PERSONALITY DISORDERS DSM-IV

CLUSTER A

PARANOID PERSONALITY DISORDER 301.0

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 4 or more of the following:

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

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

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

4) reads hidden demeaning or threatening meanings into benign remarks or events

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

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

7) has recurrent suspicions, without justification, regarding fidelity of spouse.

SCHIZOID PERSONALITY DISORDER 301.2

A pervasive pattern of detachment from social relationships & a restricted range of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by 4 or more of the following:

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

2) almost always chooses solitary activities

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

4) takes pleasure in few, if any, activities

5) lacks close friends or confidants other than first-degree relatives

6) appears indifferent to the praise or criticism of others

7) shows emotional coldness, detachment, or flattened affectivity.

SCHIZOTYPAL PERSONALITY DISORDER 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 5 or more:

1) ideas of reference (excluding delusions of reference)

2) odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, "sixth sense", or bizarre fantasies or preoccupations

3) unusual perceptual experiences, including bodily illusions

4) odd thinking & speech(e.g. vague,circumstancial, metaphorical, or stereotyped

5) suspiciousness or paranoid ideation

6) inappropriate or constricted affect

7) behavior or appearance that is odd eccentric or peculiar

8) lack of close friends or confidants other than first degree relatives

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

CLUSTER B

ANTISOCIAL PERSONALITY DISORDER 301.7

(A) There is a pervasive pattern of disregard for and violation of the rights of others occuring since age 15 years, as indicated by 3 or more of the following:

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

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

3) impulsivity or failure to plan ahead

4) irritability & aggressivenes, as indicated by repeated physical fights or assaults

5) reckless disregard for safety of self and others

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

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

(B) The individual is at least 18 years old

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

(D) The occurance is not during Schizophrenia or Manic Episode.

BORDERLINE PERSONALITY 301.83

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and a marked impulsiveness beginning by early adulthood and present in a variety of contexts, as indicated by 5 of the following:

1) frantic efforts to avoid real or imagined abandonment

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

3) identity disturbance: markedly & persistently unstable self-image or sense of self

4) impulsivity in a least 2 areas that are potentially self-damaging ( spending, sex, substance abuse, reckless driving, binge eating (not including # 5 items)

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

6) affective instability due to a marked reactivity of mood (intense episodic dysphoria, irritability, or anxiety usually lasting a few hours & rarely days)

7) chronic feelings of emptiness

8) inappropriate, intense anger or difficulty controlling anger (frequent displays of temper, constant anger, recurrent fights)

9) transient, stress related paranoid ideation or severe dissociative symptoms.

HISTRIONIC PERSONALITY DISORDER 301.50

A pervasive pattern of excessive emotionality and attention seeking, beginning in early adulthood and present in a variey of contexts, as indicated in 5 or more of the following:

1) is uncomfortable in situations in which he/she is not in the center of attention

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

3) displays rapidly shifting and shallow expression of emotions

4) consistently uses physical appearance to draw attention to self

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

6) shows self dramatization, theatricality, and exagerated expression of emotion

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

8) considers relationships to be more intimate than they actually are.

NARCISSISTIC PERSONALITY DISORDER 301.81

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 5 or more of the following:

1) has a grandiose sense of self- importance ( exaggerates achievements, and talents, expects to be recognized as superior )

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

3) believes 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

4) requires excessive admiration

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

6) is interpersonally exploitive, ie, takes advantage of others to achieve his or her own ends

7) lacks empathy: is unwilling to recognize or identify with the feelings of others

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

9) shows arrogant, haughty behaviors or attitudes.

CLUSTER C

AVOIDANT PERSONALITY DISORDER 301.82

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 4 or more of the following:

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

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

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

4) is preoccupied with being criticized or rejected in social situations

5) is inhibited in new interpersonal situations because of feelings of inadequacy

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

7) is usually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.

DEPENDENT PERSONALITY DISORDER 301.6

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 & present in a variety of contexts, as indicated by 5 or more of these:

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

2) needs others to assume responsibility for most major areas of his/her life

3) has difficulty expressing disagreement with others because of fear of loss of support or approval

4) has difficulty initiating projects or doing things on his/her own

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

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

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

8) is unrealistically preoccupied with fears of being left to take care of himself

OBSESSIVE-COMPULSSIVE PERSONALITY DISORDER 301.4

A pervasive pattern of preoccupation with orderliness, perfectionism, & mental and interpersonal control, at the expense of flexibility, openness, & efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by 4 or more of the following:

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

2) shows perfectionism that interferes with task completion ( unable to complete a project because his or her own overly strict standards are not met)

3) is excessively devoted to work and productivity to the exclusion of leisure activities and friendships

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

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

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

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

8) shows rigidity and stubborness.