin ). A significant number of these disorders fall on the so-called sociopathies, in which there is a gross discrepancy between behavior and prevailing social norms due to environmental factors and social experience of the subject. In the years after the end of the Second World War, cases of unadapted socially behavior, especially among children and adolescents. Society could not solve this problem with traditional educational and repressive influences, and under its pressure in psychiatry, interest began to increase in anomalies of character and behavior that occupy intermediate position between normality and pathology. It was taken into account that if the social environment and the upbringing of a child do not contain the conditions necessary for the harmonious formation of a personality, this can lead to persistent and irreversible changes that violate the vital interests of both the subject himself and society. In other words, socially conditioned abnormal development of character can give rise to personal changes that subsequently manifest themselves at all stages of a person’s life. The relationship of these changes to medicine is not sufficiently substantiated, but is supported by the interests of disease prevention: caused by family-pedagogical and
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V in a broad sense social neglect, changes in character and behavior in the future can acquire the properties of a stereotype and manifest themselves on every, even minor occasion (for example, repeated suicide attempts provoked by minor conflicts). Such actions sooner or later lead to social disadaptation of the subject and serve as a predisposition factor to neurotic and psychotic diseases, to the development of alcoholism and drug addiction.
Thus, it is customary to include a wide range of conditions as personality disorders, at one pole of which there are deviations in character and behavior caused by family and pedagogical neglect and unfavorable conditions of the social environment, and at the other - character anomalies associated primarily with violations of the biological functions of the central nervous system . Between it there is a chain of transitional options, in the origin of which in some cases the role of social factors outweighs, in others - biological factors.
In practical terms, it is unacceptable to classify as personality disorders such deviations in character and behavior that are entirely due to unfavorable conditions of upbringing and social environment and in which there are no clinically expressed stereotypes of deviant behavior leading to persistent social disadaptation. Deviation from this rule leads to negative consequences: unjustified placement in psychiatric institutions and psychiatric treatment of mentally healthy persons, limitation of the rights and responsibilities of the subject (exemption from military service, from criminal liability in case of committing a crime, restrictions on employment, etc.). The wrongful attribution of non-pathological forms of deviant behavior to personality disorders also serves as a reason for the passivity of educational authorities, law enforcement agencies, administration and public organizations, which tend to shift responsibility for correcting this behavior to medical organizations ().
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1. Personality disorders in childhood and adolescence
Four factors in modern society determine the development of the character and behavior of children and adolescents: family, peer reference group, youth subculture and school. Their role is important not only in itself, but it also reflects the social and cultural values ​​of the entire society. Thus, the influence of the family, which plays a leading role in the development of the character and personality of the child, focuses on the dominant cultural values ​​in society: a respectful or, on the contrary, skeptical attitude towards knowledge and education; beliefs in the acceptability or impermissibility of behavior that infringes on the rights and interests of another person; moral, religious beliefs and much more. All these factors operating in society are invisibly present in family relationships, leaving a powerful imprint on the child’s attitudes in choosing one or another form of behavior. Even the negative influence of an antisocial peer group does not serve as the root cause of social maladaptation of a child or adolescent, since even before joining this group, thanks to the attitudes formed in the family, he was already psychologically present in it and sought to imitate the behavior of its members. The role of the family is to develop the child’s readiness or unwillingness to perceive positive and negative influences surrounding social environment.
Art and the media play a large role in the formation of a youth subculture that influences the personality of a child and adolescent. But they also act in direct connection with the influence of the child’s family and microsocial environment. Thus, a child who has learned in the family and in the reference group of adolescents attitudes towards antisocial forms of behavior, disrespect for the law and morality, easily imitates patterns of negative behavior of characters in films and television programs, and accepts scenes of crime, violence and crude eroticism for imitation. An important mediator in the transmission of the basic cultural values ​​of society is schooling and education. They influence the child as
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directly and through the family and parents, who are also yesterday’s students who learned the cultural values ​​of society at school.
Among the various forms of behavior disorder in children and adolescents with personality disorders, several types of reactions can be distinguished:
a) Aggressive reactions in Children who are not prone to grouping. Such children easily get into fights, show sadistic cruelty towards other children and animals, behave defiantly with adults, showing malicious mischief. They are characterized by reactions of active protest in response to grievances, infringement of pride, and the desire to openly take revenge on their offender. This behavior is most often found in children raised in families where their parents rejected them and did not show warmth, understanding and support towards them.
b) Delinquent behavior of children prone to grouping. Delinquency is the tendency to commit offenses that do not reach the level of a criminal offense punishable at this age. These children strive to join asocial groups of peers, with whom they engage in theft and commit other group crimes. They usually refuse to attend school, return home late, are prone to leaving home and vagrancy, abuse substances, and have sexual intercourse easily. This behavior is more often observed in children in families where parents do not show interest in them and where there are antisocial subjects in the immediate environment. A child growing up in conditions of neglect achieves a sense of security and support through full membership in the delinquent group with which he seeks to identify himself. Behavioral disorders and aggressiveness do not always stem from a logically understandable conflict situation. Often they represent a hidden attempt to achieve compensation for their dissatisfaction with family relationships,
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get rid of the feeling of inferiority and inadequacy, feel brave and decisive. A defiant attitude towards teachers can also serve as a hidden means of influencing parents, attracting their attention, and getting rid of feelings of guilt.
c) Children raised in families where the attitude towards them was based on the type of expression of constant admiration for their real or imaginary merits and permissiveness, often exhibits a hysterical version of personality development with a constant desire to attract attention to oneself, with demonstrative behavior and violent outbursts emotions in response to any failures, failure to satisfy one’s inflated demands. At school, they strive for formal leadership, although they are negligent in performing public duties and do not know how to achieve real authority among their comrades.
d) In addition to personality disorders, characterized by increased affective excitability in children, their aggressiveness, and antisocial behavior, there is an inhibited version of personality disorders. In most cases, we are talking about children growing up in families where the parents themselves are characterized by anxiety and hypersensitivity. In other cases, excessive demands are placed on children to perform household responsibilities, achieve school success beyond the child's capabilities, with criticism and threats of punishment. Such children are characterized by uncertainty, excessive shyness and anxiety. They adapt poorly to children's institutions, have difficulty getting along with peers, suffer from feelings of inferiority and loneliness, and the inability to find friends. Some of them, despite satisfactory intellectual development, study with obvious stress. Low progress in school activities deepen their feelings of inferiority and guilt. e) Similar personality changes may occur in children
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with physical disabilities, suffering from chronic somatic diseases (consequences of childhood cerebral palsy, obesity, kyphosis, large birthmark in the facial area, etc.). A reduced self-concept and a significant discrepancy between the ideal self (how the child would like to see himself) and the real self (how he actually sees himself) leads to the emergence of reactions of compensation and overcompensation, which serve as a means of protecting the self-concept. Thus, a physically weak and timid child in his dreams and games imagines himself as a brave warrior, sailor; a child raised by oppressive parents prefers to play with younger children, commands them, punishes them. Overcompensation for feelings of inferiority can take the form of pathological fantasy. Thus, a child returning from a walk in the forest says that he killed a snake there, or he states that his older brother gave him a real pistol. Compensatory reactions can take the form of feigned bravado, desperate or daring actions that are not consistent with the true character of the child and are aimed at arousing the admiration of others.
Personality disorders in childhood and adolescence are relatively dynamic. As they grow older and under favorable conditions of life and upbringing, they tend to compensate, which gives the right to classify them as transient (transistor) disorders. A prognostically unfavorable sign is the pathological inertia of deviant character traits, manifested by a persistent stereotype of disturbed behavior. They find themselves in any conditions: in the family, when transferred to another educational institution, when placed in a special boarding school for difficult-to-educate children, when changing their place of residence and in a new company of peers. Such children and adolescents, upon becoming adults, continue to remain socially maladjusted in more than 80% of cases, and they are usually diagnosed with psychopathy (sociopathy).
Peculiar personality disorders are often observed in children and adolescents raised in orphanages. IN
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They are most pronounced in children entering orphanages from special medical-type institutions, where they are raised until they are 3-4 years old. These children are autistic, they have a weak need for communication, there is often a delay in speech development, and they do not know how to play ordinary children's games. The potential for self-development inherent in infancy due to internal energy by 6-8 months. fades away. A large number of so-called ones appear: the child rocks, sucks his finger, his lip, and reproduces the same movement without any apparent meaning. A child growing up in a boarding school does not learn the skills of productive contacts with adults; these contacts are superficial, nervous and hasty: they are ready to cuddle and hang on to any person who comes to the institution, but they do not know how to develop these relationships and immediately run away, switching to passive alienation or aggression.
A special problem is the phenomenon in the orphanage. In a normal family, this is a feeling that reflects involvement in one’s family, creating conditions for the child’s protection. Orphanage is a different education. Children without parents divide the world into and. At the school where orphanage children go to study, classmates from families appear in their minds as something that develops negative relationships in them. In orphanages there are cruel relationships and sexual deviations. Among their reasons is deformed compensation for missing love and positive emotions of normal communication. Lacking a developed ability to understand the spiritual world of another, to sympathize and empathize, children in boarding schools live according to group moral standards, focusing on group conscience and guarantee. The result is low social adaptation of the majority of children who have completed their studies at a boarding school and are entering independent life (V.S. Mukhina).
Differential diagnosis psychopathy and deviant behavior due to socio-pedagogical neglect is extremely complex. Percentage of diagnostic-Functional psychogenic diseases________________257
The higher the age of the patient, the higher the number of errors, and reaches 27-40% with early diagnosis of psychopathy (V. A. Guryeva, V. Ya. Gindikin). It is necessary to search for additional diagnostic criteria, including the level of self-awareness. Deviation from the normal development of self-awareness serves as the basis for establishing a pathologically altered rate of personality maturation, dysfunction of self-control and self-regulation of behavior involved in the mechanisms of deviant behavior in adolescence. A low level of self-awareness is associated with mental immaturity, which makes a teenager unprepared for social demands, sharpening his characteristic affective excitability, disinhibition of drives, and inadequate claims to adulthood.
V. S. Chudnevsky and A. Yu. Krzhechkovsky proposed a method for determining the level of self-awareness in adolescents in the context of mass preventive examinations of students starting from the age of 11. The level of self-awareness is determined using the indicator of adequacy of self-assessment (ASO) by comparing assessments of various personality parameters by the subject himself and an expert - a teacher, educator, who knows all the members of a given educational group well. A questionnaire is used that includes 22 pairs of alternative characteristics (Table 5). Questionnaire forms are distributed to all students, who, after appropriate instruction, independently evaluate in points the degree of expression of each symptom (0, 1, 2, 3). The same forms for each student, but independently filled out by an expert. To determine ASO, a number of elementary mathematical operations are performed. First, the value of self-esteem for each personality parameter (C) is determined; it is equal to the algebraic sum of points for the alternative characteristics of each pair. The second operation is to determine the value of expert assessments (EA), which is carried out in a similar way. The third operation is to calculate the algebraic difference d=C-30 for each pair of features.
