Anancastic personality disorder - manifestations, treatment

Anancastic personality disorder (APD) is a congenital or early acquired character anomaly that interferes with a person’s full adaptation in society and is manifested by pronounced subjective problems due to a person’s tendency to doubt, double-check, obsessive thoughts, etc. If a person is anantcastic, this condition can lead to a decrease in social interaction, financial problems and difficulties in obtaining education.

The main risk factors for developing anancastic personality disorder:

• hereditary predisposition (about 7%);
• age crisis;
• psychotraumatic situation (including facts of physical or mental violence);
• massive hormonal changes;
• excessive psycho-emotional stress;
• persistent stress; and so on.

Anancaste disorder, as a rule, debuts at school age with excessive shyness, constant fear of doing something wrong and worsens when the patient begins to live independently and is forced to bear responsibility for himself and his family.

Types

How can people with anancastic personality disorder be classified? Types of deviations occur at different levels. In psychotic and neurotic, at the same time, the personal characteristics characteristic of this type are preserved in everyone. Some groups of doctors divide anancastic personality disorder into compulsive and obsessive types, others do not.

The obsessive-compulsive character is fundamentally based on such protective mechanisms as “isolation of affect”, in which the emotional component of the experience is leveled out by “reactive formation”, when a negative feeling is transformed into a positive one and vice versa. The person is also convinced that he can completely control all processes - these people are overcome by a mania of total control.

Causes

The most common causes of the disorder include:

• genetic predisposition;
• birth and traumatic brain injuries suffered at an early age;
• mental illness (the disorder often accompanies autism, manic-depressive psychosis, schizophrenia);
• long-term suppressed anxiety or aggression.

According to experts, anancastic personality disorder is formed in children whose families have high demands not only on behavior, but also on emotions. This leads to the fact that the child begins to feel guilty for his inability to control feelings and desires, as well as fear of punishment.

Minuses

Anankast is characterized by an inability to adapt to environmental conditions - rigidity, as well as stubbornness, excessive love of order, laws and rules. This person is obsessed with neatness, goes into the smallest details and sometimes completely insignificant details; he can be called a perfectionist. And all this prevents him from normally completing any of the tasks he undertakes. And they are very afraid of making a mistake, because of this they are indecisive. A person is constantly overcome by “mental chewing gum”: a lot of thinking, but there is no solution to the problem.

Such people are characterized by a high degree of formality, lack of a sense of humor, excessive seriousness, and intolerance.

They are incapable of compromise, but most importantly, they demand from those around them complete submission to the rules of the life they have invented for themselves.

For them, anything that can break familiar stereotypes is alarming and unacceptable, and this anxiety is masked by various rituals. Anankasts often develop completely unacceptable desires.

As a consequence of the disease, people develop anxiety-phobic disorders and obsessive-compulsive neuroses. Is it worth saying that you should consult a psychiatrist for treatment?

Symptoms

Such disorders are characterized by inertia of thinking, stubbornness, excessive fixation of attention on details, and obsessive behavior that occurs periodically.

Obsessive thoughts often concern everyday moments. Patients perceive them as tiring and painful, and they try to resist them. But the thoughts involuntarily return again. Such thoughts lead to attacks of compulsions, which are expressed in obsessive actions in order to prevent adverse consequences. As a rule, such consequences are unlikely.

Sometimes excessive attention to detail takes on a very pronounced form, which interferes with the performance of professional duties and full-fledged life activities. Patients develop their own ideas about quality. They are usually more strict than is customary. In everyday life, a whole system of housekeeping is formed. Moreover, it is difficult to convince a person to change the procedure he has established.

