In DSM II , personality disorders were described as follows, "This group of disorders is characterized by deeply ingrained, maladaptive patterns of behavior that are perceptibly different in quality from psychotic and neurotic symptoms. Then each disorder was briefly described by a few short sentences.
The names of these disorders, and their brief descriptions, bear only a slight resemblance to what we know today as personality disorders. At this time, the fields of psychology and psychiatry were struggling to establish themselves as scientific fields of study. This new version of the DSM reflected the fact that newer, more contemporary models of mental illness and treatment were emerging.
More importantly, these newer models rested upon evidence-based practices: i. It is important to understand that scientific study cannot proceed without a means for measuring what is being studied. Thus, in order for the scientific study of mental disorders to proceed, these disorders had to be defined in such a way as to make them observable, and therefore measurable. Freud's concepts did not lend themselves to measurement.
For instance, one cannot observe, nor measure the Id. These newer and more contemporary models of mental illness reflected a significant paradigm shift within psychology and psychiatry during the s and 80s. This shift represented the declining influence of psychoanalysis and Freudian theory, and the ascendance of the cognitive-behavioral model within psychology emphasizing the observable, behavioral manifestations of disorders , and the medical model within psychiatry cataloging pathological symptoms and their biological causes.
As the name suggests, cognitive-behavioral theory was principally concerned with people's thoughts and behaviors.
Thoughts were easily reported, and people's behaviors were easily observed. As such, the cognitive-behavioral theory was perfectly suited to measurement and research, and met the scientific requirements of the day. Treatments for mental conditions took the form of interventions designed to help people learn better and more effective, healthy ways to think and behave in order to relieve their distress. Psychoanalytic theory's fell from grace.
This was because it could not be tested or proven using the scientific methods and technologies available at that time. Unfortunately, it merely theorized the causes of mental distress. These theorized causes were completely invisible; and therefore, not measurable. This included the invisible Id, Ego, and Super-Ego; the invisible conflicts between these invisible mental structures; and the invisible psycho-sexual stages of developments.
In contrast, the cognitive-behavioral theory restricted itself to addressing only the observable and measurable causes of distress. Caught in the crossfire between these two influential, psychological theories, one waxing and the other waning, and the rising role of pharmacological treatments within psychiatry, the authors of DSM III attempted to stay out of the conflict by making their document atheoretical.
They achieved this by ensuring that their disorder definitions were primarily descriptive. They refrained from endorsing one particular theory accounting for the origin and cause of mental disorders over another. The goal of DSM III was to outline the diagnostic criteria for as many conditions as possible, and to rely on, and to foster research on mental disorders.
This multi-axial system placed personality disorders onto a separate axis called Axis II. This Axis II was separated personality disorders from the rest of the major mental disorders and clinical syndromes such as Major Depression, Schizophrenia, and Bipolar Disorder, to name but a few. There is no specific test that is used to diagnose HPD.
If you are troubled by your symptoms and seek medical care, your primary care provider will likely begin by taking a complete medical history. They may perform a physical exam to rule out any physical problems that might be causing your symptoms. Psychiatrists are specifically trained to recognize and treat psychological disorders.
A psychiatrist will be able to use expert questions to get a clear view of the history of your behavior. An accurate assessment of your behaviors will help your primary care provider diagnose you. However, most people with this condition do not believe they need therapy or help, making diagnosis difficult. Many people who have HPD receive a diagnosis after they go into therapy for depression or anxiety, usually following a failed relationship or other personal conflicts. Treatment can be difficult if you have HPD.
However, therapy — and sometimes medications — can help you cope with HPD. Psychotherapy is the most common and effective treatment choice for HPD. This kind of therapy involves talking to a therapist about your feelings and experiences. Such talks can help you and your therapist determine the reasoning behind your actions and behaviors. Your therapist may be able to help you learn how to relate with people in a positive manner, instead of continually trying to get attention from them.
If you experience depression or anxiety as a part of your HPD, your primary care provider might put you on antidepressants or antianxiety medication. Lots of people with HPD lead normal lives and are able to work and be a part of society. In fact, many people with HPD do very well in casual settings. Many of them only encounter problems in more intimate relationships. Depending on your case, your HPD may affect your ability to hold a job, maintain a relationship, or stay focused on life goals.
It may also cause you to constantly seek adventure, putting you into risky situations. You are also at a higher risk for depression if you have HPD. The disorder can affect how you handle failure and loss. You should talk to your primary care provider if you have symptoms of HPD, especially if they are interfering with your everyday life and work or your ability to lead a happy, fulfilling life.
Several psychiatric disorders derived from the original term hysteria such as the conversion disorder, the somatization disorder, somatoform disorders, phobic anxiety, the term mass hysteria, and finally the HPD.