°. Zap. 101
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Table 5 Text of the questionnaire and example of calculating ACO
No. Personality parameters Score (+) Personality parameters Score (-) With EO d 1 Charming 3 Unattractive 0 +3 +3 0 2 Weak-willed 0 Strong-willed 2 -2 -2 -1 3 Irresponsible 0 Conscientious 3 -3 +2 - 5 4 Stubborn O Compliant 1 -1 +3 -4 5 Closed - Frank 3 -3 +3 -6 6 Kind 3 Evil 0 +3 +3 0 7 Dependent - Independent - - -2 6 8 Active 3 Passive - +3 + 2 +1 9 Callous 1 Responsive 3 -2 -1 -1 10 Decisive 3 Indecisive 1 +2 -3 +5 11 Sluggish - Energetic 0 0 -3 3 12 Fair 2 Unfair 2 0 +2 -2 13 Brave 3 Fearful 0 3 -1 +4 14 Impatient 3 Patient 1 +2 3 -1 15 Intransigent - Forgiving - - 0 +6 16 Confident 2 Unconfident 2 0 0 0 17 Unsociable 0 Sociable 3 -3 -3 0 18 Honest 3 Dishonest 2 +1 - 1 +2 19 Dependent - Independent 3 -3 0 -3 20 Hot-tempered 1 Calm - +1 -1 +2 21 Cheerful 3 Sad 1 +2 +3 -1 22 Willful 0 Obedient 3 -3 +3 -6
132-59 ASO = - = 0.55
EI^
\ 132
Note: 1. The numerical values ​​of EO are taken from the form filled out for this student by the class teacher. 2. Signs (+) and (-) in front of numerical values ​​d are omitted.
When examining adolescents, especially the younger age group, they often state that they do not understand the meaning of certain designations of personality traits, and they cannot evaluate them in themselves. In such cases, you should not help the subjects or give them any explanation. Ignorance of the term means the subject’s inability to give a verbal (cognitive) assessment of a given personality quality, which must be taken into account when determining the final result. Therefore, in case of ignorance of some psychological concept and the inability to use it for self-assessment, the test taker must put a dash in the column. If the subject does not understand the psychological meaning of both signs from a pair and cannot evaluate them in himself, then d is taken equal to 6, that is, it is equated to the maximum value. If one attribute from a pair is not evaluated, then the numerical value of the other is taken equal to 0. The last operation is the determination of the ACO. To do this, sum up absolute values d for all 22 pairs of features. Considering that the values ​​of d can range from 0 to b, theoretically the sum (^jd] = 59) can range from 0 to 132. Hence: 132-^1
ASO-132
Using this technique, during a mass examination of adolescents, it was found that normally, in the absence of pathological changes in character and personality, the ASO value gradually increases over the period from age 2 to 15 from 0.43 + 0.04 to 0.75 + 0.06 . In contrast, in transient psychopathic disorders (pathocharacterological reactions) and psychopathy, it remains stably at a low level. ASR above 0.62 occurs in 81% of cases in adolescents aged 14-17 years without mental disorders and only in 21% of cases in adolescents with psychopathy. ASD below 0.62 is observed in 19% of cases in mentally healthy adolescents and in 79% of cases in adolescents with clinically verified psychopathy (both transient).
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Of even greater importance for diagnosis are the extreme ASO values ​​observed in some adolescents aged 14-17 years. In mentally healthy adolescents, regardless of the characteristics of their behavior, ASD values ​​equal to 0.55 and lower are not observed. On the contrary, when pathological anomalies character and personality there are no ASO values ​​equal to 0.70 or more; Establishing them in adolescents of this age practically makes it possible to exclude the diagnosis of psychopathy.
Of certain diagnostic significance is also the establishment, during a clinical examination, of symptoms of a constitutional abnormality of the central nervous system, anomalies of the physique and internal organs, which, when taking into account other diagnostic criteria, indicate in favor of the diagnosis of psychopathy.
2. Personality disorders in adulthood
The enrichment and complexity of a person’s mental activity in adulthood, the increase in his role in society and his responsibility for his actions lead to the fact that in this period of life, personality disorders become more diverse, and it becomes possible to differentiate and classify them with a greater degree of certainty. But even under these conditions, classifications of personality disorders remain conditional, since in most cases we are talking about mixed types including symptoms different types psychopathy. The preferred classification of types of personality disorders is presented in ICD-10. .
Paranoid personality disorder is characterized by excessive sensitivity to situations that create obstacles to achieving what is desired, leading to even slight infringement of self-esteem and excessively developed pride. Patients tend to biasedly interpret any actions of people around them, depending on their sympathies and
antipathies, mistaking neutral and even friendly actions for hostile and hostile ones, seeing in everything an infringement of one’s rights. Characterized by a militant and persistent consciousness of one’s rightness in any circumstances and one’s role as a fighter for truth and justice, which are understood from the standpoint of narrow personal interests. Otherwise, patients are characterized by spiritual poverty, pettiness in everyday life, an envious and suspicious attitude towards people, an inability to forgive insults, and painful jealousy.
In case of decompensation under the influence of emerging conflicts, a litigious reaction arises, systematic persecution begins, to which the most disgusting qualities are attributed, endless complaints are written to all state, public and judicial authorities, in which any minor miscalculations of opponents are qualified as malicious and criminal, and defamatory anonymous letters are sent out. The circle of persecuted persons is constantly expanding due to all those who took part in the analysis of conflicts and who, in the patient’s opinion, did not show due integrity and impartiality. The development of struggle can give rise to over-valued delusions, including delusions of jealousy. Patients with overvalued delusions pose a great social danger, since they are prone to commit aggressive, terrorist actions against themselves or those suspected of adultery. This type of personality disorder is also referred to as paranoid psychopathy.
Emotionally unstable personality disorder (excitable psychopathy) is characterized by a tendency to act impulsively without regard for consequences. Outbursts of intense anger can lead to violence, especially if the patient's wishes and actions are resisted and criticized by others. Conflict relationships with loved ones often lead to threats of suicide and self-harm.
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Hyetrionic personality disorder (hysterical psychopathy) is characterized by extreme variability of emotional reactions and inconsistency of behavior. Patients are fickle in their affections, capricious, and their moods are changeable. They show an irrepressible desire to constantly be in the center of attention of others, to evoke sympathy, an attitude of admiration, and surprise. This is achieved through extravagant appearance, boasting, deceit and fantasy. Patients are lazy and irresponsible in the performance of everyday duties, but are lively and energetic when they expect their activities to be noticed. They strive for attention and respect in society, although they do not make much effort for this. A low level of self-awareness does not allow them to objectively evaluate their behavior: they see themselves as people capable of self-sacrifice for the sake of their loved ones and friends, without noticing their actual egoistic attitude towards them. Being sweet and flirtatious with people whom they want to make a good impression on, they become tyrants in the family, showing callousness and even cruelty towards their loved ones. In an effort to attract attention to themselves with their weakness and helplessness, such people become regular visitors to medical institutions, complaining of unbearable physical and mental suffering.
Pseudologists (pathological liars) predominate among men with hyethrionic disorder. They are distinguished by their penchant for fantasizing, talk about extraordinary incidents in which they assign themselves a spectacular role, about meeting outstanding people, trying to present himself as a more significant person than he actually is. Among them there are many petty scammers, imaginary psychics, and marriage swindlers.
Decompensation of histrionic disorder manifests itself in the form described above hysterical neurosis or psychosis.
Anankastic personality disorder is characterized by indecisiveness and a tendency to doubt.
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and exaggerated caution, lack of confidence in one’s own abilities and capabilities. In any case, patients show exaggerated attention to detail, regardless of the importance of solving the problem; they endlessly double-check the correctness of their actions. Such excessive scrupulousness and the desire for perfection (perfectionism) lead to the fact that a person is immersed in activity, avoiding all the pleasures of life, communicating with people without business necessity, and does not look for ways to express warm feelings to other people. Pedantry and formalism, stubbornness and insistence on the observance of order by everyone around them makes such people difficult to communicate in everyday life and at work.
Decompensation of abnormal personality traits in conditions of conflict manifests itself in the form of obsessive-compulsive disorders. Another name for this type of disorder is psychasthenia or psychasthenic psychopathy.
Anxious (avoidant) personality disorder is characterized by a constant feeling of tension and expectation of trouble, excessive sensitivity to criticism, and at the same time a constant desire to be liked by other people. Self-doubt is manifested by an increased tendency to introspection and a feeling of inferiority and humiliation. Fear of possible failure forces the subject to limit the circle of his attachments and avoid any activity, even minimally associated with risk. In case of decompensation, asthenic and anxiety-depressive symptoms come to the fore. Another designation for this disorder is inhibited type psychopathy or asthenic psychopathy.
Other abnormal personality traits are less common or they represent one of the variants already described*.
* Schizoid and cycloid psychopathy were described in Chapter V as pathological conditions of an endogenous nature.
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A special type of personality disorders are psychological and behavioral disorders associated with impaired sexual differentiation and sexual functions. These include transsexualism - a sexual perversion based on the subject’s belief that his existing sexual characteristics do not correspond to him. The subject persistently seeks to change his genitals through surgery or seeks to hide his gender identity by dressing in clothes worn by people of the opposite sex and adopting their behavior. Transvestism is close to transsexualism. With it, sexual satisfaction is also achieved by dressing in clothes of the other sex, but without a strong desire to identify oneself with a person of that sex.
Another group of sexual behavior disorders includes sexual preference disorders. This includes fetishism—obtaining sexual gratification by manipulating items of clothing or other objects that symbolically reflect gender; exhibitionism - achieving sexual pleasure by exposing the genitals in front of people of the opposite sex; pedophilia - perverted sexual attraction to children of both sexes; sadomasochism - achieving sexual pleasure by inflicting painful stimulation on a sexual partner or on oneself; and a number of others.
Abnormal sexual inclinations and behavior are interpreted differently in different societies and cultures and in different eras. In particular, in the International Classification of Diseases, 9th revision (ICD-9), homosexuality was identified as a special category among sexual perversions - exclusive or predominant sexual attraction to persons of the same sex with or without physical relations. In subsequent years, due to changes in social attitudes in a number of countries, as well as legislation regarding homosexuality, this type of sexual desire and behavior was no longer considered as reflecting in all
cases of pathological change in sexual preference. Therefore, ICD-10 includes only psychological and behavioral disorders associated with homosexuality, but not homosexuality itself, as painful disorders. Authoritative American sexologists W. Masters and V. Johnson believe that homosexuality is not a disease; Its therapy should be determined not by the doctor, but by the client, and only those homosexuals who do not want to come to terms with their sexual orientation need treatment, suffer from it, but cannot change it on their own.
The desire to establish a direct connection between changes in sexual behavior and disorders of endocrine functions, characteristic of the early stage of development of sexology and sexopathology, has not received sufficient confirmation. Numerous studies of the hormonal profile of men and women suffering from disorders of gender identity and sexual orientation have not yielded definitive results, and attempts at hormone therapy have been unsuccessful. This does not exclude, however, the influence on sexual behavior of more subtle neuroendocrine factors that cannot be fully analyzed at the present stage. There is, for example, a hypothesis by the German endocrinologist G. Dörner that the development of homosexuality can be at least partially influenced by the discrepancy between the genetic sex of the fetus and the sex-specific level of androgens during the critical period of brain differentiation during intrauterine development. In general, psychosexual development is the result of joint influences natural factors and education. But in any case, there is a close connection between the sexual identification and sexual orientation of the subject with the characteristics of his personality and social adaptation. This makes it justified, at least at the present stage, to include psychological and behavioral disorders in them in the sphere of personality disorders.
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A person's personality traits become apparent after late adolescence and either remain unchanged throughout life or change slightly or fade with age. The diagnosis of personality disorder (ICD-10 code) is several types of mental pathologies. This disease affects all areas of a person’s life, the symptoms of which lead to severe distress and disruption of the normal functioning of all systems and organs.

