Emotional personality disorder

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Emotionally unstable (labile) personality disorder is characterized by increased excitability, impulsivity, low ability to self-control and emotional imbalance. Like other personality disorders, it is a character pathology (“severe character”) rather than a disease. An experienced psychotherapist can help with the disorder.

Important

A “difficult character”, the inability to cope with one’s emotions is a reason to seek help from a psychotherapist.

Another name for aggressive, epileptoid, excitable, explosive personality disorder. Doctors sometimes treat it as two separate disorders—impulsive disorder and borderline personality disorder.

A common characteristic of people with both types of emotionally unstable personality disorder is that they have difficulty controlling themselves and obeying norms and rules due to poor self-control and impulsivity. Personality traits make it difficult to establish and maintain contacts with others. Treatment with a psychotherapist for such people is an opportunity to accept the characteristics of their psyche and learn to live in harmony with others.

Symptoms of epileptoid personality disorder

If we talk about the classification of emotionally unstable personality disorder, ICD-10 divides it into two subtypes:

Impulsive.
Borderline.

Emotionally unstable personality disorder of the impulsive type is characterized by severe emotional lability (frequent change of mood for no reason), a tendency to impulsive actions and aggressive outbursts with an inability to restrain itself. People with this disorder have a hard time withstanding criticism and reproach.

Epileptoids are characterized by jealousy, suspicion, a tendency to manipulate, irritability and outbursts of anger.

Emotionally unstable borderline personality disorder is less characterized by aggressive behavior towards others, but such people are prone to self-harm, even suicidal behavior. Read more about borderline disorder.

According to ICD-10, the disorder is characterized by general features of a personality disorder and specific features. The general criteria are as follows:

begins to manifest itself in childhood and adolescence, persists into adulthood;
it is difficult to identify clear phases of recovery/exacerbation;
character traits prevent you from communicating with loved ones and strangers, and prevent you from developing professionally;
a person is often self-centered, incapable of empathy (sympathy for other people), and constantly strives for pleasure.

Specific symptoms of the impulsive (explosive) type of emotionally unstable personality disorder:

Impulsivity in thoughts and actions.
Low ability to self-control.
Outbursts of anger.
Tendency to cruel and antisocial behavior.
Intolerance of blame and criticism.

To diagnose the impulsive type of emotionally unstable personality disorder, the psychotherapist talks in detail with the client.

Differential diagnosis is carried out with other personality disorders (borderline, hysterical), as well as with epilepsy. For this purpose, a pathopsychological study is used (performed by a clinical psychologist), EEG, and Neurotest.

An integrated approach to diagnosis is necessary so that the doctor can prescribe the most effective treatment for a given person.

What are emotions

In psychology, this term implies the severity of the degree of experience of events, processes occurring around a certain person, relationships with other people, and internal assessment of situations. This mental function affects the entire human body and can lead to positive or negative reactions.

The emotional response manifests itself as:

An assessment that reveals the overall significance of the received signal.
Incentives - response. For example, feedback on offense, joy, embarrassment.
Organizations – forming the power of response experiences.

Emotionally unstable personality disorder - treatment

People with emotionally unstable personality disorder especially urgently need the help of a psychotherapist. A specialist can teach them to control their emotions and prevent the negative impact of emotional outbursts on others (with impulsive disorder) and on the person himself (with borderline personality disorder).

Labile personality disorder has been described as one of the most difficult diagnoses to treat. Establishing contact with a person who suffers from an emotionally unstable personality disorder is not an easy task for a psychotherapist. Inexperienced specialists avoid a strong alliance with such patients so as not to lose their own peace of mind.

But it is important to remember that a personality disorder is not a disease; the patient does not have damage to the nervous system. Consequently, with proper treatment, it achieves serious positive results. People with borderline and aggressive personality disorders should be treated by an experienced psychotherapist.

Important

Psychotherapy is the main non-drug treatment method for mental disorders. Unlike medications that eliminate symptoms, it works with the cause - allowing you to achieve long-term, lasting results.

The main treatment method for emotional personality disorder is psychotherapy. Drug treatment is not used in all cases. Medication support is sometimes necessary if the personality disorder is combined with other illnesses, such as depression.

