F60.30x Emotionally unstable personality disorder, impulsive type / Excitable psychopathy / Epileptoid psychopathy

Pathogenesis and etiology of the disorder

A clear cause for the disorder has not been identified, but according to some theories, it may be caused by the following factors:

1. The surrounding society. Most epileptoids grew up in an environment where aggressive behavior combined with violence is considered the norm. As children grow older, they acquire the same traits as adults.
2. Heredity. The etiology of epileptoid psychopathy may involve a factor of genetic predisposition, as a result of which the disease is transmitted to children from the mother or father.
3. Brain chemistry. Serotonin (the pleasure hormone that prevents depression) functions in such patients, perhaps differently than in healthy people.
4. Birth injuries and head injuries cause the development of epileptoid psychosis as a compensatory reaction.
5. Infectious diseases of the central nervous system.

The epileptoid type of character accentuation can also develop due to the following reasons:

1. Sexual or physical abuse. People who have experienced such humiliation have an increased chance of developing this psychopathy.
2. Other types of mental disorders. People with any other antisocial disorder, including disruptive behavior, are also at risk.

Causes, risk factors of psychopathy and quality of life

The exact cause of intermittent temper disorder is unknown, but it is likely caused by a variety of environmental and biological factors. The disorder usually begins in childhood - after the age of 6 years, or in adolescence and is more common in people aged 40 years.

• Environment.

Most patients with this disorder grew up in families where explosive behavior and verbal and physical abuse were common. By being exposed to this type of abuse at an early age, the development of explosive psychopathy is most likely in children, who will display these same traits as their parents as they grow older.

• Genetics.

The etiology of the disorder may have a genetic component, resulting in the disease being transmitted from parents to children.

• Brain chemistry.

There may be differences in how serotonin, an important chemical messenger in the brain, functions in people with intermittent temper disorder.

The most common risk factors for developing the disorder, experts include:

• History of physical abuse.

People who were abused as children, have experienced multiple traumatic events, or have been sexually abused have an increased risk of explosive psychopathy disorder.

• History of other mental disorders.

People who have antisocial personality disorder, borderline personality disorder, or other disorders that involve disruptive behavior such as attention deficit hyperactivity disorder (ADHD) are at increased risk for developing intermittent temper disorder.

Patients suffering from explosive psychopathy are characterized by the following complications and features that negatively affect their quality of life:

• Interpersonal relationship disorders.

Patients, with their explosive behavior, are often perceived by others as always dissatisfied, aggressive and angry. They can provoke frequent verbal altercations and physical violence. These actions can lead to relationship problems, divorce, and family stress.

• Trouble at work, home or school.

Other problems that intermittent temper disorder leads to may include job loss, school performance, traffic accidents, financial problems and legal troubles.

• Mood problems.

Mood disorders such as depression and anxiety often occur with intermittent temper disorder.

• Problems with alcohol and other substance use.

Problems with drugs or alcohol often occur alongside exclusive psychopathy disorder.

• Physical health problems.

Medical conditions are more common and may include, for example, high blood pressure, diabetes, heart disease, stroke, ulcers and chronic pain.

• Self-harm.

Intentional injury or suicide attempts sometimes occur in patients with the most severe form of the disorder, characterized by frequent seizures.

Epileptoid personality type - 9 facets of character

Patients diagnosed with epileptic psychosis have the following features that negatively affect their standard of living:

1. Violation of relationships with members of society. Epileptoids are perceived by the people around them as always gloomy, aggressive, intolerant people. These are egocentrics who do not take into account the opinions of others. They are despotic and very demanding of others. They can initiate verbal conflicts and use physical force. This leads to frequent job changes, poor performance in educational institutions, road accidents, and problems with law enforcement agencies.
2. Difficulty controlling mood. Anxiety and depression are always inherent in patients with this type of psychopathy. In movements and thinking, a tendency towards dysphoria is manifested.
3. Problems with alcohol and drug use. They go almost hand in hand with explosive psychopathy. Epileptoids do not drink a little to lift their mood, they feel the need to get drunk until they lose their memory.
4. Among health problems, diseases of the cardiovascular system, gastrointestinal tract, and metabolism predominate.
5. Deliberate self-mutilation sometimes occurs in epileptoids with the most severe form of psychopathy, characterized by frequent outbursts of aggression.
6. Psychosis also affects sexual relationships. During sexual intercourse, an epileptoid psychopath may adhere to sadism or masochism. Some of them choose homosexual or bisexual relationships.
7. In a family, they are always tyrants, forcing all members to obey them. Such a person plays the role of a despot, maintaining his status in the family with the help of force. Fights and conflicts at home become commonplace. All his close and dear people are unhappy due to the actions of the epileptoid. He does not hesitate to punish children with physical methods.
8. “Hypersocial” traits: pedantry, accuracy, adherence to traditions, exaggerated desire for justice.
9. People of this personality type often, but not always, look the part: stocky, strong figure, massive neck and torso, large lower jaw, short arms and legs.

Diagnosis

ICD-10

This section is translated from the article Personality Disorder. (edit | history)

Diagnostic criteria from the version of the International Classification of Diseases, 10th revision ICD-10, adapted for use in Russia (general diagnostic criteria for personality disorders, which must be met in all subtypes of disorders)[3]:

Conditions that are not directly attributable to extensive brain damage or disease or other mental disorder and meet the following criteria:

• a) marked disharmony in personal attitudes and behavior, usually involving several areas of functioning, such as affectivity, excitability, impulse control, perceptual and mental processes, as well as style of relating to other people; in different cultural conditions it may be necessary to develop special criteria regarding social norms;
• b) the chronic nature of an abnormal style of behavior that arose a long time ago and is not limited to episodes of mental illness;
• c) the abnormal style of behavior is comprehensive and clearly disrupts adaptation to a wide range of personal and social situations;
• d) the above-mentioned manifestations always arise in childhood or adolescence and continue to exist into adulthood;
• e) the disorder causes significant personal distress, but this may only become apparent later in the course of time;
• f) usually, but not always, the disorder is accompanied by a significant deterioration in professional and social productivity.

— International Classification of Diseases (10th revision), adapted for use in the Russian Federation — /F60/ Specific personality disorders. Diagnostic criteria[3]

To classify a personality disorder into one of the subtypes defined in ICD-10 (for diagnosis of most subtypes), it is necessary that it meets at least three criteria defined for this type [3].

Diagnostic criteria from the official, international version of ICD-10 from the World Health Organization (general diagnostic criteria for personality disorders, which must be met in all subtypes of disorders)[4]:

• G1. An indication that an individual's characteristic and consistent patterns of internal experience and behavior as a whole deviate significantly from the culturally expected and accepted range (or "norm"). Such a deviation must manifest itself in more than one of the following areas: 1) cognitive sphere (that is, the nature of perception and interpretation of objects, people and events; the formation of attitudes and images of “” and “others”);
• 2) emotionality (range, intensity and adequacy of emotional reactions);
• 3) controlling drives and satisfying needs;
• 4) relationships with others and the manner of solving interpersonal situations.

• G2. The deviation must be complete in the sense that inflexibility, lack of adaptability, or other dysfunctional characteristics are found in a wide range of personal and social situations (that is, not limited to one “trigger” or situation).
• G3. The behavior noted in G2 indicates
  personal distress or adverse effects on the social environment.
• G4. There must be evidence that the deviation is stable and long-lasting, beginning in late childhood or adolescence.
• G5. The disorder cannot be explained as a manifestation or consequence of other mental disorders of adulthood, although episodic or chronic conditions from sections F0 to F7 of this classification may exist simultaneously with it or arise against its background.
• G6. Organic brain disease, trauma or brain dysfunction should be excluded as a possible cause of the deviation (if such an organic condition is identified, rubric 07 should be used).