What is a personality disorder

Pathology is characterized by a person’s behavioral tendency, which differs significantly from the accepted cultural norms in society. In a patient suffering from this mental illness, there is social disintegration and severe discomfort when communicating with other people. As practice shows, specific signs of a personality disorder arise in adolescence, so an accurate diagnosis can only be made at 15-16 years of age. Before this, mental disorders are associated with physiological changes in the human body.

Causes

Mental personality disorders arise for various reasons - from genetic predispositions and birth injuries to experiencing violence in different life situations. Often the disease occurs against the background of child neglect by parents, abuse of an intimate nature or the child living in a family of alcoholics. Scientific research shows that men are more susceptible to pathology than women. Risk factors that provoke the disease:

• suicidal tendencies;
• alcohol or drug addiction;
• depressive states;
• obsessive-compulsive disorder;
• schizophrenia.

Symptoms

People who have a personality disorder are characterized by an antisocial or inappropriate attitude towards all problems. This provokes difficulties in relationships with other people. Patients do not notice their inadequacy in behavioral patterns and thoughts, so they very rarely seek help from professionals on their own. Most individuals with personality pathologies are dissatisfied with their lives and suffer from constant increased anxiety, bad mood, and eating disorders. The main symptoms of the disease include:

• periods of loss of reality
• difficulty in relationships with marriage partners, children and/or parents;
• feeling of devastation;
• avoidance of social contacts
• inability to cope with negative emotions;
• the presence of feelings such as uselessness, anxiety, resentment, anger.

Classification

To make a diagnosis of a personal disorder according to one of the ICD-10, the pathology must satisfy three or more of the following criteria:

• the disorder is accompanied by deterioration in professional productivity;
• mental conditions lead to personal distress;
• abnormal behavior is pervasive;
• chronic nature stress is not limited to episodes;
• noticeable disharmony in behavior and personal positions.

The disease is also classified according to DSM-IV and DSM-5, which group the entire disorder into 3 clusters:

1. Cluster A (eccentric or unusual disorders). They are divided into schizotypal (301.22), schizoid (301.20), paranoid (301.0).
2. Cluster B (fluctuating, emotional or theatrical disorders). They are divided into antisocial (301.7), narcissistic (301.81), hysterical (201.50), borderline (301.83), unspecified (60.9), disinhibited (60.5).
3. Cluster C (panic and anxiety disorders). They are dependent (301.6), obsessive-compulsive (301.4), avoidant (301.82).

In Russia, before the adoption of the ICD classification, there was its own orientation of personality psychopathies according to P. B. Gannushkin. The system of a famous Russian psychiatrist, developed by a doctor at the beginning of the 20th century, was used. The classification includes several types of pathologies:

• unstable (weak-willed);
• affective;
• hysterical;
• excitable;
• paranoid;
• schizoid;
• psychasthenic;
• asthenic.

Types of Personality Disorders

The prevalence of the disease reaches up to 23% of all mental disorders of the human population. Personality pathology has several types, which differ in the causes and symptoms of the disease, the method of intensity and classification. Different shapes disorders require an individual approach in treatment, so the diagnosis should be treated with special care in order to avoid dangerous consequences.

Transitional

This personality disorder is a partial disorder that occurs after severe stress or moral shock. The pathology does not lead to a chronic manifestation of the disease and is not a severe mental illness. Transistor disorder can last from 1 month to 1 day. Prolonged stress is provoked by the following life situations:

• regular overstrain due to conflicts at work, nervous conditions in the family;
• tedious journey;
• going through divorce proceedings;
• forced separation from loved ones;
• being in prison;
• domestic violence.

Associative

Characterized by the rapid flow of associative processes. The patient's thoughts change so quickly to each other that he does not have time to pronounce them. Associative disorder manifests itself in the fact that the patient's thinking becomes superficial. The patient is prone to switching attention every second, so it is very difficult to grasp the meaning of his speech. The pathological picture of the disease also manifests itself in a slowdown in thinking, when it is very difficult for the patient to switch to another topic and it is impossible to highlight the main idea.

Cognitive

This is a violation in the cognitive sphere of life. Psychiatry points to such an important symptom of cognitive personality disorder as a decrease in the quality of brain performance. With the help of the central part of the nervous system, a person comprehends, interconnects and interacts with the outside world. The causes of cognitive impairment can be many pathologies, differing in the condition and mechanism of occurrence. Among them are a decrease in brain mass or organ atrophy, circulatory failure and others. Main symptoms of the disease:

• memory impairment;
• difficulty expressing thoughts;
• deterioration in concentration;
• difficulty in counting.

Destructive

Translated from Latin, the word “destructiveness” means destruction of structure. The psychological term destructive disorder indicates an individual's negative attitude towards external and internal objects. The personality blocks the release of fruitful energy due to failures in self-realization, remaining unhappy even after achieving the goal. Examples of destructive behavior of a metapsychopath:

• destruction of the natural environment (ecocide, environmental terrorism);
• damage to works of art, monuments, valuable items (vandalism);
• undermining public relations, society (terrorist attacks, military actions);
• purposeful decomposition of another person’s personality;
• destruction (murder) of another person.

Mixed

This type of personality disorder is the least studied by scientists. The patient exhibits one or the other type psychological disorders, not of a persistent nature. For this reason, mixed personality disorder is also called mosaic psychopathy. The patient's instability of character appears due to the development of certain types of addiction: gaming, drug addiction, alcoholism. Psychopathic personalities often combine paranoid and schizoid symptoms. Patients suffer from increased suspicion and are prone to threats, scandals, and complaints.

Infantile

Unlike other types of psychopathy, infantile disorder is characterized by social immaturity. A person cannot resist stress and does not know how to relieve tension. In difficult situations, the individual does not control emotions and behaves like a child. Infantile disorders first appear in adolescence, progressing as we grow older. The patient, even with age, does not learn to control fear, aggression, anxiety, therefore they are denied group work and are not accepted for military service, to the police.

Histrionic

Dissocial behavior in histrionic disorder manifests itself in the search for attention and increased excessive emotionality. Patients constantly demand from those around them confirmation of the correctness of their qualities, actions, and approval. This manifests itself in louder conversation, louder laughter, and inadequate reaction in order to concentrate the attention of others on oneself at any cost. Men and women with histrionic personality disorder display inappropriately sexual clothing and eccentric passive-aggressive behavior, which is a challenge to society.

