偏执型人格障碍课件

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1、第十一章人格障碍及其矫正(personalitydisorders)于丽琴1一、人格障碍概述(PersonalityDisorders:AnOverview)2Whatisapersonalitydisorder?maladaptivepersonalitytraitstraitsarerelativelyenduringfeaturesofapersonthatarepersistentovertimeandsituationspeoplewithpersonalitydisordersten

2、dtobe:rigidandinflexible,showarestrictedrangeoftraits,haveadominantsingletraitpersonalitydisordersareegosyntonic,morethanegodystonic3DSM－IV强调病人在认知、情感、人际关系和冲动控制方面的偏离，指出这种偏离类型在长时间内相当稳定，至少可以追溯到青少年或早期成年时。4PersonalityDisorders:FactsandStatisticsPrevalence

3、ofPersonalityDisordersAbout0.5%to2.5%ofthegeneralpopulation6-9%（Kathleen，1986）0.13‰（我国，1986）Ratesarehigherininpatientandoutpatientsettings。prevalencehigheramongpeoplewithothermentaldisorders6-9%ofpopulationhaveoneormorepersonalitydisordermostpeoplewi

4、thpersonalitydisordersnevercometotheattentionofmentalhealthprofessionals5OriginsandCourseofPersonalityDisordersThoughttobegininchildhoodRunachroniccourseComorbidityratesarehighGenderDistributionandGenderBiasGenderbiasexistsindiagnosisCriterionvs.asse

5、ssmentgenderbias6DSM-IV将10种人格障碍划分为3大类群:A类群：行为古怪、奇异ClusterAOddoreccentricExamplesincludeparanoid,schizoidB类群：戏剧化、情感强烈、不稳定ClusterBDramatic,emotional,erraticExamplesincludeantisocial,borderlineC类群：紧张、焦虑行为ClusterCFearfuloranxiousExamplesincludeavoidant,o

6、bsessive-compulsive分类DSM-IVandDSM-IV-TRPersonalityDisorderClusters7人格障碍类型clusterAclusterBclusterC偏执型表演型回避型分裂型自恋型依赖性分裂样反社会型强迫型边缘型89PERSONALITYDISORDERSHistoricalperspectiveRootsinpsychoanalysis–narcissism,masochism,etc.KarlAbraham–firsttheoristtofocu

7、sonpersonalitydisorders10PERSONALITYDISORDERSDiagnosticissuespoorunderstandingofetiologyofmostpersonalitydisorderscomorbidityanddiagnosticoverlapgenderandculturalissuesreliabilityofdiagnosis11PERSONALITYDISORDERSEtiology–TheoreticalperspectivesPsyc

8、hodynamictheoryAttachmenttheory–particularlyfordramatic,emotional,erraticCognitive-behaviouralperspectivesBiological–particularlyforodd,eccentricanddramatic,emotional,erratic1213（一）偏执型人格障碍（paranoidPD)1、临床特征2、形成原因3、治疗14临床特征主要特征：猜疑、偏执表现为对他人持久的不信任，社会隔离，