[Abstract] Abnormal psychology and personality disorder are the common mental diseases and highly harmful to human health. According to statistics, mentally induced diseases account for more than 70%. Previously, the poor understanding of their pathogenesis and the lack of effective control measures led to poor clinical curative effect. With the development of immunology in recent years, scientists now have greatly improved knowledge on allergic diseases and personality disorder. But this discipline of science is just in its beginning, there remain a lot of aspects to be explored.
[Key words] Abnormal psychology Personality Psychological diseases


Abnormal Psychology
Abnormal psychology refers to unhealthy mental activities which deviate from normal scope. The word "abnormal" differs from "normal" in relative significance. Abnormal psychology is affected by a variety of factors including social environment, habits and customs, culture, sense of value and religious mode. No absolute or definite demarcation line can, therefore, be drawn between normal psychology and abnormal psychology.
Abnormal psychology in a broad sense refers to irrealizable, irrational or unhealthy psychologic development that happens in normal persons, such as contrary psychology, day dream, sexual hallucination, self-love, idolum, projective psychology, anagogy and so on.
Abnormal psychology in a narrow sense refers to all types of abnormal personality, sexual perversion, dependence on alcohol, opium, heroin or other drugs, neuroses, psychonosema caused by brain trauma, epilepsy or somatic disease and various mental diseases.

Author's unit: Guangdong Gaoming Medical and Medicinal Institute of Encephalopathy, Gaoming, Guangdong 528500.
Abnormal Personality or Personality Disorder
Personality disorder in a narrow sense refers only to moral or antisocial personality and that in a broad sense includes all personality disorders.
Personality is an enduring disposition to act and feel in particular ways that differentiate one individual from another. These patterns are sometimes conceptualized as different categories and sometimes as different dimensions. Normal personality also differs from abnormal personality relatively. No absolute demarcation line can be drawn between abnormal personality and normal personality and between abnormal personality and nervous disease or mental disease. Only when an individual's personality defect is so severe that his social adaptive capacity is highly affected and gives much trouble to people around him can the individual be regarded as having abnormal personality.
Abnormal personality can be attributed to the following three factors:
1. Organic or biologic factors
Genetic factors play a certain role in the formation of abnormal personality. It has been shown by relevant data that the incidence of criminal offence, nervous disease, suicide, getting drunk and creating a disturbance, mental disease, intellectual maldevelopment, personality defect or abnormal personality in families with abnormal personality far exceeds that in families with normal personality. In addition, abnormal personality can often be found in sequelae of brain injury due to brain trauma and encephalitis and sequela state of chronic epilepsy and schizophrenia. Persons with sex chromosome abnormalities can also have concomitant abnormal personality or antisocial criminal impulse. An electroencephalogram screening made in a larger part of patients with abnormal personality showed that the abnormality rate of electroencephalogram in these patients is by far higher than that in the control group consisting of normal persons. These data suggest that organic factor of the brain plays a certain role in part of patients with abnormal personality.
2. Psychological factors
The psychological factors refer mainly to psychic trauma in infancy, improper upbringing, particularly the maternal deprivation and being maltreated in infancy, the effect of a broken-up family on child's psychology, over-spoiling a child (particularly the only son or daughter) of parents, inconsistent or incoherent family education of parents, and the bad examples of degenerated parents. In view of the fact that the most important period for an individual's personality to form is before 5-6 years of age, carelessness in the psychologic development of children in this period is liable to cause some type of mental disease or to commit a crime or both after growing up.
3. Harmful effects of social environment
Harmful society will create contrary psychology or spiritual contamination derived from direct environment. A most striking example is the poison and destroyment of the so-called "great proletarian cultural revolution" to young people's ideology, this "revolution" brought about quite a lot of people with abnormal psychology or personality. In addition, some unhealthy tendencies and irrational phenomena in real society, various spiritual contaminations and such actual problems as educational deprivation, unemployment and disappointment in a love affair are liable to evoke great indignation, resistance, repression, faith crisis, pessimism, giving oneself up as hopeless and drifting with the tide, thus developing personality disorder.
Classification of Abnormal Personality
1. Antisocial Abnormal Personality
It is also called "grim abnormal personality" and is the type of being most liable to have criminal or illegal activities. Various bad behaviors and habits start often with childhood, including telling lies, cutting class, stealing, coming to blows, roaming the streets and disturbance of sexual behavior. This is the origin of "problem child", who will finally become an individual typical of this abnormal personality after growing up.
