Emotionally-unstable personality disorder - Causes, symptoms and treatment. MF.

Patocharacterological properties that unite this group of personality disorders are impulsiveness with a pronounced tendency to act without taking into account the consequences and lack of self-control, combined with mood instability and turbulent outbursts that occur after the slightest incident.

Prevalence among the population reaches about 2% to 5%, "borderline" species is more often observed among women.

Symptoms of an emotionally-unstable personality disorder

Such people have increased irritability, excitability in combination with explosiveness, spitefulness, rancor, vengefulness, and the viscosity of affective reactions. Their mood swings with a predominance of gloomy-vicious background are combined with violent explosions of emotions. At the same time affective fluctuations, as well as discharges of emotions, are usually associated with external causes, although these reasons for irritation and discontent can be insignificant. These people are constantly unhappy with everyone, they are looking for a reason for quibbles. Usually, such persons lack judgment for a calm, cold assessment of the situation. Everyday everyday troubles are perceived with a hint of unhappiness, lead them to emotional tension, often outrageous flashes of anger occur. Especially noticeable is such incontinence in intra-family conflicts, when a quarrel often ends with violent acts from whipping dishes before beating family members.

Emotionally unstable( excitable) individuals can not tolerate objections, they are extremely impatient, do not listen to others' opinions in disputes, do not agree with it. They do not take into account the interests of others, they are selfish, because of this they often have conflicts with others. However, they are completely incapable of understanding their own role in frequent conflicts. Constant quarrels, accompanied by clarification of relations, determine their conviction in a special role and significance. There are ideas about a prejudiced attitude towards them, about the fact that they are not appreciated and understood in the team and family.

Two types of this variant of personality disorders are distinguished - impulsive and borderline.

The impulsive type of corresponds to the excitable psychopathy of . Psychopathy of this type is characterized by unusually strong emotional excitability. Its initial manifestations are found even at preschool age. Children often scream, get angry. Any restrictions, prohibitions and punishments cause them violent reactions of protest with spite and aggression. In the junior classes, these are "difficult" children with excessive mobility, unrestrained pranks, capriciousness and resentment. Along with a quick temper and irritability, they are characterized by cruelty and gloominess. They are rancorous and unruly. An early manifestation of a mood for a gloomy mood is combined with periodic, short( 2-3 days) dysphoria. In communicating with peers, they pretend to lead, they try to command, establish their own orders, because of what conflicts often arise. Studies often do not interest them. They are not always kept in school or vocational school, and when they go to work, they are soon dismissed.

The formed psychopathy of an excitable type is accompanied by attacks of anger, rage, affective discharges, sometimes with an affectively narrowed consciousness and a sharp motor excitement. In passion( especially easily arising during the period of alcoholic excesses), excitable individuals are able to commit ill-considered, sometimes dangerous actions. In life they are active, but incapable of long-term purposeful activity, uncompromising, harsh people, with vengeance, with the viscosity of affective reactions. Among them are often persons with disinhibition of inclinations, prone to perversions and sexual excesses.

The subsequent dynamics of excitable psychopathies is not uniform.

With a favorable current, the psychopathic manifestations stabilize and even relatively fully compensate, which is to no small extent promoted by the positive environmental influences and the necessary educational activities. Violations of behavior in such cases by 30-40 years are significantly smoothed, and emotional excitability is gradually decreasing.

However, a different dynamics is possible with a gradual increase in psychopathic characteristics. Random life, inability to curb craving, joining alcoholism, intolerance of any restrictions, and, finally, propensity to violent affective reactions serve in such cases as causes of prolonged disruption of social adaptation. In the most difficult cases, acts of aggression and violence committed during affective outbreaks lead to a conflict with the law.

The border type does not have direct analogs in the domestic taxonomy of psychopathies, although it is comparable with by the unstable type of psychopathies on some personal parameters. Borderline personality disorder needs differentiation with schizotypic disorder, schizophrenia, anxiety-phobic and affective disorders.

The borderline personality is characterized by increased impressionability, affective lability, vivid imagination, mobility of cognitive processes, constant "involvement" in events related to the sphere of actual interests or hobbies, extreme sensitivity to obstacles on the way to self-realization, functioning at the maximum of opportunities. Difficulties are also perceived in the sphere of interpersonal relations, especially the situation of frustration. The reactions of such subjects even to trivial events can acquire a hyperbolized, demonstrative character. They too often experience those feelings, which are usually found only in a situation of stress.

