Personality Psychopathology

In modern psychology, there are many definitions of the concept of “personality.” However, in such medical disciplines as psychotherapy, psychological correction, psychological diagnostics, personality terminology is widely used from the perspective of the “psychology of relationships” created by psychiatrists and psychologists A. F. Lazursky and V. N. Myaschischev, according to which this term is interpreted as system or a set of relations to the surrounding world, primarily the social, as well as to itself.

The basis of the personality is the character, which is determined by the hereditary predisposition, however, it is finally formed under the influence of education and can be distorted by the adverse effects of various factors (from chronic mental trauma to the individual to organic brain lesions).

Premorbid personality types

A premorbid personality type determines its basic traits, the type of character until the moment the mental disorder occurred. This type is described from the words of the patient or his relatives in the presentation of the history of life. Assessment of the premorbid type is extremely necessary for the diagnosis, prognosis and selection of methods of psychotherapy and rehabilitation of various mental disorders, since the risk of development of individual psychopathologies is not the same for different types.

The most famous of the developed systems of personality types, convenient for assessing premorbid traits, is the classification of “accentuated personalities” of the famous German psychiatrist Carl Leonhard. The basis of this typology of personalities lies in the variants of character accentuation, namely, excessive strengthening of its individual features, as a result of which a selective vulnerability is revealed with respect to a certain kind of psychogenic influences with good and even increased resistance to others. Unlike psychopathies and personality disorders, accentuated personalities are regarded as extreme variants of the norm. In most developed countries, they include more than half of the population.

According to K. Leonhard and A. E. Lichko, there are the following main types of accentuated personalities and character accentuations.

Hyperthymic type. Persons with this type of accentuated personality are almost always distinguished by high spirits, high vitality, activity, and unlimited energy. Short flashes of irritation and anger in patients cause opposition from others, the suppression of their violent activities, the desire to interfere in everything. Such people strive for independence and independence, however, loneliness and forced idleness, they are extremely resourceful, they know how to dodge and trap, while at the same time they do not tolerate strict discipline and a regulated regime; illegible in the choice of dating. Carried away by something new, they do not bring it to the end. Such individuals tend to overestimate their capabilities and abilities, are unjustifiably optimistic about the future, poorly cope with work that requires perseverance and accuracy.

Cycloid (affective-labile) type. This type of personality is characterized by a change in periods of recovery, when patients behave like hyperthyms, periods of decline in mood and tone. During the latter, the patients show lethargy, fatigue, a decrease in working capacity, they become unsociable and inactive. The most minor troubles during these periods are experienced very hard. Between ups and downs there can be long periods of even mood. The duration of the periods – from several days to several months.

Emotionally labile (emotive, affectively exalted) type. The main feature of people with this type of personality is the extreme variability of mood, the differences of which occur even from an insignificant cause. Well- being, working capacity, sociability and attitude to everything depend on the mood. Patients are experiencing trouble, prone to neurotic reactions, sincerely attached to those people from whom they see care and understanding. There is a great need for emotional contact, empathy.

Sensitive (alarming) type. Characteristic features of such personalities are great impressionability and a sense of inferiority. In unfamiliar surroundings, among strangers, they are timid and shy and, on the contrary, sociable and open only to those they are used to. They have a strong sense of duty and responsibility. In this connection, such personalities notice many shortcomings in themselves, then they strive to overcome them, claiming themselves not where their real abilities can unfold, namely in the area where they are weak, for example, shyness and shyness are trying to overcome by taking public office . Anxiety is most affected by the fear of making an adverse impression on others. Patients are experiencing a hostile attitude towards others.

Psychasthenic (pedantic) type. Persons with this type of personality combine indecision, tendency to rationality with anxious suspiciousness in the form of fears for their future and the future of their loved ones. Pedantry and formalism become a defensive reaction from constant internal anxiety. Invented signs and rituals become another defensive reaction. Indecision is combined with impatience when the decision has already been made. Patients are prone to introspection and self-digging. A heavy burden for them is responsibility, especially when it is necessary to answer not only for themselves, but also for others.