Character traits

A person suffering from APD has the following characteristics:

• diffidence;
• increased anxiety;
• meticulousness;
• obsession with details;
• tendency to order, lists, excessive planning;

• tendency to clean and wash everything;
• tendency to hoard, thrift;
• stubbornness and rigidity of thinking;
• excessive conscientious performance of duties;
• pedantry;
• inflexibility in matters of morality, ethics, principles;

Giphy

• hypertrophied sense of duty and responsibility;
• safety and health concerns;
• perfectionism;
• lack of hobbies, hobbies;

Classification and stages of development of anancastic personality disorder

APD begins in childhood or adolescence. Throughout its course, it goes through a number of successive stages, which can be repeated and returned.

The two main phases of personality disorders are:

• compensation;
• decompensation.

During the compensation phase, the features of APD are smoothed out, bring minimal subjective discomfort, and the person is able to get along with them. Often, to achieve this, he adjusts his life accordingly: he creates a safe environment around himself of people who can support him and help him cope with anxieties and difficulties, chooses a job with minimal responsibility (although people with APD can find a reason to worry everywhere), etc. .

The decompensation phase is a period of exacerbation of maladaptive personality traits, increased anxiety, doubt and indecision. This leads to severe subjective discomfort and interferes with full adaptation in society. During these periods, people may experience symptoms of depression from ongoing worry and anxiety, disruption to their relationships, and other social distress.

Publications in the media

Personality disorders are long-term and persistent disorders of various spheres of mental activity, devoid of productive psychotic symptoms and manifested by behavior from which either the patients themselves or society suffer. The disorders usually begin in childhood or adolescence and continue throughout later life. In foreign psychiatry, since the 70s of the 20th century, the term “psychopathy”, “which has become not a clinical diagnosis, but a synonym for the asociality of the subject,” has been replaced by the concept of “personality disorder.”