A thorough investigation and study has shown that individuals with this type of abnormal personality have the following 16 characteristics: (1) having good intelligence and being superficially likable; (2) lack of delusion and other mental manifestations of irrational thought; (3) lack of clinical manifestations of neurosis; (4) putting no trust in others; (5) dishonesty; (6) shamelessness and regretlessness; (7) having antisocial behaviors of harbouring evil intentions or doing a mischief without particular purpose; (8) morallessness and lack of correct judgement between good and evil and between right and wrong, and not drawing a lesson; (9) extreme selfishness and self-centredness; (10) unfeelingness, not loving others, showing indifference to the sufferings of others; (11) lack of self-knowledge; (12) being not amenable to reason and not responsible for interpersonal relationships; (13) being fond of fantasy, addicted to drink or not; (14) having abnormal or disturbed sexual life; (15) rarely having a real suicide unless being put in a hopeless situation or committing suicide to escape punishment; and (16) often accomplishing nothing in the program for life.
Those who have this type of abnormal personality often act impetuouly on impulse, thus bringing about sufferings of others and not themselves. However, they are, in fact, not real psychotics and according to the stipulation of Article 15 of Chinese Corporal Punishment they have complete ability to bear responsibility for their own behaviors.
No specific drugs for correcting or treating antisocial abnormal personality are available at present. Education and prevention remain the methods of first choice. Great attention should be paid to mental health of childhood, and behavioral problems and abnormal psychological tendencies exposed during childhood should be solved by the method of patient education and instruction.
2. Paranoid Personality Disorder
It is a personality distinguished by such traits as excessive sensitivity to rejection by others, subjectivity, stubbornness, suspiciousness, hostility, and self-importance. This type of personality disorder, though it may be premorbid personality basis of paranoid psychosis, differs from the latter in lack of such mental symptoms as true pathologic delusion.
No specific drugs for this type of personality disorder are available, psychotherapy and nerve block therapy are generally used.
3. Schizoid Personality Disorder
It is a personality characterized by solitariness, emotional coldness to others, excessive introspection, and eccentricity of behavior. Generally speaking, persons who have schizoid personality may have good intelligence, some may achieve great successes in natural science, philosophy, literature or art. Some schizophrenics have this personality before their illness, but most schizoid personalities do not become schizophrenic. Schizoid personality differs from schizophrenia in two main points: (1) lack of particular symptoms seen in schizophrenia, including hallucination, delusion, apathy or affective ambivalence, thought incoherence and behavioral disturbance, and possessing some adaptive capacity of real life; (2) relative stability of schizoid personality disorder throughout one's life with rare development of mental deterioration.
There are no specific remedies for this type of personality disorder. Care must be taken to avoid mental stimulation and to prevent the development of schizophrenia under malignant stimulation.
4. Affective Personality
Affective personality can be divided into the following three subtypes:
(1) Depressive Personality It is a mental state characterized by excessive sadness, emotional coldness to others and apathy. Activity can be agitated and restless or slow and retarded. Behavior is governed by pessimistic or despairing beliefs, and sleep, appetite, and concentration are disturbed. Depressive personality is liable to develop reactive depression under harmful effects.
(2) Manic Personality It is a state of mind characterized by excessive cheerfulness and increased activity. The mood is euphoric and changes rapidly to irritability. Behavior is overactive and extravagant.
(3) Cycloid Affective Personality It is characterized by a circular affective fluctuation and manifested as manic personality in mood elevation and as depressive personality in mood depression but the affective fluctuation is not so severe as to develop manic-depressive psychosis. An investigation made on the above-mentioned three subtypes of affective personality showed that the incidence of similar personality manifestations or of manic-depressive psychosis in families of persons who have affective personality disorder is significantly higher than that in normal population. Therefore, affective personality disorder may be related to the imbalance of catecholamine in the brain and to genetic factors. There are also no specific remedies for these above-mentioned personalities. It is important to avoid mental stimulation to prevent the development of reactive depression or accident of suicide under harmful stimulations. Small doses of anti-manic or anti-depressive drugs may also be tried.
5. Obsessive-compulsive Personality
It is manifested as overcautiousness, stubbornness, following rules, orders, etc. docilely, setting excessively strict demands on oneself and on others, demanding perfection, excessive frugality or even stinginess, fear of contamination and so on. There is no obvious obsession or compulsive behavior in obsessive-compulsive personality. It can be treated with behavior therapy and also with psychotherapy.
6. Hysterical Personality
It is more commonly found in females, characterized by instability and shallowness of feelings, by vulnerability to suggestion and by superficiality and a tendency to manipulate in personal relationships, and also called "dramatic personality". Patients with such symptoms are usually treated with psychotherapy and behavior therapy.
7. Delicate Personality
It can be divided into subtypes of dependence personality, passive personality and energy-vigour deficiency personality. Its features are lack of initiative, deficiency of energy vigour, being dependent on others and highly sensitive to mental stimulation, emotional instability and lack of joys of life. Persons with this personality are liable to suffer from neurasthenia, anxiety, hypochondria, depression, etc. The main point of control is to pay attention to mental health of children in addition to psychotherapy.
