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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
People with HPD are usually high-functioning, both socially and professionally. They usually have good social skills, despite tending to use them to manipulate others into making them the center of attention. HPD may also affect a person's social and/or romantic relationships, as well as their ability to cope with losses or failures. They may seek treatment for clinical depression when romantic (or other close personal) relationships end.
Individuals with HPD often fail to see their own personal situation realistically, instead dramatizing and exaggerating their difficulties. They may go through frequent job changes, as they become easily bored and may prefer withdrawing from frustration (instead of facing it). Because they tend to crave novelty and excitement, they may place themselves in risky situations. All of these factors may lead to greater risk of developing clinical depression.
Additional characteristics may include:
- Exhibitionist behavior
- Constant seeking of reassurance or approval
- Excessive sensitivity to criticism or disapproval
- Pride of own personality and unwillingness to change, viewing any change as a threat
- Inappropriately seductive appearance or behavior of a sexual nature
- Using somatic symptoms (of physical illness) to garner attention
- A need to be the center of attention
- Low tolerance for frustration or delayed gratification
- Rapidly shifting emotional states that may appear superficial or exaggerated to others
- Tendency to believe that relationships are more intimate than they actually are
- Making rash decisions
- Blaming personal failures or disappointments on others
- Being easily influenced by others, especially those who treat them approvingly
- Being overly dramatic and emotional
Some people with histrionic traits or personality disorder change their seduction technique into a more maternal or paternal style as they age.
People with hypersexual disorder experience multiple, unsuccessful attempts to control or diminish the amount of time spent engaging in sexual fantasies, urges, and behaviors in response to dysphoric mood states or stressful life events.
For a valid diagnosis of hypersexual disorder to be established, symptoms must persist for a period of at least 6 months and occur independently of a use mania or a medical condition.
A mnemonic that can be used to remember the characteristics of histrionic personality disorder is shortened as "PRAISE ME":
- Provocative (or seductive) behavior
- Relationships are considered more intimate than they actually are
- Attention-seeking
- Influenced easily by others or circumstances
- Speech (style) wants to impress; lacks detail
- Emotional lability; shallowness
- Make-up; physical appearance is used to draw attention to self
- Exaggerated emotions; theatrical
Hypersexual disorder is a pattern of behavior involving intense preoccupation with sexual fantasies, urges and activities, leading to adverse consequences and clinically significant distress or impairment in social, occupational or other important functions. It was proposed in 2010 for inclusion in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) of the American Psychiatric Association (APA).
Sadism involves gaining pleasure through themselves or others undergoing discomfort or pain. The opponent-process theory explains the way in which individuals not only display, but also enjoy committing sadistic acts. Individuals possessing sadistic personalities tend to display recurrent aggression and cruel behavior. Sadism can also include the use of emotional cruelty, purposefully manipulating others through the use of fear, and a preoccupation with violence.
Theodore Millon claimed there were four subtypes of sadism, which he termed Enforcing sadism, Explosive sadism, Spineless sadism, and Tyrannical sadism.
Sadistic personality disorder is a personality disorder involving which appeared in an appendix of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-III-R). The later versions of the DSM (DSM-IV, DSM-IV-TR and DSM-5) do not include it.
The words "sadism" and "sadist" are derived from Marquis de Sade.
Theodore Millon has proposed four subtypes of masochist. Any individual masochist may fit into none, one or more of the following subtypes:
Dependent personality disorder (DPD), formerly known as asthenic personality disorder, is a personality disorder that is characterized by a pervasive psychological dependence on other people. This personality disorder is a long-term condition in which people depend on others to meet their emotional and physical needs, with only a minority achieving normal levels of independence.
The cause of dependent personality disorder is unknown. A study in 2012 estimated that between 55% and 72% of the risk of the condition is inherited from one's parents. The difference between a "dependent personality" and a "dependent personality disorder" is somewhat subjective, which makes diagnosis sensitive to cultural influences such as gender role expectations.