Psychoneurotic

The difference between psychoneurosis is that the patient does not lose contact with reality, being fully aware of his problem. Psychiatrists distinguish three types of psychoneurotic disorders: phobia, obsessive-compulsive disorder and conversion hysteria. Psychoneurosis can be provoked by great mental or physical exercise. First-graders often face such stress. In adults, psychoneurological shocks are caused by the following life situations:

• marriage or divorce;
• job change or dismissal;
• death of a loved one;
• career failures;
• lack of money and others.

Diagnosis of personality disorder

The main criteria for the differential diagnosis of a personality disorder are poor subjective well-being, loss of social adaptation and performance, and disturbances in other areas of life. To make a correct diagnosis, it is important for the doctor to determine the stability of the pathology, take into account the cultural characteristics of the patient, and compare it with other types of mental disorders. Basic diagnostic tools:

• checklists;
• self-esteem questionnaires;
• structured and standardized patient interviews.

Treatment for Personality Disorder

Depending on the attribution, comorbidity and severity of the disease, treatment is prescribed. Drug therapy includes taking serotonin antidepressants (Paroxetine), atypical antipsychotics (Olanzapine) and lithium salts. Psychotherapy is carried out in attempts to change behavior, make up for educational gaps, and search for motivation.

Video: Personality Disorders

In our country and the CIS countries, experts consider this disease as “ low-grade schizophrenia" This term is not included in ICD-10 and is not used by Western doctors. Domestic psychiatrists consider a number of psychopathic and neurotic asthenic disorders within the framework of this disease.

In the history of psychiatry, the diagnosis of this pathology has always been given great importance. This is due to the fact that experts sought to free carriers of disorders from the label of a mental patient. The erroneous classification of them as patients with schizophrenia led not only to negative social consequences, but also had a negative impact on the outcome of treatment.

Signs of the disorder

According to ICD-10, the International Classification of Diseases, schizotypal disorder is characterized by eccentric behavior, abnormal thinking, and inappropriate emotional manifestations characteristic of schizophrenia. However, a complete picture of the symptoms typical of schizophrenia is not observed.

Symptoms of schizotypal disorder include:

• eccentric behavior and strange appearance;
• inability to maintain contact with others;
• emotional coldness and detachment;
• inappropriate affect;
• a strange worldview incompatible with the norms of society;
• paranoid ideas;
• sensorimotor illusions;
• pretentiousness of speech;
• amorphous, stereotypical thinking;
• delusional ideas and hallucinations;
• derealization or depersonalization;
• obsessive thoughts with aggressive or sexual content.

The listed symptoms may be supplemented by persistent psychopathic-like, depersonalization symptoms, more characteristic of neuroses. Schizothepic disorder in such cases is characterized by monotony, inertia, and clichedness. However, to make a diagnosis, the presence of such additional signs as decreased mental productivity, initiative, activity, and paradoxical judgments is necessary.

With this type of pathology, thinking may be impaired. Patients often exhibit emotional states, which are expressed in the form of unexpected affects of anger, suspicion, irritation. They typically consider themselves to be part of a select group who are able to predict the future and express superstition. Special meaning patients attach different symbols, omens, and premonitions. They believe not in the abstract, but in the concrete “sixth sense”, telepathy, and have a tendency to interpret what is happening.

The inner world of patients is filled with various autistic experiences and fantasies. It contains fictitious relationships with real people and imaginary images. These relationships may be accompanied by various fears, including childhood fears. Speech has a special style that is not understandable to others.

This is especially clearly seen in the patient’s communication with unfamiliar people who are not accustomed to the peculiarities. People around him pay attention to the inappropriate behavior of the carrier of the disorder; he is capable of committing unpredictable actions.

Schizotypal disorder in children has similar clinical manifestations. The characteristic symptom of the pathology is early autism, which is subsequently supplemented by a number of syndromes, which makes it possible to diagnose schizotypal disorder already in adolescence. Child monitoring preschool age can help identify features characteristic of this disease: outbursts of anger, panic attacks.

An inadequate reaction of a child can be provoked by any, in his opinion, wrong action. Seizures tend to recur whenever those around them perform actions that do not correspond to the child’s ideas. Such children usually refuse to communicate with those who have offended them, do not accept gifts from them, do not play with them, etc. During attacks, they experience an unsteady gait, clumsiness, club feet and other disturbances in coordination of movements.

Diagnostics

Schizotypal disorder can be diagnosed if the patient exhibits at least 4 signs of pathology for two or more years. The list of symptoms indicating the presence of the disease includes:

• indifferent attitude towards people, avoidance of contacts, asociality;
• shocking, eccentric behavior;
• aggressiveness or severe irritability when it is necessary to come into contact with others;
• causeless manifestations of anger;
• own diet;
• talking to yourself;
• sexual disorders;
• social fear;
• illogical, abrupt, incoherent expression of thoughts;
• paranoid syndrome;
• thinking with a magical connotation, obsessions that do not correspond to generally accepted cultural and moral norms;
• communication with real or imagined imaginary interlocutors.

The diagnosis is made as a result of an examination by a psychotherapist. During the diagnosis, the doctor determines the presence of the above signs of the disorder. One of the characteristic symptoms of the disease is the patient’s failure to recognize his inadequacy. The symptoms of schizotypal disorder are very similar to a number of other mental disorders. The main difference between pathology is the preservation of critical thinking: the patient is able to distinguish between reality and illusions. The prognosis is favorable, but in the absence of treatment, loss of adequacy of judgment and, as a result, disability is possible.

Classification

According to the International Classification of Diseases, it is customary to distinguish the following subtypes of the disorder:

• Schizophrenic reaction.
• Latent schizophrenia, including prepsychotic and prodromal schizophrenia.
• Neurosis-like schizophrenia.
• Psychopathic-like schizophrenia, including borderline schizophrenia.
• “Symptom-poor” schizophrenia, which is characterized by negative symptoms in the form of increasing autism, a narrowing of the range of emotional manifestations, and decreased productivity.
• Schizotypal disorder, unspecified. This formulation is used when there is insufficient data for a reliable diagnosis.

Causes

This disorder can arise as a result of completely various reasons, some of them are individual. Normally, a child learns to adequately perceive signals from society and show a certain socially accepted reaction to them. It is assumed that individuals with schizotypal disorder encounter developmental disorders at this stage, which leads to the emergence of pathology in behavior and mental activity.

The most common factor that triggers the mechanism of the disorder is considered to be an unfavorable family upbringing, characterized by a careless attitude to the needs of the child, insufficient attention to his upbringing, violence and severe harm. psychological trauma. The history of the development of pathology usually includes negative childhood life experiences.

The next factor that increases the chances of becoming a psychiatrist's patient is heredity. If one of your close relatives has the disorder, the risk of developing the disease increases several times. In addition, the list of causes of the development of pathology includes alcohol or drug addiction. The disorder is classified as rare: throughout the history of the pathology, the 3% barrier has not been exceeded. Women are more susceptible to developing this pathology than men.

Therapy for the disorder

In the case of schizotypal disorder, treatment involves a combination of various psychotherapeutic techniques and drug therapy. The disease is considered completely curable if the patient follows a competent approach to treatment and follows all prescribed measures. The use of medications is designed to reduce the manifestation of outbursts of anger and aggression. For this purpose, large doses of neuroleptics and small doses of tranquilizers and antidepressants are prescribed.

In the absence of severe anger and aggressive outbursts, medications are not prescribed; treatment includes the use of psychotechnics. During treatment medications schizotypal disorder, the correct dosage is of great importance. Exceeding the required dose or incorrect definition can provoke the development of secondary negative symptoms.

To correct schizotypal disorder, methods of group, family, cognitive behavioral therapy, and psychoanalysis are used, which contribute to the patient’s awareness of the presence of mental pathology and the training of adequate trusting relationships with others.

Usually, one course of psychotherapy is sufficient to correct the acute manifestations of the disorder.

After treatment, patients are able to adequately interact and respond to social signals. The prognosis is favorable, but it should be taken into account individual characteristics personality. In some cases, the disease may take an unfavorable course. Such patients are granted disability. When the disorder becomes chronic, the carrier of the pathology is exempt from conscription into the army or service in law enforcement agencies.

In addition, such a diagnosis is a reason for refusing to issue a driver’s license. In case of repeated recurrence of the disorder, the carrier is assigned a group 2 disability. With untimely treatment and inadequate treatment, severe forms of depression and schizophrenia may develop.

Schizotypal personality disorder

A chronic, slowly progressive illness, schizotypal personality disorder is a serious symptom. Modern medicine I have learned to deal with the symptoms and stop acute conditions, but for this it is necessary to consult a doctor in time. In order to detect the disease at an early stage, we will study the problem in more detail.

Many of us have witnessed inappropriate human behavior. He can constantly speak in metaphors and thinks based solely on stereotypes. Such persons are confident that others threaten their safety and live in solitude. This also includes those who deeply believe in the power of magic, superstitions, and omens. The presence of such a person in the family is especially problematic. It causes discomfort in relationships due to excessive eccentricity, coolness, and odd behavior. To understand whether a given person has a mental disorder, it makes sense to get acquainted with what schizotypal personality disorder is and learn to differentiate the condition from other mental pathologies.

Causes of personality disorder

By identifying factors that provoke the development of mental disorders in a person, specialists work with each patient individually. The cause of the disease may be episodes that occurred from early years of life. The disease can develop against the background of social, biological, physiological factors. According to doctors, when faced with various kinds of shocks at an early stage of life, the psyche develops a response that can lead to deviations in behavior, mood and mental functions. Common causes of this type of disorder include:

1. Genetic predisposition (heredity). According to statistics, psychiatrists’ patients with schizotypal personality disorders are those who have already had this pathology in their family. Excessive dopamine activity observed in parents can be transmitted through the blood. Therefore, it is important for adults to monitor the child’s behavior and visit a specialist to stop signs of the disease at an early stage.
2. Psychological trauma. Neglect of children's interests, domestic violence, alcoholism, drug addiction of parents, inadequate attitude towards children and their upbringing can cause mental disorders. This also includes relationships with peers and society.
3. Pregnancy. The body of the expectant mother is subjected to powerful physiological stress; the system “gets used” to the “foreign body” located in the womb. If pathological processes occur that cause deviations in the formation of the fetus, schizotypy may develop already at the stage of gestation or after the birth of the baby.
4. Alcoholism, drug addiction. Abuse of toxic substances - alcoholic beverages, drugs - can cause malfunction of cells in the brain, cause necrosis of entire areas, and provoke rupture of ligaments at the intercellular level. Hence - disturbances in thought processes and the development of deep pathologies, leading not only to schizotypy, but also complex forms of schizophrenia.

