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Group C: anxious or fearful disorders

The Avoidant Personality Disorder. People who present the set of symptoms typical of this disorder are acutely sensitive and may suffer intensely at the sole prospect of being criticised or meeting with the disapproval of others. They are thus reluctant to embark upon interpersonal relations unless there is a certain degree of certainty they will be accepted and appreciated. If others are warm and open towards them, avoidant personality types will tend to doubt their sincerity. In social situations these individuals are inhibited by the fear of saying something silly or finding themselves in a very embarrassing situation on account of blushing or other signs of anxiety that may occur. They feel they are incompetent and inferior to others and exaggerate the risks, dangers or difficulties connected with doing something outside their usual routine.

Dependent Personality Disorder. Subjects presenting the signs and traits of this disturbance are characterised by their insecurity, lack of self-confidence and an excessive need to be looked after, which manifests through submissive, clinging behaviour. This need results in their feeling uncomfortable if they are left alone and they often worry too much about the idea of having to look after themselves. They prefer to let others make important decisions concerning their personal life and tend to avoid making choices for themselves as they fear losing the approval of significant others. They will even go to the extent of performing quite unpleasant tasks and duties if this will ensure they are guided and taken care of. They tend to always agree with everyone, even when they are aware that others are making mistakes. Constantly seeking the consideration and reassurance of others, they reveal great difficulty in initiating activities spontaneously, which results in considerable difficulty in their daily lives.

It is found that these patients often subordinate their needs to those of others as they think that if they were to behave differently they might ruin the relations they have built up and when an intimate relationship ends, they immediately look for a new one with which to replace the former. They show a lack of confidence in their skills, both practical and intellectual. The disorder manifests mainly in women, probably also on account of forms of socialization experienced during childhood which differ from those experienced by men (Corbitt and Widiger, 1995; Weissman, 1993). The Dependent Personality Disorder frequently presents together with the Borderline and Avoidant Personality Disorders (Morey, 1988) and is often associated with the Dysthymic Disorder, Depression and Anxiety. The disturbance first appears during the first half of adult life.

Obsessive-Compulsive Personality Disorder. A personality of this type is characterised by perfectionism and worry over small details and by the scrupulous observation of rules, timetables and schedules. These persons pay so much attention to small detail that they find they can never complete any of the tasks they set about doing. These subjects are more oriented towards work and professional activities than pleasurable pastimes. They have enormous difficulty in reaching decisions on account of their fear of making mistakes and are often reluctant to organise their time in a definitive manner because they are afraid they might be concentrating on something wrong or useless. Often their personal relations suffer because they are obstinate and demand that everything be done the way they want. In general they are serious, rigid, formal and inflexible, especially about topics of a moral nature. They cannot free themselves from objects that are now old and useless even when they have no actual value. They are in fact often miserly and mean and tend to live below their means. It should be noted that the Obsessive-Compulsive Personality Disorder (OCPD) is distinguished from the Obsessive-Compulsive Disorder (OCD) on account of the absence of high levels of anxiety and the extremely serious obsessions and compulsions typical of the latter disorder. It presents a high rate of comorbidity with the Avoidant Personality Disorder.

Bibliographical references:

Clarkin, J.F., Marziali, E., & Munroe-Blum, H. (Eds). (1992). Borderline personality disorder: Clinical and empirical perspectives. New York: Guilford.

Corbitt, E.M., & Widiger, T.A. (1995). Sex differences in the personality disorders: An exploration of the data. Clinical Psychology: Science and Practice, 2, 225-238.

Kety, S.S., Rosenthal, D., Wender, P.H., Schulsinger, F. (1968). The types and prevalence of mental illness in the biological and adoptive families of adopted schizophrenics. In D. Rosenthal & S.S. Kety, The transmission of schizophrenia. Elmsford, NY: Pergamon.

Morey, L.C. (1988). Personality disorders in DSM-III and DSM-IIIR: Convergence, coverage, and internal consistency. American Journal of Psychiatry, 145, 573-577.

Modestin, J., (1987). Quality of interpersonal relationships: the most characteristic DSM-III BPD characteristic. Comprehensive Psychiatry, 28, 397-402.

Swartz, M., Blazer, D., George, L., & Winfield, I. (1990). Estimating the prevalence of borderline personality in the community. Journal of Personality Disorders, 1990, 257-272.

Weissman, M.M., (1993). The epidemiology of personality disorders: a 1990 update. Journal of Personality Disorders, 7, 44-61.

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Disturbo ossessivo compulsivo di personalita'
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