Initial pathocharacteric manifestations( emotional lability, suggestibility, predisposition to fantasies, rapid change of hobbies, instability of relations with peers) are detected already in the adolescent period. These children ignore school orders and parental prohibitions. Despite their good intellectual abilities, they do not do well, because they do not prepare for classes, are distracted in their lessons, reject any attempts to regulate their daily routine.

The distinctive properties of borderline personalities include the lability of self-esteem, the variability of ideas about both the surrounding reality and about one's self-a violation of self-identification, inconsistency of life attitudes, goals and plans, inability to withstand the opinions of others. Accordingly, they are suggestible, flexible to influences from the outside, easily adopt the forms of behavior that are not approved by society, commit drunkenness, accept stimulants, drugs, even acquire criminal experience, commit an offense( most often it is petty fraud).

Border type psychopaths easily fall into dependence on other, sometimes unfamiliar people. Closer, they quickly form a complex structure of relationships with excessive subordination, hatred or adoration, the formation of supervalued attachments;the latter serve as a source of conflict and suffering associated with fear of rupture and impending loneliness, and may be accompanied by suicidal blackmail.

The life path of borderline personalities is very uneven, full of unexpected turns in the social route, family status. Periods of relative calm are replaced by different kinds of collisions;easy transitions from extreme to extreme - this is a sudden, overcoming all obstacles, love, culminating in an equally sudden rupture;and enthusiasm for a new business with objectively high professional success, and a sudden sharp change of place of work after a minor production conflict;this is also a passion for travel, leading to a change of residence and progression. However, despite all life shocks, these people do not lose their sanity, get into trouble, are not as helpless as they might seem, can at the right time find an acceptable way out of the situation. The inherent "zigzags" of behavior do not prevent sufficiently good adaptation. Easily adjusting to new circumstances, they remain able to work, find work, arrange anew life.

Within the framework of the dynamics of the borderline personality disorder, there are long periods of recovery with increased activity, a sense of optimal intellectual functioning, acute perception of the surrounding life, which can be replaced by dysthymic phases, most often in connection with psychogenic or somatic pregnancy, childbirth, disease, provocation. At the forefront in the clinical picture in these cases, complaints are made about the reduction of mental capabilities, a sense of incompleteness of feelings and cognitive functions, and in more severe cases - the phenomenon of mental anesthesia.

Among other pathological reactions in borderline disorders, psychogenic transient outbreaks with a variegated clinical picture are most often encountered, including along with affective dissociative hysterical, poorly systematized delusional disorders. Unlike schizophrenia, they are characterized by psychogenic provocation, transient nature, reversibility.

Criteria of Emotional-Disruptive Personality Disorder

Personality disorder, in which there is a pronounced tendency to act impulsively, without taking into account the consequences, along with the mood instability. The ability of planning is minimal;flashes of intense anger affect often lead to violence, or "behavioral explosions," they are easily provoked when impulsive acts are condemned by others, or they are hampered. There are two varieties of this personality disorder, and with both there is a common basis of impulsivity and lack of self-control.

Included:

• aggressive personality;
• borderline disorder;
• borderline identity;
• is an excitable person.

F60.30х Emotionally unstable personality disorder, impulsive type.

The predominant characteristics are emotional instability and lack of control of impulsiveness. Outbreaks of cruelty and threatening behavior are common, especially in response to condemnation by others.

Includes:

• an excitable personality disorder;
• is an explosive personality disorder;
• is an aggressive personality disorder;
• is an aggressive person.

Excluded:

• - dissocial personality disorder( F60.2x).

F60.31x Emotionally unstable personality disorder, borderline type.

There are some characteristics of emotional instability, and in addition, the image of self, intentions and internal preferences( including sexual preferences)( characterized by a chronic sense of emptiness) are often incomprehensible or violated. The inclination to be included in a tense( unstable) relationship can lead to renewed emotional crises and is accompanied by a series of suicidal threats or acts of self-harm( although all this can also happen without obvious provocative factors).

Included:

• borderline personality disorder.