To make a diagnosis of personality disorder, it is necessary to exclude organic brain damage, which can cause similar behavioral disorders. If a somatic and/or neurological disease (for example, a brain tumor) leading to central nervous system dysfunction is detected, a diagnosis of “organic personality disorder” is made. In Russian psychiatry, starting from the 30s and until now, the doctrine of personality disorders (psychopathy), belonging to P.B., is most recognized. Gannushkin (1933). In accordance with the teachings of P.B. Gannushkin use the following provisions: • disorders are so pronounced that they lead to disruption of the patient’s adaptation to society; • totality of disorders; in this case, we are not talking about individual abnormal character traits, but about the fact that the personality as a whole is woven from pathological characterological properties; • persistence, stability and low reversibility of disorders throughout the patient's life. Frequency : 6–9% of the population. Classification and clinical picture The classification of personality disorders is conditional, because in most cases we are talking about mixed types, including symptoms of different types of personality disorders. • Paranoid personality disorder (paranoid psychopathy) •• Patients experience unreasonable suspicions that others are using, deceiving, or harming them. They are unkind to others, unable to forgive insults or disrespect, and express unreasonable doubts about the fidelity of their spouse or sexual partner. Patients persistently believe that they are right in all situations •• Patients with paranoid personality disorder seem unemotional and lack warmth. They are impressed only by strength and power, only in these cases do they pay attention to people, while those whom they consider weak, sick, infirm, inferior, they deeply despise •• In case of decompensation under the influence of emerging conflicts, systematic persecution begins “ offenders,” endless complaints are written to state, public and judicial authorities, in which any minor miscalculations of opponents are qualified as malicious and criminal, and defamatory anonymous letters are sent. The circle of persecuted persons is constantly expanding due to all those who took part in the analysis of conflicts and who, in the patient’s opinion, did not show due integrity and impartiality. In such situations, the development of overvalued delusions is possible, incl. delirium of jealousy. Patients with overvalued delusions are dangerous because they are prone to committing aggressive actions against their “enemies” or a sexual partner suspected of adultery. • Schizoid personality disorder (schizoid psychopathy) •• Patients are characterized by a reluctance to have close relationships with others and a lack of joy from such relationships. As a child, they like to play quiet and calm games alone, most often at home, never share their experiences with their parents, and cannot find a common language with their peers •• Schizoid individuals remain cold and distant, do not take part in everyday life, are uncommunicative, silent, do not follow fashion. They have no or poorly developed need for emotional contact with other people, no close friends, but at the same time they can be strongly attached to animals •• Patients strive for individual activities that do not require competition, and are able to spend an unusually large amount of effort and time on studying abstract sciences, such as mathematics, astronomy, philosophy •• Characterized by reduced interest or absence of interest in sexual relations. Men often don't get married because... they are unable to maintain intimate contact; women sometimes passively submit to an aggressive man, agreeing to marry him if he wants •• Patients are indifferent to praise or criticism. They respond to most threats, real or imaginary, by fantasizing about omnipotence and withdrawing from real life •• Despite social isolation and detachment from the outside world, patients can think and develop so far that they are able to give the world truly original, creative ideas. • Dissocial (antisocial) personality disorder •• Patients are prone to lies and impulsive actions; unable to plan. Patients are often irritable and aggressive. Ignoring personal safety or the safety of others is typical; irresponsible attitude towards one's responsibilities; indifference •• Lying, truancy, running away from home, theft, fighting, drug use and illegal activities are typical manifestations that begin in childhood. Antisocial personalities do not have depression or anxiety, which is surprising given the situation they are in, and their own explanations for what is happening to them seem crazy •• They like to manipulate others and often involve others in plans for easy money or achievement fame or notoriety, which in the end almost inevitably leads to financial ruin. A notable feature is the lack of regret about one's actions. • Emotionally unstable personality disorder (excitable psychopathy) •• In situations that do not meet the interests of patients, they give violent reactions of irritation, dissatisfaction and anger. Outside of situations that are emotionally significant for patients, reactions are often quite adequate. Outbursts of intense anger can lead to violence, especially if the patient's wishes and actions are resisted and criticized by others. Conflictful relationships with loved ones often lead to auto-aggression, including suicide attempts and self-harm •• Patients are desperately trying to avoid loneliness. They form unstable interpersonal relationships with people with alternating fluctuations between extreme idealization and extremely negative assessment •• Characterized by a violation of self-awareness (pronounced and long-lasting instability in the self-image) and a lack of adequate assessment of their reactions and behavior. Patients try to find reasons and circumstances that justify such behavior •• Patients are prone to impulsive actions that are committed without sufficient logical assessment, without taking into account their possible consequences and are associated with potential risks (wasting money, promiscuity in sexual relations, disregard for traffic rules) • • Mood is unpredictable and capricious (episodic dysphoria, irritability, short temper, anxiety) •• ICD-10 distinguishes two types of disorder: the impulsive type, characterized primarily by emotional instability and lack of emotional control, and the borderline type, which is additionally characterized by a disorder of self-perception and goals and internal aspirations, a chronic feeling of emptiness, tense and unstable interpersonal relationships and a tendency towards self-destructive behavior, including suicidal gestures and attempts.

• Histrionic personality disorder (hysterical psychopathy) •• Characterized by a feeling of discomfort in situations where the patient is not the object of attention. Patients try to evoke sympathy, an attitude of admiration, and surprise. This is achieved by extravagant appearance, boasting, deceit, fantasy, inappropriate sexual charm in appearance or behavior •• Patients are capricious and inconsistent. Their emotional reactions are labile, superficial and theatrical. The mood is extremely changeable. They are characterized by suggestibility, susceptibility to the influence of people or circumstances •• A low level of self-awareness does not allow them to objectively assess their behavior: they see themselves as people capable of self-sacrifice for the sake of their loved ones and friends, not noticing their actual selfish attitude towards them •• Being sweet and flirtatious with people on whom they want to make a good impression, they become tyrants in the family, showing callousness and even cruelty towards their loved ones •• In an effort to attract attention to themselves with their weakness and helplessness, such people become regular visitors to medical institutions, making complaints about unbearable physical and mental suffering •• Psephologists (pathological liars) predominate among men. Characterized by a tendency to fantasize, stories about extraordinary events in which they assign themselves a spectacular role, about meeting outstanding people, trying to present themselves as a more significant person than they actually are. Among them there are many petty scammers, imaginary psychics, and marriage swindlers.