The most effective techniques for working with people who suffer from emotionally labile personality disorder are cognitive behavioral therapy and dialectical behavior therapy. They help patients become aware of the thoughts and feelings that influence their actions and teach them how to control themselves.

If all the doctor’s recommendations are followed and, most importantly, the patient’s desire to interact with the psychotherapist, therapy has a lasting positive effect. At the same time, the specialist does not seek to change the patient’s personality, but helps to accept himself and learn to live in harmony with himself and others.

Author: Specialist of the Alliance Mental Health Center

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The International Classification of Diseases, 10th Revision, lists BPD as “Emotionally unstable personality disorder (F60.3).”[2] It is this name that is common in Russia. This disorder is also called borderline disorder.

The causes of BPD are not completely clear, but it is becoming increasingly clear that the appearance of this disorder is due to genetic, brain, and social factors. Borderline disorder occurs 5 times more often in people with disrupted family relationships (neglected by parents, active criticism and rejection from loved ones). BPD is 3 times more common in women than in men.[3]

Unfavorable life factors (for example, physical or emotional abuse) also play an important role in the appearance of this deviation. A number of neurophysiological studies have shown that the manifestations of the disorder are associated with frontal-limbic groups of neurons.[4][5][6]

Prevalence

According to a 2008 study, the prevalence of the disorder in the population is 5.9%. About 20% of psychiatric hospitalizations are for patients with BPD.[7]

Emotional lability refers to sudden mood swings: panic or sadness may be replaced by attacks of aggression, then a burning feeling of guilt may arise, etc.

Separation anxiety is the anxiety that a person experiences due to separation from home and loved ones.

About mania

Today I got up again without an alarm clock at 7 am, although I went to bed at three in the morning. I redid a bunch of things, project after project. And just little and little! I would like to buy a one-way ticket somewhere (but I have no money, literally at all). Otherwise I would have left right now. In fact, I would like to stay in this state, I feel so strong and brave)). And I don’t remember the details of those days when I was a corpse. I really don’t understand why, it’s still cool!

4th day. The feeling of euphoria still does not go away. I slept for 4 hours today and got back to work. This, of course, is very cool, but it scares me a little... I don’t think about anything at all that could trigger it, that is, I just don’t care about the negativity that I thought about a week ago. I just want to constantly do something, go somewhere, communicate, be in a crowd.

Now I’m in Moscow, I woke up at home, the feeling that I was pumped with something last Thursday, very hard, and only released yesterday. Now I'm just chained to the bed, I want to shoot myself. I called the doctor myself. I have a feeling that it was not me, but another person. Who did such wild crap that now I have to pay for.

Pathogenesis of borderline personality disorder

As with other mental disorders, the pathogenesis of BPD is multifactorial and not fully understood. According to some studies, borderline disorder shares similarities and causes with post-traumatic stress disorder (PTSD). In addition, their pathogenetic relationship is possible.

Most researchers agree that a history of childhood chronic emotional trauma contributes to the development of BPD. However, it is worth noting that insufficient attention is paid to studying the role of other pathogenetic factors: congenital brain dysfunctions, genetics, neurobiological factors and social environmental factors.

Social factors refer to the interaction of people in the process of growing and maturing in their families, surrounded by friends and other individuals.

Psychological factors include personality and temperament, adaptation to the environment, and developed skills to cope with stress.

Genetics

The heritability of BPD is approximately 40%. In reality, it is quite difficult to achieve an objective assessment of genetic factors. For example, the twin method can give overestimated indicators due to the presence of traumatic factors in the common family of siblings.[9] However, one study found that BPD is the third most heritable personality disorder out of ten. A study in the Netherlands (Trull & colleagues) found that genetic material on chromosome nine is associated with symptoms of BPD. Based on this, scientists concluded that genetic factors play a key role in the individual characteristics of the disorder in each individual patient. The same researchers previously found that 42% of BPD symptoms are determined by genetics and 58% by environmental influences.[10]

Features of the brain

A number of studies in the field of neuroimaging in BPD have shown the presence of reduction (decrease) of brain matter in specific areas. These departments are normally involved in regulating the response to stress and regulating the emotional sphere. We are talking about the hippocampus, the orbital-frontal areas of the cerebral cortex (prefrontal cortex), and the amygdala.[11]