8. Explosive Personality
It includes aggressive personality, excitable personality, agitating personality, emotional instability-type personality, argumentative-type personality, and paranoid personality. It is characterized by explosion of very strong anger and impulse due to minor mental stimulation which is difficult to control by oneself and liable to evoke violent aggressive behavior. It is also known as episodic dyscontrol syndrome. Generally speaking, persons with this type of personality do not necessarily have antisocial tendency but may, under harmful effects, commit an offence against the law and usually have a certain responsibility for a crime. Psychotherapy is usually the method of choice, adequate amount of psychosedative may also be used in stage of attack.
9. Infantilism-type Personality
It is characterized by emotional immaturity and behavioral infantilism and sometimes accompanied by mild oligophrenia. No specific remedies are available for this type of personality.
10.Organic Personality Disorder
It is also called organic abnormal personality, refers to changes in personality due to organic changes of the brain, and is generally manifested as degenerated morals and ethics and some moral antisocial behaviors. Such diseases as craniocerebral trauma, encephalitis, meningitis, presenile encephalatrophy, brain tumor, birth trauma and cerebral lesion syndrome can all lead to the development of organic personality disorder. In addition, epileptic personality and schizoid personality disorder also belong to this category.
Epileptic personality disorder found in epileptics with long-term grand mal epilepsy is characterized by too long-winded and repetitious speech, a suspicious frame of mind, strong retaliation, liability to be irritated, hot-temperedness, and sometimes violent behavior due to minor problem. Sometimes, patients with epileptic personality disorder may fall into pathological affect state under strong mental stimulation (with concomitant obvious disturbance of consciousness), thus evoking severe impulses and harmful acts. Antiepileptics and tranquilizers are indicated.
Schizoid personality disorder is characterized by solitariness, emotional coldness to others, excessive introspection, and eccentricity of behavior. Some schizophrenics have this personality before their illness, but most schizoid personalities do not become schizophrenic. Patients with schizoid personality disorder should be followed up, re-examined and treated promptly to prevent development or relapse of schizophrenia.
In the presence of illegal activities, patients with the above-mentioned organic personality disorder generally have part of responsibility for a crime.
11.Other Psychopathic Behaviors
Principally, there are the following three
kinds:
(1) Munchhausen's syndrome It is a
mental disorder in which the patient persistently tries to obtain hospital treatment for an illness that is nonexistent, an extreme form of malingering. The disease may be described in vivid detail, and in some cases injury may be deliberately self-inflicted in an attempt to give the appearance of authenticity to the claims being made.
(2) Kleptomania It is a pathologically strong impulse to steal, often in the absence of any desire for the stolen object(s). It is sometimes associated with depression. This abnormal behavior differs from both "psychiatric collection", which is seen in senile dementia and chronic schizophrenia, and general hardened thief, but, generally speaking, persons with kleptomania have part of responsibility for a larceny.
(3) Pyromania It is an excessively strong impulse to set things on fire, often in the absence of any desire for retaliation, destroyment, frame-up or other motives. If there is special sexual pleasant sensation in setting things on fire, the pyromania is known as "pyroerotomania". It should be differentiated from general arsonists. Persons with pyromania or pyroerotomania should have part of responsibility for committing arson.
Psychotherapy is indicated to the above-mentioned three psychopathic behaviors.
Sexual Perversion or Parasexuality
It refers to any abnormal sexual behavior. The abnormality may be in the sexual object or in the activity engaged in. The activity is sexually pleasurable. The definition of what is normal varies with different cultures. Treatment is necessary only when the perversion causes suffering.
1. Homosexuality
Homosexuality refers to the condition of being sexually attracted, covertly or overtly, by members of one's own sex, it can affect either sex. The cause of homosexuality remains unclear, although explanations in terms of either a deviant family structure or an environment with limited opportunities for heterosexual contacts are increasingly accepted. The vast majority of homosexuality is due to lopsided development of sexual psychology except that a minority of it (less than 5%) may have morphological abnormality of sex chromosome, true or false hermaphroditism or cryptorrhea. Therapy may be offered to individuals wishing to change their sexual orientation. There are no drugs available for changing sexual orientation, although it is possible to depress the sexual drive. Treatment consists of psychotherapy or specific behavior therapy designed to eliminate homosexual behavior and fantasy and to increase heterosexual behavior.
(1) Clinical Classification
Homosexuality is clinically divided into three main types:
(a) Active and Passive Type In homosexuality the one who plays the part of a husband is called active type and the other who plays the part of a wife is called passive type. The male passive type (excluding the unwilling follower) and the female active type have the most severe abnormal psychology, they are often the offenders to lure others to commit homosexuality and should be put under surveillance.