Although different authors extensively studied this theme across time, the authors will focus on HPD. It has been used since ancient times and appears in texts of the Egyptians, Greeks, and Romans. Since then, the meanings of hysteria have mirrored the preoccupations of the societies at each time.
The oldest record is an Egyptian medical papyrus dating from around BC, the Kahun Papyrus , which is the first known medical gynecological text. One of his most striking views was that men could also suffer hysterical symptoms caused by retained sperm.
His ideas contributed to initiate a debate, which had run for centuries, over whether men could or not have hysteria. During Middle Ages, as the attitude toward sickness changed from naturalistic to demonotheologic, with Augustine of Hippo — AC and other theologians, hysteria came to be seen as a manifestation of demonic possession. With the renewed interest on empiricism and science during Renaissance, old Greek concepts of hysteria were recuperated. Similar therapies to those prescribed in ancient Greek civilizations, such as genital stimulation by horse riding, dancing and, in particular, marriage and sexual intercourse were still prescribed for such condition Edwards, Some of these authors defied the original theories that connected hysteria to the uterus and some defended that the disease was originated in the brain.
He believed in a nervous origin instead of vapors opening the door to the desexualisation of the disease Risse, The famous clinician Thomas Sydenham, — was one of the most important contributors to the study of hysteria at his time. He published a treatise on hysteria called Epistolary Dissertation on the Hysterical Affections and stated that hysteria was the most common of all diseases afflicting both men and women and the more richer and civilized a patient was, the more likely he or she was to be afflicted.
One of his most remarkable conclusions was that hysteria could take multiple forms in order to imitate several other diseases, frequently triggered by intense emotions such as anger, grief, terror or passions Gilman et al. William Cullen, , a noted Scottish physician, published Synopsis Nosologiae Methodicae , a classification of diseases where hysteria figured on the group called neuroses. These diseases were considered to result from nervous system malfunction involving changes in sensibility and motion.
Hysteria was included in the class of illnesses characterized by irregular muscular contractions, the so-called spasmodic diseases, but Cullen still admitted that in its origin were gynecological problems Risse, During this period, hysteria was a serious subject in medical schools and textbooks. Some authors considered it to reflect psychological frustrations directly linked to the restricted role of women in society Risse, He introduced sociological and material concepts in the comprehension of hysteria, such as living and working conditions.
The industrialization, with the development of the trains and the subsequent numerous traumatic accidents, brought up the discussion about the hysteria in men. Using a photographic camera, after long and detailed observations and methodical comparisons of hysteria with other conditions, he considered two main forms of hysteria—with and without convulsions.
Epileptoid; 2. Contortions and acrobatic postures Clownism ; 3. Final delirium Teive et al. According to him, the presumed neurological impairment was dynamic in nature and produced by unconscious mental processes Macmillan, Hysterical symptoms occurred in genetically predisposed individuals and were manifested within familiar circumstances.
Despite the influences of his master, he presented his own theory about hysteria, as well as several approaches and specific criteria in order to differentiate organic from hysterical symptomatology Mai, ; Allilaire, ; Clarac et al. Later, Charcot introduced hypnosis as a therapeutic technique and also as an experimental tool to the study of hysterical phenomena and its underlying neurophysiology and psychogenic trauma-related mechanisms of the hysterical neuroses Levin, Charcot and his group have been criticized by the School of Nancy and his main investigator Hippolyte Bernheim, — , a French physician and neurologist.
While Charcot believed that hypnosis was based on physiologically well-determined phenomenon only applied, as a therapeutic and diagnostic technique, to hysterical patients, Bernheim proposed that it was based on changes in psychological functioning; different features of hypnosis would therefore reflect different degrees of suggestibility.
He also argued that suggestibility was a normal human trait and not an abnormal phenomenon as Charcot defended Macmillan, Another important author that had influenced the work of Freud was Pierre Janet, — , also a Charcot follower.
Janet considered that hysteria results from the idea the patient has about pathology, translating it into a physical disability. Freud defied the traditional idea that defended that hysteria was caused by the lack of conception and motherhood, proposing that hysteria was a disorder caused by a lack of libidinal evolution setting the stage for the Oedipal conflict , so the consequence, and not the cause, would be the lack of conception as a result of the incapacity of the hysterical to live a mature relationship.
In fact, with the war and after that, during the s and the s, the interests in this matter grew rapidly. Freud explored traumatic experiences occurring in the family in order to provide an explanation for hysteria. Unacceptable feelings connected to seduction were repressed and converted into somatic symptoms.
Latter he found that many of these reports were false, so he concentrate on intrapsychic factors. Patients repressed not actual happenings but their own sexual fantasies Slipp,
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