General Personality Disorders
A: enduring pattern of inner experience & behavior that deviates from expectations of individuals culture. Pattern manifested in two (or more) of the following areas:
- Cognition
- Affectivity
- Interpersonal functioning
- Impulse control
B. Enduring pattern is inflexible & pervasive across personal & social situations
C. Enduring pattern leads to distress & impairment in
D. Pattern is stable & of long duration, onset can be traced back at least to adolescence, or early adulthood
E. Enduring pattern is not better explained as a manifestation or consequence of other mental disorder
F. Enduring pattern not attributable to physiological effects or substance use
3 Cluster of PD
Cluster A:
- Paranoid
- Schizoid
- Schizotypal
Cluster B:
- Antisocial
- Histrionic
- Borderline
- Narcisstic
Cluster C:
- Avoidant
- Dependent
- Obsessive - Compulsive
3 Cluster of PD - Prevalences
Cluster A: 5,7%
Cluster B: 1,5%
Cluster C: 6%
A: Paranoid - DSM-5 Criteria
A: Pervasive distrust & suspiciousness of others, their motives interpreted as malevolent. Begin in early adulthood & present in variety of contexts, as indiciated by 4 or more of the following:
- Suspects, without sufficient basis, that others are exploiting, harming, deceiving
- Preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates
- Reluctant to confide in others bcause of unwarranted fear that information will be used maliciously
- Reads hidden demeaning or threatening meanings into benign remarks or events
- Persistently bears grudges
- Perceives attacks on his/ her character or reputations that are not apparent - quick to react angrily or counterattack
- Has recurrent suspicions, without justification, regarding fidelity of spuse of sexual partner
B. Does not occur exlusively during course of schizophrenia, a bipolar disorder, or depressive disorder or another psychotic disorder. Not attributable to physiological effects of another medical condition
A: Paranoid - Key words
- Distrust, suspicious
- Trying to stay clear of others – do not trusting anyone
- Extreme paranoia
- Do not spend a lot of time with other people due to this paranoia & trust
- E.g., Joseph Stalin
A: Schizoid - DSM5
A: Pervasive pattern of detachment from social relaionships & restricted range of expression of emotions in interpersonal setting. Begins in early adulthood and present in variety of contexts. Indicated by 4 or more of the following:
- Neither desires nor enjoys close relationships, including being part of a family.
- Almost always chooses solitary activites
- Has little, if any interest, in having sexual expereiences with another person
- Takes pleasure in few, if any, activites
- Lacks close frinds or confidants others than first-degree relatives
- Appears indifferent to the praise or criticism of others
- Shows emotional coldness, detachment, flattened affectivity
B. Does not occur during schizophrenia, bipolar, depressive, autism, or other psychotic disorder.
A: Schizoid - Key words
- Detachment of social relationships
- Restricted range of emotional expression
- People stay clear of others, shallow of emotions – not interested in social interactions
- “Me on my own is fine”
- E.g., Dexter
A: Schizotypal - DSM5
A: Pervaisve pattern of social, interpersonal deficits marked by acute discomfort with and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentries of behaviors. Beginning by early adulthood, as indiciated by 5 or more of the followin:
- Ideas of reference (excluding delusions of reference)
- Odd beliefs, magical thinking that influences behavior and is inconsistent with cultural norms (e.g., telepathy, sixth sense)
- Unusual perceptual experiences, including bodily illusions
- Odd thinking and speeck (e.g., vague, circumstanial, metaphorical9
- Suspiciousness or paranoid ideation
- Inappropriate or constricted affect
- Behavior or appearance that is odd, eccentric, peculiar
- Lack of close friends or confidants other than first-degree relatives
- Excessive social anxiety that does not diminish with familarity - associated with paranoid fears instead of negative judgments of self
B. Does not occur during schizophrenia, bipolar, depression, psychiatric disorder, or autism.
A: Schizotypal - Key words
- Discomfort around social relationships
- Eccentric thoughts, behavior
- People are just different in their own mind – unique mind, unique ideas
- Closest to schizophrenia (in schizophrenia it comes in waves – schizotypal is more constant)
- E.g., Willy Wonka
B: Antisocial - DSM5
A: Pervasive pattern of disregard for and violation of the rights of others, occuring since age 15, as indicated by 3 or more of the following:
- Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly perfroming acts that are grounds for arrest
- Deceitfulness - repeated lying, use of aliases, conning others for personal profit & pleasure
- Impulsivity or failure to plan ahead
- Irritability & aggressiveness - repeated physical fights or assaults
- Reckless disregards for safety of self or others
- Consistent irresponsibility - repeated failure to sustain consistent work, financial obligations
- Lack of remorse - being indiffernt or rationalizing when having hurt someoe
B: at least 18 years old
C: evidence of conduct disorder with onset before 15 years
D: Occurence of antisocial behavior not during course of schizophrenia or bipolar disorder
B: Antisocial - Key words
- Disregards & violation of rights and rules
- I do not care about the rules, about knowing the rules, I do not care about breaking them
- Often in contact with the law
- In childhood: conduct disorder
- E.g., Van der Sloot, serial Killer
PS: Psychopathy is not necessarily antisocial (it’s more manipulation)
B: Borderline - DSM5
A: pervasive pattern of instability or interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood. Indicated by 5 or more of the following:
- Frantic effors to avoid real or imagined abandonment.