Schizotypal personality disorder: symptoms

First of all, you need to understand that this type of disorder can occur in many people. We repeatedly witness oddities in manners, which are characterized by excessive anxiety, asocial manners, an overly sensitive attitude towards seemingly familiar things. In the presence of such individuals, a normal person feels awkward, he feels discomfort, since communication is difficult due to the unusual, strange behavior of the patient. And if at the early stage of the disorder everything is perceived tolerantly, with reference to character traits and worldview, then as the disease progresses, very serious shades arise, which include hypochondriacal, neurotic, psychopathic tendencies. In order to spot the problem in time, you need to pay attention to the following manifestations:

• increased suspicion, social withdrawal;
• egocentrism, odd behavior;
• paranoia;
• alienation, emotional coldness, inadequacy;
• the way of thinking is amorphous, detailed, the attitude towards even small things is overly detailed;
• disturbance of perception, depersonalization, illusions;
• obsessions, inability to resist them;
• in rare cases, auditory hallucinations and delusional ideas are possible.

Persons with such an illness are prone to inadequate opinions that are not inherent in society, are carried away by implausible sciences, magic, the occult, and believe in fortune telling, omens, and superstitions. They constantly see signs of fate in everything, read the publications of charlatans, purchase unnecessary goods from scammers at significantly inflated prices, etc.

Important: to determine a person’s tendency to schizotypy, it is not necessary to have all of the listed signs. It is enough for 4 of them to be observed for about two years.

Schizoid and schizotypal personality disorders: what is the difference

These two diseases are very similar in symptoms. If both are combined in a person, they manifest themselves through eccentric behavior, egocentrism, cold attitude towards others, lack of emotions, which causes bewilderment. Some patients experience autistic deviations, paucity of contacts, interests, one-sided outlook, paradoxical behavior, and emotions. In case of schizoid disorder, which develops from an early age, the patient’s characteristic signs appear clearly. In the case of schizotypy, symptoms are observed in childhood quite rarely, only many years later, as the disease develops.

Manifestations in adolescence

Schizoid and schizotypal personality disorder in adolescence is difficult to diagnose even in a differential way. But over the years, as the symptoms become more obvious, condition-specific symptoms make it possible to establish a diagnosis. The differential diagnosis is intended to exclude schizophrenia, a disease that leads to more serious threats to life and others.

Many people mistakenly believe that schizoids are dangerous to society. Patients of this type consider themselves outside observers and practically do not participate in events and do not make friends. It is for this reason that if a person has schizoid personality disorder, the army is completely contraindicated for him or there are restrictions. This includes the place of service, duration, etc. Even from school years, if behavioral characteristics have already been observed, they endure bullying and ridicule from their peers. By the young age of conscription, unlike their peers, they have no experience of communicating with the opposite sex, no communication skills, aggression, outbursts of anger, and irritability are observed. At the same time, they are completely defenseless, which leads to problems in communication.

Schizotypal personality disorder: symptoms in children

Signs of the disorder in children and adults are similar in their manifestations. According to medical statistics, this diagnosis is often preceded by autism. The disease can be diagnosed only in adolescence, when the child exhibits residual or acquired syndromes of schizotypal disorder. Adults need to pay attention to the following points in children’s behavior in order to identify the problem and contact a specialist:

• The baby has a desire to eat and drink only from the same dishes. If you offer him even the most favorite dish in another container, he will flatly refuse.
• Panic, anger, irritability, aggression arise at the slightest change in the actions of strangers: they put a toy in the wrong place, hung a towel in the wrong place, opened a window. The child gets used to only the same type of actions, and their slight violation provokes an attack.
• Food prepared and served by a person who looked the wrong way, said the wrong thing, or performed other actions that are not entirely familiar to the child will be categorically rejected.
• Loss of coordination of movements - clumsy gait, constantly hitting corners, falling with the whole body, long steps, club feet.
• Each attack ends with softness, the body seems to sag. Adults cannot calm the baby; attempts to hug and calm them down cause crying.

Important: attacks of schizotypal personality disorder, classified in ICD 10 as code F21, often lead to the risk of strokes. Therefore, you need to contact specialists in time for adequate treatment.

Prognosis for schizotypal disorder

Like most mental disorders, this disease is incurable. If symptoms appear, you need to prepare for the disease to progress. But there is good news - after some time, even if it is long, the process will stabilize and will not particularly affect the quality of a person’s life. And compared to schizophrenia, the prognosis for schizotypy is much more favorable: the personality defect is not so clearly expressed.

Important: with schizotypy, people manage their personal lives quite successfully - they have families, higher education, work in successful companies, have good memory, coherence and high discipline.

To prevent the problem from getting worse, you must not give up and consider yourself mentally ill. It is necessary to take adequate treatment, regularly visit a specialist, which will allow for high-quality and active image life.

Is there any disability for schizotypy?

Symptoms of a disease are not always grounds for filing a disability claim. Experts look at the course of the disease - continuous or paroxysmal, social adaptation, and a person’s communication skills.

To the general clinical picture, to which special attention include specialists, is influenced by the fact whether the patient needs inpatient treatment and how often he spends time in a specialized clinic.

The disease progresses differently for everyone, since the character and characteristics of the psyche are individual. To obtain disability, you should collect a number of documents, confirmations from a psychiatrist, testifying to the patient’s condition.

Treatment and prevention of schizopathy

As we already know, it is absolutely impossible to start a problem. After the first signs, it is necessary to contact a specialized psychiatrist and, under his strict supervision, undergo diagnosis and adequate treatment. Many people mistakenly believe that there is no point in treating this disease or that it will go away on its own. Symptoms can worsen over time and bring significant discomfort not only to the patient himself, but also to those around him.

Under the influence of the latest treatment methods, innovative drugs, psychotherapy, the condition is alleviated:

• leaving obsessive fears, ideas, actions;
• aggression, outbursts of anger, irritability, panic are suppressed;
• Delusions, hallucinations, and illusions are excluded.

Important: in the case of schizotypy, there is no need for an aggressive form of therapy, as in schizophrenia, but you cannot do without medication, since in advanced conditions all types of symptoms leading to suicide worsen.

As preventive measures, to prevent attacks and taking into account the endogenous nature of the disease, it is necessary to protect the patient from conflicts, provoking actions, words, movements. Mental pathology can develop when severe stress, carrying a child, excessive physical stress, somatic diseases. This means that it is important to protect a person from diseases and create a harmonious, light and pleasant environment around him.

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Schizotypal personality disorder in children

Schizotypal personality disorder is a pathology mental processes, manifested by anomalies in psycho-emotional response and mental activity. People with the described diagnosis are characterized by eccentric behavior, unsociability, a tendency to be isolated from society, and a delusional mood. At the same time, there are no disorders indicative of schizophrenia, and there are also no prevalent or typical symptoms of schizophrenia.

Schizotypal personality disorder is clinically similar to schizophrenia, but the symptoms are more subtle. An essential sign of the described pathology can be considered excessive suspicion, isolation and distrust.

Causes of schizotypal disorder

Due to many reasons individual character Schizotypal personality disorder may develop. An individual, starting from an early age, learns to adequately perceive messages coming from society and respond appropriately to them. A number of psychotherapists are convinced that at this stage, subjects with a history of schizotypal personality disorder experienced some disturbances that led to deviations in behavioral response and mental operation.

The most common factors provoking the formation of the described disorder are considered to be neglect of a child’s needs on the part of his adult environment, lack of attention to the adequate upbringing of the child, an unfavorable atmosphere in the family, past violence or serious psychological trauma.

Often, schizotypal personality disorder is found in subjects whose relatives have a history of a similar illness. From this we can assume that genetic predisposition plays an important role in the development of the described pathological condition.

Individuals who abuse alcohol or suffer from drug addiction, are at risk of developing this pathology.

If the symptoms of the disease are not recognized in a timely manner and adequate treatment is not prescribed, the prognosis for schizotypal disorder is unfavorable. This pathology often leads to severe depressive states, the formation of anxiety disorders and the development of schizophrenia.

Suggested causes of schizotypal personality disorder:

Hereditary predisposition that provokes increased activity of dopamine (“dopamine theory”);

Mental disorders in parents;

Lack of attention in childhood;

Frequent stressful situations;

Schizotypal disorder and schizophrenia are often characterized by similar symptoms, as a result of which some scientists have suggested that the factors that provoke the development of illnesses will also be similar. They determined that schizotypal manifestations, similar to schizophrenic symptoms, are often associated with defective communication interactions in the family.

Symptoms of schizotypal disorder

It is often difficult to distinguish schizotypal disorder from schizophrenia and schizoid personality disorders.

Signs of schizotypal disorder are characterized by mild severity. Basically, symptoms include detachment, isolation, emotional coldness, eccentricity, eccentric appearance, “magical thinking” (that is, patients believe that they have superpowers). In general, mental activity and behavioral response do not correspond to generally accepted cultural norms.

