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Personality Disorders : Personality Disorders 4.17.2007


Personality Disorders : Personality Disorders Axis II Personality Disorders and Mental Retardation Diagnosed separately from Major Mental Disorders on Axis I Designed so consideration can be given to prevailing personality patterns, which may be less obvious than Axis I disorders Egosyntonic - the symptoms are part of who you are, this is who you are meant to be


Personality Disorders : Personality Disorders Personality patterns Maladaptive Inflexible Pervasive Enduring Deviant Cause significant distress or impairment


Personality Disorders : Personality Disorders An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture. This pattern is manifested in two (or more) of the following areas: Cognition (ways of perceiving the self, others, and events) Affect (range, intensity, lability, and appropriateness of affect) Interpersonal Functioning Impulse Control The enduring pattern is inflexible and pervasive across a broad range of personal and social situations


Personality Disorders : Personality Disorders C. The enduring pattern leads to significant distress or impairment in functioning D. The pattern is stable and of long duration, and its onset can be traced back at least to adolescence or early adulthood E. Not better accounted for by another mental disorder F. Not due to a GMC or substance


Types of Personality Disorders : Types of Personality Disorders Paranoid Personality Disorder Schizoid Personality Disorder Schizotypal Personality Disorder Antisocial Personality Disorder Borderline Personality Disorder Histrionic Personality Disorder Narcissistic Personality Disorder Avoidant Personality Disorder Dependent Personality Disorder Obsessive-Compulsive Personality Disorder


Clusters : Clusters Cluster A Paranoid Personality Disorder Schizoid Personality Disorder Schizotypal Personality Disorder Cluster B Antisocial Personality Disorder Borderline Personality Disorder Histrionic Personality Disorder Narcissistic Personality Disorder Cluster C Avoidant Personality Disorder Dependent Personality Disorder Obsessive-Compulsive Personality Disorder


Cluster A : Cluster A Odd, eccentric ways of thinking or behaving Paranoid Personality Disorder Pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent Schizoid Personality Disorder Pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts Schizotypal Personality Disorder Pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior


Paranoid Personality Disorder : Paranoid Personality Disorder Four or more of the following: Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her


Paranoid Personality Disorder : Paranoid Personality Disorder Four or more of the following (continued): Reads hidden demeaning or threatening meanings into benign remarks or events Persistently bears grudges Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner


Paranoid Personality Disorder : Paranoid Personality Disorder


Facts about Paranoid PD : Facts about Paranoid PD Prevalence: 0.5-2.5% 10-30% 2-10% Gender: Can begin as:


Schizoid Personality Disorder : Schizoid Personality Disorder Four or more of the following: Neither desires nor enjoys close relationships, including being part of a family Almost always chooses solitary activities Has little, if any, interest in having sexual experiences with another person


Schizoid Personality Disorder : Schizoid Personality Disorder Four or more of the following (continued): Takes pleasure in few, if any, activities Lacks close friends or confidants other than first-degree relatives Appears indifferent to the praise or criticism of others Shows emotional coldness, detachment, or flattened affect


Schizoid Personality Disorder : Schizoid Personality Disorder


Facts about Schizoid PD : Facts about Schizoid PD Prevalence: Gender: Can begin as: Note:


Schizotypal Personality Disorder : Schizotypal Personality Disorder Five or more of the following: Ideas of reference Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms Unusual perceptual experiences including bodily illusions Odd thinking or speech (vague, metaphorical, etc.) Suspiciousness or paranoid ideation


Schizotypal Personality Disorder : Schizotypal Personality Disorder Five or more of the following (continued): Inappropriate or constricted affect Behavior or appearance that is odd, eccentric, or peculiar Lack of close friends or confidants other than first degree relatives Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self


Schizotypal Personality Disorder : Schizotypal Personality Disorder


Facts about Schizotypal PD : Facts about Schizotypal PD Prevalence: 3% 15% 50% Gender: Can begin as:


Cluster B : Cluster B Dramatic, emotional, or erratic Antisocial Personality Disorder Pervasive pattern of disregard for and violation of the rights of others Borderline Personality Disorder Pervasion pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity Histrionic Personality Disorder Pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts Narcissistic Personality Disorder Pervasive pattern of grandiosity, need for admiration, and lack of empathy


Antisocial Personality Disorder : Antisocial Personality Disorder A. Three or more of the following recurring since age 15 Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure Impulsivity or failure to plan ahead


Antisocial Personality Disorder : Antisocial Personality Disorder A. Three or more of the following recurring since age 15 (continued): Irritability and aggressiveness, as indicated by repeated physical fights or assaults Reckless disregard for safety of self or others Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another


Antisocial Personality Disorder : Antisocial Personality Disorder B. At least 18 years old C. Evidence of Conduct Disorder with onset before age 15 D. Not exclusively during the course of Schizophrenia or a Manic Episode