Avoidant individuals often choose jobs of isolation so that they do not have to interact with the public regularly, due to their anxiety and fear of embarrassing themselves in front of others. Some with this disorder may fantasize about idealized, accepting, and affectionate relationships, due to their desire to belong. Individuals with the disorder tend to describe themselves as uneasy, anxious, lonely, unwanted and isolated from others. They often feel themselves unworthy of the relationships they desire, so they shame themselves from ever attempting to begin them.
People with avoidant personality disorder are preoccupied with their own shortcomings and form relationships with others only if they believe they will not be rejected. Loss and social rejection are so painful that these individuals will choose to be alone rather than risk trying to connect with others (see rejection sensitivity). They often view themselves with contempt, while showing an increased inability to identify traits within themselves that are generally considered as positive within their societies.
- Hypersensitivity to rejection and criticism
- Self-imposed social isolation
- Extreme shyness or anxiety in social situations, though the person feels a strong desire for close relationships
- Avoids physical contact because it has been associated with an unpleasant or painful stimulus
- Feelings of inadequacy
- Drastically reduced or absent self-esteem
- Self-loathing, autophobia or self-harm
- Mistrust of others or oneself; exhibits heightened self-doubt
- Emotional distancing related to intimacy
- Highly self-conscious
- Self-critical about their problems relating to others
- Heightened attachment-related anxiety, which may include a fear of abandonment
- Problems in occupational functioning
- Lonely self-perception, although others may find the relationship with them meaningful
- Feeling inferior to others
- Substance abuse and/or dependence
- In some extreme cases, agoraphobia
- Uses fantasy as a form of escapism to interrupt painful thoughts
Self-defeating personality disorder (also known as masochistic personality disorder) was a proposed personality disorder. It was discussed in an appendix of the manual's revised third edition (DSM-III-R) in 1987, but was never formally admitted into the "Diagnostic and Statistical Manual of Mental Disorders" (DSM). As an alternative, the diagnosis personality disorder not otherwise specified, remains in use in for the DSM-5. A classification proposed for future versions is the personality disorder-trait specified (PD-TS). Some researchers and theorists continue to use the DSM-III-R criteria. The official diagnostic code number was, "301.90" (personality disorder NOS).
Passive–aggressive personality disorder was listed as an Axis II personality disorder in the DSM-III-R, but was moved in the DSM-IV to Appendix B ("Criteria Sets and Axes Provided for Further Study") because of controversy and the need for further research on how to also categorize the behaviors in a future edition. According to DSM-IV, Passive–aggressive personality disorder is "often overtly ambivalent, wavering indecisively from one course of action to its opposite. They may follow an erratic path that causes endless wrangles with others and disappointment for themselves." Characteristic of these persons is an "intense conflict between dependence on others and the desire for self-assertion." Although exhibiting superficial bravado, their self-confidence is often very poor, and others react to them with hostility and negativity. This diagnosis is not made if the behavior is exhibited during a major depressive episode or can be attributed to dysthymic disorder.
Externalizing disorders often involve emotion dysregulation problems and impulsivity that are manifested as antisocial behavior and aggression in opposition to authority, societal norms, and often violate the rights of others. Some examples of externalizing disorder symptoms include, often losing one's temper, excessive verbal aggression, physical aggression to people and animals, destruction of property, theft, and deliberate fire setting. As with all DSM-5 mental disorders, an individual must have functional impairment in at least one domain (e.g., academic, occupational, social relationships, or family functioning) in order to meet diagnostic criteria for an externalizing disorder. Moreover, an individual's symptoms should be atypical for their cultural and environmental context and physical medical conditions should be ruled out before an externalizing disorder diagnosis is considered. Diagnoses must be made by qualified mental health professionals. DSM-5 classifications of externalizing disorders are listed herein, however, can also be used to classify externalizing disorders. More specific criteria and examples of symptoms for various externalizing disorders can be found in the DSM-5.
There are no specific criteria for "externalizing behavior" or "externalizing disorders." Thus, there is no clear classification of what constitutes an externalizing disorder in the DSM-5. Attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), antisocial personality disorder(ASPD), pyromania, kleptomania, intermittent explosive disorder (IED), and substance-related disorders are frequently referred to as externalizing disorders. Disruptive mood dysregulation disorder has also been posited as an externalizing disorder, but little research has examined and validated it to date given its recent addition to the DSM-5, and thus, it is not included further herein.
