Symptomatic and Syndromal Continuity in Personality Disorders: Can We Establish A Psycho-periodic Table?

Klinik Psikofarmakoloji Bülteni, Cilt: 20, Say›: 2, 2010 / Bulletin of Clinical Psychopharmacology, Vol: 20, N.: 2, 2010 www.psikofarmakoloji.org Siever and Davis (1991) describe that the borders between personality disorders and Axis I psychiatric disorders are not well-pronounced so that these disorders can be perceived as a continuation of each other on both ends. The authors also indicate that all psychiatric disorders can be reduced to dimensions in respect to cognitive/perceptual, impulsivity/aggression, affective instability and anxiety/inhibition in order to easily comprehend such a continuity. There is a second important thing which is pointed out by Siever; the clinicians have so far considered anxiety/inhibition as a trait of introversion and impulsivity/aggression as a trait of extroversion, which naturally resulted in interpretation of narcissistic and antisocial personality disorders as extroverted personalities, and avoidant and dependent personality disorders as introverted personalities. Although our categorization, which is based on Siever’s classification, is somewhat contradictory to what we knew so far, it provides us an important tool to establish a timeline for psychopathological continuity. The following will help to set a basis for this argument: the narcissistic personality disorder is an early pathology with a poor object cathexis, and the individual displaying a pathology rather depending on narcissistic cores within his/her self. And, therefore, the defense mechanisms used are more primitive. On the other hand, individuals with an avoidant and dependent personality disorder are less dependent on narcissistic cores, and they have strong object cathexis. As a natural outcome, these Symptomatic and Syndromal Continuity in Personality Disorders: Can We Establish A Psycho-periodic Table?