Ego syntonic
not seen as problematic by individual
ego dystonic
seen as problematic by individual
3 p’s of PDs
pervasive
persistent
pathological
Cluster A
odd/eccentric
paranoid
schizoid
schizotypal
Cluster B
dramatic/erratic
antisocial
borderline
histrionic
narcissistic
Cluster C
anxious/fearful
avoidant
dependent
obsessive-compulsive
DSM paranoid PD
- pervasive distrust + suspicion of others, begins by early adulthood, 4+ 0f: suspects that others are exploiting, harming, deceiving; preoccupied with unjustified doubts of loyalty; reluctant to confide in other because of fear it’ll be used against them; reads hidden threatening meanings; persistently bears grudges; perceives attacks not seen by others and quick to attack; recurrent suspicion without justification about fidelity of spouse or partner
- not occur exclusively during course of PS/BD.depressive disorder with psychotic features; another psychotic disorder; another medical condition
DSM schizoid PD
- pervasive social relationship detachment and restricted interpersonal emotional expression from early adulthood, 4+ of: not enjoying close relationships; always chooses solitary activities; little sexual experience interest; few activities pleasurable; lacks close friends or confidants; indifferent to praise/criticism; emotional coldness/detachment
- not occurring exclusively with SP, BD, DD with PF, Psychotic disorder, ASD and other medical condition
DSM schizotypal PD
- pervasive social and interpersonal deficits;; acute discomfort with close relationships and distprtions and behaviour eccenricities; beginning by early adulthood and in various contexts with 5+ of: ideas of reference/delusions of reference; off beliefs/magical thinking; unusual perceptual experiences; odd thinking/speech; suspiciousness; inappropriate/contricted affect; behaviour or appearance eccentric; lack close friends; excessive social anxiety that doesn’t diminish with familiarity
- not exlusively with sp, bd, dd with psychosis, other psychotic disorder or asd
DSM APD
- pervasive disregard and violation of others rights since 15Y and 3+ of: failure to conform to social norms; deceitfulness; impulsivity; irritability; reckless diregard for safety; irresponsibility; lack of remorse
- 18+ YO
- conduct disorder before 15YO
- AS behaviour not exclusively during SP or BD course
BPD dysregulation of up to 5 domains
emotional
cognitive
behavioural
interpersonal
sense of self
DSM5 BPD
- pervasive pattern of instability of IPR, SI, affects and impulsivity from early adulthood across contexts, with 5+: frantic efforts to avoid abandonment; unstable and intense relationships; identity disturbances; impulsivity in at least 2 areas that are self dmaaging; recurrent suicidal behaviour; affective instability; chronic emptiness; intense anger; transient paranoid ideation or severe dissociative symptoms
linehan’s biosocial model
BPD produced by combination of high emotional sensitivity and invalidating enviornment
emotional sensitivity
reactivity of emotional system comprising:
ease of activation of an emotional response
peak intensity of emotions
time to return to emotional baseline
DSM5 histrionic PD
pervasiv excessive emotionality and attention seeking from early adulthood and across contexts, with 5+: uncomfortable when not centre of attention; interaction sexually seductive/provocative; rapid shifting/shallow emotions; physical appearance to draw attention to self; excessive style; self-dramatisation of emotions; suggestible; considers relations more intimate than actually are
DSM5 narcissistic PD
pervasive grandiosity, admiration need, empathy lacking, beginning by early adulthood and across context with 5+ of:
grandiose self importance
preoccupies with fantasies of unlimited success, power, brilliance, idela love
believes they are special
require excessive admitation
entitlement
exploiting others
lacks empathy
envious of others or believes they are of them
arrogant
DSM5 Avoidant PD
pervasive socoial inhibition, inadequace, hypersensitivyt to negative ecaluation from early adulthood and across context, 4+ of: avoids occupational activities requiring interpersonal contact; unwilling to get involved with others unless certain of being likes
restrained with intimate relationships; preoccupied with criticism; inhibited in new interpersonal situations; views self as inept and inferior; reluctant to take risks in case of embarassment
DSM5 Dependent PD
pervasive need to be taken care of leading to submissive/clinging behaviour and separation fears from early adulthood across contexts and 5+ of:
difficulty making everyday decisions without reassurance
needs others to take their responsibilities
cant disagree
cant initiate
extreme lengths to get support
uncomfortable when alone
urgently seeking new relationships when one ends
unrealistically preoccupied with fears of being left
DSM5 O-C PD
pervasive preoccupation with orderliness by early adulthood across contexts and 4+ of:
preoccupied with details to point of activity being lost
perfectionism interferes with task completion
excessively devoted to work to exxlusion of leisure and friends
overly inflexible
unable to discard wornout object
reluctant to delegate
does not spend
rigid and stubborn
issues with categorical models
excessive cooccurrence
heterogeneity within diagnostic categories (number of criteria required)
diagnosis instability over time
low prevalence
Dimensional models
continuum
look at outliers, and their personality pathologies