- Pattern of unstable and instense relationships - alternating between extremes of idealization & devaluation
- Identity disturbance: unstable self-image and sense of self
- Impulsivity in at least two areas that are self-damaging (e.g., spending, sex, substance use, binge eating, reckless driving)
- Recurrent suicidal behavior, gestures, threats
- Affective instability due to a marked reactivity of mood
- Chronic feelings of emptiness
- Inappropriate, intense anger & difficulty controlling anger
- Transient, stress-related paranoid ideation
B: Borderline - Key words
- Instability in how you see yourself, how you feel & how you relate to others
- Today all is good, today all is bad – black & white
- Self-harm behavior (drinking, cutting, smoking) – struggling with self-image
- Nobody is actually your crowd – you do not really belong
- Often have 1-2 people that they cling to
- E.g., Angelina Jolie & Amy Winehouse
B: Histrionic - Key words
- Me being the center of attention
- Attention-seeking
- Trying to avoid the feeling of being “nobody”
- Big emotions, loud personalities
- Often sexualize & provocative behavior
- “Hysteria”, “Hysterical neurosis”
- E.g., Mean girls
B: Histrionic - DSM5
A: Pervasive pattern of excessive emotionality and attention seeking. Beginning by early adulthood and in a variety of contexts. Indicated by 5 or more of the following:
- Uncomfortable in situations in which he or she is not center of attention
- Interaction with others often characterized by inappopriate 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, exaggerated expression of emotion
- Is suggestible
- Considers relationships to be more intimate than they are
B: Narcissism - DSM5
A. Pervasive pattern of grandiosity, need for admiration, and lack of empathy. Beginning by early adulthood and present in variety of contexts, as indicated by 5 or more of the following:
- Has a grandiose sense of self-importance (e.g., exaggerated achievements and talents, expects to be recognized as superior without commensurate achievements)
- Preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
- Believes that he is special and unique and can only be understood by, or should associate with, other special or high-status people
- Requires excessive admiration
- Has a sense of entitlement of especially favorable treatment
- Is interpersonally exploitative
- Lacks empathy
- Often envious of others or believes others are enviours of him
- Shows arrogant behavior or attitudes
B: Narcissism- Key words
- Want to be big and important
- Grandiosity, need for admiration & lack of empathy
- Important to value them as unique and special but also the therapist needs to be unique and special (often)
- E.g., Kim Kardashian
C: Avoidant - DSM5
A: Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitvity to negative evaluation. Indicated by 4 or more of the following.
- Avoids occupational activities that involve sig. interpersonal contact because of fear of criticism, disapproval, or rejection
- Unwilling to get involved with people unless certain of being liked.
- Shows restraint with intimate relationships because of the fear of being ridicules or shamed.
- Preoccupied with being criticized or rejected in social situatoins.
- Inhibited in interpersonal situations because of feelings of inadequacy
- Views self as socially, personally unappealing or inferior to others
- Unusually reluctant to take personal risks or to engage in any new activities because they may prove embarassing
C: Avoidant - Key words
- Stay clear of social relationships
- Social inhibition
- Feelings of inadequacies
- Sensitive to rejection – interested in social relationships but it is difficult
- Therefore, stay clear of relationships
- Similar to schizoid but with the difference that they want to have relationships
- E.g., Michael Jackson
C: Dependent - DSM5
A: Pervasive pattern 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 variety of contexts. Indicated by 5 or more of the following:
- Has difficulty making everyday decisions without excessive amount of advice and reassurance of others.
- Needs others to assume responsibility for most major areas of life
- Difficulty expressing disagreement with others because of fear of loss of support or approval
- Difficulty initiating projects or doing things on hiw own (lack of self-confidence)
- 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 fear of being unable to care for himself.
- Urgently seeks another relationships as a source of care and support when relationship ends.
- Unrealistically preoccupied with fears of being left
C: Dependent - Key words
- Submissive, clingy, need to be taken care of
- Please do not leave me alone
- Need someone to be there for you
- Fear of being alone
- Look for long standing relationships
C: Obsessive Compulsive - DSM5
A: Pervaisve pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness and efficiency. Indicated by 4 or more of the following:
- Preoccupied with details, rules, lists, order, organization, schedules to extent that major point of activity is lost
- Shows perfectionism that interferes with task completion
- Execssively devoted to work and productivity to the exclusion of leisure activity and friendships
- Overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values
- Unable to discrd worn-out or worthless objects even when having no sentimental value
- Reluctant to delegate tasks or to work with others, unless they submit exactly his way of things
- Miserly spending style towards self and others, money is viewed as something to be hoarded for future catastrophes
- Rigidity and subborness
C: Obsessive Compulsive - Key words
- Need of orderliness
- Perfectionism
- Anxiety of chaos
- Want a structure
- Impacts social relationships – even though your messiness does not really impact me, I do not want you to be messy.
- E.g., Steve Jobs
Gender Dysphoria (children) - DSM5
A: marked incongruence between one’s expereinced/ expressed gender ad assigned gender of at least 6 months - manifested by at least 6 of the following:
1. Strong desire to be of the other gender or an instance that one is the other gender
2. In boys (assigned gender) strong preference for cross-dressing or simulating female attire & in girls (assigned) strong preference for wearing masculine clothing
3. Strong preference for cross-gender roles in make-believe play or fantasy play
4. Strong preference for toys, games, activities stereotypically engaged in by the other gender
5. Strong preference for playmates of the other gender
6. Boys (assigned) strong rejection of typical masculine toys, in girls (assigned) rejection of typical feminine toys
7. Strong dislike for one’s sexual anatomy
8. Strong desire for primary and/or secondary sex characteristic that
match one’s experienced gender
B: Distress / Impairment