Original text (English)

• G1. Evidence that the individual's characteristic and enduring patterns of inner experience and behavior deviate markedly as a whole from the culturally expected and accepted range (or 'norm'). Such deviation must be manifest in more than one of the following areas: (1) cognition (ie ways of perceiving and interpreting things, people and events; forming attitudes and images of self and others);
• (2) affectivity (range, intensity and appropriateness of emotional arousal and response);
• (3) control over impulses and need gratification;
• (4) relating to others and manner of handling interpersonal situations.
• G2. The deviation must manifest itself pervasively as behavior that is inflexible, maladaptive, or otherwise dysfunctional across a broad range of personal and social situations (ie not being limited to one specific 'triggering' stimulus or situation).
• G3. There is personal distress, or adverse impact on the social environment, or both, clearly attributable to the behavior referred to under G2.
• G4. There must be evidence that the deviation is stable and of long duration, having its onset in late childhood or adolescence.
• G5. The deviation cannot be explained as a manifestation or consequence of other adult mental disorders, although episodic or chronic conditions from sections F0 to F7 of this classification may co-exist, or be superimposed on it.
• G6. Organic brain disease, injury, or dysfunction must be excluded as possible cause of the deviation (if such organic causation is demonstrable, use category F07).

— International Classification of Diseases (10th revision) — /F60/ Specific personality disorders. Diagnostic criteria[4]

According to ICD-10, F60.30 is an impulsive type of emotionally unstable personality disorder[2]. To make a diagnosis, one must meet the more general criteria for personality disorder and emotionally unstable personality disorder.

The directly impulsive type is characterized by even greater emotional instability and lack of impulse control. Outbursts of cruelty and threatening behavior are common for him, especially in response to condemnation from others.

Included[2]:

• excitable personality disorder;
• explosive personality disorder;
• aggressive personality disorder and aggressive personality;

Excluded[2]:

• dissocial personality disorder (60.260.2).

Symptoms at different stages of growing up

The disease manifests itself in different ways - it all depends on age. If you know these nuances, you can prevent further progression of psychopathy. And the sooner you start treatment, the better.

As you get older, epileptic psychosis manifests itself as follows:



1. Epileptoid child. A child with this disorder may cry for a very long time, even for several hours, and it is impossible to calm him down. Such children want to be a tyrant in games, dictating the rules. They love to surreptitiously torment the younger ones and those who cannot give them back, and abuse their pets. These are “difficult children”, fighters who do not get along well in a children's group.

In elementary school, children with such psychopathy are distinguished by “hypersocial” traits: excessive accuracy when filling out copybooks and notebooks and careful handling of their belongings.

• Epileptoid teenager. The most highly excitable psychopathy manifests itself at the time of puberty. At this age, sick teenagers are characterized by dysphoria - anger, apathy, and a sullen appearance. Teenagers themselves look for reasons to incite conflict. Even a slight restriction of freedom can lead to an attack of aggression. Such teenagers are characterized by harsh language and cruelty, and sometimes a tendency to self-harm. Such teenagers often become pyromaniacs and dromomaniacs.
• Adult psychotic. By the time they are growing up, psychopaths begin to exhibit antisocial and illegal behavior, and practice alcohol abuse or debauchery. Some patients by the age of 30 can eventually learn to control their outbursts of anger - then they interact with society without problems. The majority ends up in colonies and prisons, where they play the role of informal negative leaders.

Pathogenesis and etiology of the disorder

A clear cause for the disorder has not been identified, but according to some theories, it may be caused by the following factors:

1. The surrounding society. Most epileptoids grew up in an environment where aggressive behavior combined with violence is considered the norm. As children grow older, they acquire the same traits as adults.
2. Heredity. The etiology of epileptoid psychopathy may involve a factor of genetic predisposition, as a result of which the disease is transmitted to children from the mother or father.
3. Brain chemistry. Serotonin (the pleasure hormone that prevents depression) functions in such patients, perhaps differently than in healthy people.
4. Birth injuries and head injuries cause the development of epileptoid psychosis as a compensatory reaction.
5. Infectious diseases of the central nervous system.

The epileptoid type of character accentuation can also develop due to the following reasons:

1. Sexual or physical abuse. People who have experienced such humiliation have an increased chance of developing this psychopathy.
2. Other types of mental disorders. People with any other antisocial disorder, including disruptive behavior, are also at risk.

Epileptoid personality type - 9 facets of character

Patients diagnosed with epileptic psychosis have the following features that negatively affect their standard of living:

1. Violation of relationships with members of society. Epileptoids are perceived by the people around them as always gloomy, aggressive, intolerant people. These are egocentrics who do not take into account the opinions of others. They are despotic and very demanding of others. They can initiate verbal conflicts and use physical force. This leads to frequent job changes, poor performance in educational institutions, road accidents, and problems with law enforcement agencies.
2. Difficulty controlling mood. Anxiety and depression are always inherent in patients with this type of psychopathy. In movements and thinking, a tendency towards dysphoria is manifested.
3. Problems with alcohol and drug use. They go almost hand in hand with explosive psychopathy. Epileptoids do not drink a little to lift their mood, they feel the need to get drunk until they lose their memory.
4. Among health problems, diseases of the cardiovascular system, gastrointestinal tract, and metabolism predominate.
5. Deliberate self-mutilation sometimes occurs in epileptoids with the most severe form of psychopathy, characterized by frequent outbursts of aggression.
6. Psychosis also affects sexual relationships. During sexual intercourse, an epileptoid psychopath may adhere to sadism or masochism. Some of them choose homosexual or bisexual relationships.
7. In a family, they are always tyrants, forcing all members to obey them. Such a person plays the role of a despot, maintaining his status in the family with the help of force. Fights and conflicts at home become commonplace. All his close and dear people are unhappy due to the actions of the epileptoid. He does not hesitate to punish children with physical methods.
8. “Hypersocial” traits: pedantry, accuracy, adherence to traditions, exaggerated desire for justice.
9. People of this personality type often, but not always, look the part: stocky, strong figure, massive neck and torso, large lower jaw, short arms and legs.

Diagnosis[edit | edit code]

ICD-10[edit | edit code]

This section is translated from the article Personality Disorder. (edit | history)

Diagnostic criteria from the version of the International Classification of Diseases, 10th revision ICD-10, adapted for use in Russia (general diagnostic criteria for personality disorders, which must be met in all subtypes of disorders)[3]:

Conditions that are not directly attributable to extensive brain damage or disease or other mental disorder and meet the following criteria:

• a) marked disharmony in personal attitudes and behavior, usually involving several areas of functioning, such as affectivity, excitability, impulse control, perceptual and mental processes, as well as style of relating to other people; in different cultural conditions it may be necessary to develop special criteria regarding social norms;
• b) the chronic nature of an abnormal style of behavior that arose a long time ago and is not limited to episodes of mental illness;
• c) the abnormal style of behavior is comprehensive and clearly disrupts adaptation to a wide range of personal and social situations;
• d) the above-mentioned manifestations always arise in childhood or adolescence and continue to exist into adulthood;
• e) the disorder causes significant personal distress, but this may only become apparent later in the course of time;
• f) usually, but not always, the disorder is accompanied by a significant deterioration in professional and social productivity.

— International Classification of Diseases (10th revision), adapted for use in the Russian Federation — /F60/ Specific personality disorders. Diagnostic criteria[3]

To classify a personality disorder into one of the subtypes defined in ICD-10 (for diagnosis of most subtypes), it is necessary that it meets at least three criteria defined for this type [3].

Diagnostic criteria from the official, international version of ICD-10 from the World Health Organization (general diagnostic criteria for personality disorders, which must be met in all subtypes of disorders)[4]:

• G1. An indication that an individual's characteristic and consistent patterns of internal experience and behavior as a whole deviate significantly from the culturally expected and accepted range (or "norm"). Such a deviation must manifest itself in more than one of the following areas: 1) cognitive sphere (that is, the nature of perception and interpretation of objects, people and events; the formation of attitudes and images of “” and “others”);
• 2) emotionality (range, intensity and adequacy of emotional reactions);
• 3) controlling drives and satisfying needs;
• 4) relationships with others and the manner of solving interpersonal situations.

