Week 1: Personality Disorders
DSM-5: Personality Disorders
A personality disorder – is an enduring pattern of inner experience and behavior – that:
1. Deviates markedly from the expectations of the individual’s culture
2. Is pervasive and inflexible
3. Has an onset in adolescence – or early adulthood
4. Is stable over time
5. Leads to distress or impairment
There are different types of personality disorders – including:
Paranoid Personality A pattern of distrust and suspiciousness such that others’ motives
Disorder are interpreted as malevolent
Schizoid Personality A pattern of detachment from social relationships and a
Disorder restricted range of emotional expression
Schizotypal Personality A pattern of acute discomfort in close relationships, cognitive or
Disorder perceptual distortions, and eccentricities of behavior
Antisocial Personality
A pattern of disregard for, and violation of, the rights of others
Disorder
Borderline Personality A pattern of instability in interpersonal relationships, self-image,
Disorder and affects, and marked impulsivity
Histrionic Personality A pattern of excessive emotionality and attention seeking
, Disorder
Narcissistic Personality A pattern of grandiosity, need for admiration, and lack of
Disorder empathy
Avoidant Personality A pattern of social inhibition, feelings of inadequacy, and
Disorder hypersensitivity to negative evaluation
Dependent Personality A pattern of submissive and clinging behavior related to an
Disorder excessive need to be taken care of
Obsessive-Compulsive A pattern of preoccupation with orderliness, perfectionism, and
Personality Disorder control
Personality Change Due to A persistent personality disturbance that is judged to be due to
Another Medical the direct physiological effects of a medical condition – e.g.,
Condition frontal lobe lesion
1. The individual’s personality pattern meets the general
criteria for a PD, and traits of several personality
disorders are present – but the criteria for any specific
Other Specified Personality
PD are not met
Disorder and Unspecified
2. The individual’s personality pattern meets the general
Personality Disorder
criteria for a PD, but the individual is considered to
have a PD that is not included in the DSM-5
classification – e.g., passive-aggressive PD
,Personality Disorders - Clusters
The personality disorders are grouped into three clusters – based on descriptive similarities
1. Cluster A – Odd, Eccentric
- Includes paranoid, schizoid, and schizotypal PDs
2. Cluster B – Dramatic, Emotional, Erratic
- Includes antisocial, borderline, histrionic, and narcissistic PDs
3. Cluster C – Anxious, Fearful
- Includes avoidant, dependent, and obsessive-compulsive PDs
Individuals frequently present with co-occurring PDs from different clusters
Dimensional Models for Personality Disorders
The diagnostic approach used – represents the categorical perspective that PDs are qualitatively
distinct clinical syndromes
General Personality Disorder
Diagnostic Features
Personality Traits – enduring patterns of (1) perceiving, (2) relating to, and (3) thinking about
the environment and oneself
, - Exhibited in a wide range of social and personal contexts
Only when personality traits are (1) inflexible and (2) maladaptive – and cause sig functional
impairment or subjective distress
- They constitute personality disorders
Diagnosis of PD
The diagnosis of PDs – requires an evaluation of the individual’s long-term patterns of
functioning
- Particularly – personality features must be evident by early adulthood
The personality traits that define these disorders – must also be distinguished from characteristics
that emerge in response to
(1) Specific situational stressors
(2) More transient mental states – e.g., bipolar, depressive, or anxiety disorders;
substance intoxication
The clinician – should assess the stability of personality traits over time – and across different
situations
- Often necessary to conduct more than one interview – and space these over time
Assessment – can be complicated by the fact that the characteristics that define a PD – may not
be considered problematic by the individual – i.e., the traits are often ego-syntonic
- Overcome this – by supplementary info from other informants
Development and Course
The features of a PD – usually become recognizable during adolescence or early adult life
By definition – a PD is an enduring pattern of thinking, feeling, and behaving – that is relatively
stable over time
1. Some types of PD – i.e., antisocial and borderline PDs – tend to become less evident
or to remit with age
- This is less true for some other types – e.g., obsessive-compulsive and schizotypal
