偏执型人格障碍ppt课件.ppt

（六）反社会型人格障碍(Antisocial PD) 1、临床特征 2、形成原因 3、治疗 临床特征 特征 经常发生违反社会规范的行为 表现：工作不良，婚姻不良，酒精与药物滥用，情感肤浅、无情、自我中心，不诚实、欺骗、作弄他人，冲动性、攻击性及法律问题等 患病率 Vaillant Perry (1985) 在0.05-15% 之间 男性多于女性 3% in men and 1% in women. Most common in poor urban areas. 75% in prison populations. Familial pattern present. Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure. Impulsivity or failure to plan ahead. Irritability and aggressiveness, as indicated by repeated physical fights or assaults. Reckless disregard for safety of self or others. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another. The individual is at least age 18 years, and there is evidence of Conduct Disorder with onset before age 15 years. The occurrence of antisocial behavior is not exclusively during the course of Schizophrenia or a Manic Episode. 形成原因 生物学因素 遗传、神经生物学的假说 社会心理学 家庭与社会环境的影响，缺乏情感和父母粗暴拒绝 心理分析 超我发展不完善 认知心理学 在道德原则和推理能力上的发展滞后 治疗 传统的心理治疗和医学治疗均无显著的效果 行为治疗 学习对问题情境作新的反应 认知治疗 提高其认知能力，改善社会和道德行为 Set firm limits. Try not to be manipulated. Have high level of skepticism. Be careful not to prescribe excessive and/or unnecessary medications. 边缘型人格障碍(Borderline PD) 1、临床特征 2、形成原因 3、治疗 临床特征 特征 人际关系、自我形象和情感的不稳定 表现：人际关系不良，不能耐受孤独，常感孤单和空虚，易抑郁，情绪不稳定，行为具冲动性，易发生自伤、自杀行为，存在自我认同障碍 患病率 美、德等国：0.2-4.6％ 女性多于男性 1-2% of the population. o Twice as common in women as in men. o Increased prevalence of Major Depressive Disorder, Alcohol Abuse/Dependence, and Substance Abuse found in first-degree relatives. Frantic efforts to avoid real or imagined abandonment. A pattern of unstable and intense interpersonal relationships characterized by alternating bet