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Definition of Erratic Behavior Disorder in Children or Adults


Dopamine D2 receptor gene variants: association and linkage studies in erratic behaviour disorders in children and adults.
Blum K, Sheridan PJ, Wood RC, Braverman ER, Chen TJ, Comings DE.
Department of Pharmacology, University of Texas Health Science Center, San Antonio 78284, USA.

Drug and alcohol seeking behaviour has become a great global problem affecting millions of inhabitants with a cost to society in the billions. Dopaminergic reward pathways have frequently been implicated in the etiology of addictive behaviour. While other neurotransmitters have also been implicated, to date the only molecular genetic defect which has been found to associate with alcoholism, drug dependency, obesity, smoking, pathological gambling, attention-deficit-hyperactivity disorder (ADHD), Tourette syndrome, as well as other related compulsive behaviours, are the variants of the dopamine D2 receptor gene (DRD2). In this review of the available data on the subject, we report a number of independent meta-analyses that confirm an association of DRD2 polymorphisms and impulsive-additive-compulsive behaviour (IACB), which we have termed "Reward Deficiency Syndrome". While we agree that Meta-analyses of all exant studies support an association of variants of DRD2 and IACB, correct negative findings with alcoholism may be due to differences in assessing controls and inclusion/exclusion criteria for selection of diseased probands.

Med Hypotheses. 2004;63(3):538-48.

Erratic Behavior


Histrionic (Hysterical) Personality: People with a histrionic personality conspicuously seek attention, are dramatic and excessively emotional, and are overly concerned with appearance. Their lively, expressive manner results in easily established but often superficial and transient relationships. Their expression of emotions often seems exaggerated, childish, and contrived to evoke sympathy or attention (often erotic or sexual) from others. People with a histrionic personality are prone to sexually provocative behavior or to sexualizing nonsexual relationships. However, they may not really want a sexual relationship; rather, their seductive behavior often masks their wish to be dependent and protected. Some people with a histrionic personality also are hypochondriacal and exaggerate their physical problems to get the attention they need.

Narcissistic Personality: People with a narcissistic personality have a sense of superiority, a need for admiration, and a lack of empathy. They have an exaggerated belief in their own value or importance, which is what therapists call grandiosity. They may be extremely sensitive to failure, defeat, or criticism. When confronted by a failure to fulfill their high opinion of themselves, they can easily become enraged or severely depressed. Because they believe themselves to be superior in their relationships with other people, they expect to be admired and often suspect that others envy them. They believe they are entitled to having their needs met without waiting, so they exploit others, whose needs or beliefs they deem to be less important. Their behavior is usually offensive to others, who view them as being self-centered, arrogant, or selfish. This personality disorder typically occurs in high achievers, although it may also occur in people with few achievements.

Antisocial Personality: People with an antisocial personality (previously called psychopathic or sociopathic personality), most of whom are male, show callous disregard for the rights and feelings of others. Dishonesty and deceit permeate their relationships. They exploit others for material gain or personal gratification (unlike narcissistic people, who exploit others because they think their superiority justifies it).

Characteristically, people with an antisocial personality act out their conflicts impulsively and irresponsibly. They tolerate frustration poorly, and sometimes they are hostile or violent. Often they do not anticipate the negative consequences of their antisocial behaviors and, despite the problems or harm they cause others, do not feel remorse or guilt. Rather, they glibly rationalize their behavior or blame it on others. Frustration and punishment do not motivate them to modify their behaviors or improve their judgment and foresight but, rather, usually confirm their harshly unsentimental view of the world.

People with an antisocial personality are prone to alcoholism, drug addiction, sexual deviation, promiscuity, and imprisonment. They are likely to fail at their jobs and move from one area to another. They often have a family history of antisocial behavior, substance abuse, divorce, and physical abuse. As children, many were emotionally neglected and physically abused. People with an antisocial personality have a shorter life expectancy than the general population. The disorder tends to diminish or stabilize with age.

Borderline Personality: People with a borderline personality, most of whom are women, are unstable in their self-image, moods, behavior, and interpersonal relationships. Their thought processes are more disturbed than those of people with an antisocial personality, and their aggression is more often turned against the self. They are angrier, more impulsive, and more confused about their identity than are people with a histrionic personality. Borderline personality becomes evident in early adulthood but becomes less common in older age groups.

People with a borderline personality often report being neglected or abused as children. Consequently, they feel empty, angry, and deserving of nurturing. They have far more dramatic and intense interpersonal relationships than people with cluster A personality disorders. When they fear being abandoned by a caring person, they tend to express inappropriate and intense anger. People with a borderline personality tend to see events and relationships as black or white, good or evil, but never neutral.

When people with a borderline personality feel abandoned and alone, they may wonder whether they actually exist (that is, they do not feel real). They can become desperately impulsive, engaging in reckless promiscuity , substance abuse, or self-mutilation. At times they are so out of touch with reality that they have brief episodes of psychotic thinking, paranoia, and hallucinations.

People with a borderline personality commonly visit primary care doctors. Borderline personality is also the most common personality disorder treated by therapists, because people with the disorder relentlessly seek someone to care for them. However, after repeated crises, vague unfounded complaints, and failures to comply with therapeutic recommendations, caretakers—including doctors—often become very frustrated with them and view them erroneously as people who prefer complaining to helping themselves.




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