PERSONALITY DISORDERS & REPERTORIAL APPROACH

Dr S.K.PANDEY, READER
DEPT. OF REPERTORY
NEHRU HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL

As per aphorism 215 of Organon of Medicine, all the so-called mental

& emotional diseases are nothing more than corporeal diseases in
which the symptoms of derangement of the mind and disposition
peculiar to each of them is increased, whilst the corporeal symptoms
decline(more or less rapidly),till it at length attains the most striking
one sidedness, almost as though it were a local disease in the
invisible subtle organ of the mind or disposition. Dr Hahnemann has
classified
mental
diseases
into
four
types(Aphorisms
216,221,224,225)
1.Mental diseases appearing with the decline of corporeal diseases
which threatens to be fatal(Aphorism-216 Somato-psychic type)
2 Mental diseases appearing suddenly as an acute disease in patients
ordinary calm state caused by some exciting factors(Aphorism-221)
3 Mental diseases of doubtful origin(Aphorism-224)
4 Mental diseases arising from prolong emotional cause-(Aphorism225Psycho- somatic- type)
In modern medicine personality disorder, as defined in the
Diagnostic and Statistical Manual of the American Psychiatric
Association, Fourth Edition, Text Revision (DSM-IV-TR), is an
enduring pattern of inner experience and behavior that differs
markedly from the expectations of the individual's culture, is
pervasive and inflexible, has an onset in adolescence or early
adulthood, is stable over time, and leads to distress or impairment.
Personality disorders are a long-standing and maladaptive pattern of
perceiving and responding to other people and to stressful
circumstances. Ten personality disorders, grouped into 3 clusters
(i.e., A, B, C), are defined in the DSM-IV-TR.1

FREQUENCY
Individuals may have more than one personality disorder. The
following are prevalences for specific personality disorders in the
general population:
Paranoid personality disorder - 0.5-2.5%
Schizotypal personality disorder - 3%
Antisocial personality disorder - 3% of men, 1% of women
Borderline personality disorder - 2%

Histrionic personality disorder - 2-3%

Narcissistic personality disorder - Less than 1%
Avoidant personality disorder - 0.5-1%
Obsessive-compulsive personality disorder - 1%
MORTALITY/ MORBIDITY
Patients with personality disorders are at higher risk than the
general population for many (Axis I) psychiatric disorders. Mood
disorders are a particular risk across all personality diagnoses. Some
co morbidities are more specific to particular personality disorders
and clusters.
Cluster A: PARANOID PERSONALITY DISORDER may appear as a
prodrome to delusional disorder or frank schizophrenia. These
individuals are at risk for agoraphobia, major depression, obsessivecompulsive disorder, and substance abuse. Individuals with schizoid
personality disorder may develop major depression. Patients with
schizotypal personality disorder may develop brief psychotic
disorder, schizophreniform disorder, or delusional disorder. At the
time of diagnosis, 30-50% have concurrent major depression, and
most have a history of at least one major depressive episode.
Cluster B: ANTISOCIAL PERSONALITY DISORDER is associated with a
risk for anxiety disorders, substance abuse, somatization disorder,
and pathological gambling. Borderline personality disorder is
associated with a risk for substance abuse, eating disorders
(particularly bulimia), and posttraumatic stress disorder. Suicide is a
particular risk in borderline patients. Histrionic personality disorder
is associated particularly with somatoform disorders. People with
narcissistic personality disorder are at risk for anorexia nervosa and
substance abuse as well as experiencing depression.
Cluster C: AVOIDANT PERSONAILTY DISORDER is associated with
anxiety disorders (especially social phobia). Dependent personality
disorder carries a risk for anxiety disorders and adjustment disorder.
People with obsessive-compulsive personality disorder may be at risk
for myocardial infarction because of their common type A lifestyles.
They may also be at risk for anxiety disorders. Notably, they are
probably not at increased risk for obsessive-compulsive disorder.
RACE
No differences in prevalence across the races have been noted.
SEX