Sick individuals are often unable to adequately interpret ongoing events, since they regard them as meaningless incidents. Also common manifestations of this disease include various speech disorders and difficulties in concentrating. Subjects suffering from the described pathology, as a rule, are not able to maintain a consistent conversation, constantly switch to abstract topics and lose the essence of the conversation. Their speech is characterized by vagueness and incoherence. The patient communicates through fragmentary phrases that he repeats constantly. Free associations Such people cause their interlocutors to lose their train of thought. At the same time, the described problems relating to attention and mental functioning do not lead to a complete detachment from reality (a break with reality). This distinguishes schizotypal disorder from schizophrenia.

Social alienation of the subject is almost always an integral part of schizotypal disorder. Sick individuals are able to communicate communicatively only with a limited circle of people. Such a circle, as a rule, includes close relatives who know about the presence of pathology, as a result of which they were able to adapt to its specific features.

Outsiders not only do not understand the behavioral reactions and speech of a sick subject, but can often provoke panic attacks, anger and aggression in him. A fairly common manifestation of schizotypal deviation is the patient’s communication with himself or fictional characters. At moments of such communicative interaction, an individual may exhibit previously uncharacteristic openness and various emotional reactions, such as crying, screaming. During such periods, a person often shares his experiences with a non-existent interlocutor, shares childhood memories and experienced events. Despite attempts to isolate themselves from society, sick people do not feel lonely.

As a result of the problems described, most sick individuals are characterized by a tendency to aimlessly waste time and an idle, unproductive lifestyle. Therefore, they often choose jobs that do not require qualifications or special knowledge.

Typical signs of schizotypal disorder:

Unreasonable outbursts of anger;

Flowing into a rage, throwing household items nearby;

Closedness and unsociability;

Frequent mood changes for no apparent reason;

The appearance of obsessive thoughts and ideas;

Detailed and stereotypical thinking;

In addition to the signs listed above, patients may also experience the following symptoms: depersonalization and derealization, delusional states (that is, states that cannot be interpreted as a true delusional disorder), hallucinations.

In children, the signs of schizotypal disorder are similar to the symptoms of this disease in adults. Children are often diagnosed with autism, and schizotypal deviation is usually detected during puberty as residual or newly acquired syndromes. In children, even minor factors can provoke anger, panic attacks, and outbursts of aggression. A baby is capable of an inappropriate reaction if a parent arranges his toys or hangs his clothes in the wrong order. Attacks of aggression, anger or panic will occur every time the actions of others do not correspond to the sick child’s ideas about how to correctly perform various tasks. If someone from the baby’s immediate circle has offended him, he may subsequently refuse to interact with him or accept food or gifts from him. Some kids agree to drink and eat only from a certain plate and cup. If the necessary utensils are not at hand, then a sick child may refuse to eat altogether. In addition, children exhibit pronounced deviations in the coordination of movements, such as clumsiness, unsteady gait, clumsiness, and club feet.

Schizotypal disorder prognosis. If not identified and treated adequately in childhood this pathology, then the risk of strokes and the development of severe deviations in mental functioning increases significantly.

Schizotypal disorder and schizophrenia have a similar clinical picture, but schizotypal deviation is characterized by limited symptoms and washed-out manifestations. All personal changes come slowly. In addition, people with schizotypal deviation do not lose their sense of reality, unlike people suffering from schizophrenia, who live in their own reality, which they impose on others.

A diagnosis of schizotypal disorder is possible if more than four of the following symptoms are present over a two-year period:

Indifference to what is happening and the surrounding society;

Eccentricity in behavior, eccentricity in appearance;

New acquaintances cause irritability;

Unreasonable outbursts of anger;

Inadequate mental activity;

Assertiveness in own ideas that go against generally accepted sociocultural norms;

Deviations in intimate life;

Incoherence in speech;

Communication with fictional characters or non-existent people.

When an official conclusion is made, schizotypal disorder is assigned a disability of the second group.

Treatment of schizotypal disorder

The described personality disorder is characterized by absolute denial of the sick individual own illness, their abnormality, eccentricity, inadequacy of mental activity and perception of reality. Treatment often takes place due to insistence close circle and the patient's relatives. Often, at the initial stage of therapy, this provokes negative behavior of the sick individual in relation to family members.

First of all, the success of treatment for schizotypal personality disorder depends on the stage of neglect of the disease, the form of its course and the individually characteristic clinical manifestations.

The basis of the general principles of therapy are the following methods: drug treatment, psychotraining and psychotherapy (methods of cognitive behavioral therapy, group and family therapy techniques are more often used).

The examination of sick individuals, first of all, includes mandatory inspection a psychotherapist and a conversation that allows you to detect characteristic behavioral deviations and speech disorders.

Diagnosis of schizotypal disorder is possible after a comprehensive examination and testing, for example, using the Schizotypal Personality Questionnaire (SPQ test). This technique contains 74 interrogative sentences, which cover nine main manifestations of schizotypal deviation in accordance with the International Classification of Diseases (ICD-10). More than 50% of respondents whose test results exceeded diagnostic level, was subsequently diagnosed with schizotypal disorder.

In addition to the SPQ technique, there are also other tests aimed at establishing the level of social anhedonia, psychoticism, and possible deviations in perception (author Eysenck). However, only the SPQ method brings together all the clinical manifestations of schizotypal disorder.

To make a diagnosis of schizotypal disorder, the long-term presence of characteristic symptoms along with the absence of personality deficits is necessary. In addition, the diagnosis of schizophrenia must be excluded. For this purpose, collecting a family history, medical history and life history will help.

It is very important to avoid over- and underdiagnosis. Misdiagnosis of schizophrenia is especially dangerous for patients. Since in this case they will receive unreasonably intensive care. In addition to this, due to the dissemination of information about the diagnosis of such an illness as schizophrenia among friends, the patient will receive social isolation, aggravating the symptoms.

A patient suffering from schizophrenia completely loses touch with the surrounding reality. With schizotypal disorder, patients retain the ability to think critically and distinguish reality from their own illusions.

A specialist can diagnose the described disorder based on visible disharmony in the individual’s positions and behavioral responses, as well as on specific personality characteristics, such as impaired impulse control, emotional response, perception, mental activity, and style of relating to the environment. The described characteristics become obvious because the individual stubbornly rejects the need to adjust his own behavior, even despite the negative consequences of his actions. In other words, typical symptom This mental pathology is the sick individual’s denial of the inadequacy of his behavior.

In addition, in order to make a correct diagnosis of schizotypal deviation, the patient must have additional manifestations, namely a decrease in mental productivity, initiative, paradoxical judgments, decreased activity, and emotional leveling.

In addition to the clinic described above, the specialist usually identifies the inadequacy of the use of defense mechanisms. The use of defense mechanisms is inherent in all human individuals, but in case of personality disorders they are ineffective due to their inadequacy.

After a diagnosis of schizotypal disorder is made, treatment is prescribed depending on the individual symptoms, form and stage of the disease.

Drug therapy is mainly based on the administration of small doses of antipsychotics. If the patient develops other conditions over time, for example, phobia, depression, anxiety or panic attacks, then antipsychotics, antidepressants and sedatives can be used. However, psychiatrists do not recommend using drug therapy as the only treatment method. Purpose medicines justified only in the presence of persistent aggressiveness and frequent outbursts of anger of the patient. If the described symptoms are absent, then it is better not to prescribe drug therapy, so as not to provoke a negative reaction in the patient’s behavior. In addition, patients suffering from a personality disorder quite often violate the use of medications, which can cause suicidal behavior.

Cognitive-behavioral techniques, group and family therapy techniques contribute to the patient’s awareness of his own mental disorder. Psychotherapeutic methods are aimed at teaching the individual to build trusting relationships with the environment, acquiring the necessary socio-behavioral skills. Basically, after a full course of therapy, it is possible to correct the patient’s mental activity, teach him to adequately respond to any messages from the social environment and interact in society.

The main goal of behavioral therapy can be considered to alleviate the main manifestations of adaptation disorders, such as social isolation, recklessness, emotional outbursts, and self-doubt.

Psychotherapy, first of all, is aimed at the individual work of the therapist with the sick individual. The doctor explains to an individual suffering from schizotypal disorder in what manifestations his behavior is antisocial, explains to him his negative reactions to what is happening, mental activity and perceptions that are unusual and incomprehensible to others. The primary task of the psychotherapist is to correct the patient’s behavioral response, minimize the likelihood of aggression and outbursts of anger, reduce apathy in relation to social life, and teach openness in relationships with close associates and relatives. In addition, the obligatory task of the psychotherapist is to minimize (even to the point of completely eliminating) the sick subject’s communication with himself and non-existent people.

Psychotherapy includes not only sessions individual lessons with patients, but also a series of communication trainings in groups, which can consist either exclusively of people suffering from schizotypal disorder or of the patient’s relatives. Joint trainings with relatives are necessary to improve the quality of the patient’s communicative interaction and the perception of him by loved ones.

In addition, psychotrainings conducted in small groups are considered indispensable in the treatment of this disease. They teach the patient to find a common language, communicate with the external environment, teach him to negotiate, solve minor problems not related to everyday life, and prepare him for a social way of existence.

The time required to achieve positive dynamics of therapy is individual for each patient.

Today, family therapy is considered one of the most effective methods aimed at correcting schizotypal deviations. It helps the sick individual to stabilize emotionally, relieves him of conflict, and also helps to establish family relationships and raises the patient’s morale.

Schizotypal disorder is often assigned a disability, which exempts patients from military service and work in law enforcement organizations. Often, a sick individual may be temporarily or permanently deprived of a driver’s license in accordance with the conclusion of a medical board.

For schizotypal disorder, the prognosis is always individual. Since this disease is chronic and characterized by periodic exacerbations. Often, schizotypal personality disorder leads to depression, anxiety disorder, or schizophrenia.

Symptoms and treatment of schizotypal personality disorder

Schizotypal personality disorder is a type pathological disorder psyche, which is accompanied by anomalies psycho-emotional state and thought processes.