• Anancastic personality disorder (anancastic psychopathy, obsessive-compulsive personality disorder) •• The basis of a psychasthenic personality is anxiety and self-doubt. Since childhood, such individuals have been characterized by shyness, increased impressionability, and constant fear of doing something wrong •• Patients are absorbed in organizing or planning their activities to such an extent that the main goal of the work is not achieved. They strive for improvement, which prevents them from completing the task. Patients are busy working and achieving results to such an extent that relationships with other people are sometimes very difficult for them •• They are not characterized by impulses or spontaneous impulses. Before taking any step, they evaluate it for a painfully long time, doubt its expediency •• Characterized by excessive conscientiousness, scrupulousness and lack of flexibility in matters of morality, ethics or moral values ​​•• Patients are unable to get rid of worn-out or unnecessary things, even if they not associated with sentimental memories •• They are unwilling to share responsibilities or work with others unless others perform the work to the fullest extent of the patients' requirements •• Possible intrusive thoughts and actions that do not reach the severity of obsessive-compulsive disorder.

• Anxious (avoidant) personality disorder (inhibited type psychopathy) •• These patients are usually considered “complex people” in everyday life. The central clinical feature of this disorder is increased sensitivity to criticism, disapproval and dissatisfaction from others, as a result of which patients avoid contact with people. They are reserved in intimate relationships due to fear of reproaches or ridicule from a sexual partner •• Patients are afraid to speak in public or make requests of others (the disorder is often combined with social phobia). They sometimes misinterpret people's statements as demeaning or ridiculing them. Refusal of any request is accompanied by withdrawal on their part, and they feel insulted •• In the professional sphere, such patients often avoid taking on responsibilities or participating in new activities for fear of being in a difficult situation, and rarely achieve great success or earn authority . On the contrary, at work they show themselves to be shy and try to please everyone in everything •• Failure of social support can lead to anxiety and depression. • Dependent personality type disorder •• The core manifestation of the disorder is self-doubt, low self-esteem. Patients avoid responsibility; the need to perform leadership functions causes severe anxiety. In relationships with others, patients play only auxiliary, subordinate roles, are humiliated in order to be accepted and are often unfairly exploited in the interests of others. The loss of a meaningful relationship with a dominant person is fraught with the subsequent development of a depressive episode •• They find it difficult to do some work for themselves, but it is easy to do similar tasks for someone else. Patients find it difficult to make decisions in everyday life without outside help or reassurance. Characterized by fear of loneliness. Patients seek care and support from others, going so far as to voluntarily perform activities that are not enjoyable. Patients can endure insults, infidelity or drunkenness of their spouse for a long time. In the event of the loss of a close relationship, there is a need to find a new close connection as a source of care and support.

• Narcissistic personality disorder. Patients tend to exaggerate their own achievements and talents. They are characterized by preoccupation with fantasies of unprecedented success, unlimited power, brilliance, beauty or ideal love. Patients are convinced of their own uniqueness and ability to communicate or be related to other special or high-status people (or institutions). They easily develop a need for excessive admiration from others, unreasonable expectations of very good treatment or unquestioning submission to demands. Patients often use others to achieve their own goals. Patients with narcissistic disorder are characterized by an inability to show empathy; envy of others and the belief that others are jealous of him. • Passive-aggressive personality disorder •• The core feature of the disorder is a constant attitude towards passive resistance to management. Patients cannot stand up for themselves or speak directly about their needs and desires. At the same time, they are always dissatisfied, irritated and disappointed with someone or something. Patients constantly look for flaws in the authoritarian figures to whom they are subordinate and do not make any attempts to free themselves from their dependent position. Passive-aggressive individuals are envious and spiteful towards those who are more fortunate. Patients believe that they work much better than others think about it, reacting with indignation to the suggestion that their productivity could be higher •• When forced to achieve success at work, they experience severe anxiety. Those with whom patients are in close relationships are rarely calm and happy. Patients can, for example, ruin a party with their complaints and claims, without making, with some excuses, their positive contribution to it •• Patients often even find it difficult to formulate what a situation should look like in which they would be satisfied. Such patients often threaten to commit suicide, but as a rule, things do not go as far as suicide attempts. •• The disorder is often complicated by alcoholism, depression and somatization disorder.

