Personality Disorders

. A heterogeneous group of disorders that are coded on Axis II of the DSM andare regarded as longstanding, permanent, and inflexible patterns of behaviorand mental experience that deviate from the expectations of a person's cultureand that impair social and occupational functioning and may cause emotionaldistress.

Three Clusters:. Odd/Eccentric - Cluster A

o Paranoido Schizoido Schizotypal

. DramaticlErratic - Cluster Bo Borderlineo Histrionico Narcissistico Antisocial

. Anxious/Fearful- Cluster Co Avoidanto Dependento Obsessive compulsive

. DSM-IV-TR Criteria for,Paranoid PersonalityDisorder

Presence of four or more of the fol-

lowing and not occurring exclusivelyduring a course of schizophrenia,psychotic depression, or as part of apervasive developmental disorder;also not due to a general medicalconcjitioo:

. Pervasive suspicioushess.bfbeing harmed, deceived, or

. exploited. Unwarranteddoubtsaboutthe

loyalty or trustworthiness offriends or associates

. Reluctanceto confideinothersbecause of preceding criterion

. Hiddenmeaningsread intotheinnocuous actions of others

. Grudgesforperceivedwrongs

. Angryreactionsto perceivedattacks on character or reputa-tion

. Akinto firsttwo criteria,unwar-ranted suspiciousness of thefidelityof spouse or other sexualpartner

. DSM-IV-TR Criteria for- Schizoid Personality

Disorder

Presence of four or more of the fol-

lowing and not occurring exclusivelyduring a course of schizophrenia,psychotic depression, or as part of apervasive developmentaf disorder;also not due to a general medicalcOJldition: .

. Lack of desire or enjoyment ofclose relationships.

. Almost e~9lusivepreference forsolitude

. Uttle interest in sex withothers

. Few ifany pleasures

. Lack of friends

. Indifferenceto praise or criticismfromothers

. Rat affect,emotionaldetachment

. DSM-IV-TRCriteria for- Schizotypal Personality

Disorder

Presence of five or more of the fol-

lowing and not occurring exclusivelyduring a course of schizophrenia,psychotic depression, or as part of apervasive developmental disorder:. Ideasofreference .

. p!!.Culiarbeliefsor magical think-ing, e:g., beliefin~xfrasensorypercep~iQ(L ....

. Unusualpe.rceptions,e.g., dis-torted beliefsabout one's body

. Peculiarpatternsofspeech

. Extremesuspiciousness,para-noia

. Inappropriateaffect

. Odd behavioror appearance

. Lackof close friends

. Extremediscomfort and some-times extreme anxietyaroundother people

. DSM-IV-TR Criteria forBorderline PersonalityDisorder '

. DSM-IV-TR Criteria forHistrionic PersonalityDisorder

, '

Presence of five or more of 1hefol- : Presenceof five or more of the fol-

lowing: j' ,i lowing ,8 Franticefforts to avoidabandon-; . Strong need to be the:center of,

ment, both real arid imagined, " attention /' , ,

. Instabilityand ,extremeintel)sity 8 Inappropriatelx,sex.uallysedJc,.,.'

in interpe~pnal relationships,'. .. tive behavior/ " " , ,

,_marked bysp1itting,t~an§>,.ide- . _,8a'pidlys~.ittingexpressio,n.-of-alizing6thers in ope'm9ment -emotions','"",'

aQdrevjlil]g-thei'n~ge'riext ' . ,LJ,seotp-bysicarap~iance to. Unstable~~oseofself drawatterjti9n,tc{self

,. Impulsivebehavior, including .~Speectl excessivelyimpression-reckless spending and sexual istic, passionatelyheld opinionspromiscuity lacking in detail

. Recurrentsuicidal (gesturesas . Exaggerated,theatrical emo-well as genuine attempts) and tional expressionself-mutilating behavior 8 Overly suggestible

8 Extremeemotional lability . Misreads relationshipsas being8 Chronic feelingsof emptiness more intimate than they actually8 Extremeproblems controlling are

anger. Paranoidthinking and dissocia-

tive symptoms triggered bystress

. DSM-IV-TR Criteria forNarcissistic PersonalityDisorder

Presence of five or more of the fol-

lowing:8 Grandiose view of one's impor~

tance, arrogance-

8 Preoccupationwith one's suc-cess, brilliance,beauty.

8 - ~reme ~eed'for adlT1iration '. .. Strong sense of eotitler,nJ~nt

'.- Je.!1cJE?ncyJoexploit others

, ::! o~~~,,-~!,?JtI(;)rs":

. DSM-IV-TR Criteria forAntisocial PersonalityDisorder

Pervasivepattern of disregard for the

rights of others since the age of 15and at least three of the characteris-

tics 1 through 7 plus 8 through 10:

1. Repeated law-breaking2. Deceitfulness, lying

, ,3. Impulsivity"'4. Irritableness and aggressiveness

,,5. Reckless disregard for own

, safety and that6f others6. Irresponsibility as seen in unreli-

able employment history or not

meeting financial obligations7. Lack of remorse

8. Age at least 189. Evidence of conduct disorder

before the age of 1510. Antisocial behavior not occur-

ring exclusively during episodesof schizophrenia or mania

. DSM-IV-TR Criteria forAvoidant PersonalityDisorder

Presence of at least four of the fol- ;. I

lowing: '

. Avoidance of interpersonal con-tacts because of;fear.s of critic

cismor rejection" .',. Unwillingnessto get involved

, with,-other~.unless certai~.of- -being liked ' -

'. Restraintinintimaterelation-ships for fEJ~,ofbeing shamedor ridiculed

. Preoccupationaboutbeingcriti-cized or rejected

. Feelings of inadequacy

. Feelings of inferiority

. Extremereluctanceto trynewthings for fear of being embar-rassed

~-.' DSM-IV-TR Criteria for- Dependent Personality

Disorder'

Presence of at least fiveof the fol-lowing:. Difficultymakingdecisibns with-

out excessive advice ,and reas- ,

surance from <;>then~ , " "

. Need for others to take re;spon-sibilityfor moStmajor~s6f life

-. Difficultydisagreeingwith others-", for fea':.()f losing th~ir support

- -. "Difficultydoingthings on own" Becauseoflackofself-confi-

dence. Doingunpleasant things as a

way to obtain the approval andsupport of others

. Feelingsofhelplessnesswhenalone because of lack of confi-

dence in ability to handle thingswithout the intervention of others

. Urgentlyseekingof newrela-tionship when present one ends

. Preoccupationwithfearsofhaving to take care of self

. DSM-IV-TR Criteria for

Obsessive-CompulsivePersonality Disorder

Presence of at least four of the fol-lowing:. Preoccupation with rules and

details to the extent that the,major point of an activityis lost

. Extremepertec~ionismto the,_._degreethat.projects are seldom-, --complefed.- ,!;x,ces,sivedevotiol)towork to

the exclu~ionof ieisureand- Triehdships

. Inflexibilityabout morals

. Difficultydiscardingworthlessitems

. Reluctanceto delegateunlessothers conform to one's stan-dards

. Miserliness

. Rigidityandstubbornness