Cluster A: SCHIZOID PERSONALITY DISRODER is slightly more

common in males than in females.
Cluster B: ANTISOCIAL PERSONALITY DISORDER is 3 times more
prevalent in men than in women. Borderline personality disorder is 3
times more common in women than in men. Of patients with
narcissistic personality disorder, 50-75% are male.
Cluster C: OBSESSIVE-COMPULSIVE PERSONALITY DISORDER is
diagnosed twice as often in men than in women.
AGE
Personality disorders generally should not be diagnosed in children
and adolescents because personality development is not complete
and symptomatic traits may not persist into adulthood. Therefore,
the rule of thumb is that personality diagnosis cannot be made until
the person is at least 18 years of age. Because the criteria for
diagnosis of personality disorders are closely related to behaviors of
young and middle adulthood, DSM-IV-TR diagnoses of personality
disorders are notoriously unreliable in the elderly population
PARANOID PERSONALITY DISORDER
Individuals with this disorder display pervasive
suspiciousness. Common beliefs include the following:

distrust

and

Others are exploiting or deceiving the person.

Friends and associates are untrustworthy.
Information confided to others will be used maliciously.
There is hidden meaning in remarks or events others perceive as
benign.
The spouse or partner is unfaithful.
REPERTORIAL APPROACH
SYNTHESIS REPERTORY
MIND SECTION
Adaptability, loss of
Admonition
Dogmatic

KENTS REPERTORY
MIND SECTION
Delusions, criticized, that she is
Delusions, murdered that he would be
Distrustful
Eccentricity
Forsaken
Suspicious

(Page no.-23)
(Page no.-29)
(Page no.-37)
(Page no.-39)
(Page no.-49)
(Page no.-85)

SCHIZOID PERSONALITY DISORDER

This type of personality disorder is uncommon in clinical settings. A

person with this disorder is markedly detached from others and has
little desire for close relationships. This person's life is marked by
little pleasure in activities. People with this disorder appear
indifferent to the praise or criticism of others and often seem cold or
aloof.
REPERTORIAL APPROACH
SYNTHESIS REPERTORY
MIND SECTION
Abstraction of mind
Aloof
Apathy

Indifference
Paranoia

KENTS REPERORY
MIND SECTION
Apathy
Estranged from society

(Page no.-9)
(Page no.-39)

Quite

(Page no.-70)

Solitude

(Page no.-81)

Unfriendly

(Page no.-91)

BBCR
MIND SECTION
Anthrophobia, aversion to others

(PageNo-192)

Aversion to, family, certain persons

(Page no.-193)

Awkwardness

(Page no.-193)

Benumbed

(Page no.-193)

Company, aversion to

(Page no.-195)

Depression

(Page no.-198)

Foolish, silly absurd

(Page no.-202)

Introspective, introverted, absorbed

(Page no.-209)

Unsocial

(Page no.-220)

SCHIZOTYPAL PERSONALITY DISORDER

People with this disorder exhibit marked eccentricities of thought,
perception, and behavior. Typical examples are as follows:
Ideas of reference (i.e., believing that public messages are directed
personally at them)
Odd beliefs or magical thinking
Vague, circumstantial, or stereotyped speech
Excessive social anxiety that does not diminish with familiarity
Idiosyncratic perceptual experiences or bodily illusions
REPERTORIAL APPROACH

SYNTHESIS REPERTORY

MIND SECTION

Admonition
Aloof
Anxiety

KENTS REPERTORY

MIND SECTION

Quite

(Page no.-70)

Solitude

(Page no.-81)

BBCR

MIND SECTION

Benumbed
Headstrong
Imagination, fancies
Ideas, fixed

(Page no.-194)
(Page no.-203)
(Page no.-207)
(Page no.-284)