• G2. The deviation must be complete in the sense that inflexibility, lack of adaptability, or other dysfunctional characteristics are found in a wide range of personal and social situations (that is, not limited to one “trigger” or situation).
• G3. The behavior noted in G2 indicates
  personal distress or adverse effects on the social environment.
• G4. There must be evidence that the deviation is stable and long-lasting, beginning in late childhood or adolescence.
• G5. The disorder cannot be explained as a manifestation or consequence of other mental disorders of adulthood, although episodic or chronic conditions from sections F0 to F7 of this classification may exist simultaneously with it or arise against its background.
• G6. Organic brain disease, trauma or brain dysfunction should be excluded as a possible cause of the deviation (if such an organic condition is identified, rubric 07 should be used).

Original text (English)

• G1. Evidence that the individual's characteristic and enduring patterns of inner experience and behavior deviate markedly as a whole from the culturally expected and accepted range (or 'norm'). Such deviation must be manifest in more than one of the following areas: (1) cognition (ie ways of perceiving and interpreting things, people and events; forming attitudes and images of self and others);
• (2) affectivity (range, intensity and appropriateness of emotional arousal and response);
• (3) control over impulses and need gratification;
• (4) relating to others and manner of handling interpersonal situations.
• G2. The deviation must manifest itself pervasively as behavior that is inflexible, maladaptive, or otherwise dysfunctional across a broad range of personal and social situations (ie not being limited to one specific 'triggering' stimulus or situation).
• G3. There is personal distress, or adverse impact on the social environment, or both, clearly attributable to the behavior referred to under G2.
• G4. There must be evidence that the deviation is stable and of long duration, having its onset in late childhood or adolescence.
• G5. The deviation cannot be explained as a manifestation or consequence of other adult mental disorders, although episodic or chronic conditions from sections F0 to F7 of this classification may co-exist, or be superimposed on it.
• G6. Organic brain disease, injury, or dysfunction must be excluded as possible cause of the deviation (if such organic causation is demonstrable, use category F07).

— International Classification of Diseases (10th revision) — /F60/ Specific personality disorders. Diagnostic criteria[4]

According to ICD-10, F60.30 is an impulsive type of emotionally unstable personality disorder[2]. To make a diagnosis, one must meet the more general criteria for personality disorder and emotionally unstable personality disorder.

The directly impulsive type is characterized by even greater emotional instability and lack of impulse control. Outbursts of cruelty and threatening behavior are common for him, especially in response to condemnation from others.

Included[2]:

• excitable personality disorder;
• explosive personality disorder;
• aggressive personality disorder and aggressive personality;

Excluded[2]:

• dissocial personality disorder (60.260.2).

Personality Features

To see the features of an epileptoid character, let's compare this type with hysteroids and narcissists. What do all three categories have in common? Obviously, this is love and a craving for attention from the environment, but the fundamental difference is that each of these features “seeks” its own special attention. Narcissists crave confirmation of their grandiosity and originality, hysterics, by hook or by crook, attract direct attention to themselves, but the epileptoid type of accentuation is based on attracting indirect attention to themselves. How to understand this?

Firstly, direct interaction with people is not always important for epileptoids: it is enough for them to know and feel that they are being noticed. Their methods of attracting attention to themselves are very diverse, but they are all very well veiled and hidden. At first glance, they seem to be quite ordinary people, but it is impossible not to notice them: they shuffle, accidentally drop something, act out, mischief, stutter and litigate. In general, these are very noisy people.

And at the same time, epileptoids try to avoid direct attention directed directly at them. For example, when directly trying to call such a person to dialogue (because of a slander, for example), it is extremely difficult. The fact that you have already bought into this “duck” is enough for them.

Impulsive personality disorder

ICD-10

This section is translated from the article Personality Disorder. (edit | history)

Diagnostic criteria from the version of the International Classification of Diseases, 10th revision ICD-10, adapted for use in Russia (general diagnostic criteria for personality disorders, which must be met in all subtypes of disorders)[3]:

Conditions that are not directly attributable to extensive brain damage or disease or other mental disorder and meet the following criteria:

• a) marked disharmony in personal attitudes and behavior, usually involving several areas of functioning, such as affectivity, excitability, impulse control, perceptual and mental processes, as well as style of relating to other people; in different cultural conditions it may be necessary to develop special criteria regarding social norms;
• b) the chronic nature of an abnormal style of behavior that arose a long time ago and is not limited to episodes of mental illness;
• c) the abnormal style of behavior is comprehensive and clearly disrupts adaptation to a wide range of personal and social situations;
• d) the above-mentioned manifestations always arise in childhood or adolescence and continue to exist into adulthood;
• e) the disorder causes significant personal distress, but this may only become apparent later in the course of time;
• f) usually, but not always, the disorder is accompanied by a significant deterioration in professional and social productivity.

— International Classification of Diseases (10th revision), adapted for use in the Russian Federation — /F60/ Specific personality disorders. Diagnostic criteria[3]

To classify a personality disorder into one of the subtypes defined in ICD-10 (for diagnosis of most subtypes), it is necessary that it meets at least three criteria defined for this type [3].

Diagnostic criteria from the official, international version of ICD-10 from the World Health Organization (general diagnostic criteria for personality disorders, which must be met in all subtypes of disorders)[4]:

• G1. An indication that an individual's characteristic and consistent patterns of internal experience and behavior as a whole deviate significantly from the culturally expected and accepted range (or "norm"). Such a deviation must manifest itself in more than one of the following areas: 1) cognitive sphere (that is, the nature of perception and interpretation of objects, people and events; the formation of attitudes and images of “” and “others”);
• 2) emotionality (range, intensity and adequacy of emotional reactions);
• 3) controlling drives and satisfying needs;
• 4) relationships with others and the manner of solving interpersonal situations.

• G2. The deviation must be complete in the sense that inflexibility, lack of adaptability, or other dysfunctional characteristics are found in a wide range of personal and social situations (that is, not limited to one “trigger” or situation).
• G3. The behavior noted in G2 indicates
  personal distress or adverse effects on the social environment.
• G4. There must be evidence that the deviation is stable and long-lasting, beginning in late childhood or adolescence.
• G5. The disorder cannot be explained as a manifestation or consequence of other mental disorders of adulthood, although episodic or chronic conditions from sections F0 to F7 of this classification may exist simultaneously with it or arise against its background.
• G6. Organic brain disease, trauma or brain dysfunction should be excluded as a possible cause of the deviation (if such an organic condition is identified, rubric 07 should be used).

Original text (English)

• G1. Evidence that the individual's characteristic and enduring patterns of inner experience and behavior deviate markedly as a whole from the culturally expected and accepted range (or 'norm'). Such deviation must be manifest in more than one of the following areas: (1) cognition (ie ways of perceiving and interpreting things, people and events; forming attitudes and images of self and others);
• (2) affectivity (range, intensity and appropriateness of emotional arousal and response);
• (3) control over impulses and need gratification;
• (4) relating to others and manner of handling interpersonal situations.
• G2. The deviation must manifest itself pervasively as behavior that is inflexible, maladaptive, or otherwise dysfunctional across a broad range of personal and social situations (ie not being limited to one specific 'triggering' stimulus or situation).
• G3. There is personal distress, or adverse impact on the social environment, or both, clearly attributable to the behavior referred to under G2.
• G4. There must be evidence that the deviation is stable and of long duration, having its onset in late childhood or adolescence.
• G5. The deviation cannot be explained as a manifestation or consequence of other adult mental disorders, although episodic or chronic conditions from sections F0 to F7 of this classification may co-exist, or be superimposed on it.
• G6. Organic brain disease, injury, or dysfunction must be excluded as possible cause of the deviation (if such organic causation is demonstrable, use category F07).

— International Classification of Diseases (10th revision) — /F60/ Specific personality disorders. Diagnostic criteria[4]

According to ICD-10, F60.30 is an impulsive type of emotionally unstable personality disorder[2]. To make a diagnosis, one must meet the more general criteria for personality disorder and emotionally unstable personality disorder.

The directly impulsive type is characterized by even greater emotional instability and lack of impulse control. Outbursts of cruelty and threatening behavior are common for him, especially in response to condemnation from others.

