personality disorders

*located on axis II

-divided into three "clusters"

cluster A (odd or eccentic disorders)

• paranoid personality disorder
• schizoid personality disorder
• schizotypal personality disorder

cluster B (dramatic, emotional, or erratic disorders)

• antisocial personality disorder
• borderline personality disorder
• histrionic personality disorder
• narcissistic personality disorder

cluster C (anxious or fearful disorders)

• avoidant personality disorder
• dependent personality disorder
• obsessive-compulsive personality disorder

paranoid personality disorder

*diagnostic code: 301.0

*cluster A

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 them
• persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights
• perceives attacks on their 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

which 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

schizoid personality disorder

*diagnostic code: 301.20

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 other

• shows emotional coldness, detachment, or flattened affectivity

which 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

schizotypal personality disorder

*diagnostic code: 301.22

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., paranormal beliefs, 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

which does not occur exclusively during the course of schizophrenia, a mood disorder with psychotic features, another psychotic disorder, or a pervasive developmental disorder

antisocial personality disorder

*diagnostic code: 301.7

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

which does not occur exclusively during the course of schizophrenia or a manic episode

-the individual must be 18 years of age

-there must be evidence of conduct disorder with onset before 15 years of age

borderline personality disorder

*diagnostic code: 301.83

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