People with this diagnosis are withdrawn and prone to delusional moods. This pathological condition must be treated to avoid complications.

Schizotypal personality disorder has characteristic symptoms that can be used to identify its occurrence in the early stages of development.

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What it is?

Schizotypal personality disorder is a chronic and slowly progressive disease associated with a person’s mental state.

This disease is characterized by a person’s detachment from generally accepted norms of behavior in social environment, a special type of thinking and emotional state.

In medical practice, schizotypal personality disorder is often equated to a latent form of schizophrenia. The disease is incurable and manifests itself in regular attacks of exacerbation of symptoms.

Schizotypal personality type - what does it mean?

Schizotypal personality disorder and schizotypal personality type are different conditions. In the first case, a certain type of mental disorder is implied, in the second - a specific character trait of a person.

People with this personality type have many distinctive characteristics that may be alien and incomprehensible to others. This character trait increases the risk of developing mental disorders and automatically places a person at risk.

Distinctive features of people with a schizoid personality type:

• complex fragmented perception of reality (great importance is attached to little things);
• a tendency to withdraw (manifests itself not only in the lack of desire to make new acquaintances, but also in the paucity of expression of emotions; it is difficult to determine signs of joy or sadness in such a person);
• in a team, such people are distinguished by discipline, the ability to independently solve any problems, trying to communicate with colleagues as little as possible (such people, as a rule, are engaged in a narrow specialization and completely concentrate on their profession);
• a tendency to talk to oneself (a person talks to his reflection, pronounces questions out loud, as if consulting with someone and receiving an answer).

Read about the symptoms and signs of obsessive-compulsive disorder here.

Schizotypal disorder - what is it? Find out from the video:

Causes and risk groups

The main reasons for the development of schizotypal personality disorder include hereditary predisposition and the nuances of upbringing in childhood.

In the first case, there is a risk of transmitting pathology at the genetic level if such anomalies were diagnosed not only in parents, but also in close relatives.

In the second, a pathological condition can be provoked by ignoring children's needs, using methods of violence against a child, and various psycho-emotional experiences.

The following factors increase the risk of developing schizotypal personality disorder:

• abuse of bad habits (especially the use of alcohol and drugs);
• genetic predisposition (increased production of dopamine and mental disorders in close relatives);
• consequences of frequent stressful situations(as well as a tendency to depression);
• pathological mental states during pregnancy (the consequence will be a negative impact on the formation of the psyche in the unborn child);
• peculiarities of upbringing (lack of attention from parents, excessive guardianship, etc.).

How to get rid of obsessive thoughts? Find out about this from our article.

Intelligence in schizotypal personality disorder:

Features of manifestation in children

It is extremely difficult to diagnose schizotypal personality disorder in children.

One of the main features of this pathology is the manifestation of the first symptoms exclusively in adolescence and adulthood.

Some factors should alert parents. A number of symptoms in a child may indicate a risk of developing schizotypal personality disorder in the future.

Alarming symptoms in children:

• refusing food for specific reasons (cooking by the wrong person, offering food with certain person etc.);
• the occurrence of eating food only from one plate (if you offer food in another dish, the child will refuse to eat);
• tendency to attacks of aggression at the slightest changes in the behavior of others (for example, a toy is in the wrong place, a window is not open as usual, etc.);
• poor coordination of movements (may manifest itself in the child’s gait or sudden loss of balance);
• tendency to lethargy after attacks of aggression (symptoms of weakness abruptly replace aggressiveness).

Symptoms and signs

The symptoms of schizotypal personality disorder are similar to those of schizophrenia, but are less severe.

The thoughts and statements of a person with such a deviation are not understandable to the people around him. Because of this feature, his circle of contacts is to a large extent narrows. Only close relatives can find a common language with such a person through long-term adaptation.

Symptoms of schizotypal personality disorder manifest themselves in the following conditions:

• social alienation;
• lack of bright emotions;
• tendency to communicate with fictitious personalities;
• eccentric behavior;
• magical coloring of thinking processes;
• desire for an antisocial life;
• disturbance of mental functions;
• excessive isolation;
• tendency to paranoia;
• sudden mood swings;
• unreasonable attacks of aggression;
• the presence of obsessive thoughts and ideas;
• tendency to hallucinate;
• amorphous way of thinking;
• excessive suspicion.

How to treat neurosis obsessive states in children? You will find recommendations from psychologists on our website.

Schizothymia, schizoid accentuation, schizotypal personality disorder - differences:

Schizotypal and delusional disorders

Schizotypal and delusional disorders are difficult to distinguish in the initial stages. The unifying factor is the presence of deviations in thinking.

Schizotypal disorders are accompanied by delusional states, but in this case delusion will be a concomitant symptom of mental disorder.

The duration of the attacks also differs (in their independent form, delusional disorders have a short-term manifestation).

Features of schizotypal and delusional disorders:

1. Delusional disorders belong to the category of mental disorders, accompanied by the emergence of systematized delusions characterized by stable manifestations (for example, delusions of jealousy, delusions of grandeur, delusions of persecution, etc.).
2. With schizotypal personality disorders, delirium takes on a bizarre coloring (a person can hardly be called mentally ill, his behavior is strange, but has some magical overtones, for example, a tendency to invent the presence of non-existent people, talking to himself, etc.).

What methods does treatment include?

It is impossible to cure schizotypal personality disorder or reduce its symptoms on your own. The only method of effective therapy is a combination of psychotherapeutic methods and the use of special medications.

If this mental disorder is detected, contacting a doctor is inevitable. Psychotherapists treat this disease, but in some cases therapy is supplemented by sessions with a psychologist.

Therapy for schizotypal disorders includes the following techniques:

1. Cognitive behavioral therapy (this technique is not only the main one, but also the most effective way elimination of mental disorders, the task of such therapy is to identify the causes of the pathological condition, select methods for teaching the patient self-control, change his thinking and perception of the environment, as well as reduce the risk of relapse of the disease).
2. Individual and group sessions with a specialist (the patient can be assigned only individual or group sessions, as well as their combination in one course of therapy; during the sessions, the causes that provoked schizotypal disorders are identified, and a plan for their maximum relief is drawn up).
3. Family psychotherapy (the goal of this technique is to develop the patient’s correct communication skills with relatives; family members should take part in some classes; the doctor explains in detail the optimal communication options and works with the person’s psycho-emotional state).
4. Classes with dolphins and horses (communication with these animals has therapeutic effect and has an extremely beneficial effect on the psycho-emotional state of a person, especially in the presence of mental disorders).
5. Drug therapy (neuroleptics, tranquilizers, antidepressants and other drugs to restore a person’s psycho-emotional state).

Can it be cured?

Schizotypal personality disorder is an incurable disease. It is completely impossible to get rid of it.

The positive aspect of timely and complete therapy is the ability to quickly relieve symptoms and increase the time interval between relapses.

The prognosis for such a mental disorder is individual and depends on numerous factors, but in most cases it is not possible to avoid repeated manifestations of the pathology.

With proper treatment of the pathology, the following favorable prognoses are possible:

• obtaining higher education;
• good position;
• no problems in starting a family.

Disability

Schizotypal personality disorder is the basis for assigning a patient a certain disability group (not assigned to all patients).

This nuance causes numerous restrictions. People with this diagnosis cannot engage in certain types of work (for example, work in law enforcement agencies). The patient's quality of life can be significantly reduced due to many limitations.

Disability in schizotypal personality disorder entails the following consequences:

• ban on military service;
• permanent deprivation of a driver's license or inability to obtain one.

A distinctive feature of schizotypal personality disorder is its chronic course.

Relapses can occur suddenly and with varying degrees of intensity.

A complication of the pathological condition can be schizophrenia, which will be almost impossible to get rid of. Therapy for mental disorders should begin as early as possible from the moment of their first manifestations.

Deviations that negatively affect children's adaptability to their environment are now commonly called personality disorders. Such mental disorders in children are detected quite rarely, since throughout the entire period of growing up the psyche constantly undergoes changes. Sometimes children develop conditions that have characteristics of a personality disorder.

Once a child reaches adolescence, we can talk about the end of personality formation. If signs of a personality disorder persist during this period, then we can already talk about a condition that needs correction.

Causes of disharmony

Personality disorders in children can take different forms. Based on the causes of the disease, there are three main types:

• a hereditary disorder is caused by the presence of a genetic predisposition and is passed on from generation to generation:
• acquired disorder progresses with the wrong approach to raising a child, as well as with prolonged influence of a negative environment and examples;
• organic psychopathy develops as a result of injury or infectious disease of some parts of the brain or the entire central nervous system.

Prerequisites for the development of disharmony may appear during pregnancy. To prevent this from happening, a woman must monitor her health and avoid deviations that could negatively affect the condition of the baby.

The psychological climate in the family has a great influence on the process of forming a child’s personality. If a child has suffered a head injury or contracted an infectious disease, it is necessary to take active steps to ensure a speedy recovery. Otherwise, there is a high risk of developing complications, including personality disorders.

Symptoms and diagnosis

Diagnosing personality disorders in children is quite difficult. Specialists need to observe a small patient for about 6 months in order to be able to make an accurate diagnosis.

Personality disorder manifests itself in different ways, depending on the type of disease:

1. A paranoid type disorder is accompanied by the appearance in a child of one idea, which turns out to be extremely valuable for him. This could be the idea of ​​illness, persecution or jealousy, etc. In this state, children become extremely suspicious; they react very sharply to refusals to satisfy their desires.

2. The disorder may have a schizoid overtone. A typical behavior of a child with a similar personality imbalance is refusal to communicate. In this state, it is very difficult to establish a trusting relationship with someone; the child is restrained in emotions and is not capable of empathy. But at the same time, the patient loves to fantasize.

3. Weak-willed psychopathy or dissocial type of personality disorder is manifested in complete non-compliance with generally accepted moral standards. The child does not have his own principles, and is also unable to maintain family and friendly ties.

