Personality Disorders

Personality Disorders

Axis II categorical system became the subject of controversy. There is not agreement in making correct diagnosis for the people with Axis-II disorder. Current categories are rejected by some specialists, who turn to alternative methods instead. Different types of personality disorder can be so alike that it becomes sometimes difficult to differentiate them. This becomes a reason of misdiagnosis. One of the essential problems concerning this issue is that criteria of distinguishing disorder are very different in different clinics. For example, people with avoidant personality disorder can have same symptoms as people, who have dependent personality disorder. The problem with DSM-IV-TR’s approach to personality uses multiple categories in order to classify personality disorders. Such an approach creates much difficulties in classifying and interpreting personality disorder. Newest approaches count on the degree of personality traits rather than their different types.
In the current categorical system of Axis II there are dimensional and prototypal models, which analyze personal disorders from different point of view and present different approaches on studying of personality traits. Prototypal model makes out several prototypes of personality disorders, while dimensional model makes an accent on different personality dimensions. The latest researches prove that personality disorders should be classified according to their degree rather than type. That is why dimensional approach to the classification of personality disorders becomes more and more popular within last years. Dimensional approach states that people with personality disorder have same traits as normal people do. The only difference that these features are expressed in excessive degree.
The bright example of dimensional model is Five-Factor Model, while prototypal model is presented by Millon’s Evolutionary Model.
The Five-Factor Model includes five personality dimensions, which are called “Oceans”. These dimensions are Openness to new experience, Conscientiousness, Extraversion, Agreeableness and Neuroticism. These dimensions form the personality. Taking into account these dimensions we can characterize any person. These characteristics stay stable for about 45 years, beginning from young childhood and till mature age (Soldz & Vaillant, 1999). These dimensions, especially in pairs, can be transformed genetically (Loehlin, McCrae, Costa, & John, 1998). During the prehistoric period these five dimensions used to have an adaptive value, as states Buss (Buss, 1996). According to this model five dimensions are considered universe and knowing one’s relations and attitude to these dimensions it is possible to choose the appropriate therapy in every particular case (Costa & McCrae, 1992).
Evolutionary Model was by Millon in 1969. He proposed eight prototypes that should be interpreted at the levels of severity rather than personality disorders. “These personalities were fit into a theoretical system that emphasized the strength of the interpersonal attachment and the mode of accommodation” ¬(Widiger, 1993). Millon’s theory came through a number of changes, as long as it has got its present form under the influence of the editions of the Diagnostic and Statistical Manual of Mental Disorders. Millon states that such disorders as schizophrenia or just depression present decompensation of basic personality. Nowadays 3 more prototypes were added to the model.
Mind-body dualism is still a controversial issue in psychology. Unfortunately, this question is often ignored by psychologists. Such ignorance gives birth to dualism in psychology. On the one hand, there are branches in psychology, which are preoccupied with body only. Neuropsychology and biological psychology are based on the study of human body, for example. On the other hand, there are separate branches of psychology, which deal only with mind, such as psychology of cognition and attitudes. Human creature is a combination of mind and body, which coexist and work only together. We can not talk about valuable human creature if one of these factors is neglected. Despite the fact that psychology often addresses body and mind, it addresses them as separate entities and rarely treats the problem as a whole. Fortunately, newest powerful brain scanning techniques allow to study the reaction of the brain to the different stimuli and describe experiences it can get. Hopefully, newest research methods will finally let overcome this separation in the future. At the present moment different theories of mental illnesses treatment deal either with body or with mind. Different approaches to the problem of mind-body dualism give birth to different approaches to the treatment of mental illnesses. Some specialists regard mind as a source of all mental illnesses. That is why they try to cure mind. Other group of specialists believes body and brain to be the main source of the problem. Differences in the approaches explain the choice of different methods and technique.
In behavior medicine specialists use the biopsychological model, which was developed by Dr George Engel. This person found out that biological, social and psychological levels are closely interconnected and this connection affects the functioning of the organism. With the help of this observation according to the biosychological model, an illness or disorder can not be analyzed only from the perspective of pathophysiology, but it affects many levels of functioning. This model gives a wider understanding of illness process regarding it as a multiple process including the effect of the physician-patient relations.
Modern researchers make a strong accent on the psychosomatical reason of many illnesses. This means that many illnesses of the body are caused by psychological processes. Blood pressure disorders, stomach aches and man other diseases can have psychological reasons. This means that the state of human psychics has a direct impact on the state of human body and very often treating physical diseases doctors fail because they treat only physical manifestations of the illness, which has psychological causes. This approach is comparatively new in modern medicine but a lot of specialists agree that co-working of psychologists and therapists could be very fruitful for treating many physical diseases.

Bibliography
1. Buss, D. M. (1996). Social adaptation and five major factors of personality. In J. S. Wiggins (Ed.), The five-factor model of personality: Theoretical perspectives (pp. 180-207). New York: Guilford.
2. Loehlin, J. C., McCrae, R. R., Costa, P. T., Jr., & John, O. P. (1998). Heritabilities of common and measure-specific components of the Big Five personality factors. Journal of Research in Personality, 32, 431-453.
3. McCrae, R. R., & Costa, P. T., Jr. (1996). Toward a new generation of personality theories: Theoretical contexts for the five-factor model. In J. S. Wiggins (Ed.), The five-factor model of personality: Theoretical perspectives (pp. 51-87). New York: Guilford.
4. Soldz, S., & Vaillant, G. E. (1999). The Big Five personality traits and the life course: A 45-year longitudinal study. Journal of Research in Personality, 33, 208-232.
5. Widiger, T.A., & Corbitt, E.M. (1993). The MCMI-II personality disorder scales and their relationship to DSM-III-R diagnosis. In R. Craig (Ed.), The Millon Clinical Multiaxial Inventory: A clinical research information synthesis (pp. 181-201). NY: Lawrence Erlbaum.