(reward dependence)
Norepinephrine
Relevant Stimuli
Novelty
Potential reward
Potential relief of monotony or punishment Conditioned signals for punishment, novelty, or frustrative nonreward Conditioned signals for reward or relief of punishment
人格障碍的诊断及治疗策 略解读
课程提纲
• DSM-IV和DSM-V系统人格障碍诊断的变化 • 精神动力学取向的诊断 • SWAP-200
– 简介 – 用SWAP-200做诊断 – 不同的人格障碍和治疗策略
• 案例研究（边缘、自恋和表演）
人格障碍的诊断及治疗策略
DSM-IV和DSM-V人格障碍诊断及 变化
Behavioral activation (novelty seeking)
Principal Monoamine Neuromodulator
Dopamine
Behavioral inhibition (harm avoidance)
Serotonin
Behavioral maintenance
人格维度
子因素
开放性（Openness）
思想、幻想、审美、行动、情感、价值观
尽责性（Conscientiousness） 能力、秩序、责任感、上进心、自律、深思熟虑
外向性（Extraversion） 乐群、自信、活跃、兴奋寻求、积极情绪、热心
随和性（Agreeableness） 神经质（Neuroticism）
DSM 类别系统
D S M -I (1 9 5 2 )
P e rs o n a lity P a tte rn D is tu rb a n c e
In a d eq u a te P a ra n o id C y c lo th y m ic S c h iz o id
D S M -II (1 9 6 8 )
2. Character Domains (Moderately influenced by family environment, only weakly heritable) a. Self-transcendence （超越） b. Cooperativeness c. Self-directedness
A n tis o c ia l D y s s o c ia l
A s th e n ic A n tis o c ia l E x p lo s iv e
D S M -III (1 9 8 0 )
A x is I c y c lo th y m ic d iso rd e r
C lu s te r A P a ra n o id
1. Temperament Domains (Moderately heritable, not greatly influenced by family environment) a. Novelty Seeking b. Harm Avoidance c. Reward Dependence d. Persistence
In a d eq u a te P a ra n o id C y c lo th y m ic S c h iz o id
P e rs o n a lity T ra it D is tu rb a n c e
E m o tio n a lly u n s ta b le P a ss ive -a g g re ss ive
信任、坦率、利他、顺从、谦逊、温和 焦虑、敌意、抑郁、自我意识、冲动、脆弱
Three Major Brain Systems Influencing Stimulus – Response Characteristics
Brain System (Related Personality Dimension)
Behavioral Response
Exploratory pursuit Appetitive approach Active avoidance, escape
Passive avoidance, extinction
Resistance to extinction
Cloninger’s Seven-Factor Model
Type Sanguine Melancholic Choleric Phlegmatic
Style
Hopeful Enthusiastic
Optimistic
Sad
Irascible Irritable Apathetic
Slow
维度 类别
人格的维度系统
• Interpersonal Circumplex - Leary, Wiggins, Kiesler • Three factors - Eysenck & Eysenck • Four factors - Livesley et al., Clark et al. • Five factors - Costa & McCrae • Seven factors - Cloninger et al.
人格？
韦 小 宝
迈克 ·泰森
看电影迟到了， 拿着票却被看门 老头拦在门口， 说必须等到下一 场才让进。
林 黛 玉
许三多
Hippocrates Classification
Element Air
Earth Fire Water
Humor Blood Black Bile Yellow Bile Phlegm
d ep en d en t typ e a g g re s s ive ty p e
H y s te ric a l P a ss ive -a g g re ss ive
C o m பைடு நூலகம் u ls iv e
O b s e s s iv e -c o m p u ls iv e
S o c io p a th ic P e rs o n a lity D is tu rb a n c e