Included[2]:

• excitable personality disorder;
• explosive personality disorder;
• aggressive personality disorder and aggressive personality;

Excluded[2]:

• This section This section ↑ 1 2 3 4 5 6 Sergeev I. I. Psychiatry and narcology / Sergeev I. I., Lakosina N. D., Pankova O. F. - M.: "MEDpress-inform", 2009. - P. 475 -477. — 752 p. — ISBN 5-98322-498-0. ↑ 1 2 3 4 World Health Organization. F6 Personality and behavior disorders in adulthood // International Classification of Diseases (10th revision). Class V: Mental and behavioral disorders (F00-F99) (adapted for use in the Russian Federation). - Rostov-on-Don: Phoenix, 1999. - pp. 249-250. — ISBN 5-86727-005-8. ↑ 1 2 3 World Health Organization. F6 Personality and behavior disorders in adulthood [F60—F69] // International Classification of Diseases (10th revision). Class V: Mental and behavioral disorders (F00-F99) (adapted for use in the Russian Federation). - Rostov-on-Don: Phoenix, 1999. - P. 245-246. — ISBN 5-86727-005-8. ↑ 1 2 World Health Organization. The ICD-10 Classification of Mental and Behavioral Disorders. Diagnostic criteria for research. — Jeneva. — P. 149-150. — 263 p. (English)

Conflict character traits

Every feature has its positive and negative features. Let's start the analysis with the disharmonious traits of the epileptoid type of character. As we have already noted, the epileptoid type of character accentuation is similar in signs and manifestations to epileptic changes.

The first negative trait is suspiciousness and vindictiveness. These people remember insults for a long time and even after a long time, if possible, they will try to “annoy” the offender, from which, by the way, they get a lot of pleasure.

Another unpleasant feature is obsession, obsessiveness. Often these people pester potential “victims” like a ban leaf. Also, epileptoids easily “get stuck” on some idea or emotion, which for a long time directs all their behavior. Within the framework of pathology, this is expressed as rigidity of thoughts and actions, as well as the inability to change the style of action. For example, if you ask a patient with epilepsy (and not an accented one!) to draw circles, and after a while ask him to start drawing triangles, he will not be able to change his actions.

Another problem is greed. These people are excellent shuttle traders, but they live by the principle “we ourselves are always not enough.” If they have the opportunity to grab their piece, they will definitely do it, even in unethical ways.

In addition to this, they are very envious. On this basis, a craving for litigiousness often develops, and these people tend to complain and slander. In everyday terms, these are the so-called “professional” complainants, inundating all kinds of authorities with dozens of letters.

The craving for complaining is also based on their grumpiness, eternal dissatisfaction with everyone and everything. Actually, they are characterized by epileptoid pedantry in external manifestations, although, as we will see later, this is also their strong point.

At the same time, epileptoid pedantry and explosiveness go side by side. Epileptoids have virtually no ability to restrain their negative emotions. Therefore, the latter can easily move from excessive mannerisms to explosive shocking. Strong, especially negative experiences usually take over the mind.

The logic of their life: the end justifies the means, they often use others to achieve their goals, although in terms of their ability to manipulate they are definitely inferior to both narcissists and hysterics.

And finally, often epileptoids, due to pedantry, get stuck on their health, they are characterized by hypochondriasis and imaginary illness, and the lack of “treatment” gives rise to their love of litigiousness.

First observation

M. A, born in 1910, entered the department on October 20. 1958.

Born into a peasant family with many children. He cannot give definite information about the health of his parents and immediate relatives. My father drank, but in moderation. My childhood was difficult due to material need; from the age of 6 I was already helping adults in the fields, I was not in good health, I ate poorly. He suffered from scarlet fever and “some kind of typhus.”

Until 1931, he graduated from only the 4th grade of a rural school and worked as a housewife. At that time he characterized himself as lively and sociable. He liked to walk late into the night and sing a song. But there was not enough time for all this, since after the death of his father in the First World War, he turned out to be the eldest man in the house. Felt more responsible for the smaller ones.

From the age of fifteen to sixteen I drank moonshine, but very rarely, on major holidays, when there was no field work. Every time I got drunk, “we’re all like that,” “to the point of lying down,” and the next morning I got a hangover. As a rule, I didn’t remember the end of the party the next day.

In 1931 he moved to Moscow and started working. After moving to the big city, he became, in his words, timid and timid. Sent money to the village.

Gradually I became friends with people from the city, made acquaintances with girls, and began going to parks and cinemas. I liked Moscow.

I didn’t particularly like to read books, but when I came across them, I chose ones about adventures and about the village.

By 1937, he changed his place of work and went to work at a plant, where he has worked continuously to this day, with the exception of the war years. I never wanted to study, explaining this by the fact that I had no time to work.

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In production, he acquired the specialty of a roller, which requires not theoretical knowledge, but dexterity and experience, in which he achieved high skill. He recalls with pleasure the first years of his work at the plant.

He tells how well he was greeted there and treated kindly. It's like being born again. He became, as before in his village, lively, sociable, and bolder. I liked the work, I liked the work environment, the life in the hostel.

He treated his work honestly, very conscientiously, staying in the shop for a long time, and was praised for his diligence. Received awards and gratitude. I wasn’t particularly advanced, and the thought of it didn’t even cross my mind. He worked like everyone else: “many people received thanks from us.” He was a right-hand trader, often elected by members of various factory commissions.

I always loved people and people loved me. He says that he was very cheerful, loved to joke, laugh, sing songs, and participated in the drama club. During these years (1930-1940) one did not drink alcohol at all, since this was not the case in the hostel, in the workshop, or at the factory.

A few years before the war he got married. He loved his wife and was very attached to his children. During this period, he somewhat retreated from public life, had a lot of worries and invested in his family.

Since 1941 at the front. From the very first days of combat, I constantly experienced a feeling of fear: “such thoughts creep in, it turns everything upside down, you don’t know what to do with yourself.” It was especially difficult after the attack and upon the arrival of reinforcements: “I felt very sorry for the people.”

I experienced the death of my comrades. He “filled this state with vodka”, exchanging alcohol for tobacco (as a non-smoker) and sugar, since his portion was not enough. He didn’t get drunk much, “he just became calmer.”

In 1941, after a concussion with loss of consciousness for several minutes, he suffered from surdomutism for a month and was treated in the medical battalion. In 1942, his unit found itself cut off from the front line, behind enemy lines. We spent a year and a half as partisans. Despite the connection with the mainland, they often had to starve and freeze. Nevertheless, no one was sick with anything, “at least someone had a runny nose.”

But morale was very difficult, especially when ammunition was running low. He was afraid of being captured, afraid that he would be killed and his children would be left orphans. But he did not show his outward fear. Has several awards.

By the end of the war, fear and fear disappeared. Became “more indifferent.” But according to him, “the fear is over, but the appetite for vodka is gone.”

After demobilization in 1945, he continued to drink alcohol systematically, 3–4 times a week. I felt the need for alcohol. I could drink 1 - 1.5 liters of vodka. Every time he got drunk, the next morning he often did not remember what happened to him during the period of intoxication.

Troubles began at home and at work, I tried to abstain and did not drink for 1 - 1.5 months, but each time I broke down.

In 1947, a withdrawal syndrome developed, which is now very severe: “life is ending,” shortness of breath, heart palpitations, weakness, sweating, and severe tremors. He can be so pitiful, so weak, that his wife herself goes out to buy vodka for him.

In a hangover, physical symptoms predominate, but also from the mental sphere - an anxious state, anticipation of some kind of misfortune, sometimes hearing calls by name.

Drinks heavily, for 2-3 or 5-7 days, with breaks of 2-4 weeks. Binge drinking begins with the first drink. He notes that he has recently begun to drink less alcohol: during binge drinking he drinks in fractional doses of up to 0.5 - 0.8 liters of vodka, not like before, when he could drink 1 - 1.5 liters “in one sitting.”

An acute conflict situation has arisen at home and at work. According to his wife, he has become callous, not affectionate, and does not care about his family at all. Extremely hot-tempered, looking for reasons for scandals. Untidy, sloppy, can behave indecently in front of children.