4. Emotional instability can also be observed in children with personality imbalance. This type of psychopathy occurs most often in adolescents. Aggression and cruelty are common symptoms of this condition and occur in outbreaks. From time to time, you can hear threats from a teenager to commit suicide.

5. Distinctive feature hysterical psychopathy is demonstrativeness. The patient’s behavior, all his actions and emotions are aimed at attracting attention to himself.

6. A psychasthenic disorder is diagnosed in a child if he is constantly in anxious state associated with worries about every little thing or detail. The patient strives to complete any task the best way, eventually it becomes an obsession, leading to personality imbalance.

7. Excessive fears and anxiety, leading to self-restraint in activities or communication, are characteristic of sensitive personality disorder in children.

Children may also develop a personality disorder, which experts call dependent. In this state, the child is afraid of his helplessness. Such children do not know how to make decisions on their own.

Manifestations of some types of personality disorder are very often mistaken for pedagogical neglect. Only an experienced psychoanalyst or psychiatrist can distinguish pathological changes in the psyche from elementary bad manners. When the first symptoms appear, parents should seek qualified help. If proper treatment and correction are not carried out, the child will have difficulties adapting to society in the future.

Treatment

The doctor chooses the most appropriate treatment regimen based on the reasons that caused the pathological changes in the child’s psyche. If we are talking about a hereditary form of the disease or organic disorders in the functioning of the central nervous system, then the emphasis is on drug treatment and supportive therapy. For diagnosis, specialists working at the Psychoendocrinology Center use the most modern developments and techniques aimed at identifying the cause of the disease. The small patient is monitored for a long time, after which a decision is made on the choice of treatment regimen.

Acquired forms of personality disorders in children can be corrected in most cases. Drug treatment rarely brings significant results; psychotherapy plays a large role in healing. If the need to take medications nevertheless arises, the doctor at the Psychoendocrinology Center prescribes only one drug, which is taken in a course.

Regardless of what causes personality disorder in children, it is necessary to begin treatment after detecting the first signs of the disease. Timely contact with specialists and strict adherence to recommendations will ensure positive success from treatment.

One of the most controversial categories in the clinical field. Some people argue that this is just a pseudo-clinical name for scammers and other criminal elements. Others think it's serious mental disorder, which clinicians need to better understand and treat more effectively.

The main anomaly uniting this group of psychopathic individuals is considered to be underdevelopment of higher moral feelings.

Selecting this type personality disorders carried out on the basis of social criteria, the main of which is the inability to follow prevailing social norms and live in accordance with the law.

Sociopaths are indifferent to social standards; These are lovers of strong sensations, impulsive, lacking a sense of responsibility, despite numerous penalties and punishments, they are not able to learn lessons from negative experiences.

Selecting this type personality disorders, if we approach the problem from a clinical position, seems to be largely conditional. In the domestic nosographic tradition, such a group of personality disorders was not identified, since it was believed that there could not be a specific group of psychopathic personalities whose main property is a tendency to break the law. This point of view undoubtedly has certain grounds and it can be argued that offenses are possible in any type of personality disorder, just as in completely healthy individuals. At the same time, the clinical, mainly forensic-psychiatric, reality is that individuals of a psychopathic type turn out to be permanent residents of places of detention, committing repeated criminal acts. Usually they were and are classified as individuals of the excitable type, although certain differences from them can be detected. Some of them belong to the circle of schizoid psychopathy (emotionally cold expansive schizoids), others to emotionally unstable and narcissistic personality disorders.

Stages of development of dissocial personality disorder

Psychopathic individuals united in this group are distinguished from an early age by the absence of any spiritual interests, promiscuity, selfishness, and impulsiveness. They are stubborn, grumpy, deceitful, cruel - they mock their younger ones, torture animals, they early form opposition to their parents, and sometimes open hostility towards others. During early school and adolescence, sociopaths exhibit patterns of negative behavior, such as truancy, running away from home, committing acts of violence, damaging property, and starting arson. When communicating with people, they are distinguished by their temper, sometimes reaching bouts of rage and anger. At school they use foul language and start fights; Before reaching adulthood, they begin to steal, run away from home, and become wanderers. Systematic production activity unbearable for them. Their track record is replete with frequent absenteeism and job changes. Moreover, upon dismissal, as a rule, future employment is not planned. Due to the lack of spiritual motivation, affection, attention to others, they neglect traditions, ignore social, moral and legal norms and grossly violate the family structure. Over time, sociopaths end up in prison. For many people with this disorder, criminal behavior declines after age 40; some, however, continue to engage in criminal activity throughout their lives.

Symptoms of Dissocial Personality Disorder

They combine complacency and a firm belief in their rightness with a lack of critical assessment of their actions. Any reprimand or remark is regarded as a manifestation of injustice. Usually these people are careless with money. In a state of intoxication, they become even more angry, conflictual, fight, and destroy everything around them. Their whole life is a chain of continuous conflicts with public order: from counterfeiting securities, thefts and robberies to brutal acts of violence. At the same time, they are driven not only by selfish interests, but also by the desire to annoy and insult others. They usually skillfully achieve their own benefit at the expense of other people. They are deprived of a sense of compassion, shame, honor, repentance, and conscience. Their main feature is heartlessness. Apart from substance use disorders, this personality disorder is most closely associated with criminal behavior in adults.

In the most typical, “nuclear” cases of this group with pronounced emotional changes, it is always necessary differential diagnosis with an endogenous process (schizophrenia), early-onset moral dullness is often a sign of a previous attack or slowly developing schizophrenia with heboid manifestations or chronic mania.

Causes of Dissocial Personality Disorder

At the heart of explanations of antisocial personality disorders are based on psychodynamic, behavioral, cognitive and biological theories.

1. Psychodynamic theorists suggest that this disorder, like many other personality disorders, begins with a lack of parental love during infancy, and this leads to a lack of general trust in people. Children who are diagnosed with antisocial personality disorder react to such early experiences with emotional detachment and try to establish contacts with others only through force and destructive means. In support of psychodynamic theory, researchers find that people with this disorder are more likely than others to experience stress during their childhood, particularly in forms such as family poverty, domestic violence, and parental fighting or divorce. Many of them were also raised by parents who themselves suffered from antisocial personality disorder. There is no doubt that having such a parent, a person could lose faith in other people.
2. Many behavioral theorists suggest that antisocial symptoms may have been acquired through imitation, or imitation. As evidence, they also point to the high prevalence of antisocial personality disorder among parents of people with the disorder.
3. Other behaviorists believe that some parents unintentionally instill antisocial behavior in their children by regularly reinforcing the child's aggressive behavior. For example, when a child misbehaves or responds with violence to parental requests or demands, parents may give in to restore a peaceful relationship. Unintentionally, they can instill in the child stubbornness, and perhaps even cruelty.
4. Cognitive theorists believe that people with antisocial personality disorder adhere to attitudes that do not take into account the significance of the needs of others. People with this disorder have a really hard time accepting points of view that differ from their own.
5. Finally, a number of studies suggest that in antisocial personality disorder Biological factors may play an important role. Research shows that people with this disorder are often less anxious than others. In turn, they may be missing an element that is key to the learning process. This may explain why they have such a hard time learning from their mistakes or picking up on the emotional reactions of others. Several studies have found that subjects with antisocial personality disorder are less able than control subjects to solve laboratory tasks, such as finding the way out of a maze, where the key reinforcers are punishments, such as some form of shock or monetary fine. When experimenters make punishments more explicit or force subjects to pay attention to them, learning improves. However, left to their own devices, subjects with this disorder do not respond much to punishment. It may be that negative events simply do not cause these individuals as much anxiety as they do other people. Biological researchers have found that subjects with this disorder often respond to warnings or anticipation of stress with low brain arousal, such as slow arousal of the autonomic nervous system and low-frequency EEG waves. Due to low arousal, these individuals may have difficulty detecting threatening or emotional situations, and such situations may have little impact on them. It is also possible that low physiological arousal causes people with this personality disorder to take risks and seek adventure. Antisocial activities may attract them precisely because they satisfy the need for greater arousal. This idea is supported by the fact that antisocial personality disorder, as we have seen previously, is often accompanied by sensation-seeking behavior.

Diagnosis of dissocial personality disorder

A personality disorder, usually characterized by gross inconsistency between behavior and prevailing social norms, characterized by:

1. callous indifference to the feelings of others;
2. a rude and persistent attitude of irresponsibility and disregard for social rules and responsibilities;
3. inability to maintain relationships in the absence of difficulties in their formation;
4. extremely low tolerance to frustration, as well as a low threshold for the discharge of aggression, including violence;
5. inability to feel guilt and benefit from life experiences, especially punishment;
6. a pronounced tendency to blame others or put forward plausible explanations for one’s behavior, which leads the subject to conflict with society.

As an additional feature, there may be constant irritability. In childhood and adolescence, conduct disorder may confirm the diagnosis, although it is not necessary.

It should be noted:

Included:

• sociopathic disorder;
• sociopathic personality;
• immoral personality;
• antisocial personality;
• antisocial disorder;
• antisocial personality;
• psychopathic personality disorder.

Excluded:

• behavioral disorders (F91.x);
• emotionally unstable personality disorder (F60.3-).

Treatment of dissocial personality disorder

Approximately one third of all people with this disorder receive treatment, but none of the currently available treatments appear to be effective.

Most are forced into treatment by their employers, schools, or law enforcement agencies, or they come to the attention of therapists for some other disorder.

Some cognitive behavioral therapists try to get clients with antisocial personality disorder to think about moral issues and the needs of other people.

Anti-feralization programs are aimed at making a person more confident, self-esteem, and more committed to the interests of the group. Some individuals appear to benefit from such programs. However, in general, most of today's treatment approaches have little or no effect on people with antisocial personality disorder.