Personality Disorders - Specific Criteria

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Individual criteria for PDs from the DSM-IV. A bit tricky because some PDs share features.

Antisocial

B. The individual is at least age 18 years.

Antisocial

C. There is evidence of Conduct Disorder with onset before age 15 years.

Antisocial

consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations

Antisocial

deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure

Antisocial

failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest

Antisocial

impulsivity or failure to plan ahead

Antisocial

irritability and aggressiveness, as indicated by repeated physical fights or assaults

Antisocial

lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

Antisocial

reckless disregard for safety of self or others

Antisocial

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...

Avoidant

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...

Avoidant

avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection

Avoidant

is inhibited in new interpersonal situations because of feelings of inadequacy

Avoidant

is preoccupied with being criticized or rejected in social situations

Avoidant

is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing

Avoidant

is unwilling to get involved with people unless certain of being liked

Avoidant

shows restraint within intimate relationships because of the fear of being shamed or ridiculed

Avoidant

views self as socially inept, personally unappealing, or inferior to others

Borderline

a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

Borderline

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...

Borderline

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)

Borderline

chronic feelings of emptiness

Borderline

frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

Borderline

identity disturbance: markedly and persistently unstable self-image or sense of self

Borderline

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.

Borderline

inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

Borderline

recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

Borderline

transient, stress-related paranoid ideation or severe dissociative symptoms

Dependent

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...

Dependent

feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself

Dependent

goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant

Dependent

has difficulty expressing disagreement with others because of fear of loss of support or approval. Note: Do not include realistic fears of retribution.

Dependent

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)

Dependent

has difficulty making everyday decisions without an excessive amount of advice and reassurance from others

Dependent

is unrealistically preoccupied with fears of being left to take care of himself or herself

Dependent

needs others to assume responsibility for most major areas of his or her life

Dependent

urgently seeks another relationship as a source of care and support when a close relationship ends

General diagnostic criteria for a PD

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: 1. cognition (i.e., ways of perceiving and interpreting self, other people, and events) 2. affectivity (i.e., the range, intensity, lability, and appropriateness of emotional response) 3. interpersonal functioning, and 4. impulse control

General diagnostic criteria for a PD

B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.

General diagnostic criteria for a PD

C. The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder.

General diagnostic criteria for a PD

D. The enduring pattern is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., head trauma).

General diagnostic criteria for a PD

E. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.

General diagnostic criteria for a PD

F. The pattern is stable and of long duration and its onset can be traced back at least to adolescence or early adulthood.

Histrionic

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...

Histrionic

considers relationships to be more intimate than they actually are

Histrionic

consistently uses physical appearance to draw attention to self

Histrionic

displays rapidly shifting and shallow expression of emotions

Histrionic

has a style of speech that is excessively impressionistic and lacking in detail

Histrionic

interaction with others is often characterized by inappropriate sexually seductive or provocative behavior

Histrionic

is suggestible, i.e., easily influenced by others or circumstances

Histrionic

is uncomfortable in situations in which he or she is not the center of attention

Histrionic

shows self-dramatization, theatricality, and exaggerated expression of emotion

Narcissistic

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...

Narcissistic

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)

Narcissistic

has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

Narcissistic

has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

Narcissistic

is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

Narcissistic

is often envious of others or believes that others are envious of him or her

Narcissistic

is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

Narcissistic; Antisocial

lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

Narcissistic; Histrionic

requires excessive admiration

Narcissistic

shows arrogant, haughty behaviors or attitudes

Obsessive-Compulsive

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...

Obsessive-Compulsive

adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes

Obsessive-Compulsive

is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)

Obsessive-Compulsive

is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)

Obsessive-Compulsive

is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost

Obsessive-Compulsive

is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things

Obsessive-Compulsive

is unable to discard worn-out or worthless objects even when they have no sentimental value

Obsessive-Compulsive

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)

Obsessive-Compulsive

shows rigidity and stubbornness

Paranoid

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...

Paranoid

has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner

Paranoid

is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates

Paranoid

is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her

Paranoid

perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack

Paranoid

persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights

Paranoid

reads hidden demeaning or threatening meanings into benign remarks or events

Paranoid

suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her

Schizoid

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...

Schizoid

almost always chooses solitary activities

Schizoid

appears indifferent to the praise or criticism of others

Schizoid

has little, if any, interest in having sexual experiences with another person

Schizoid

lacks close friends or confidants other than first-degree relatives

Schizoid

neither desires nor enjoys close relationships, including being part of a family

Schizoid

shows emotional coldness, detachment, or flattened affectivity

Schizoid

takes pleasure in few, if any, activities

Schizotypal

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...

Schizotypal

behavior or appearance that is odd, eccentric, or peculiar

Schizotypal

excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self

Schizotypal

ideas of reference (excluding delusions of reference)

Schizotypal

inappropriate or constricted affect

Schizotypal

lack of close friends or confidants other than first-degree relatives

Schizotypal

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)

Schizotypal

odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped)

Schizotypal; Paranoid

suspiciousness or paranoid ideation

Schizotypal

unusual perceptual experiences, including bodily illusions

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