Subi’s review on Influence of Personality Disorder in Alcoholism

Writen by Dr. Hari S. Chandran

The personality pattern of behaviour is generally recognized lay early adolescence. These change persists through out life, causing difficulties to the individuals and members of the family. Personality traits are normal, prominent aspects of personality. Personality disorders result when these personality traits become abnormal, ie. become inflexible and maladaptive, and cause significant social or occupational impairment or significant subjective distress.

Diagnostic and Statistical Manuel of Mental Disorders- IV edition, Text Revision, 2000 (DSM-IV-TR) is American Psychiatric Association’s Classification of mental disorders, DSM-IV-TR is a minor revision of the DSM-IV (1994).

In DSM-IV-TR, the personality disorder are coded on “Axis” and have been divided into three clusters. They are

1) Clusters A

Personality disorder, thought to be on a schizophrenic- continuum. These are (i) Paranoid PD, (ii) Schizoid PD (iii) Schizotypal PD. The diagnostic guidelines for specific personality disorder include the following features.

i) Paranoid PD
Suspicious
Mistrustful
Jealous
Sensitive
Self Importance

ii) Schizoid PD
Emotionally cold
Detached
Aloof
Lucking enjoyment
Introspective

iii) Schizotypal PD
Socially anxious
Experience cognitive and perceptual distortions
Show oddities or speech and inappropriate affective responses
Behave eccentrically.

2) Cluster B

Personality disorders thought to be on a ‘psychopathic continuum.’ These are

(i) Antisocial PD, (ii) Histrionic PD, (iii) Narcissistic PD (iv) Borderline PD. The diagnostic guideline for personality disorder include the following features.

i) Antisocial PD
Callous
Transient Relationship
Irresponsible
Impulsive of insitable
Lack guil of remorse
Fail to accept responsibility

ii) Histrionic PD
Self dramatization
Suggestibility
Shallow, Labile, affect
Sack Allenton of excitement
Inappropriately Seductive
Over concern with physical attractiveness.

iii) Narcissistic PD
Grandiose self importance
Fantasizes unlimited success, Power etc.
Believes himself special
Requires excessive admiration
Exploits others, luck empathy
Envious believes others envy him

iv) Borer line PD
Identity disturbance
Intense and unstable relationships
Effort to avoid abandonment
Recurrent suicidal behaviour
Chronic feelings of emptiness
Transient stress - related paranoid ideation.

3) Cluster - C

Personality disorders, characterized by ‘introversion’. These are (i) Avoidant PD (ii) Dependent PD (iii) Obsessive Compulsive PD. The diagnostic guidelines for personality disorders include the following features.

i) Avoidant PD
- Feeling of tension
- Feels socially inferior
- Pre-occupied with rejection
- Avoids involvement, risks and social activity

ii) Dependent PD
- Unduly complain
- Allow others take responsibility
- Feel unable to care for himself
- Fear of being left of care himself
- Need excessive help to make decision

iii) Obsessive - Compulsive PD
- Pre-occupied with details, rules etc.
- Over conscientious and scrupulous
- Rigid and stubborn
- Excessively doubling and cautious

Individuals with personality disorder have greater chances of becoming dependent on alcohol. Person with paranoid personality disorder uses alcohol to avoid their sadness and feelings. Schizhypal personalities become dependent on alcohol. In order to avoid anxiety. To get escape from guilt and remorse anti-social personalities uses alcohol. The Histrionic PD uses alcohol in order to seek attention and excitement. Narcissistic personalities always try to exploits others, by using alcohol they become partly conscious and get the courage for doing among. Avoidant personalities become alcoholic addict to get relief from anxiety and tension chronic feeling of emptiness and fear of being left alone lead the dependent and personalities to alcoholic addict. Some become alcoholic addict in order to avoid situation, risk and responsibilities. Obsessive compulsive disordered person take alcohol inorder to get confidence.

Addiction to alcohol and drug has become a problem for the individuals family and community. With a large number of people taking to alcoholism due to psychological and socio-cultural factors, the health problems have also become alarming. Alcoholic Anonymous describes alcoholism as a physical condition associated with mental obsession. It is considered to have physical, psychological, sociological and alcoholic parts of sickness.

By pharmacological definition alcohol is a drug and may be classified as a sedative, tranquililizes, hypnotic or anaesthetic, depending upon the quantity consumed. Of all the drugs, alcohol is the only drug whose self-induced intoxication is socially acceptable.

Alcohol is a depressant which means it slows the functions of the control nervous system. Alcohol usually blocks some of the messages trying to get to the brain. This alters a persons perceptions, emotions, movements, vision and hearing. In very small amounts, alcohol can help a person feel more relaxed or less anxious. More alcohol causes greater changes in the brain resulting in intoxication.

Alcohol is rapidly absorbed from the stomach and small intestine. Within 2 - 3 minutes of consumption, it can be detected in the blood - the max. concentration is usually reached about one hour after consumption. The presence of food in the stomach inhibits the absorption of alcohol because of dilution.

When the patient is dependent on alcohol a sudden cessation of drinking may cause severe withdrawal symptoms and signs occurring when the substance is reduced or stopped. The nature, time to onset and course of the symptoms very for different substance. The most common withdrawal syndrome is the longer. Mild tremous, nausea, vomiting, weakness, irritability, insomania and anxiety are also seen. Delirium tramens, alcoholic seizures, alcoholic hallunosis, are the severe forms of withdrawal syndrome.

Hospitalisation, clinical investigation, Detoxication, Detevent measures, psychotherapy, sociotherapy are some of the treatments for alcohol dependence.

CONCLUSION

In brief alcohol help a person feel more relaxed or less anxious, because it is a depressant. This makes the disordered personalities dependent on alcoholism.

REFERENCE

Dr Hari S. Chandran, Alcohol, Stress, Article. A short text of psychiatry, Niray, Ahija.

No. 1

The patient ‘P’ of age 32 was admitted in the hospital for de-addiction treatment. He belongs to the community of Ezhava. Patient is a graduate and also completed diploma in interior designing currently he is unemployed and unmarried. His father is a retired person and mother a housewife. He has one sister, she is a post graduate.

Patient is admitted in hospital on 5th August 2006. He repeatedly uses alcohol after every six months for a period of one week. He had lost his friend in an accident and become depressed. He is not interested in doing job and taking responsibilities. He had a disorder of personality and become alcoholic. After the treatment patient was discharged from the hospital on 19th August 2006.

No. 2

Patient ‘S’ was admitted in the hospital for de-addiction treatment. He is 38 years old and belongs to marthoma, x’-catholic. His occupation is business. Patient is divorced. His family consists of father, mother brother and sister in-law. He is a disorder personality. Sometimes patient become aggressive and outburst. Patient suffer from auditory hallucination. Patient use excessive conception of alcohol of last 10 years.

No. 3

Client ‘R’ of age 28 was admitted in Hospital for psychiatric illness. His educational qualification is S.S.L.C. Patient ‘R’ is unmarried and live with his parents. He had one brother and one sister. The patient has an inadequate personality. He become aggressive, violent and destroying objects. The patient repeatedly make complain on other. Disordered pattern of behaviour lead him to alcoholic addiction

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