Accentuations of character Accentuated personalities (K. Leonhard) occupy an intermediate position between mentally healthy people and patients with personality disorders. They adapt in life more easily than psychopathic ones, and their adaptation is more stable, however, even in unfavorable conditions, states of decompensation may arise in them. In their characteristics, they differ from ordinary people, and these characteristics (emphasis) are not considered as a manifestation of the disease, although in difficult conditions for the individual, failure of adaptation and disruption of interpersonal relationships may be possible. The leading signs of character accentuations may resemble reduced manifestations of the corresponding psychopathy. For example, accentuated personalities of the hysterical type are similar to those suffering from histrionic personality disorder: they are prone to theatricality, self-affirmation in the eyes of others, etc. However, these manifestations are not so vivid in them and the general disharmony of personality is much less pronounced. Within the framework of accentuated states, mixed variants are often noted, including signs of different types of character accentuations. The diagnosis of a personality disorder is invalid if there are only isolated characterological deviations that are well compensated and lead to pathological behavioral disorders only during relatively short periods of decompensation associated with mental trauma. In this case, a diagnosis of character accentuation is made. Research methods • EEG • MRI/CT • Psychological methods (MMPI, thematic apperception test, Rorschach test).

Differential diagnosis • Paranoid personality disorder differs from delusional disorder in the absence of delusional ideas. This disorder can be differentiated from paranoid schizophrenia on the basis that in paranoid personality disorder there are no hallucinations, emotional-volitional and thinking disorders. Patients with borderline personality disorder differ from this type in their ability to form strong emotional relationships with others. Paranoid personality disorder differs from antisocial personality disorder in that there is no history of antisocial behavior. They are similar to schizoid psychopaths by limited emotionality, but are distinguished by dominant suspicion and distrust. It is most difficult to distinguish paranoid disorder from schizotypal disorder, for which suspiciousness is also a characteristic feature. Unlike schizotypal patients, patients of this type do not have such a bizarre complex of behavioral, sensory and mental disorders; they are characterized not so much by the absence of distortions in communication skills, but by their characteristic orientation (eccentricity, eccentricity). • Schizoid personality disorder. Unlike schizoid disorder, patients with schizotypal disorder are characterized by more pronounced emotional-volitional and thinking disorders, subpsychotic episodes and less successful social adaptation. Patients of the emotionally unstable and anxious (evasive) type have a richer and more emotional social life, are sensitive to their loneliness, are more interested in interpersonal relationships and rarely resort to autistic fantasy. Patients with paranoid disorder are able to establish stable and emotionally rich relationships with others; they more often use psychological defense in the form of projection.

