第十一章 人格障碍及其治疗幻灯片.pptVIP

第十一章人格障碍及其矫正(personality disorders) 一、人格障碍概述(Personality Disorders: An Overview)  What is a personality disorder? maladaptive personality traits traits are relatively enduring features of a person that are persistent over time and situations people with personality disorders tend to be: rigid and inflexible, show a restricted range of traits, have a dominant single trait personality disorders are egosyntonic, more than egodystonic DSM－IV强调病人在认知、情感、人际关系和冲动控制方面的偏离，指出这种偏离类型在长时间内相当稳定，至少可以追溯到青少年或早期成年时。 Personality Disorders: Facts and Statistics Prevalence of Personality Disorders About 0.5% to 2.5% of the general population 6-9% （Kathleen ，1986） 0.13‰（我国，1986） Rates are higher in inpatient and outpatient settings。prevalence higher among people with other mental disorders 6-9% of population have one or more personality disorder most people with personality disorders never come to the attention of mental health professionals Origins and Course of Personality Disorders Thought to begin in childhood Run a chronic course Comorbidity rates are high Gender Distribution and Gender Bias Gender bias exists in diagnosis Criterion vs. assessment gender bias  DSM-IV将10种人格障碍划分为3大类群: A类群：行为古怪、奇异 Cluster A Odd or eccentric Examples include paranoid, schizoid B类群：戏剧化、情感强烈、不稳定 Cluster B Dramatic, emotional, erratic Examples include antisocial, borderline C类群：紧张、焦虑行为 Cluster C Fearful or anxious Examples include avoidant, obsessive-compulsive 人格障碍类型 cluster A cluster B cluster C 偏执型 表演型 回避型 分裂型 自恋型 依赖性 分裂样 反社会型 强迫型 边缘型 PERSONALITY DISORDERSHistorical perspective Roots in psychoanalysis – narcissism, masochism, etc. Karl Abraham – first theorist to focus on personality disorders PERSONALITY DISORDERSDiagnostic issues poor understanding of etiology of most personality disorders comorbidity and diagnostic overlap gender and cultural issues reliability of diagnosis PERSONALITY DISORDERSEtiology – Theoretical perspectives Psy