The Diagnostic and Statistical Manual of Mental Disorders revision IV (DSM-IV) describes passive–aggressive personality disorder as a "pervasive pattern of negativistic attitudes and passive resistance to demands for adequate performance in social and occupational situations."
Passive-aggressive behavior is the obligatory symptom of the passive–aggressive personality disorder. Persons with passive–aggressive personality disorder are characterized by procrastination, covert obstructionism, inefficiency and stubbornness.
Personality disorder not otherwise specified (also known as personality disorder NOS or PDNOS) is a DSM-IV Axis II personality disorder.
The DSM-5 does not have an equivalent to Personality Disorder NOS. However Personality disorder-trait specified (PD-TS) remains under consideration for future revisions. The DSM 5 "Unspecified Disorder" is not a personality disorder, it is used to enhance specificity of an existing disorder or it is an emergency diagnosis unto itself (i.e. Unspecified Mental Disorder, 300.9), without being attached to another disorder.
In the American Psychiatric Association's DSM-5, schizotypal personality disorder is defined as a "pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts."
At least five of the following symptoms must be present: ideas of reference, strange beliefs or magical thinking, abnormal perceptual experiences, strange thinking and speech, paranoia, inappropriate or constricted affect, strange behavior or appearance, lack of close friends, and excessive social anxiety that does not abate and stems from paranoia rather than negative judgments about self. These symptoms must not occur only during the course of a disorder with similar symptoms (such as schizophrenia or autism spectrum disorder).
The motives of the patient can vary: for a patient with factitious disorder, the primary aim is to obtain sympathy, nurturance, and attention accompanying the sick role. This is in contrast to malingering, in which the patient wishes to obtain external gains such as disability payments or to avoid an unpleasant situation, such as military duty. Factitious disorder and malingering cannot be diagnosed in the same patient, and the diagnosis of factitious disorder depends on the absence of any other psychiatric disorder. While they are both listed in the DSM-IV-TR, factitious disorder is considered a mental disorder, while malingering is not.
Factitious disorder should be distinguished from somatic symptom disorder (formerly called somatization disorder), in which the patient is truly experiencing the symptoms and has no intention to deceive.
In conversion disorder (previously called hysteria), a neurological deficit appears with no organic cause. The patient, again, is truly experiencing the symptoms and signs and has no intention to deceive.
The differential also includes body dysmorphic disorder and pain disorder.
Schizotypal personality disorder (STPD) or schizotypal disorder is a mental disorder characterized by severe social anxiety, thought disorder, paranoid ideation, derealization, transient psychosis, and often unconventional beliefs. People with this disorder feel extreme discomfort with maintaining close relationships with people, mainly because they think that their peers harbor negative thoughts towards them, so they avoid forming them. Peculiar speech mannerisms and odd modes of dress are also symptoms of this disorder. Those with STPD may react oddly in conversations, not respond or talk to themselves.
They frequently interpret situations as being strange or having unusual meaning for them; paranormal and superstitious beliefs are common. Such people frequently seek medical attention for anxiety or depression instead of their personality disorder. Schizotypal personality disorder occurs in approximately 3% of the general population and is more common in males.
The term ""schizotype"" was first coined by Sandor Rado in 1956 as an abbreviation of ""schizophrenic phenotype"". STPD is classified as a cluster A personality disorder ("odd or eccentric disorders") and is considered to be the most impairing disorder in this cluster.
Cluster B personality disorders are a categorization of personality disorders as defined in the DSM-IV and DSM-5.
Cluster B personality disorders are characterized by dramatic, overly emotional or unpredictable thinking or behavior and manipulative, exploitative interactions with others. They include antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder.
The British National Health Service has described those with this disorder as someone who, "struggles to relate to others. As a result, they show patterns of behaviour most would regard as dramatic, erratic and threatening or disturbing."
There are four recognized Cluster B personality disorders:
- Antisocial personality disorder (DSM-IV code 301.7): a pervasive disregard for the law and the rights of others.