• Antisocial personality disorder. An antisocial psychopath differs from a mentally healthy criminal in that the criminality of his behavior is only one of the parameters of globally impaired personality functioning. When assessing antisocial behavior, it is very important to take into account the social norms of the cultural group to which the patient belongs. • Borderline personality disorder. Differential diagnosis with schizophrenia is based on the presence or absence of prolonged psychotic episodes of characteristic negative symptoms. Schizotypal individuals are characterized by strange behavior and fragmentary delusional ideas about relationships. Paranoid individuals are characterized by strong suspicion. Borderline individuals experience a chronic feeling of emptiness, impulsivity, short-term psychotic episodes, and suicidal attempts to manipulate others. • Histrionic personality disorder. It is most difficult to determine the difference between histrionic and borderline personalities. Suicides and subpsychotic episodes are more typical for the latter type. Brief reactive psychoses and dissociative disorders may coexist with a diagnosis of histrionic personality disorder. • Narcissistic personality disorder. Borderline, histrionic, and antisocial personality disorders are often comorbid with narcissistic disorders. Patients with narcissistic personality disorders are less anxious than patients with borderline disorders and their lives are less chaotic; Suicide attempts are more common in borderline than narcissistic personality disorders. Unlike the antisocial type, narcissistic patients are less impulsive, less likely to abuse alcoholic beverages and break the law. Hysterical personalities, like narcissistic ones, often display traits of exhibitionism and try to manipulate others, but they are more capable of warm emotional relationships. • Obsessive-compulsive personality disorder. Unlike obsessive-compulsive personality disorder, obsessive-compulsive disorder is characterized by true obsessions and compulsions. If the latter are present, a diagnosis of obsessive-compulsive disorder should be made. • Avoidant personality disorder. Avoidance of communication with other people is characteristic of both the schizoid and anxious types, but the schizoid patient is distinguished by the desire and lack of desire to communicate, while the anxious patient is distinguished by the desire to communicate, uncertainty and fear. The clinical pictures of the anxious and dependent types are similar, but with the anxious type, communication difficulties manifest themselves in the fear of communication, with the dependent type - in the fear of being left alone. The borderline and hysterical type are distinguished from the anxious type by the tendencies to manipulate other people, irritability and unpredictable behavior characteristic of these patients.

• Dependent personality disorder. Addiction features are found in many types of mental disorders, making differential diagnosis difficult. The clinical pictures of the anxious and dependent types are similar, but with the anxious type, communication difficulties manifest themselves in the fear of communication, with the dependent type - in the fear of being left alone. Dependence on others is also characteristic of the hysterical and borderline types, but dependent individuals usually maintain a long-term connection with the same person on whom they depend, and not with a group of people, and they have no tendency to manipulate others. Patients of the schizoid type and with schizotypal disorder tend to be isolated rather than dependent. Dependent behavior can be found in patients with agoraphobia, but agoraphobic patients also have a higher level of general anxiety or the possibility of developing panic attacks. • Passive-aggressive personality disorder. Despite the known external similarity, behavior in passive-aggressive disorder is less spectacular, dramatic, emotional and aggressive than in cases of hysterical and borderline disorders.

TREATMENT Psychotherapy and drug therapy are used to treat personality disorders. These treatments should not be pitted against each other. With the right combination of psychotherapy and drug treatment, an enhanced effect is noted. Drug therapy plays a small role in the treatment of patients with personality disorders • Antipsychotic drugs in small doses are prescribed for aggressive behavior, psychomotor agitation, decompensation of paranoid personality disorder (for example, levomepromazine 25–75 mg/day, haloperidol 5–15 mg/day) • Anxiolytic drugs (for example, diazepam, bromodihydrochlorophenylbenzodiazepine) reduce anxiety and improve the well-being of patients, but these drugs should be prescribed with extreme caution (if possible, do without them) due to the high risk of developing addiction and dependence in patients with personality disorder • With the development of depressive conditions antidepressants are used (for example, amitriptyline 75–150 mg/day). Antidepressants (especially clomipramine) are also effective in decompensating obsessive-compulsive personality disorder, manifested by symptoms of obsessive-compulsive disorder. Psychotherapy (group, family, individual, psychoanalysis) is the most preferred method of treatment. With the help of psychotherapy, they change the patient’s attitudes, his idea of ​​his “I”, and help find ways to build correct interpersonal relationships.

