[49주차] Disorders of Personality: 19. Unstable Styles, Borderline Types, Cyclophrenic Disorders: The UBC Spectrum(pp. 933-937)

Differential Diagnoses

psychotic Axis I mood disorders vs. UBC personality patterns
- Disorders, therefore, are transitory, of relative short duration, in contrast to the more permanent and disturbed lifestyle of the basic personality.(ego-dystonic vs ego-syntonic)
스트레스가 지속되거나 입원이 잦아지면 둘 간의 경계가 흐려짐
Thought and perceptual pathologies are primary in the socially isolated schizotypal, whereas mood instability and ambivalence typify the interpersonally connected borderline.
SPH와의 차이: Both borderlines and histrionics give evidence of labile emotions associated with interpersonal manipulations and attention-seeking. However, borderlines are also noted by their angry disruptions in relationships with others and by their repetitive feelings of emptiness and loneliness.
MPP와의 차이: Although the paranoid shares the same level of severity as the borderline, there is a tendency toward rigidity and consistency in behavior that is lacking in the borderline, who also demonstrates a self-destructiveness and sense of aloneness not seen among paranoids.

카드에 걸쳐 우울이나 공격성에 연관된 반응이 함께 나타날 수 있음.
카드에 명확히 투사: Personal identifications may be readily observed, with the current emotional state and attitudes presented in a straightforward manner.

Desirous of seeking affection and approval from others,
- Dependency strivings push him to be overly compliant, to be self-sacrificing, to downplay his personal strengths and attributes, and to place himself in inferior or demeaning positions.
yet unsure of their feelings toward him(그래서 다른 사람을 시험해 봄), smothered by deep resentments, yet fearful of the consequences of assertion and anger, Allen would often be in a state of turmoil, in an unresolvable conflict that precluded finding a single and stable course of action.
He may vacillate between being socially agreeable, sullen, aggrieved, despondent, obstructive, and contrite.
- When threatened by separation and disapproval, he may express guilt and self-condemnation in the hope of regaining support, reassurance, and sympathy.
우울, 분노, 조증을 오가는 불안정한 정동
- 특히 의존과 불신을 오가는 가운데 성격적 구조로서의 dysthymia나 major depression을 지니게 될 수 있음("this moody and ambivalent man")
a moderate level of pathology characterizes the overall personality organization of this man.
- Defective psychic structures suggest a failure to develop adequate internal cohesion and a less than satisfactory hierarchy of coping strategies.
- Deficits in his social attainments
- Although he is usually able to function on a satisfactory basis, he may experience periods of marked emotional, cognitive, or behavioral dysfunction.