He became angry, rude, beats children whom he previously loved dearly, starts fights on the streets, in pubs, repeatedly came home all beaten, has several reports to the police. Such excesses are not always committed when drunk, but often when sober.

I quarreled with all my friends, workmates, and bosses. Everywhere and everywhere he sees problems and bad attitudes towards himself, and threatens to find justice for everyone.

The family was completely intolerant; the wife left many times with the children and hid them with neighbors. At work - frequent absenteeism, appearing drunk. He was repeatedly transferred to low-paid work as punishment and convicted by a comrades' court. They don’t fire him only out of respect for his past and because, in his bright moments, he still proves himself to be a good specialist.

In the department he complains of poor sleep: he has trouble falling asleep, sleeps anxiously, and wakes up early. She notes a sluggish appetite, headaches in the mornings and evenings. He takes the prescribed medicine carefully, although every time he remains dissatisfied with the nurse who gives intravenous infusions. He goes to work willingly, works diligently, with visible pleasure, preferring hard types of physical labor.

Constantly among the sick. He is very uneven in his dealings with people, often quarrels, but quickly cools down. He is always friendly with the doctor, loves to sit in the office and talk: he speaks figuratively, expressively, with a sense of humor. Instead of “drink vodka,” he says “swallow the viper.” He talks about himself in detail, without hiding any compromising details.

Completely critical of his condition. He feels shame in front of his wife, children, comrades, and understands his duty to them. He sees the cause of all the troubles in abuse, “and I blame people out of malice.” He himself associates changes in his character with alcoholism, calling himself a chronic alcoholic. These changes consist mainly of hot temper, “I don’t remember myself” and anger. He says to quickly leave, he understands that there is no one to blame. Then he worries about his actions, but he can’t help himself. “Every little thing makes you mad.”

He notes that in recent years it has become more difficult to work and gets tired quickly. He became reluctant to carry out his duties: “just to do it so that they wouldn’t ask.” Several times, through negligence, I allowed a major marriage to take place.

Harmonious character traits

We should not assume that the traits we have described appear in all cases or are always negative. Many accented people fit very harmoniously into society and use their strengths very well.

Actually, let's list them. First of all, it's a trick. And it is not always associated with deceit. Such people can effortlessly find a way out of a seemingly hopeless situation.

Secondly, cunning and pedantry help the latter to defend their interests and gain benefits from very difficult situations.

Thirdly, epileptoids think through their appearance in detail, they know how to take care of themselves and are sometimes very sophisticated and extravagant.

Fourthly, they are truly the creators of their lives. A dream quickly becomes a goal, which also quickly becomes a result.

In view of such creativity, they easily give up what gets in the way, and in a fit of emotion they are able to achieve serious results in achieving their goals. On the other hand, this is a problem - epileptoids often become victims of drug addiction and addiction.

As we see, these are certain character traits on which a person’s entire life and behavior is built. However, an epileptoid psychopath and an epileptoid personality type are different people. The first, due to his overly pronounced characteristics, experiences difficulties (like his environment) in normal socialization, while an accentuated person still coordinates his actions with the environment and is very mobile in society.

Manipulation

But we should not lose sight of the fact that, nevertheless, epileptoids are prone to manipulation. To avoid falling into this trap, let’s look at three “favorite” manipulation strategies.

The first of our favorite strategies involves litigiousness.
Literally it can be described as “I will complain about you, and you will get it from me!” In simple terms, epileptoids often “show off” their victims. It's not uncommon for this strategy to work all the time. In this case, it is better to either break contacts with the person or try to level out problematic situations depending on the situation. Another strategy is to cover up one’s actions with the role, state or emotion being performed. In such cases, you can often hear “I have to,” or that “it’s not me, but my condition.” All that remains is to point out the constant responsibility of a person for his actions.

And finally, taking the position of a victim, because “a soldier will not hurt a child!” Here emotions, complaints, and vindictiveness come into play.

Intermittent explosive disorder multiplied by the Internet

Basically, this is a calm person who can joke sweetly and have light conversations on forums for weeks. But up to a certain point. Any little thing can make him angry, and this sweet man will begin to send everyone to distant distances, urging him on with a choice swear word. And cursing you, and your family and anyone passing by. And it would seem...

In real life, there are less than 10% of people prone to IER. They are clearly characterized by unstable mood. These people tend to explode over any, often insignificant, reason. To the point that the store didn’t give change for a ruble, and they made a scandal as if they weren’t given a thousand or even worse. People with this disorder are prone to uncontrollable aggression.

How do they live?

It is obvious that the characteristics of these people greatly influence their lives, determining the range of phenomena that bring them pleasure or, on the contrary, disappoint, terrify and bring displeasure into their lives.

To understand how to safely communicate with an epileptoid type, it is necessary to take into account the factors of pleasure and displeasure, because we should not forget that these people are carriers of an explosive nature.

Let's start with what does not satisfy them and brings displeasure:

Fanatic Page Refresh Syndrome

Internet addiction manifests itself in different ways, but one of the main ones is precisely this: refreshing the page.

Whether it's a new post on social networks or a new photo, that's it. All subscribers and friends should intuitively feel when an F5 fan has posted something and immediately, abandoning everything else, go like, repost and write comments. Moreover, this delightful post should thunder on the Internet like no one has ever thundered before.

But now the post is posted and the wait for national recognition begins. The author methodically updates the page every three minutes. Having received at least some response, even in the form of a vague comment (and if the comment is not one word, then wow), the author becomes more active, diligently writes a very detailed answer and again freezes in anticipation.

But if such a wonderful post remains unnoticed by the public for more than five (!) minutes, then the author writes a second post about how everyone is a pig and how could you, where are the comments, who am I trying for, and the like.

In real life, such an effect causes a person’s desire to obtain psychological comfort by immediately satisfying his needs, through dependence. A good example of this behavior is a small child who wants a toy in a store and chooses a tantrum as the way to get it.

Some types of accentuation

Of course, the epileptoid type of accentuation is a collective concept. For the most part, when diagnosing such conditions, specified subtypes of accentuations are distinguished. In particular, these are epileptoid hysterical and schizoid epileptoid types.

The peculiarity of the former is that, together with the main signs of the epileptoid type, demonstrative behavior acquires great weight. With such accentuation, people are no longer so afraid of direct attention, they are even more willing to provoke it.

Moreover, they have a more pronounced hypochondriasis and confidence in the presence of diseases. There is some switching between signs of hysteria and epileptoidism. A person’s explosiveness and readiness to explode at any little thing also increases. Often, against this background, the general aggressiveness of behavior and the readiness to use extreme measures to eliminate one’s own displeasure increase.

Another type is schizoid-epileptoid. In the case of this diagnosis, what is striking, first of all, is pretentiousness and excessive extravagance in the tastes, style of a person, and in all his behavior. At the same time, tolerance for direct attention decreases, and notes of secrecy and aloofness may appear. Moreover, these people are even more likely to get stuck in a world of surreal experiences, being influenced by what they see for a long time. The resourcefulness and cunning of such people also increases, in particular due to the fact that schizoidism implies some diversity of thinking, that is, a lack of fixation on the social meaning of a thing. For example, a spoon can not only be used to eat soup, but also to dig a hole, play drums and be used as a decoration.

Types of psychopathy

Classifications of psychopathy are very diverse. There have been attempts to reduce all types of psychopathy to two - excitable and inhibited; there were descriptions including more than a dozen types. The following types are included in ICD-10.

Schizoid personality disorder (schizoid psychopathy) according to ICD-10 is characterized by the following character traits:

• inability to experience pleasure (anhedonia);
• emotional coldness and inability to express warm or hostile feelings towards others;
• weak reaction to praise and blame; little interest in sexual intercourse with others;
• a tendency to fantasize to oneself (autistic fantasy) and introspection (immersion in the inner world);
• lack of close, trusting contacts with others;
• difficulty in understanding and assimilating generally accepted norms of behavior, which is manifested by eccentric actions.