Course and prognosis. • Personality disorders usually begin in childhood or adolescence and continue throughout later life. The ability to adapt to personality disorders depends on the severity of the behavioral disorder and external factors. Patients can be adapted under conditions favorable to them (compensation) and maladapted with pronounced manifestations of their characteristic psychopathic manifestations under unfavorable conditions (decompensation). Decompensating factors can be somatic and infectious diseases, intoxication, and emotional stress. The dynamics of psychopathy are closely related to age. The most dangerous periods in terms of decompensation are puberty and involution. A common feature of all pathological conditions is non-progress. After decompensation, the patient's personality returns to its original state. • Patients tend to avoid treatment. The course is chronic and progressive, leading to social and labor decompensation, but some patients may experience improvement. Synonyms • Pathological personality development • Character anomaly • Pathological character • Psychopathy

ICD-10 • F68 Other personality and behavior disorders in adulthood •• F69 Personality and behavior disorder in adulthood, unspecified

When should you suspect a disorder?

To suspect anancastic personality disorder, you should pay attention to the following symptoms:

• constant, unnecessary doubts and double-checks, excessive caution;
• excessive preoccupation with details: rules, schedule, organization, subordination, which sometimes harms the process itself;
• a clear focus only on the “ideal” result of the activity or “nothing at all”, perfectionism, which significantly inhibits the mentioned activity;
• over-obligation and over-conscientiousness, which fixates a person on the activity being performed to the detriment of his personal life;
• thoroughness, strict adherence to social norms and orders;
• inability to adapt to a changed situation, stubbornness, panicky reluctance to change the planned plan;
• the requirement to do everything “just like him”, an inexplicable inability to cede part of the work to other people.

The last point is worth considering in a little more detail. The fact is that the anankast is absolutely convinced that he is the only one who performs some type of activity the way it needs to be performed. And it doesn’t matter what it is: drawing up an important financial report or hanging the keys to offices on the nails of the duty officer at the entrance.

At work

Watch your boss. If he cannot and does not want to disrupt the algorithm according to which his work proceeds, he has difficulty delegating authority, and demands that everything be strictly done only as he says, you have a possible anankasta in front of you. There are many of them in leadership positions.

At the same time, he is absolutely sure that he is doing everything correctly, this is the only way it should be, there are no more options. He has pens and pencils lined up on his desk, his monitor stands in a strictly certain place without a single speck of dust, and his keyboard lies at a certain angle. The chief anankast will require, for example, that the numbers in the report appear not on the left or in the middle of the column, but strictly on the right. Lack of understanding on the part of colleagues of such subtleties makes the patient with anancastic disorder angry and refuse to work with such “stupid” employees.

How to avoid making a mistake with a diagnosis?

In order to have confidence in the diagnosis, the sick person must meet certain characteristics, which usually appear already at the initial stage of the formation of personal qualities. When anancaste disorder develops, a person becomes stingy. He is constantly concerned about saving a certain amount for an emergency. This could be a natural disaster, catastrophe, or other reason.

In this situation, a person perceives financial well-being not just as money, but as an opportunity for salvation. It is difficult, almost impossible, to convince such a person and force him to make concessions; he desperately defends his opinion, absolutely confident that he is right.

Clear signs of the disease

In his youth, the future anankast is shy and always overly controls himself. To accurately make such a diagnosis, you need to identify four or more of the following signs that appear as a person matures.

1. Excessive attention to details and rules, strict adherence to the plan, often to the detriment of the result and meaning.
2. Perfectionism leads to relationship problems.
3. Excessive immersion in work at the expense of leisure, even when there is no obvious lack of finances.
4. Excessive desire to accumulate money, condemnation of unnecessary spending. Every penny seems wasted.
5. Such people do not know how to cooperate with others.
6. Inflexibility in all areas.
7. Discomfort when changing the familiar environment, any repairs and rearrangements are painful for anankast; he has difficulty parting with old things.
8. Emotions are under strict control and often do not appear.
9. It is difficult to make contact with new people.

Establishing diagnosis

The diagnosis is made based on the analysis of the following psychopathological symptoms:

• constant doubts and anxiety;
• pathological perfectionism;
• painful pedantry;
• excessive detail;
• stubbornness;
• requiring others to comply with its rules;
• suppression of one's own desires for the sake of one's own rules.