- Borderline personality disorder (DSM-IV code 301.83): extreme "black and white" thinking, instability in relationships, self-image, identity and behavior often leading to self-harm and impulsivity.
- Histrionic personality disorder (DSM-IV code 301.50): pervasive attention-seeking behavior including inappropriately seductive behavior and shallow or exaggerated emotions.
- Narcissistic personality disorder (DSM-IV code 301.81): a pervasive pattern of grandiosity, need for admiration, and a lack of empathy.
One of the symptoms of conduct disorder is a lower level of fear. Research performed on the impact of toddlers exposed to fear and distress shows that negative emotionality (fear) predicts toddlers' empathy-related response to distress. The findings support that if a caregiver is able to respond to infant cues, the toddler has a better ability to respond to fear and distress. If a child does not learn how to handle fear or distress the child will be more likely to lash out at other children. If the caregiver is able to provide therapeutic intervention teaching children at risk better empathy skills, the child will have a lower incident level of conduct disorder.
The following conditions commonly coexist (comorbid) with dependent personality disorder:
- mood disorders
- anxiety disorders
- adjustment disorder
- borderline personality disorder
- avoidant personality disorder
- histrionic personality disorder
Depressive personality disorder (also known as melancholic personality disorder) is a controversial psychiatric diagnosis that denotes a personality disorder with depressive features.
Originally included in the American Psychiatric Association's DSM-II, depressive personality disorder was removed from the DSM-III and DSM-III-R. Recently, it has been reconsidered for reinstatement as a diagnosis. Depressive personality disorder is currently described in Appendix B in the DSM-IV-TR as worthy of further study. Although no longer listed as a personality disorder, the diagnosis is included under the section “personality disorder not otherwise specified”.
While depressive personality disorder shares some similarities with mood disorders such as dysthymia, it also shares many similarities with personality disorders including avoidant personality disorder. Some researchers argue that depressive personality disorder is sufficiently distinct from these other conditions so as to warrant a separate diagnosis.
Bipolar disorder is difficult to diagnose. If a person displays some symptoms of bipolar disorder but not others, the clinician may diagnose bipolar NOS. The diagnosis of bipolar NOS is indicated when there is a rapid change (days) between manic and depressive symptoms and can also include recurring episodes of hypomania. Bipolar NOS may be diagnosed when it is difficult to tell whether bipolar is the primary disorder due to another general medical condition, such as a substance use disorder.
Personality disorders (PD) are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's culture. These patterns develop early, are inflexible, and are associated with significant distress or disability. The definitions may vary somewhat, according to source. Official criteria for diagnosing personality disorders are listed in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM) and the of the "International Classification of Diseases" (ICD). The DSM-5 lists personality disorders in the same way as other mental disorders, rather than on a separate 'axis', as previously.
Personality, defined psychologically, is the set of enduring behavioral and mental traits that distinguish between individual humans. Hence, personality disorders are defined by experiences and behaviors that differ from societal norms and expectations. Those diagnosed with a personality disorder may experience difficulties in cognition, emotiveness, interpersonal functioning, or impulse control. In general, personality disorders are diagnosed in 40–60% of psychiatric patients, making them the most frequent of psychiatric diagnoses.
Personality disorders are characterized by an enduring collection of behavioral patterns often associated with considerable personal, social, and occupational disruption. Personality disorders are also inflexible and pervasive across many situations, largely due to the fact that such behavior may be ego-syntonic (i.e. the patterns are consistent with the ego integrity of the individual) and are therefore perceived to be appropriate by that individual. This behavior can result in maladaptive coping skills and may lead to personal problems that induce extreme anxiety, distress, or depression. These behaviour patterns are typically recognized in adolescence, the beginning of adulthood or sometimes even childhood and often have a pervasive negative impact on the quality of life.
Many issues occur with classifying a personality disorder. Because the theory and diagnosis of personality disorders occur within prevailing cultural expectations, their validity is contested by some experts on the basis of inevitable subjectivity. They argue that the theory and diagnosis of personality disorders are based strictly on social, or even sociopolitical and economic considerations.