0.19 Personality disorders  (Page 4/6)

The third category describes intrapsychically-conflicted personalities , individuals whose internal orientations move in opposite directions. Thus, these individuals remain at war with themselves. In both the sadistic personality disorder and the masochistic personality disorder the pleasure-pain polarity is transposed, such that normally pleasurable stimuli are experienced as painful and vice versa. For the compulsive personality disorder and the negativistic personality disorder it is the self-other polarity that is disordered. Individuals with compulsive personality disorder are caught within a conflict between obedience and defiance, but they suppress the conflict in order to appear well controlled and single-minded. In contrast, those with negativistic personality disorder fail to resolve their conflicts, resulting in indecisiveness, inconsistent attitudes, oppositional behavior and emotions, and they become generally erratic and unpredictable.

The three categories of disordered personality described above are primarily stylistic. Style, in this context, refers to the functional manner in which individuals relate to their internal and external worlds. The final category defines structurally-defective personalities , much more deeply embedded disorders that affect the function of the mind itself. Thus, the disorders in this final category are considered more severe than those in the categories described above. Schizotypal personality disorder involves eccentric thoughts, behaviors, and perceptions that mirror those found in schizophrenia. Individuals with borderline personality disorder exhibit deep and variable moods, including extended periods of dejection and disillusionment, occasional periods of euphoria, and frequent episodes of irritability, self-destructive acts, and impulsive anger. The paranoid personality disorder is characterized by suspicion and hostility, and the tendency to misread others and respond with anger to perceived deception and betrayal. And finally, the decompensated personality disorder, likely the most profoundly deteriorated personality type, involves consistent and pervasive impairment that is rarely broken by clear thoughts or normal behavior. Individuals with decompensated personality disorder typically require institutionalization, since they simply cannot function in society.

As you can see, the personality disorders described by Millon include the disorders listed in the DSM classification scheme, though the categories he uses are different than the three clusters in the DSM system. Millon also describes five disorders not included in the DSM system. For the most thorough discussion of the categories and disordered personality types described above, see Millon’s Disorders of Personality: DSM-IV and Beyond, 2 nd Ed. (1996). For a number of different perspectives on the development of personality disorders, including cognitive, psychoanalytic, attachment, and neurobehavioral models (among others), see Major Theories of Personality Disorder, 2 nd Ed. , edited by Lenzenweger and Clarkin (2005).