The most striking character trait is isolation and unsociability (from childhood they preferred to play alone). They often live by their unusual interests and hobbies, in which they can achieve success (unique information in a narrow field, deep interest in philosophical and religious issues, unusual collections, etc.). Hobbies and fantasies fill the inner world, almost always closed to others. Fantasies are intended for oneself and can be ambitious or erotic (with outward asexuality). Emotional restraint looks like coldness, although inner feelings can be strong and deep. It is difficult to establish informal emotional contacts. Lack of intuition is manifested by the inability to understand other people's desires, fears, and experiences. They are prone to nonconformism - they do not like to act “like everyone else.” Situations where it is necessary to quickly and indiscriminately establish informal contacts, as well as the violent invasion of strangers into one’s inner world, are difficult to bear.

Dissociative identity disorder (psychopathy of an unstable type, antisocial personality disorder) according to ICD-10 is recognized by the following characteristics:

• disregard for the feelings of others and a lack of empathy - the ability to penetrate into their experiences;
• irresponsibility and disregard for social norms, rules and responsibilities;
• inability to maintain stable relationships with others; low tolerance to frustration (inability to get what you want);
• ease of aggressive outbursts, including violence; lack of guilt and inability to learn from the past, especially from punishment;
• tendency to blame others for everything and complain about failures;
• constant irritability.

The main feature is a constant thirst for light entertainment and pleasure, an idle lifestyle with evasion of all work, study, and fulfillment of any duties, both social and family. Since adolescence, they have been drawn to antisocial companies, alcohol, and drugs. Sexual life serves only as a source of pleasure. They are unable to fall in love or become attached to loved ones and friends. They are indifferent to their future and live in the present. They are weak-willed and cowardly, they try to run away from any difficulties and troubles. They do not tolerate loneliness well - they are unable to occupy themselves with anything. The situation of neglect, lack of guardianship and strict control is detrimental.

Emotionally unstable personality disorder (emotionally labile type of psychopathy, explosive, affective, impulsive, excitable, epileptoid psychopathy) according to ICD-10 represents a group with various disorders of the emotional sphere. In Russian psychiatry, it is customary to distinguish between two close, but not identical, types.

Explosive (affectively labile) psychopathy is characterized by emotional outbursts at the slightest provocation, but anger is easily replaced by tears, swearing and throwing things - by moaning, aggression towards others - by self-harm, attempted suicide. The mood often changes, which leads to restlessness, lack of composure, and distractibility. They are completely uncontrollable, boil over at the slightest comments or opposition, and react extremely painfully to emotional rejection and any stress.

Epileptoid psychopathy is distinguished by the fact that, in addition to explosiveness (a tendency to uncontrollable affective reactions with aggression and auto-aggression), states of dysphoria periodically arise - a dark and angry mood, during which patients are looking for something to vent their accumulated evil on. Dysphoria lasts from several hours to several days. Violent affective reactions are usually preceded by a gradual boiling of initially suppressed irritation. In the heat of the moment, during fights, they become wild and are capable of inflicting serious damage. Sometimes disturbances of impulses are revealed, most often sadistic-masochistic tendencies. They take pleasure in tormenting, sophisticatedly mocking or brutally beating the weak, defenseless, dependent on them, unable to fight back. Often, from childhood, they love to torture and kill animals. But they can receive sensual pleasure by causing pain to themselves with cuts and burns from burning cigarettes. Alcohol intoxication is more often of the dysphoric type. They like to get drunk to the point of insensibility. Suicidal attempts can be either demonstrative with the aim of blackmailing someone, or during dysphoria with the actual intention of committing suicide.

Histrionic personality disorder (hysterical psychopathy), according to ICD-10, can be diagnosed when:

• the presence of a tendency to self-dramatization, theatrical behavior, exaggerated expression of emotions;
• suggestibility, easy susceptibility to the influence of others;
• superficial and labile effectiveness; self-centeredness with the desire to forgive oneself everything and not take into account the interests of others;
• constant desire to be appreciated and slight vulnerability;
• thirst for situations where you can be the center of attention;
• manipulative behavior (any kind of manipulation) in order to achieve their goals.

Among the listed character traits, the most striking is the constant desire to be in the center of attention of others, demonstrativeness, and pretentiousness. For this purpose, they even resort to performances depicting suicide attempts. Suggestibility, often highly emphasized, is in fact very selective: one can only suggest that which does not contradict egocentric aspirations. But the level of aspirations is high: they claim much more than their abilities and capabilities allow. Under the influence of severe mental trauma, hysterical psychoses can occur - twilight states, pseudodementia, etc.

Anancastic (obsessive-compulsive) personality disorder (psychasthenic psychopathy) according to ICD-10 is characterized by:

• indecision, constant doubts;
• excessive precautions regarding a possibly dangerous or unpleasant course of events;
• perfectionism (i.e. the desire to always achieve the highest results, to do everything in the best way, regardless of the unimportance of the matter);
• the need to re-check what has been done;
• extreme preoccupation with detail in trivial matters and loss of broad perspective;
• extreme conscientiousness, scrupulousness, concern, preventing one from experiencing pleasure;
• pedantry and adherence to conventions with limited ability to express warm feelings;
• rigidity and stubbornness, insistence that others obey the order they have established;
• the appearance of unwanted thoughts and impulses, which, however, do not reach the level of severe obsession;
• the need to plan all activities in advance in the most insignificant details.

Obsessive thoughts, movements, rituals, fears, self-invented “signs” and “prohibitions” are observed almost constantly, sometimes intensifying and sometimes weakening (for example, for important occasions, always wear the same clothes, walk only one route, do not touch anything). why black, etc.). Pedantry, the desire to foresee everything in advance and plan it in the smallest detail, minute adherence to rules serve as compensation for constant fear for the future - one’s own and that of one’s loved ones. Other compensatory mechanisms may turn out to be exaggerated: indecision when a decision has already been made turns into impatience, shyness into unexpected and unnecessary categoricalness. This type of psychopathy usually manifests itself from school years, but intensifies when they begin to live independently and need to be responsible for both themselves and others.

Anxious (“avoidant”) personality disorder (sensitive psychopathy) according to ICD-10 criteria can be recognized by:

• constant feeling of internal tension and anxiety;
• shyness and feelings of inferiority, self-doubt;
• constantly trying to please and be accepted by others;
• increased sensitivity to criticism from others;
• by tendency to refuse to enter into relationships with others until they are sure that they will not be criticized;
• a very limited circle of personal attachments;
• tendencies to exaggerate the potential danger and risk of everyday situations, avoiding some of them, which, however, does not reach stable phobias (obsessive fears);
• according to a limited lifestyle that allows you to feel safe.

Great impressionability and a sense of inferiority are two main traits. They see many shortcomings in themselves and are afraid of being ridiculed and condemned. Their isolation is purely external - a consequence of being fenced off from strangers and unfamiliar situations. They are quite sociable with those they are used to and trust. The situation in which they become the subject of unkind attention from others, when a shadow falls on their reputation or they are subjected to unfair accusations, becomes intolerable. They are prone to depressive reactions, during which they can gradually and secretly prepare for suicide or are capable of unexpected desperate acts leading to serious consequences (including causing serious harm or killing their offenders).

According to ICD-10 criteria, dependent personality disorder corresponds to one of the types of asthenic psychopathy. It is characterized by a tendency to shift responsibility for oneself onto others and to completely submit to the interests of the one on whom one depends, neglecting one’s own desires. They evaluate themselves as helpless, incompetent and unbearable. They have a fear of abandonment and a constant need for reassurance in this regard. They cannot stand loneliness and feel empty and helpless when ties with those on whom they depend are severed. Responsibility for misfortunes is transferred to others.

Mixed types of personality disorder are diagnosed when it is difficult to identify a separate type due to the fact that the traits of different types are represented relatively evenly. However, completely “pure” types of psychopathy are relatively rare - the type should be determined by the predominant features. Just as with character accentuations, mixed types can be intermediate (mainly hereditarily determined, for example, schizoid-epileptoid psychopathy), or amalgam (the endogenous core of one type is overlaid with the traits of another due to the long-term unfavorable influence of the environment, for example, on the constitutional traits of emotional lability during upbringing in childhood, as a “family idol”, histrionic, i.e. hysterical, traits are superimposed).