The amygdala is smaller in absolute volume and more active in people with BPD. Reduced amygdala volume has also been found in patients with obsessive-compulsive disorder. One study found abnormally high activity in the left amygdala of people with BPD when they looked at cards depicting people in negative emotions. Because the amygdala generates all emotions, including negative ones, this unusually high activity may explain the intense and prolonged emotional expressions of fear, grief, anger and shame experienced by people with BPD. The same fact is interpreted by their ability to subtly recognize the emotions of other people.[12]
The prefrontal cortex tends to be less active in individuals with BPD, especially when memories of their “emotional abandonment” are recalled. This relative decrease in activity is most pronounced in the right anterior gyrus . Given the role of the prefrontal cortex in regulating emotional arousal, the relative inactivity of these areas may explain the difficulty people with BPD have in regulating their emotions and responding to stress.[13]

The hypothalamic-pituitary-adrenal (HPA) axis regulates the production of cortisol , which is released in response to stress. Levels of this adrenal hormone are actually higher in people with BPD than in the general population. This is a sign of HPA axis hyperreactivity. Hyper-reactivity may explain a higher biological response to stress and greater vulnerability to disturbing factors. Also, high cortisol levels are associated with a high risk of suicidal behavior.[12]

Neurobiological factors (estrogens)

A controlled study in 2003 found that BPD symptoms in women were predictably associated with estrogen (female sex hormone) levels during the menstrual cycle.[14]

Personal development factors (childhood trauma)

There is a strong relationship between child abuse, especially child sexual abuse, and the development of BPD.

Children who experience chronic self-maltreatment and difficulty forming attachments early in life are hypothesized to be on the path to developing BPD.[15]

Story

It is important to note that the term “borderline” has been used in a variety of ways that are quite different from the DSM-III-R criteria for BPD, and that the misuse of this diagnostic label has long been criticized (e.g., Knight, 1953). The term was originally used when the clinician was unsure of the diagnosis because the client was exhibiting a mixture of neurotic and psychotic symptoms. Many clinicians viewed these clients as being on the border between neurotic and psychotic, and thus the term "borderline" was coined. In some circles, the term "borderline" is still used as a "garbage can" term for people who are difficult to diagnose, or is understood to mean "near psychotic", despite the lack of empirical material to support this interpretation of the disorder.

Another meaning of the term “borderline” is related to the reference to borderline “personality structure” in the extensive literature of psychodynamically oriented authors (for example, Gunderson & Singer, 1975; Kernberg, 1975, 1977; Masterson, 1978). Although these authors differ to some extent in their definitions of borderline personality structure (see Stone, 1985), this personality structure is characterized by a “poorly integrated identity,” “primitive defensive actions,” and “relatively strong boundaries between self and object.” , and “a fairly intact capacity for reality testing” (Masterson, 1978). It is important to note that, in addition to the difficulty of operationalizing them, these characteristics are not associated with any specific set of behaviors or symptoms. Thus, borderline symptoms can be observed both in the presence and absence of a borderline personality structure, and at the same time, a borderline personality structure can be observed in both the presence and absence of borderline symptoms. For example, Stone (1985) describes one person as “a schizotypal borderline (DSM-III) personality with a psychotic structure.”

Classification and stages of development of borderline personality disorder

American psychologist Theodore Millon identified 4 subtypes of BPD:[16]

1. Sad Borderline Disorder (includes avoidant or dependent personality traits).

Characteristic features: compliance, humility, loyalty, modesty; feeling of vulnerability and constant danger; the individual experiences feelings of hopelessness, depression, helplessness and impotence.

2. Touchy borderline disorder (includes passive-aggressive personality traits).

Characteristic features: negativism (opposition to everything), impatience, anxiety, as well as stubbornness, defiant behavior, gloominess, pessimism; a person is easily offended and quickly disappointed.

3. Impulsive borderline disorder (includes histrionic and antisocial personality traits).

Characteristics: capriciousness, superficiality, frivolity, feverish and seductive behavior; fearing loss, a person easily falls into agitation (excitement); gloominess and irritability; potentially suicidal intent.

4. Self-injurious borderline disorder (includes depressive and masochistic, as well as self-destructive personality traits).