Schizoid (introverted) type. This type of personality is known as a pattern of closure. Although formal contacts with people of this type are usually not difficult, however, emotional contacts usually prove to be an impossible task for them. The isolation of such personalities is accompanied by external restraint, and sometimes coldness. The lack of empathy manifests itself in the inability to respond to the joy, sadness or fear of another person. There is also a lack of intuition – the inability to understand the experiences of others, to guess about the unspoken desires or concerns of others, to feel sympathy or hostility towards oneself. The inner world filled with hobbies and fantasies becomes a native element for such people. Patients fantasize about themselves, they do not share their fantasies with others. They also differ in independence and propensity to non-conformism.

Epileptoid (explosive, excitable) type. For such types of personality, a tendency toward short periods of angry, dreary mood with boiling irritation and, as a result, a necessary search for an object on which to “disrupt evil” is characteristic. During these periods, affective explosiveness is particularly pronounced. Affects are strong and long lasting, patients during them are able to reach unrestrained rage. Also strongly expressed are instincts, in particular, sexual attraction, which is combined with strong jealousy, and sometimes with sadistic and masochistic inclinations. With respect to others manifest imperiousness. All the behavior of such people is distinguished by heaviness, retardation, inertness. Petty accuracy, meticulous observance of the rules, and pedantry that bothers others, are combined with thrift, prudence and rancor.

Hysteroid (demonstrative, histrionic) type. Persons with this type of personality draw attention to themselves with an insatiable thirst to be in the center of attention. This is served by deceit and fantasy, the propensity to portraying and posturing, a mock-exaggerated expression of emotions, excessive dramatization of events. Related to this is the claim to an exceptional position among others, as well as a high level of aspirations for their future. Good acting skills allow you to mislead gullible people. The suggestibility often attributed to hystericals is highly selective — it only applies to what can attract the attention of others and show off in front of them. Patients like to change the company of friends, assuring that they “have given up on” the former.

Unstable type. For individuals of this type is characterized by continuous increased craving for pleasure, entertainment, idleness, idleness. They strive to evade any labor, duty, and duty. They live today, they do not set any long-term goals. Any hard work pushes them away. Real attachments are never felt for anybody – neither for relatives, nor for friends. Nobody falls in love – sex life is just one of the ways to get pleasure. They are attracted to any antisocial companies that promise entertainment. Cowardice and lack of initiative condemn them to a subordinate role. They often begin to abuse alcohol and other intoxicating substances, thereby trying to escape from difficulties, troubles and trials.

Conformal type. This type is represented by people of “their environment”. Their life rule is to think, act, live as their usual environment. In this connection, they are completely the product of their microenvironment, in a good environment they are not bad people, in an unfavorable environment they can easily drink themselves and take the road of crime. Conformity in everything to their surroundings is combined with conservatism, due to the difficulty of adapting to new conditions, unusual environment, new trends, lack of personal initiative, preference to always go the usual way, to act on hardened stencils. Another feature is striking noncriticality: everything that comes through the usual channels of information is perceived as truth. Patients lose composure with drastic changes in life when they lose their familiar society.

Mixed types are quite common. They can be intermediate when features of two types can be traced from a young age, sometimes from childhood (for example, a mixed hysteroepileptoid type), or amalgamic, when features of a different type are layered on the basis of one type due to prolonged adverse influence of the environment cruel relationships in the environment contributes to the attachment of some epileptoid traits on the basis of other types).

Personality disorders

Psychopathy, or the pathology of the person, is described in more detail in Part 3 of Section 4 of this book, and also provides characteristics for each case, in particular, for various mental disorders. Such disorders are constitutional – predisposed to heredity, or are formed due to the long-term adverse effects of the environment in childhood or adolescence.

Pathological personality development is characterized by its increasing changes in a certain type due to mental trauma, manifested in the “place of least resistance” of this type of character accentuation. In more rare cases, changes in personality during such development can grow to the level of psychosis. Only then is the ability to report and act on one’s actions lost.

A separate group is the pathological development of the personality, due to severe physical defects, such as blindness, deafness, and congenital paralysis.

Personal defects can be characterized as the consequences of severe mental illness or organic brain lesions, and the changes that are evolving are persistent. There are several types of personality defects, namely: schizophrenic, epileptic, organic and others.

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