The relationship between panic disorder/agoraphobia and personality disorders.
ABSTRACT This selective review of the relationship between panic disorder/agoraphobia and DSM-III personality disorders points to a preponderance of dependent, avoidant, and histrionic features and reveals a certain degree of covariation between severity of Axis I disorder and personality functioning. However, the link between panic/agoraphobia and Axis II disorders does not appear to be specific because (1) general features such as neuroticism, stress, dysphoric mood, and interpersonal sensitivity, rather than duration and severity of panic attacks and phobias, emerge as unique predictors or determinants of personality disorder; and (2) similar personality profiles are obtained in a heterogenous population of psychiatric outpatients or patients with social phobia, obsessive-compulsive disorder, and major depression.
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ABSTRACT: Hypochondriasis (HC) has presented physicians and researchers with nosological challenges since Freud’s era. Part of the difficulty lays in the significant overlap between the constructs of mental illness and personality disorders that already exists when it comes to understanding almost any psychological phenomena (i.e., state versus trait debate). Indeed, many of the symptoms of HC are similar to those of other mental illnesses such as anxiety, yet HC has also been associated with particular personality traits, cognitive styles, attitudes, and personality disorders. Likewise, there has been debate as to whether HC should be considered secondary to some other disorder or as a primary diagnosis in its own right. Finally, the etiology of HC is not well understood. Empirical literature suggests possible genetic components to HC, in addition to several potential environmental factors. In this article we review key theoretical works and empirical studies on the intersection of personality dysfunction and HC. In addition, we consider the role that trauma may play in the development of HC in certain individuals. Traumatic experiences are already widely linked to somatoform disorders. However, the characteristic features of hypochondriacal presentation (e.g., illness conviction, illness phobia, and failure to respond to reassurance from physicians) may be related to particular types of traumatic experiences which, when they occur in infancy and/or childhood, interfere with secure attachment and identity formation.Current Psychiatry Reviews 01/2014; 10(1). DOI:10.2174/1573400509666131119005651
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ABSTRACT: This article discusses a new personality disorder entity, “traumatic stress personality disorder,” conceptualized as a composite organization with transactional properties that mutually structure post-traumatic stress disorder (PTSD) and personality disorders (PDs). The transactional/synergistic view of PTSD/PD comorbidity derives in part from scientific findings that PTSD's enduring biological effects are discernible in the personality of individuals 30 to 50 years or more after the overwhelming event, and from psychodynamic formulations on the development and structuring of personality defenses. An intertheoretical therapy model is also presented, and consists of multiple therapies actively integrated to meet the patient's complex post-trauma needs. This article argues for the development of theoretical, investigatory, and therapeutic measures to address PTSD/PD configurations in traumatized victims. Basically, the position espoused is that PTSD/PD should be measured as one rather than two entities, with neither component being considered as a confounding but integral factor in measurement. The eight components of traumatic stress personality disorder are discussed, along with a case study to demonstrate the model's clinical applications. The integration of cognitive, behavioral, psychodynamic, and existential treatment approaches is geared to assist the victim to developmental progress to survivor status, and then beyond this level of integration to thriver a person whose adaptational learning in therapy created a “vital psychological immune system” that consistently protects against dissociative regression in response to the daily stresses of life. Transference, countertransference, therapists' self-care and self-monitoring are seen as integral to the treatment of traumatic stress personality disorders.Journal of Contemporary Psychotherapy 01/1997; 27(4):323-367. DOI:10.1023/A:1025618625487