Characteristic features: isolation, self-punishment, anger, conformity, deference, ingratiation, progressively rigid and gloomy state; there is a risk of suicide.

Severity of personality disorder[17]

Degrees of severity of personality disorders

Light

Average

Heavy

Interpretation Neuropsychic instability (the opposite concept is neuropsychic stability) is a tendency to breakdowns of the nervous system under significant physical and mental stress.
This concept includes various pre-morbid conditions (extreme variants of the mental norm) with a hidden, not expressed, or moderately expressed, but compensated form of the course, caused by deficits in the functioning of the nervous system and reducing the adaptive capabilities of the body. In the origin of neuropsychic instability, the determining role is played by the biological inferiority of the nervous system (congenital or acquired) in combination with unfavorable psychological and social factors. Neuropsychic instability gives rise to: suicidal attempts, self-harm, desertion, assault, evasion of official tasks, irritability, conflict, withdrawal, isolation, posturing, inability to perform due to forgetfulness, tearfulness, non-resistance to humiliation. Sources of neuropsychic instability: mental illness, illness (meningitis, encephalitis), traumatic brain injury, alcoholism, drug addiction, substance abuse, family troubles, mental retardation. Methods for identifying persons with neuropsychic instability: observation, analysis of documents, conversation, analysis of independent characteristics, testing, analysis of performance results, experiment, correspondence with parents, medical examination. Psychological and pedagogical dictionary of a naval unit teacher educator. - Novorossiysk: Publisher: Novorossiysk. G.A. Bronevitsky, G.G. Bronevitsky, A.N. Tomilin. 2005.

See what “Nervous-mental instability” is in other dictionaries:

Neuropsychic instability - <*> Neuropsychic instability is understood as a tendency to disturbances in mental activity under significant mental and physical stress... Source: Order of the Minister of Defense of the Russian Federation dated January 26, 2000 N 50 (as amended on May 12, 2005) About... ... Official terminology
MENTAL TRAUMA - MENTAL TRAUMA, experiences that are unpleasant or frightening, b. or m. deeply disrupting basic mental and somatic processes. These experiences can be of a different nature, both in content and affective coloring, as well as in intensity and... ... Big Medical Encyclopedia
Interrogation in a conflict situation is one of the procedural forms of professional communication between an investigator and interrogated persons for various, often incompatible (as opposed to interrogation in a conflict-free situation) purposes. Often a conflict situation of interrogation is characterized by active... ... Encyclopedia of modern legal psychology
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Psychogram of a customs service specialist - A section of the professiogram, which reflects in scientific psychological concepts the system of requirements of the customs profession for the psychological and psychophysiological qualities of a customs officer and the measure of their severity. Fundamentals of professionography and systems... ... Encyclopedia of modern legal psychology
NEURASTENIA is a state of disorder characterized by irritable weakness, excessive fatigue, and increased fatigue. Neurasthenia was described as a specific disorder by the American physician J. Baird (1839–1883) in his work... ... Encyclopedic Dictionary of Psychology and Pedagogy
Carbon disulfide - CS2, a compound of sulfur and carbon. Colorless liquid, density 1.2927 g/cm3, tkip 46.26°C, melting point 112.1°C. Solubility in water is insignificant; it can be mixed with alcohol, ether, and chloroform in any proportions. Vapors at 236 °C... ... Great Soviet Encyclopedia
Traumatic brain injury - I Traumatic brain injury Traumatic brain injury is mechanical damage to the skull and (or) intracranial formations (brain, meninges, blood vessels, cranial nerves). Accounts for 25-30% of all injuries, and among deaths with... ... Medical Encyclopedia
Narcology - This article needs to be completely rewritten. There may be explanations on the talk page... Wikipedia
Neuroses are (neuroses; Greek neuron nerve + ōsis) reversible borderline mental disorders, recognized by patients, caused by the influence of traumatic factors and occurring with emotional and somatovegetative disorders. The main reason... ... Medical encyclopedia

InterpretationTranslationEmotional instability is the tendency to exhibit excessively strong, short-lived, unpredictable and maladaptive emotional reactions.
* * * – emotional lability, a tendency to express sharply and unpredictably strong emotions, easy variability of feelings and moods, especially as a result of inadequate reactions to weak stimuli. Wed. the image of Nozdryov in “Dead Souls” by N. Gogol, Sheila Castleside in “Blackout at Gretley” by J. Priestley.

