Dergi Ara >>
Yıl:2008; Cilt: 2; Sayı: 1-2>> Özet
TAM METİN
Psikiyatride Derlemeler, Olgular ve Varsayımlar (RCHP); 2008;2(1-2):7-18
Kişilik, Huy ve Psikopatoloji
S Aslan
Gazi Üniversitesi Tıp Fakültesi, Psikiyatri Anabilim Dalı
Kişilik nedir? Bizim kişiliği tanımlamamız klinikte gözlemlediğimiz bozuklukları kavramamızı nasıl etkiliyor? Farklı
yapılarda kişiliğin en iyi tanımı nasıl yapılabilir? Bu yazıda bu sorular üzerinde durulacaktır.
Kişilik içsel kaynaklardan ortaya çıkan ve yaygın olarak kişinin davranışlarına hakim olan, biyolojik yapı ve deneyimle
öğrenilenleri kapsayan, algılama, öğrenme, düşünme, başa çıkma ve davranış örüntülerini anlatmaktadır. Kabaca
bir ayrım yapılırsa huy kişiliğin biyolojik, karakter ise yetiştirilme ile öğrenilen sosyal ve kültürel yönlerini içermektedir.
Kişilik huy ve karakterin dinamik etkileşiminin bir sonucudur.
Kişilik özelliklerinin sınıflandırma çabaları çok eskilere dayanmaktadır. Kategorik modellerin yanı sıra boyutsal
modeller son yıllarda ön plana çıkmıştır. İdiografik model kişiliğin sınıflanamayacağını her kişiliğin kendine özgü bir
yapı oluşturduğunu varsayarken, nomotetik model ise bir sistem olan kişiliğin sınıflanabileceğini varsaymaktadır.
Bu yazıda kişilik ve psikopatolojiyi tanımlayan psikoanalitik karakter kavramı ve Kernberg'i n modeli, tanımlayıcı
(descriptive) psikiyatrinin kategorik modeli ve kategorik modelin getirdiği sorunlar tartışılmıştır. Kategorik yaklaşım
kişilik yapısını yeterince tanımlayıcı değildir. Kategorik yaklaşım yüksek komorbidite oranları doğurmaktadır ve
tanısal geçerliliği düşüktür. Buna karşın boyutsal modelin tanımlamadaki eksiklikleri tek başına açıklayıcı olmasını
engellemektedir. Kişiliği ve psikopatoloji ilişkisini açıklayan spektrum modeli ve daha ayrıntılı olarak boyutsal
modeller incelenmiştir. Beş faktör modeli ve Cloninger'i n psikobiyolojik modelinin klinik araştırmalarla ilişkisi ayrıntılı
incelenmiştir. Tanısal değerlendirmede diğer bir seçenek ise kategorik çok eksenli sınıflandırmaya (taxonomy) yeni
bir eksen olarak boyutsal değerlendirmenin eklenmesidir.
Halihazırda kullanılan sınıflayıcı DSM modeli yetersizliklerine rağmen klinisyenler arasında ortak bir dil oluşturma
açısından oldukça yararlıdır. Bununla birlikte boyutsal (dimentional) değerlendirmenin sınıflandırma sistemine
girmesi, DSM kategorilerinin yerini almasa bile ayrı bir eksen olarak huy ve karakter özelliğinin de değerlendirilmesi
hiç klinik pratikte hastaların tanımlanması ve tedavi planı için bütünleyici/tamamlayıcı bir rol üstlenerek yararlı
olabilir.
Personality, Temperament and Psychopatology
What is personality? How does our definitions of personality affect understanding clinical pictures of personality
disorders? How can the content of different personality structrure best described? In this article we searched
answers for this qeustions.
Personality is seen as a complex pattern deeply embedded psychological characteristics that are expressed
automatically in almost every area of psychological funtioning. Basically character refers to social and
pychological charactersitics acquired during upbiringing. Temperament refers basic biological disposition that
affect behaviours. Personality is resulted of dynamically enteraction of character and temperamental features.
Taxonomy efforts in personality disorders have a long history. Beside categorical models recently dimentional
models becaming popular. Idiographic model assumed that inividuals personality can not be classified into
different types, and can not be measured quantitatively. Whereas nomothetic model suggested that personality
can be classified as system structure, and could be measured.
In this review psychoanalytic character concept, Kernberg's contrbuitons to the model, descriptive model of
classification and its flaws were discussed. Categroical classifications could not descirbe clinical structure of
personality, diagnositical validty was lower and have a higher comorbidity frequency. Unfortunately dimentional
models insufficient to explain entire personality structure. Personality and its relationship beetwen psychopathology
were also discussed. Five factor model and Cloninger's psychobiological model and its relationship with clinical
studies were reviewed. In diagnositical taxonomy other choice may be adding dimentional axis to mulitaxial
model of DSM classification.
Currently used official classification system Daignositical and Statistical Manual for Mental Disorders (DSM) is
helpfull for creating common [language] among clinicans. On the other hand adding offcial classification system
dimentional assessment as a new axis, assessment of temperament and character features as a integrative/
complementary role and would be helpfull.


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