Organic psychopathy is most often mixed, representing various combinations of emotionally labile, histrionic and dissociative traits (i.e. explosive, hysterical and unstable psychopathy). Diagnosis of organic psychopathy is based on the following signs. There is a history of intrauterine, birth and early postnatal (first 2-3 years of life) traumatic brain injuries, brain infections and neurointoxication. Residual neurological “microsymptoms” are revealed: asymmetry of facial innervation, mild oculomotor disturbances, uneven tendon and skin reflexes, mild diencephalic disorders. An X-ray of the skull shows abnormalities of ossification and signs of increased intracranial pressure; the EEG usually shows pronounced diffuse changes. A pathopsychological examination reveals attention deficits and fatigue when repeating tasks.

Other classifications of psychopathy. Many classifications have been proposed. Some of them are descriptive - types are distinguished according to the most striking character traits, others are based on a certain principle. In Russian psychiatry, an example of the first is the taxonomy of P. B. Gannushkin (1933), and the second - his student O. V. Kerbikov (1968), as well as B. V. Shostakovich (1988) and A. E. Lichko (1977) .

P.B. Gannushkin described several groups of psychopathy.

The group of cycloids (constitutional-depressive, constitutional-excited, cyclothymic, emotive-labile) are distinguished by the characteristics of the dominant mood - constantly depressed, elevated, periodically or frequently changing. The group of asthenics (neurasthenics, “overly impressionable”, psychasthenics) was united by a tendency to easy exhaustion and “irritable weakness”. In addition, groups of schizoids, paranoids, epileptoids, hysterical and unstable psychopaths, etc. were identified, most of which are included in ICD-10 under the same or different names. For classification, O.V. Kerbikov took the types of higher nervous activity of I.P. Pavlov and, first of all, divided psychopathy into excitable (explosive, epileptoids) and inhibited (asthenics, psychasthenics). But especially outside the chosen principle were “pathologically closed” (i.e. schizoid), hysterical, unstable, sexual and mosaic (i.e. mixed) psychopathy. B.V. Shostakovich used the psychological principle for taxonomy: the predominance of changes in the sphere of thinking (schizoids, psychasthenics, paranoid), in the sphere of affective disorders (epileptoids, excitables, cycloids, hysterical) or in the sphere of volitional disorders (unstable, sexual). A.E. Lichko combined the taxonomy of psychopathy and character accentuations, describing the same types, which are either variants of the norm (accentuation) or reaching a pathological level of deviation (psychopathy).

More about symptoms

An essential feature of explosive psychopathy disorder is the occurrence of discrete episodes of failure to resist aggressive impulses that lead to serious malicious acts or destruction of property. The degree of aggressiveness expressed during the episode is grossly out of proportion to any provocation or exposure to the psychosocial stressor.

The diagnosis is quite complex and can only be made after excluding other mental disorders that may explain episodes of aggressive behavior. These may include antisocial personality disorder, borderline personality disorder, psychotic disorder, manic episode, conduct disorder, or attention deficit hyperactivity disorder.

In addition, aggressive episodes due to the direct physiological effects of chemicals, such as drugs or medications, as well as general health due to reasons caused by head injuries, Alzheimer's disease, may have a similar clinical picture.

The patient may describe aggressive episodes as "loss of control" or "mental attacks" in which explosive behavior is preceded by a feeling of tension or agitation and then immediately followed by a feeling of relief. The person may later feel upset, remorseful, regretful, or embarrassed as a result of their aggressive behavior.

Common signs that characterize explosive psychopathy:

• Several discrete episodes of failure to resist aggressive impulses that result in severe displays of negative emotions or destruction of property.
• The degree of aggressiveness expressed during the episodes is grossly out of proportion to any surrounding psychosocial stressors.
• Aggressive episodes are not associated with other mental disorders;
• Aggressive behavior can occur in the context of many other mental disorders, as an addition to poor mental health. The diagnosis of intermittent temper disorder should be considered only after all other disorders associated with aggressive impulses or behavior have been ruled out.

Health News | family | beauty | relationship

Author: Rewriter. Category: Mental health.

It is very normal for the average person to come in such extreme amounts of stress that it makes them furious, and perhaps even violent. That being said, there are some people who constantly lose their temper, overreacting to situations that don't require such extreme temper tantrums. This condition is known as intermittent explosive disorder, or IED, and involves impulsive, violent, and aggressive behavior when such behavior is not appropriate. Cases such as road rage are examples of behavior such as domestic violence. Other signs that may indicate an explosive device are throwing and/or breaking objects, and other cases of increased aggressiveness and short temper, or tantrums.

Symptoms of intermittent explosive disorder

Those with ied may have a tendency to attack other people or their belongings and belongings, without good reason or care, resulting in damage and injury, sometimes severe. This disorder usually begins during adolescence and is often a symptom or cause of anxiety, depression, or substance abuse. Some common behaviors are different when dealing with intermittent temper disorder, such as:

• Excessive and unjustified rage
• Increased irritability
• Increased Energy Levels
• Tremor
• Tingling
• Heartbeat
• Breast lift
• Racing thoughts

Excessive and often explosive actions and impulses are usually not an appropriate response to the situation that caused them, and people often act without any thought given to their actions and their consequences. Some behavioral and verbal outbursts associated with ied include:

• Screamed
• Threatening or attacking people or even animals
• Physical intimidation (such as pushing, or slapping)
• Fights
• Damage to property
• Argue
• Tirades

People may experience a sense of relief after an outburst, which may alternate with remorse and regret when they have allowed time for self-reflection.

Co-morbidity of intermittent explosive disorder

IED is a form of chronic aggression that is common in those who have Cluster B personality disorder, which includes personality characteristics such as narcissism. It is often difficult to distinguish intermittent explosive disorder from these personality characteristics, and it is also difficult to distinguish explosiveness from substance abuse, or intentional and intended violence. Many studies related to group B personality disorders and IEDs suggest correlations and overlaps between them.

Causes of Intermittent Explosive Disorder

The main causes of this disorder relate to environmental and biological factors. This disorder has the ability to tear apart lives only psychologically and physically, and a person can cause irreparable harm during an attack of severe aggression. Several medications have shown positive effects in treating symptoms, several of which will be discussed later. Common causes of IEDs are described below:

Wednesdays

In many cases of IEDs, those who are able come from families that have had high levels of explosive and aggressive behavior. Experiencing this type of behavior from an early age causes the child to develop increased changes in these traits as they get older.

Genetics

It is also possible that the disease can be passed from parents to children genetically.

Brain Chemistry

People with ied may have different chemical processes going on inside their brain, such as a difference in how serotonin works.

Diagnosis of intermittent explosive disorder

To diagnose intermittent explosive disorder, health care professionals use the DSM IV and TR, which essentially diagnoses the condition by excluding other conditions and disorders. Behaviors that will lead to an IED diagnosis include:

• Numerous cases of unreasonable and extreme aggression that cause harm to person or property.
• The amount of aggression undertaken individually is completely disproportionate and unnecessary in this situation.
• Cruelty cannot be attributed to any other condition, be it physical or psychological.

Treatment of intermittent explosive disorder

There are often two treatment methods for IEDs used by healthcare professionals: psychotherapeutic and psychopharmacological. Each procedure is described in detail below.

Psychotherapeutic

This type of treatment works in two ways:

1. To determine which situations and incidents trigger aggressive behavior
2. To learn how to deal with these situations and manage your anger effectively

This type of therapy is known as cognitive behavioral therapy or CBT, and it is widely used to treat individuals with ied. Techniques such as coping skills training, breathing exercises, and cognitive restructuring work with the hope of reducing a person's anger.

Pharmacological

Currently, there is no specific medicine developed to treat IEDs. That being said, various medications such as antidepressants can be effective in treating symptoms. After visiting a doctor and undergoing the appropriate assessments, they will be able to suggest the best course of treatment for you to take, if any.