(b) Absolute and Relative Type The absolute type refers to the exclusive erotosexual demand on the same sex and the aversion to the opposite sex, also known as unipolar homosexuality. With erotosexual demand on both sexes, the name relative type or bipolar homosexuality is given. Although the one who has relative type homosexuality can get married and bear children, the one who has absolute type homosexuality, if married under social pressure without radical correction, will often have such sexual disorders as impotence and sexual coldness, with the result that their marriage breaks up and divorce follows.
(c) Transient or Compensatory Type Homosexuality It refers to the homosexual behavior occurred in special environment in which one lives without sexual partner for a long period. In most cases, it disappears after returning to normal surroundings, and psychological correction is easy, too.
(2) Prophylactico-therapeutic Measures
(a) Take positive education on legal system as the main measure, make homosexuals realize that homosexuality is a behavior contrary to our traditional morals and breaking the law of our country.
(b) Encourage the homosexuals to transfer their interest in this abnormal sexuality to proper beneficial activities.
(c) Behavior therapy It is a psychotherapy of conditional reflex of aversion, that is, a stimulation of a given form is given to a homosexual to induce his sexual impulse, followed by a stimulation of aversion (such as weak electric current stimulation or subcutaneous injection of apomorphine) to produce very unpleasant nausea and vomiting. Repeated stimulations in this way can lead to gradual extinction of homosexual psychology and sexuality.
(d) Drug assistance Homosexuals who do have cryptorrhea may be treated with sexual hormones on a trial basis, those who have secondary depression may be treated with anti-depression agents, and those who have too strong sexual impulse to control may be treated with tranquilizers.
In short, sexual perversion of homosexuality should be treated early and in a comprehensive way; the earlier the correction of the abnormal sexual psychology, the better the effectiveness.
2. Transvestitism
It refers to the condition in which sexual pleasure is obtained by dressing in the clothes of the opposite sex. It may occur in both heterosexual and homosexual people and may be directly related to masturbatory or other sexual behavior. Treatment may be by behavioral techniques such as aversion therapy, but is not always needed. If a person who has transvestitism acts indecently towards or rapes or seduces a woman, or has sodomy or indecent behavior or other criminal acts, he should bear complete responsibility for these illegal activities.
3. Transsexualism
It refers to the condition of one who firmly believes that (or she) belongs to the sex opposite to his (or her) biological gender. Surgical sex reassignment is sometimes justifiable, to make the externals of the body conform to the individual's view of himself (herself). However, in view of the fact that this surgical sex reassignment cannot radically correct the sexual perversion and is hard to produce satisfactory socio-psychological effect expected, the practice of making surgical sex reassignment is not accepted by medical circles of our country.
4. Fetishism
It refers to sexual attraction to an inappropriate object (known as a fetish). This may be a part of the body (e.g. the foot or the hair), clothing (e.g. underwear or shoes), or other objects (e.g. leather handbags). In all these cases the fetish has replaced the normal object of sexual love, in some cases to the point at which sexual relationships with another person are impossible or are possible only if the fetish is either present or fantasized. Treatment can involve psychotherapy or behavior therapy using aversion therapy.
5. Exhibitionism
Exposure of the genitals to another person, as a sexually deviant act. The incidence of this sexual perversion in foreign countries takes second place following homosexuality and that in China occupies first place because of lack of statistical data on homosexuality. Persons who have exhibitionism often hide in an out-of-the-way lane, get sexual pleasure by exposure of their genitals to young women they meet, then escape rapidly. Further obscene acts are rarely seen. Treatment can involve psychotherapy or behavior therapy using aversion therapy.
6. Voyeurism
It refers to the condition of obtaining sexual pleasure by watching other people undressing or enjoying sexual relations. Treatment consists of psychotherapy or behavior therapy using aversion therapy.
7. Sadism and Masochism
Sadism is found mainly in males and refers to sexual excitement in response to inflicting or thinking about inflicting pain upon other people. This type of sexual perversion can constitute a crime of wife's being maltreated.
Sadistic erotomania is frequently encountered in men who rape women, erotic amok is its most severe form. In erotic amok a phrenetic sexual pleasure is obtained by brutally killing females. An offender of erotic amok is sentenced by all countries of the world to the death penalty.
Masochism refers to sexual pleasure derived from the experience of pain. It is more commonly found in females. They often combine with sadistic erotomaniacs into partners.
8. Other Sexual Perversions
In addition to the above-mentioned seven common sexual perversions, there are also bestiality, necrophilia, incest erotism, girl-loving erotism, oral obscenity, friction obscenity, sexual asphyxia, fondness for pornographic books and obscene pictures, propensity to talk obscenely in telephone, and morbid masturbation.
The basic principle of correction and treatment of the above-mentioned various sexual perversions is the same as that of homosexuality.