ANTISOCIAL PERSONALITY DISORDER

Antisocial
personality
disorder:
Individuals
with
antisocial
personality disorder display a pervasive pattern of disregard for and
violation of the rights of others and the rules of society. Onset must
occur by age 15 years & includes following features:
Repeated violations of the law
Pervasive lying and deception
Physical aggressiveness
Reckless disregard for safety of self or others
Consistent irresponsibility in work and family environments
Lack of remorse

Some person with antisocial disorder are terrorists & some terrorists
suffer from Antisocial personality disorder. Many terrorists
demonstrate diagnostic feature of ASPD without possessing the
actual disorder. Terrorists are not born terrorists. Most people
believe in something bigger than life.
REPERTORIAL APPROACH

SYNTHESIS REPERTORY

MIND SECTION

Abusive
Adulterous
Anger
Antisocial
Brutality
Corrupt
Desire, to kill
Destructiveness
Misanthropy
Rage
Rakes

KENTS REPERTORY

MIND SECTION

Desire, to murder
Destructiveness

(Page no.-68)
(Page no.-36)

Hard-hearted

(Page no.-51)

Hatred

(Page no.-51)

Impulse, to kill

(Page no.-54)

Inhumanity

(Page no.-56)

Kill, desire to

(Page no.-60)

Kill, threatens

(Page no.-60)

Murder, desire to

(Page no.-60)

TERRORIST

The definition of terrorism has proved controversial. Various legal

systems and government agencies use different definitions of
"terrorism". Moreover, the International community has been slow to
formulate a universally agreed, legally binding definition of this
crime. These difficulties arise from the fact that the term "terrorism"
is politically and emotionally charged.
Angus Martyn in a briefing paper for the Australian Parliament has
stated that "The international community has never succeeded in
developing an accepted comprehensive definition of terrorism.
During the 1970s and 1980s, the United Nations attempts to define
the term foundered mainly due to differences of opinion between
various members about the use of violence in the context of conflicts
over national liberation and determination. These divergences have
made it impossible to conclude a Comprehensive Convention on
International Terrorism that incorporates single, all-encompassing,
legally binding, criminal law definition terrorism.

In the meantime, the international community adopted a series of

sectoral conventions that define and criminalize various types of
terrorist activities. In addition, since 1994, the United Nations
General Assembly has condemned terrorist acts using the following
political description of terrorism: "Criminal acts intended or
calculated to provoke a state of terror in the general public, a group
of persons or particular persons for political purposes are in any
circumstance unjustifiable, whatever the considerations of a political,
philosophical, ideological, racial, ethnic, religious or any other nature
that may be invoked to justify the.
A 2003 study by Jeffrey Record for the US Army quoted a source
(Schmid and Jongman 1988) that counted 109 definitions of
terrorism that covered a total of 22 different definitional elements.
Record continued "Terrorism expert Walter Laqueur also has counted
over 100 definitions and concludes that the 'only general
characteristic generally agreed upon is that terrorism involves
violence and the threat of violence.' Yet terrorism is hardly the only
enterprise involving violence and the threat of violence. So does war,
coercive diplomacy, and bar room brawls.
As Bruce Hoffman has noted: "terrorism is a pejorative term. It is a
word with intrinsically negative connotations that is generally
applied to one's enemies and opponents, or to those with whom one
disagrees and would otherwise prefer to ignore. (...) Hence the
decision to call someone or label some organization 'terrorist'
becomes almost unavoidably subjective, depending largely on
whether one sympathizes with or opposes the person/group/cause
concerned. If one identifies with the victim of the violence, for
example, then the act is terrorism. If, however, one identifies with
the perpetrator, the violent act is regarded in a more sympathetic, if
not positive (or, at the worst, an ambivalent) light; and it is not
terrorism. For this and for political reasons, many news sources
(such as Reuters) avoid using this term, opting instead for less
accusatory words like "bombers", "militants", etc.
CAUSES OF TERRORISM
Terrorism has occurred throughout history for a variety of reasons.
Its causes can be historical, cultural, political, social, psychological,
economic, or religiousor any combination of these. Some countries
have proven to be particularly susceptible to terrorism at certain
times, as Italy and West Germany were during the 1970s. Terrorist
violence escalated