What You Can Do to Control Your Anger

There are many things you can try to reduce the amount of anger you feel, but the first thing you need to do is recognize the signs of anger. These signs may include increased breathing rate, increased heart rate, clenched fists, and increased tension. If you begin to notice any of these signs, immediately remove yourself from the situation that is causing your anger to develop.

A good anger management technique is to count to ten. This allows you time to calm down and think about the situation. Another good way is to slowly inhale and exhale. Breathing slowly can help calm your mood and allow you to think more clearly. Always remember to exhale more than you inhale, and keep it slow and calm.

Pathogenesis and etiology of the disorder

A clear cause for the disorder has not been identified, but according to some theories, it may be caused by the following factors:

1. The surrounding society. Most epileptoids grew up in an environment where aggressive behavior combined with violence is considered the norm. As children grow older, they acquire the same traits as adults.
2. Heredity. The etiology of epileptoid psychopathy may involve a factor of genetic predisposition, as a result of which the disease is transmitted to children from the mother or father.
3. Brain chemistry. Serotonin (the pleasure hormone that prevents depression) functions in such patients, perhaps differently than in healthy people.
4. Birth injuries and head injuries cause the development of epileptoid psychosis as a compensatory reaction.
5. Infectious diseases of the central nervous system.

The epileptoid type of character accentuation can also develop due to the following reasons:

1. Sexual or physical abuse. People who have experienced such humiliation have an increased chance of developing this psychopathy.
2. Other types of mental disorders. People with any other antisocial disorder, including disruptive behavior, are also at risk.

Epileptoid personality type - 9 facets of character

Patients diagnosed with epileptic psychosis have the following features that negatively affect their standard of living:

1. Violation of relationships with members of society. Epileptoids are perceived by the people around them as always gloomy, aggressive, intolerant people. These are egocentrics who do not take into account the opinions of others. They are despotic and very demanding of others. They can initiate verbal conflicts and use physical force. This leads to frequent job changes, poor performance in educational institutions, road accidents, and problems with law enforcement agencies.
2. Difficulty controlling mood. Anxiety and depression are always inherent in patients with this type of psychopathy. In movements and thinking, a tendency towards dysphoria is manifested.
3. Problems with alcohol and drug use. They go almost hand in hand with explosive psychopathy. Epileptoids do not drink a little to lift their mood, they feel the need to get drunk until they lose their memory.
4. Among health problems, diseases of the cardiovascular system, gastrointestinal tract, and metabolism predominate.
5. Deliberate self-mutilation sometimes occurs in epileptoids with the most severe form of psychopathy, characterized by frequent outbursts of aggression.
6. Psychosis also affects sexual relationships. During sexual intercourse, an epileptoid psychopath may adhere to sadism or masochism. Some of them choose homosexual or bisexual relationships.
7. In a family, they are always tyrants, forcing all members to obey them. Such a person plays the role of a despot, maintaining his status in the family with the help of force. Fights and conflicts at home become commonplace. All his close and dear people are unhappy due to the actions of the epileptoid. He does not hesitate to punish children with physical methods.
8. “Hypersocial” traits: pedantry, accuracy, adherence to traditions, exaggerated desire for justice.
9. People of this personality type often, but not always, look the part: stocky, strong figure, massive neck and torso, large lower jaw, short arms and legs.

Alcoholism. Personality changes in alcoholism

Currently, there are two opposing points of view on the relationship between personal changes that occur during alcoholism and the character traits of patients that were observed in them before the onset of alcohol abuse. Some believe that the ongoing personality changes are not directly related to the premorbid makeup of alcoholics. Others hold a largely opposite point of view.

We gave preference to the second point of view. Therefore, the described personality changes in the first and second stages, designated as a sharpening of personality, are divided into separate groups depending on the previously predominant characterological type.

Sharpening personality

Asthenic type

Irritable weakness, characteristic of asthenia in general, is manifested in this case by the predominance of excitability and vulnerability over exhaustion. This is more noticeable in relationships with loved ones, while at work and in other places such individuals are characterized by a certain restraint. Irritation can easily give way to expressed dissatisfaction, anger, and rudeness, but calm also easily sets in, often with a feeling of regret about what happened. Understanding of unpleasant impressions is often insignificant. However, there may be patients with quite deep reflection regarding changes in their lifestyle and relationships with others. This is most clearly revealed in them in a state of intoxication. Humiliated, with a feeling of inferiority beyond excesses, they become rude, demanding, blaming everyone but themselves after drinking alcohol. Many people have a tendency towards anxious fears, in particular of a hypochondriacal nature.

Explosive type

The most characteristic feature is the easily arising affects of expressed hostility, nagging, dissatisfaction, resentment, irritation, which, when further intensified, are replaced by the affects of malice, anger, and in some cases, aggressive actions directed primarily against loved ones. In the presence of viscosity of affect and dysphoria, they resemble epileptoids. Affective tension often occurs in the form of outbursts. Asthenic reactions - a feeling of remorse, recognition of one's guilt, the ability to understand the motives of the actions of others - are usually inaccessible to them. In everyday life, their actions do not take into account the opinions of others and are often straightforward and demanding. Affects lack shades and nuances. Stenic tension predominates, without tendencies to reflection.

Syntonic type

Persons who have a slightly elevated mood with optimism, cheerfulness, contentment with others and with themselves. Short bursts of irritation or dissatisfaction do not affect their relationships with others, including loved ones. They are talkative, indiscriminate in their choice of acquaintances, and overly frank after only a short conversation. They feel at ease among people. They prefer work that involves communicating with people. In conversation they use rude words without much embarrassment, which nevertheless are devoid of offensive connotations or distinct cynicism. They have a fairly developed sense of duty, although they are not scrupulous in small things. In addition to the attraction to alcohol, they may also be characterized by other forms of lower drives.

Dysthymic type

In some cases, it is possible to identify distinct emotional lability with a slight change of opposite affects. Under the influence of insignificant external signs or without them, depression, elements of a feeling of hopelessness, exaggerated and unfounded cheerfulness or optimism arise. An elevated mood is usually accompanied not so much by joy as by a certain excitement. In other cases, we are talking about silent, serious, humorless, prone to isolation, somewhat gloomy pessimists, in whom one can often identify diverse affective reactions to their drunkenness, a rich internal processing of current circumstances and relationships with others. Autochthonous and reactive, they easily develop prolonged, erased depression.

Hysterical type

Exaggerated manifestations in behavior and statements predominate. The desire to “appear better than one is,” expressiveness, posing, theatricality, emphasizing one’s positive qualities and capabilities, even to the point of outright bragging or self-praise. As a rule, such individuals have exaggerated self-esteem with a simultaneous desire to belittle the role of others. An elevated opinion of oneself can take the form of sanctimonious self-deprecation or emphasized suffering that others cannot understand. The tendency to exaggerate can reach the level of outright lies with pathological fiction. Characterized by increased responsiveness to external events and easily occurring excitability, especially in cases where the events are at least slightly related to a given person. The instability of interests and hobbies, their superficiality, and increased suggestibility can easily be combined with short-lived but violent passion or stubbornness. An increase in hysterical traits occurs not only under the influence of the situation, but in some cases may be associated with the appearance of a low mood with a hint of dysphoria.

Schizoid type

Closedness prevails, up to a complete lack of need for communication. Reflection and autistic fantasy may occur. The background of the mood is determined either by the traits of indifference, or by a depressed-sullen affect. The features of psychoaesthetic disproportion in its various combinations are constant.

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Symptoms at different stages of growing up

The disease manifests itself in different ways - it all depends on age. If you know these nuances, you can prevent further progression of psychopathy. And the sooner you start treatment, the better.

As you get older, epileptic psychosis manifests itself as follows:



1. Epileptoid child. A child with this disorder may cry for a very long time, even for several hours, and it is impossible to calm him down. Such children want to be a tyrant in games, dictating the rules. They love to surreptitiously torment the younger ones and those who cannot give them back, and abuse their pets. These are “difficult children”, fighters who do not get along well in a children's group.

In elementary school, children with such psychopathy are distinguished by “hypersocial” traits: excessive accuracy when filling out copybooks and notebooks and careful handling of their belongings.