PDs
DSM-5: Personality Disorders
A personality disorder – is an enduring pattern of inner experience and behavior – that:
1. Deviates markedly from the expectations of the individual’s culture
2. Is pervasive and inflexible
3. Has an onset in adolescence – or early adulthood
4. Is stable over time
5. Leads to distress or impairment
There are different types of personality disorders – including:
Paranoid Personality A pattern of distrust and suspiciousness such that others’ motives
Disorder are interpreted as malevolent
Schizoid Personality A pattern of detachment from social relationships and a
Disorder restricted range of emotional expression
Schizotypal Personality A pattern of acute discomfort in close relationships, cognitive or
Disorder perceptual distortions, and eccentricities of behavior
Antisocial Personality
A pattern of disregard for, and violation of, the rights of others
Disorder
Borderline Personality A pattern of instability in interpersonal relationships, self-image,
Disorder and affects, and marked impulsivity
Histrionic Personality A pattern of excessive emotionality and attention seeking
, Disorder
Narcissistic Personality A pattern of grandiosity, need for admiration, and lack of
Disorder empathy
Avoidant Personality A pattern of social inhibition, feelings of inadequacy, and
Disorder hypersensitivity to negative evaluation
Dependent Personality A pattern of submissive and clinging behavior related to an
Disorder excessive need to be taken care of
Obsessive-Compulsive A pattern of preoccupation with orderliness, perfectionism, and
Personality Disorder control
Personality Change Due to A persistent personality disturbance that is judged to be due to
Another Medical the direct physiological effects of a medical condition – e.g.,
Condition frontal lobe lesion
1. The individual’s personality pattern meets the general
criteria for a PD, and traits of several personality
disorders are present – but the criteria for any specific
Other Specified Personality
PD are not met
Disorder and Unspecified
2. The individual’s personality pattern meets the general
Personality Disorder
criteria for a PD, but the individual is considered to
have a PD that is not included in the DSM-5
classification – e.g., passive-aggressive PD
,Personality Disorders - Clusters
The personality disorders are grouped into three clusters – based on descriptive similarities
1. Cluster A – Odd, Eccentric
- Includes paranoid, schizoid, and schizotypal PDs
2. Cluster B – Dramatic, Emotional, Erratic
- Includes antisocial, borderline, histrionic, and narcissistic PDs
3. Cluster C – Anxious, Fearful
- Includes avoidant, dependent, and obsessive-compulsive PDs
Individuals frequently present with co-occurring PDs from different clusters
Dimensional Models for Personality Disorders
The diagnostic approach used – represents the categorical perspective that PDs are qualitatively
distinct clinical syndromes
General Personality Disorder
Diagnostic Features
Personality Traits – enduring patterns of (1) perceiving, (2) relating to, and (3) thinking about
the environment and oneself
, - Exhibited in a wide range of social and personal contexts
Only when personality traits are (1) inflexible and (2) maladaptive – and cause sig functional
impairment or subjective distress
- They constitute personality disorders
Diagnosis of PD
The diagnosis of PDs – requires an evaluation of the individual’s long-term patterns of
functioning
- Particularly – personality features must be evident by early adulthood
The personality traits that define these disorders – must also be distinguished from characteristics
that emerge in response to
(1) Specific situational stressors
(2) More transient mental states – e.g., bipolar, depressive, or anxiety disorders;
substance intoxication
The clinician – should assess the stability of personality traits over time – and across different
situations
- Often necessary to conduct more than one interview – and space these over time
Assessment – can be complicated by the fact that the characteristics that define a PD – may not
be considered problematic by the individual – i.e., the traits are often ego-syntonic
- Overcome this – by supplementary info from other informants
Development and Course
The features of a PD – usually become recognizable during adolescence or early adult life
By definition – a PD is an enduring pattern of thinking, feeling, and behaving – that is relatively
stable over time
1. Some types of PD – i.e., antisocial and borderline PDs – tend to become less evident
or to remit with age
- This is less true for some other types – e.g., obsessive-compulsive and schizotypal
PDs