Wed. instability of behavior.

Encyclopedic dictionary of psychology and pedagogy. 2013.

See what “Emotional instability” is in other dictionaries:

EMOTIONAL INSTABILITY - The tendency to be emotionally labile, to express one’s unpredictably strong emotionality extremely sharply... Explanatory Dictionary of Psychology
Emotional lability - Instability of emotional states, rapid change of one emotional reaction to another. E. l. is one of the signs of incoordination, disorders of higher nervous activity and the human psyche as a whole... Adaptive physical culture. Concise encyclopedic dictionary
Lability of affect is instability of mood, its constant fluctuations, frequent changes for minor reasons or for no apparent reason. In clinically significant cases, it is considered a manifestation of emotionally labile psychopathy. Synonyms: Emotional... ... Encyclopedic Dictionary of Psychology and Pedagogy
Neuroses are a group of functional neuropsychic disorders, the main causes of which are intrapsychic conflict (in psychoanalysis) and/or a traumatic situation (in domestic psychiatry), see Neurosis. Different types are known... ... Encyclopedic Dictionary of Psychology and Pedagogy
Nursing - I Nursing. Nursing is a set of activities that provide comprehensive care for the patient, fulfillment of medical prescriptions, creation of optimal conditions and environment conducive to a favorable course of the disease, the fastest ... ... Medical encyclopedia
infantilism - a; m. [from lat. infantilis infantile, children]. 1. Honey Developmental retardation, manifested in the preservation in an adult of physical or mental traits characteristic of a child. Suffer from infantilism. 2. Book. Behavior, character traits of an adult ... Encyclopedic Dictionary
Dialectical behavior therapy (DBT) was created around 1987 by American psychologist Marsha M. Linehan to treat patients suffering from borderline personality disorder. This approach helps reduce the risk... ... Wikipedia
Neuroses are (neuroses; Greek neuron nerve + ōsis) reversible borderline mental disorders, recognized by patients, caused by the influence of traumatic factors and occurring with emotional and somatovegetative disorders. The main reason... ... Medical encyclopedia
Mental retardation - This article should be Wikified. Please format it according to the article formatting rules. Mental retardation (abbr. DPR) is a violation of the normal pace of mental development, when individual mental functions ... Wikipedia
Psychogram of a customs service specialist - A section of the professiogram, which reflects in scientific psychological concepts the system of requirements of the customs profession for the psychological and psychophysiological qualities of a customs officer and the measure of their severity. Fundamentals of professionography and systems... ... Encyclopedia of modern legal psychology

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Organic personality disorder
The frontal lobe of the brain (in red), when damaged, this syndrome occurs.
ICD-10	F
ICD-9

Organic personality disorder (personality disorder of organic etiology)

- a personality disorder caused by disease, damage or dysfunction of the brain.

Types of pathology, signs and symptoms

Treatment of emotional disorder begins with determining its type and the cause of the condition. Psychiatric diagnostics allow us to identify different types of diseases, and the degree of their severity, adequacy, and stability. Communication with the patient makes it possible to identify mood disorders, as well as a number of depressive and manic syndromes. Often, painful behavioral traits are a consequence of not only neuropsychic diseases, but also diseases of internal organs.

The category of pathological disorders of emotional strength includes:

Sensitivity. With this deviation, patients have excessive vulnerability and hypersensitivity, which are most characteristic of psychopathy.
Cold. The category of patients with this trait is characterized by pronounced indifference to the people around them and the events taking place. They lack compassion and empathy. Most often detected in schizophrenia.
Stupidity. In a conversation with a client, poverty and impoverishment of sensory experiences are noted. A defect reflecting a schizophrenic symptomatic picture.
Apathy. A person with an apathetic syndrome complex exhibits a lack of motivation for any type of activity and a disappearance of desires. Indifference is combined with dullness and poverty of feelings. Most often, apathy is characteristic of patients with organic brain pathology, but it also occurs as part of depressive syndrome and schizophrenia.

In addition to the described disorders, there are deviations in the adequacy and stability of emotions (lability, explosiveness and weakness).