Antisocial Personality Disorder : Antisocial Personality Disorder


Antisocial Personality Disorder : Antisocial Personality Disorder Requires symptoms of Conduct Disorder before age 15 (Childhood Disorder) Only disorder that requires symptoms of another disorder to be present


Facts about Antisocial PD : Facts about Antisocial PD Prevalence: 1-3% 3-30% 66-75% Gender:


Borderline Personality Disorder : Borderline Personality Disorder Five or more of the following: Frantic efforts to avoid real or imagined abandonment Pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation Identity disturbance: markedly and persistently unstable self-image or sense of self Impulsivity in at least two areas that are potentially self-damaging


Borderline Personality Disorder : Borderline Personality Disorder Five or more of the following (continued): Recurrent suicidal behavior or self-mutilating behavior Affective instability due to a marked reactivity of mood Chronic feelings of emptiness Inappropriate, intense anger or difficulty controlling anger Transient, stress-related paranoid ideation or severe dissociative symptoms


Borderline Personality Disorder : Borderline Personality Disorder


Facts about Borderline PD : Facts about Borderline PD Prevalence: 2% 10% 20% Gender: Associated w/:


Histrionic Personality Disorder : Histrionic Personality Disorder Five or more of the following: Is uncomfortable in situations in which he or she is not the center of attention Interaction with others is often characterized by inappropriate sexually seduction or provocative behavior Displays rapidly shifting and shallow expression of emotions Consistently uses physical appearance to draw attention to self


Histrionic Personality Disorder : Histrionic Personality Disorder Five or more of the following (continued): Has a style of speech that is excessively impressionistic and lacking in detail Shows self-dramatization, theatrically, and exaggerated expression of emotion Is suggestible Considers relationships to be more intimate than they actually are


Histrionic Personality Disorder : Histrionic Personality Disorder


Facts about Histrionic PD : Facts about Histrionic PD Prevalence: 2-3% 10-15% Gender: Note:


Narcissistic Personality Disorder : Narcissistic Personality Disorder Five or more of the following: Has a grandiose sense of self-importance Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love Believes that he or she is 'special' and unique and can only be understood by, or should associate with, other special or high-status people Requires excessive admiration


Narcissistic Personality Disorder : Narcissistic Personality Disorder Five or more of the following (continued): Has a sense of entitlement (i.e. unreasonable expectations of favorable treatment or others complying to their expectations) Takes advantage of others Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others Is often envious of others or believes that others are envious of him/her Shows arrogant, haughty behaviors or attitudes


Narcissistic Personality Disorder : Narcissistic Personality Disorder


Facts about Narcissistic PD : Facts about Narcissistic PD Prevalence: andlt;1% 2-16% Gender: Associated w/:


Cluster C : Cluster C Anxious or fearful Avoidant Personality Disorder Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation Dependent Personality Disorder Pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation Obsessive-Compulsive Personality Disorder Pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency


Avoidant Personality Disorder : Avoidant Personality Disorder Four or more of the following: Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection Is unwilling to get involved with people unless certain of being liked Shows restraint within intimate relationships because of the fear of being shamed or ridiculed


Avoidant Personality Disorder : Avoidant Personality Disorder Four or more of the following: Is preoccupied with being criticized or rejected in social situations Is inhibited in new interpersonal situations because of feelings of inadequacy Views self as socially inept, personally unappealing, or inferior to others Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing


Avoidant Personality Disorder : Avoidant Personality Disorder


Facts about Avoidant PD : Facts about Avoidant PD Prevalence: 0.5-1% 10% Gender: Can begin as:


Dependent Personality Disorder : Dependent Personality Disorder Five or more of the following: Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others Needs others to assume responsibility for most major areas of his or her life Has difficulty expressing disagreement with others because of fear of loss of support or approval Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence rather than a lack of motivation or energy)


Dependent Personality Disorder : Dependent Personality Disorder Five or more of the following (continued): Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself Urgently seeks another relationship as a source of care and support when a close relationship ends Is unrealistically preoccupied with fears of being left to take care of himself or herself


Dependent Personality Disorder : Dependent Personality Disorder


Facts about Dependent PD : Facts about Dependent PD Prevalence: 2% Gender: Tend to:


Obsessive-Compulsive Personality Disorder : Obsessive-Compulsive Personality Disorder Four or more of the following Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost Shows perfectionism that interferes with task completion Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships Is overconscientious, scupulous, and inflexible about matters of morality, ethics, or values


Obsessive-Compulsive Personality Disorder : Obsessive-Compulsive Personality Disorder Four or more of the following (continued): Is unable to discard worn-out or worthless objects even when they have no sentimental value Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things Adopts a miserly spending style toward both self and others, money is viewed as something to be hoarded for future catastrophes Shows rigidity and stubornness


Obsessive-Compulsive Personality Disorder : Obsessive-Compulsive Personality Disorder


Facts about Obsessive-Compulsive PD : Facts about Obsessive-Compulsive PD Prevalence: 1% 3-10% Gender: Associated w/: