Personality Disorders 101

admin, Sunday 06 May 2012 - 12:47:00

Listed below are some of the recognized personality disorders that frequently contribute to rocky marriages, and ultimately, to divorce. Be aware that these conditions are also commonly found in the general population at large, but the determination of whether or not a true disorder is present depends on the severity and number of the diagnostic criteria found.

If these profiles are used during a parenting evaluation or family therapy it would be best to just describe the behavior(s) and let the therapist draw his or her own conclusions. Otherwise, they'll think you're practicing therapy, for which you are almost certainly not qualified.


Paranoid Personality Disorder
Diagnostic Criteria
A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by 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 reads hidden demeaning or threatening meanings into benign remarks or events
  • persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights
  • 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
Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, or another Psychotic Disorder and is not due to the direct physiological effects of a general medical condition.

Note: If criteria are met prior to the onset of Schizophrenia, add "Premorbid," e.g., "Paranoid Personality Disorder (Premorbid)."

Associated Features
Odd/Eccentric/Suspicious Personality
Dramatic/Erratic/Antisocial Personality

Differential Diagnosis
Delusional Disorder, Persecutory Type; Schizophrenia, Paranoid Type; Mood Disorder With Psychotic Features; Personality Change Due to a General Medical Condition; symptoms that may develop in association with chronic substance use; paranoid traits associated with the development of physical handicaps; Schizotypal Personality Disorder; Schizoid Personality Disorder; Borderline and Histrionic Personality Disorders; Avoidant Personality Disorder; Antisocial Personality Disorder; Narcissistic Personality Disorder.


Schizoid Personality
Diagnostic Criteria
A pervasive 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, as indicated by 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
  • 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 affectivity
Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder and is not due to the direct physiological effects
Of a general medical condition.
Note: If criteria are met prior to the onset of schizophrenia, add "Premorbid," e.g., "Schizoid Personality Disorder (Premorbid)."

Associated Features
Odd/Eccentric/Suspicious Personality

Differential Diagnosis
Delusional Disorder; Schizophrenia; and Mood Disorder With Psychotic Features; Autistic Disorder; Asperger's Disorder; Personality Change Due to a General Medical Condition; symptoms that may develop in association with chronic substance use; Schizotypal Personality Disorder; Paranoid Personality Disorder; Avoidant Personality Disorder; Obsessive-Compulsive Personality Disorder.


Schizotypal Personality
Diagnostic Criteria
A pervasive 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, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  • ideas of reference (excluding delusions of reference)
  • odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g.,superstitiousness, belief in clairvoyance, telepathy, or "sixth sense"; in children and adolescents, bizarre fantasies or preoccupations)
  • unusual perceptual experiences, including bodily illusions
  • odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped)
  • suspiciousness or paranoid ideation
  • 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
Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder.
Note: If criteria are met prior to the onset of schizophrenia, add "Premorbid," e.g., "Schizotypal Personality Disorder (Premorbid)."


Associated Features
Depressed Mood
Odd/Eccentric/Suspicious Personality

Differential Diagnosis
Delusional Disorder; Schizophrenia; Mood Disorder With Psychotic Features; Autistic Disorder; Asperger's Disorder; Expressive and Mixed Receptive-Expressive Language Disorders; Communication Disorders; Personality Change Due to a General Medical Condition; symptoms that may develop in association with chronic substance use; Paranoid Personality Disorder; Schizoid Personality Disorder; Avoidant Personality Disorder; Narcissistic Personality Disorder; Borderline Personality Disorder; Schizotypal features during adolescence.


Antisocial Personality
Diagnostic Criteria
There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following:
  • 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
  • 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
  • the individual is at least age 18 years.
  • there is evidence of Conduct Disorder with onset before age 15 years.
  • the occurrence of antisocial behavior is not exclusively during the course of Schizophrenia or a Manic Episode.
Associated Features
Depressed Mood
Addiction
Dramatic/Erratic/Antisocial Personality


Differential Diagnosis
Substance-Related Disorder; Schizophrenia; Manic Episode; Narcissistic Personality Disorder; Histrionic Personality Disorder; Borderline Personality Disorders; Paranoid Personality Disorder; Adult Antisocial Behavior.


Conduct Disorder
Diagnostic Criteria
A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of three (or more) of the following criteria in the past 12 months, with at least one criterion present in the past 6 months:

  • Aggression to people and animals
  • often bullies, threatens, or intimidates others
  • often initiates physical fights
  • has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun)
  • has been physically cruel to people
  • has been physically cruel to animals
  • has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery)
  • has forced someone into sexual activity
Destruction of property
  • has deliberately engaged in fire setting with the intention of causing serious damage
  • has deliberately destroyed others' property (other than by fire setting)
Deceitfulness or theft
  • has broken into someone else's house, building, or car
    often lies to obtain goods or favors or to avoid obligations (i.e., "cons" others)

  • has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery)
Serious violations of rules
  • often stays out at night despite parental prohibitions, beginning before age 13 years
  • has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period)
  • is often truant from school, beginning before age 13 years
  • the disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
  • if the individual is age 18 years or older, criteria are not met for Antisocial Personality Disorder.
Specify type based on age at onset:
Childhood-Onset Type: onset of at least one criterion characteristic of Conduct Disorder prior to age 10 years

Adolescent-Onset Type absence of any criteria characteristic of Conduct Disorder prior to age 10 years

Specify severity:

Mild: few if any conduct problems in excess of those required to make the diagnosis and conduct problems cause only minor harm to others

Moderate: number of conduct problems and effect on others intermediate between "mild" and "severe"

Severe: many conduct problems in excess of those required to make the diagnosis or conduct problems cause considerable harm to others

Associated Features
Learning Problem
Depressed Mood
Hyperactivity
Addiction
Dramatic/Erratic/Antisocial Personality

Differential Diagnosis
Oppositional Defiant Disorder; Attention-Deficit/Hyperactivity Disorder; Manic Episode; Adjustment Disorder; Child or Adolescent Antisocial Behavior;
Antisocial Personality Disorder.


Borderline Personality
Diagnostic Criteria
A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the
following:

  • frantic efforts to avoid real or imagined abandonment.
    Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
  • a 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 (e.g., spending, sex, substance abuse, reckless driving, binge eating).
    Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
  • recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
  • affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
  • chronic feelings of emptiness
  • inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
  • transient, stress-related paranoid ideation or severe dissociative symptoms
Associated Features
Depressed Mood
Addiction
Dramatic/Erratic/Antisocial Personality

Differential Diagnosis
Mood Disorders; Histrionic Personality Disorder; Schizotypal Personality Disorder; Paranoid Personality Disorder; Narcissistic Personality Disorder; Antisocial Personality Disorder; Dependent Personality Disorder; Personality Change Due to a General Medical Condition; symptoms that may develop in association with chronic substance use; Identity Problem.


Histrionic Personality
Diagnostic Criteria
A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by 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 seductive or provocative behavior
  • displays rapidly shifting and shallow expression of emotions
  • consistently uses physical appearance to draw attention to self
  • has a style of speech that is excessively impressionistic and lacking in detail
  • shows self-dramatization, theatricality, and exaggerated expression of emotion
  • is suggestible, i.e., easily influenced by others or circumstances
  • considers relationships to be more intimate than they actually are
Associated Features
Depressed Mood
Somatic/Sexual Dysfunction
Anxious/Fearful/Dependent Personality
Dramatic/Erratic/Antisocial Personality

Differential Diagnosis
Borderline Personality Disorder; Antisocial Personality Disorder; Narcissistic Personality Disorder; Dependent Personality Disorder; Personality Change Due to a General Medical Condition; symptoms that may develop in association with chronic substance use.