Clinical picture

Organic personality disorder is characterized by significant changes in the pattern of behavior habitual before the illness. Drives, needs and expression of emotions are impaired. Cognitive performance is usually reduced in the areas of anticipation and planning, similar to the impairments in frontal lobe syndrome.

This disorder can manifest itself as a personality syndrome in limbic epilepsy, as a consequence of a lobotomy, after a leucotomy, damage to the frontal lobes of the brain (or damage to other surrounding areas of the brain).

The development of a characteropathic variant of psychoorganic syndrome with organic brain damage is classified as pseudopsychopathy[1].

With the frontal lobe syndrome of the frontal variant, dissocial personality disorder develops. ADHD and other behavioral disorders may occur in childhood.

Diagnostics

The diagnostic criteria of the International Classification of Diseases, 10th Revision (ICD-10) require the presence of 2 or more of the following features:[2]

significantly reduced ability to cope with goal-directed activities, especially those that require a long time and do not quickly lead to success;
altered emotional behavior, characterized by emotional lability, superficial unjustified fun (euphoria, inappropriate playfulness), which is easily replaced by irritability, short-term bouts of anger and aggression. In some cases, the most striking feature may be apathy;
expressions of needs and drives may arise without regard to consequences or social conventions (the patient may commit antisocial acts, such as theft, make inappropriate sexual demands, exhibit gluttony, or fail to observe personal hygiene);
cognitive impairment in the form of suspicious or paranoid thoughts or excessive preoccupation with a single, usually abstract topic (such as religion, “right and wrong”);
pronounced changes in the pace and flow of speech production, with features of random associations, over-inclusion (expanded inclusion of side associations in the topic), viscosity and hypergraphia;
altered sexual behavior (hyposexuality or change in sexual preference).

About self-harm

My first suicide attempt happened at the age of 15, when I was in school. The trigger was a banal reason - a friend went for a walk with another girl, but forgot about me. I locked myself in the bathroom with a blade and a feeling of complete insignificance and devastation, cried for a long time, and then cut my hand. There was a lot of blood.

There were no signs of trouble in the morning. In the evening there was a party (without alcohol, which is important), a bad joke, and I closed myself off. About twenty minutes later I went into the kitchen and stabbed myself three times in my hand with a knife. Strongly. Stitched up.

I can't help but think about hurting myself. I don't know how to get rid of them. Even when I’m having fun, I’m having fun with my friends, I think: what if I jump in front of a train on the subway now. Or yesterday we were in the PG, I thought - what if now we’re going down from the bridge? When I see sharp objects, I always think about how they dig into my hand and blood gushes out. Constant, intrusive thoughts.

Please don't cut yourself! I understand that in moments of breakdown the brain turns off, and we are controlled by the second self. But you can come to an agreement with it... Once I succeeded! Cold shower. Yes, it's that simple. Stick yourself under ice water: you will scream so much that all emotions will subside.

Etiology

ICD-10 provides an indication of the cause of personality disorder:

due to traumatic brain injury (F07.00)
in connection with vascular disease of the brain (F07.01)
in connection with epilepsy (F07.02)
due to brain tumor (F07.03)
in connection with HIV infection (F07.04)
in connection with neurosyphilis (F07.05)
in connection with other viral and bacterial neuroinfections (F07.06)
in connection with other diseases (F07.07)
due to mixed diseases (F07.08)
due to an unspecified disease (F07.09).
due to complicated diabetes mellitus

Literature

Alexei Franulic, Elizabeth Horta R.
Organic personality disorder after traumatic brain injury: cognitive, anatomic and psychosocial factors. A 6 month follow-up (English) // Brain Injury : journal. - 2009. - Vol. 14. - doi:10.1080/026990500120538.

>ICD-10 Personality DisordersSpecific This page was last edited on March 21, 2021 at 08:49 pm. Sources used:

https://cmzmedical.ru/zabolevaniya/emotsionalno-neustoychivoe-rasstroystvo-lichnosti/
https://probolezny.ru/pogranichnoe-rasstroystvo-lichnosti/
https://millitary_psychology.academic.ru/709/neuro-psychological_instability
https://psychology_pedagogy.academic.ru/21209/emotional_instability
https://wiki2.org/ru/organic_personality_disorder