precipitously in those two countries for a decade before declining

equally dramatically. Other countries, such as Canada and The
Netherlands, have proven to be more resistant, and have
experienced only a few isolated terrorist incidents.
In general, democratic countries have provided more fertile ground
for terrorism because of the open nature of their societies. In such
societies citizens have fundamental rights, civil liberties are legally
protected, and government control and constant surveillance of its
citizens and their activities is absent. By the same token, repressive
societies, in which the government closely monitors citizens and
restricts their speech and movement, have often provided more
difficult environments for terrorists. But even police states have not
been immune to terrorism, despite limiting civil liberties and
forbidding free speech and rights of assembly. Examples include
Russia under tsarist rule and the Communist-ruled Union of Soviet
Socialist Republics, as well as the People's Republic of China,
Myanmar, and Laos.
In broad terms the causes that have commonly compelled people to
engage in terrorism are grievances borne of political oppression,
cultural domination, economic exploitation, ethnic discrimination,
and religious persecution. Perceived inequities in the distribution of
wealth and political power have led some terrorists to attempt to
overthrow democratically elected governments. To achieve a fairer
society, they would replace these governments with socialist or
communist regimes. Left-wing terrorist groups of the 1960s and
1970s with such aims included Germanys Baader-Meinhof Gang,
Italys Red Brigades, and the Weather Underground (see
Weathermen) in the United States.
Other terrorists have sought to fulfill some mission that they believe
to be divinely inspired or millennialist (related to the end of the
world). The Japanese religious cult Aum Shinrikyo, responsible for a
nerve gas attack on the Tokyo subway in 1995 that killed 12 people,
falls into this category. Still other terrorists have embraced
comparatively more defined and comprehensible goals such as the
re-establishment of a national homeland (for example, Basque
separatists in Spain) or the unification of a divided nation (Irish
nationalists in Northern Ireland).

Finally, some terrorists are motivated by very specific issues, such as

opposition to legalized abortion or nuclear energy, or the
championing of environmental concerns (see Environment) and
animal rights. They hope to pressure both the public and its
representatives in government to enact legislation directly reflecting
their particular concern. Militant animal rights activists, for example,
have used violence against scientists and laboratory technicians in
their campaign to halt medical experimentation involving animals.
Radical environmentalists have sabotaged logging operations and the
construction of power grids to protest the spoiling of natural
wilderness areas. Extremists who oppose legalized abortion in the
United States have attacked clinics and murdered doctors and other
employees in hopes of denying women the right to abortion.
National governments have at times aided terrorists to further their
own foreign policy goals. So-called state-sponsored terrorism,
however, falls into a different category altogether. State-sponsored
terrorism is a form of covert (secret) warfare, a means to wage war
secretly through the use of terrorist surrogates (stand-ins) as hired
guns. The U.S. Department of State designates countries as state
sponsors of terrorism if they actively assist or aid terrorists, and also
if they harbor past terrorists or refuse to renounce terrorism as an
instrument of policy.
State sponsorship has proven invaluable
organizationsby supplying arms, money,

to

some

terrorist

and a safe haven, among other things. In doing so, it has

transformed ordinary groups, with otherwise limited capabilities,
into more powerful and menacing opponents. State sponsorship can
also place at terrorists disposal the resources of an established
countrys diplomatic, military, and intelligence services. These
services improve the training of terrorists and facilitate planning and
operations. Finally, governments have paid terrorists handsomely for
their services. They thereby turn weak and financially impoverished
groups into formidable, well-endowed terrorist organizations with an
ability to attract recruits and sustain their struggle.

The U.S. Department of State has designated seven countries as

state sponsors of terrorism: Iran, Iraq, Syria, Libya, Cuba, North
Korea, and Sudan. In the year 2000, it named Iran as the most active
supporter of terrorism for aid to groups such as Hezbollah, Hamas,
and Palestine Islamic Jihad. Although the former Taliban government
in Afghanistan sponsored al-Qaeda, the radical group led by Saudi
exile Osama bin Laden, the United States did not recognize the
Taliban as a legitimate government and thus did not list it as a state
sponsor of terrorism. The newer terrorist organization like ISIS and
other organizations have common objectives like creating mass
anxiety, fear,panic, creating sense of helplessness and hopelessness
among people, demonstrating the incompetence of authorities,
destroying a sense of security and safety. Destruction is the key note
of terrorism.

REPERTORIAL APPROACH

SYNTHESIS REPERTORY

MIND SECTION
Anarchist
Antisocial
Brutality
Corrupt
Mania, homicial
Passionate
Programming everything
Unsympathetic
Secretive

KENTS REPERTORY

MIND SECTION

Audacity

Cruelty

Estranged from family , society

(Page no.-63)

(Page no.-17)

(Page no.-39)

Hard hearted

Insanity, behave like crazy people

Insanity, brutal

Insanity, malicious

Kill, desire to

(Page no.-51)

(Page no.-56)

(Page no.-56)

(Page no.-56)

(Page no.-60)

Malicious

(Page no.-69)

Obstinate

(Page no.-9)

Plans, making many revengeful plans

(Page no.-69)

Rage

(Page no.-71)

Repulsive mood

(Page no.-71)

Thought, persistent of evil

(Page no.-87)

Threatening

(Page no.-88)

Unfilling

(Page no.-91)

Violent

(Page no.-91)

BORDERLINE PERSONALITY DISORDER

The central feature of borderline personality disorder is a pervasive
pattern of unstable and intense interpersonal relationships, selfperception, and moods. Impulse control is markedly impaired.
Transiently, such patients may appear psychotic because of the
intensity of their distortions. Borderline personality disorder is one of
the most commonly overused diagnoses in DSM-IV-TR. Diagnostic
criteria require at least 5 of the following features:
Frantic efforts to avoid expected abandonment
Unstable and intense interpersonal relationships
Markedly and persistently unstable self-image
Impulsivity in at least 2 areas that are potentially self-damaging
(e.g., sex, substance abuse, reckless driving)
Recurrent suicidal behaviors or threats or self-mutilation
Affective instability
Chronic feelings of emptiness
Inappropriate and intense anger
Transient paranoia or dissociation
REPERTORIAL APPROACH
SYNTHESIS REPERTORY

MIND SECTION

Anger

(Page no.-91)

Death, desire

(Page no.-91)

Moping

(Page no.-91)

KENTS REPERTORY

MIND SECTION

(Page no.-91)

Anger

(Page no.-91)

Emotional

(Page no.-91)

Injure, fears to be alone, lest he should himself (Page no.-91)

Mutilating

Suicidal disposition

(Page no.-91)

(Page no.-91)

BBCR

MIND SECTION

Irritable

Beside, oneself frantic, madness

(Page no.-209)

(Page no.-194)

Ecstasy

(Page no.-199)

Suicidal

(Page no.-218)

HISTRIONIC PERSONALITY DISORDER

Patients with histrionic personality disorder display excessive
emotionality and attention-seeking behavior. They are quite dramatic
and often sexually provocative or seductive. Their emotions are
labile. In clinical settings, their tendency to vague and
impressionistic speech is often highlighted

REPERTORIAL APPROACH

SYNTHESIS REPERTORY

MIND SECTION

Coquettish

Frivolous

KENTS REPERTORY

MIND SECTION

Amorous

(Page no.-2)

NARCISSTIC PERSONALITY DISORDER

Narcissistic patients are grandiose and require admiration from
others. Particular features of the disorder include the following:
Exaggeration of their own talents or accomplishments
Sense of entitlement
Exploitation of others
Lack of empathy
Envy of others
An arrogant, haughty attitude

REPERTORIAL APPROACH

SYNTHESIS REPERTORY

MIND SECTION
Arrogant
Admiration
Haughty
Pompous
Vanity
KENTS REPERTORY
MIND SECTION
Arrogance

(Page no.-9)

Envy

(Page no.-39)

Jealousy

(Page no.-60)

Haughty

(Page no.-51)

Pride

(Page no.-69)

BBCR
MIND SECTION
Contemptuous, mocking

Dogmatic

(Page no.-196)

(Page no.-199)

Domineering

(Page no.-199)

Importance feels his

(Page no.-207)

Proud, arrogant, self esteem, haughty

(Page no.-214)

AVOIDANT PERSONALITY DISORDER

Avoidant patients are generally very shy. They display a pattern of

social inhibition, feelings of inadequacy, and hypersensitivity to
rejection. Unlike patients with schizoid personality disorder, they
actually desire relationships with others but are paralyzed by their
fear and sensitivity into social isolation.
REPERTORIAL APPROACH

KENTS REPERTORY

MIND SECTION

Abandoned

(Page no.-1)

Anxiety

(Page no.-4)

Dejection

Fear, people, of

(Page no.-18)

(Page no.-46)

Forsaken

(Page no.-49)

Frightened easily

(Page no.-49)

Sensitive

(Page no.-79)

Shy

(Page no.-80)

Solitude

(Page no.-9)

BBCR

MIND SECTION

Unsociable, shy, averse to society

(Page no.-220)

DEPENDENT PERSONALITY DISORDER

While many people exhibit dependent behaviors and traits, people
with dependent personality disorder have an excessive need to be
taken care of that result in submissive and clinging behavior,
regardless of consequences. Diagnosis requires at least 5 of the
following features:
Difficulty making decisions without guidance and reassurance
Need for others to assume responsibility for most major areas of the
person's life
Difficulty expressing disagreement with others
Difficulty initiating activities because of lack of confidence
Excessive measures to obtain nurturance and support
Discomfort or helplessness when alone
Urgent seeking for another relationship when one has ended
Unrealistic preoccupation with fears of being left to fend for
themselves

REPERTORIAL APPROACH
SYNTHESIS REPERTORY

MIND SECTION

taciturn

KENTS REPERTORY

MIND SECTION

Clinging
12)

(Page no.-

Company, desire for

(Page no.-12)

Fear, alone, of being

(Page no.-43)

Irresolution

(Page no.-57)

Magnetized, desire to be

(Page no.-63)

BBCR

MIND SECTION

Dejection

(Page no.-197)

Depression

(Page no.-198)

Despair

(Page no.-198)

Low Spirited

(Page no.-210)

Melancholy

(Page no.-215)

OBSESSIVE-COMPULSIVE PERSONALITY DISORDER

People with obsessive-compulsive personality disorder are markedly

preoccupied with orderliness, perfectionism, and control. They lack
flexibility or openness. Their preoccupations interfere with their
efficiency despite their focus on tasks. They are often scrupulous and
inflexible about matters of morality, ethics, and values to a point
beyond cultural norms. They are often stingy as well as stubborn.

REPERTORIAL APPROACH

SYNTHESIS REPERTORY

MIND SECTION

Activity, desires
Checking
Compulsions
Dogmatic
Foppish
Neurosis

KENTS REPERTORY

MIND SECTION

Delusion, of washing

(Page no.-35)

Fastidious

(Page no.-42)

Fixed notions

(Page no.-48)

Obstinate

(Page no.-69)

Pre-occupied

(Page no.-69)

Washing always, her hands

(Page no.-92)

BBCR

MIND SECTION

Headstrong

(Page no.-203)

Depression

(Page no.-198)

Rigid feeling

(Page no.-917)

Bibiliography
1.American Psychiatric Association

2.Boger Boenninghausen Characteristic Repertory

3. Borderline Personality Disorder DSM-IV
4. Hoffman B, inside terrorism Columbia University
5. Kents repertory
6. Knerrs repertory
7. Left wing extremist data & satp(2010)
8. Organon of Medicine 6.Synthesis repertory
9. Synthesis Repertory