It is believed that if a person has at least three of the listed signs, then such a person is anankast.

Diagnostics

If we talk about making a diagnosis, this should be done only after appropriate observations of a person’s behavior over a certain period of time. It is advisable to make a diagnosis when a person reaches adulthood, since character traits characteristic of young people in adolescence should also be taken into account.

To make an accurate diagnosis, the following important aspects must be taken into account:

1. Manifestations of the disorder must be total and independent of circumstances.
2. Stability of symptoms that were observed in adolescence and continue to be present in older age.
3. Excessive tendency to doubt, which cannot be confused with a person’s everyday doubts in connection with life circumstances.
4. Unreasonable occurrence of persistent thoughts that do not change over time.
5. The presence of perfectionism, which prevents the person from achieving the goals and objectives set for him.

Treatment of anancastic personality disorder

Psychotherapeutic treatment of anancastic personality disorder is aimed at eliminating the anxious and suspicious state and depends on the severity of the disorder and the discomfort caused. Patients accept all methods of psychotherapeutic treatment on a conscious level, but on an unconscious level they show strong resistance.

In severe forms of anancastic personality disorder, anxiolytics and atypical antipsychotics are used. For minor manifestations of autonomic disorders, beta-blockers are indicated.

There are contraindications, consultation with a specialist is necessary!

For anancastic personality disorder, which is accompanied by depression, the doctor prescribes antidepressants. If the disorder is one of the symptoms of a mental illness, treatment is aimed at treating the underlying disease.

In most cases, manifestations of anancastic personality disorder can be eliminated or minimized within a year from the start of treatment. If symptoms persist, the disorder becomes chronic.

Treatment of the disease

Anancastic personality disorder must necessarily be subject to comprehensive treatment. During therapy, it is worth paying increased attention to the patient’s desire to actively control emotional manifestations. Methods of therapy:

1. Immerse yourself in creativity by allowing the patient to express his experiences, for example, in form and color.
2. Group classes give excellent results, but at the stage of psychopathy they are not always possible.
3. To eliminate vegetative manifestations (increased sweating and blood pressure, increased heart rate), additional consultations with cardiologists, neurologists, prescription of psychotropic drugs and other drugs are necessary. Competent and timely treatment of anancastic personality disorder will help return a full-fledged healthy person to society.

Possible complications and consequences

The main consequence of anancastic personality disorder is a significant change and (or) deviation from generally accepted behavioral norms and trends accepted in a specific social environment, accompanied by personal and social disintegration.

Anancastic personality disorder often accompanies mental illnesses such as autism, manic-depressive psychosis, and schizophrenia.

In this case, there is the formation of certain disturbances in the actions, thinking and perceptions of others, which leads to a deterioration in the quality of life of the patient and his immediate environment.

Prevention of anancastic personality disorder

• Prevention of traumatic influences
• Proper child rearing
• Changing patients' attitudes towards traumatic situations using persuasion, self-hypnosis, suggestion.

Jealousy and... greed?

Anancasts usually occupy leadership positions. They are jealous - they feel betrayed when part of their work is entrusted to a more active and flexible person. And if not, how does it all end? A patient with anancaste disorder takes on all the work on himself, and this leads to emotional and moral exhaustion, since this is an unbearable burden. Greed? Rather, the desire to do everything with dignity, in the best possible way. The best. The problem of a perfectionist. Try to praise such a person - he will look ten years younger, he will be so pleased!

But if the anancast stalls, he gets bogged down in details, misses deadlines, and gets fired. As a result, he suffers even more from the fact that he could not do what he should, eats himself, plunging deeper into the disease, leaving society in the wilds of his personality: a vicious circle results.

Forecast

In most cases, the prognosis is favorable. Manifestations of anancaste disorder can be eliminated or reduced to an acceptable level within a year from the start of treatment. If its symptoms persist, the disorder becomes chronic, with periods of improvement and deterioration.

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