Narcissistic Personality Disorder
Diagnostic Criteria
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
  • has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
  • 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 (or institutions)
  • requires excessive admiration
  • has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
  • is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
  • 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 or her shows arrogant, haughty behaviors or attitudes
Associated Features
Depressed Mood
Dramatic/Erratic/Antisocial Personality

Differential Diagnosis
Histrionic Personality Disorder; Antisocial Personality Disorder; Borderline Personality Disorder; Obsessive-Compulsive Personality Disorder; Schizotypal
Personality Disorder; Paranoid Personality Disorder; Manic Episodes; Hypomanic Episodes; Personality Change Due to a General Medical Condition; symptoms that may develop in association with chronic substance use.


Avoidant Personality
Diagnostic Criteria
A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by 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
  • 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
Associated Features
Depressed Mood
Anxious/Fearful/Dependent Personality
Differential Diagnosis
Social Phobia, Generalized Type;Panic Disorder With Agoraphobia; Dependent Personality Disorder; Schizoid Personality Disorder; Schizotypal Personality Disorder; Paranoid Personality Disorder; Personality Change Due to a General Medical Condition; symptoms that may develop in association with chronic substance use.


Dependant Personality
Diagnostic Criteria
A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by 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. Note: Do not include realistic fears of retribution.
  • has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy)
  • 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
Associated Features
Depressed Mood
Anxious/Fearful/Dependent Personality
Dramatic/Erratic/Antisocial Personality

Differential Diagnosis
Mood Disorders; Panic Disorder; Agoraphobia; general medical conditions; Borderline Personality Disorder; Avoidant Personality Disorder; Personality Change Due to a General Medical Condition; symptoms that may develop in association with chronic substance use.



Obsessive-Compulsive Personality
Diagnostic Criteria
A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by 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 (e.g., is unable to complete a project because his or her own overly strict standards are not met)
  • is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)
  • is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)
  • 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 stubbornness
Associated Features
Depressed Mood
Somatic/Sexual Dysfunction
Guilt/Obsession
Anxious/Fearful/Dependent Personality

Differential Diagnosis
Obsessive-Compulsive Disorder; Narcissistic Personality Disorder; Antisocial Personality Disorder; Schizoid Personality Disorder; Personality Change Due to a General Medical Condition; symptoms that may develop in association with chronic substance use.


Bipolar Disorder
Diagnostic Criteria
Bipolar disorder is a condition in which people go back and forth between periods of a very good or irritable mood and depression. The "mood swings" between mania and depression can be very quick.

Bipolar disorder affects men and women equally. It usually starts between ages 15 - 25. The exact cause is unknown, but it occurs more often in relatives of people with bipolar disorder.

Types of bipolar disorder:
  • People with bipolar disorder type I have had at least one manic episode and periods of major depression. In the past, bipolar disorder type I was called manic depression.

  • People with bipolar disorder type II have never had full mania. Instead they experience periods of high energy levels and impulsiveness that are not as extreme as mania (called hypomania). These periods alternate with episodes of depression.

  • A mild form of bipolar disorder called cyclothymia involves less severe mood swings. People with this form alternate between hypomania and mild depression. People with bipolar disorder type II or cyclothymia may be wrongly diagnosed as having depression.
The manic phase may last from days to months. It can include the following symptoms:
  • Easily distracted
  • Little need for sleep
  • Poor judgment
  • Poor temper control
  • Reckless behavior and lack of self control, such as:
    • Binge eating, drinking, and/or drug use
    • Poor judgment
    • Sex with many partners (promiscuity)
    • Spending sprees
  • Very elevated mood
  • Excess activity (hyperactivity)
  • Increased energy
  • Racing thoughts
  • Talking a lot
  • Very high self-esteem (false beliefs about self or abilities)
  • Very involved in activities
  • Very upset (agitated or irritated)
These symptoms of mania occur with bipolar disorder I. In people with bipolar disorder II, the symptoms of mania are similar but less intense.




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