1. Personality Disorders

2. Personality disorders are
stable and enduring patterns of thought, feeling, and behavior (i.e., trait-like syndromes)
that emerge relative early (by adolescence)
that deviate from the norms of one’s culture
that are pervasive and inflexible across many aspects of one’s life
and that lead to distress or impairment (negative consequences for the functioning and the happiness of the individual) (DSM-IV, 1994)

4. Brief descriptions of the DSM-IV Personality Disorders
Cluster and disorder
Description
Cluster A (odd, eccentric)
Schizoid
Extreme detachment and lack of interest in relationships
Schizotypal
Discomfort in close relationships, combined with eccentric behaviors and thoughts
Paranoid
Extreme distrust and suspiciousness of others
Cluster B (dramatic, emotional, erratic)
Antisocial
Disregard for and violation of the rights of others
Borderline
Extreme impulsivity and instability of relationships, self-image, and emotions
Histrionic
Excessive attention seeking and exaggerated expression of emotions
Narcissistic
Excessive sense of self-importance and entitlement
Cluster C (anxious, fearful)
Avoidant
Extreme shyness, low self-esteem, and fear of rejection
Dependent
Excessive need to be taken care of, with submissive and clinging behavior
Obsessive-compulsive
Excessive preoccupation with order, perfection, and control

5. Cluster A disorders (odd, eccentric)
Schizoid
extreme degree of detachment from others
very limited expression of emotions
not interested in family, sexual, work, or friendship relationships
prefers almost always to be alone
indifferent to praise or criticism
feels little joy or pleasure (anhedonia)

6. Cluster A disorders (odd, eccentric)
Schizotypal
detachment from others
extreme discomfort with social relationships
a pattern of odd thinking and eccentric behaviors
superstitious or fascinated with the paranormal
bizarre perceptual experiences

7. Cluster A disorders (odd, eccentric)
Paranoid
strong suspiciousness of others’ motives
sense of being persecuted
quick to take offense when none is intended
likely to hold grudges

8. Cluster B disorders (dramatic, emotional, erratic)
Antisocial
disregards and violates the rights of others
lies to and “cons” others for personal gain
has no remorse for the harm they cause others
aggressive, irresponsible, impulsive, and reckless

9. Cluster B disorders (dramatic, emotional, erratic)
Borderline
extreme instability in own self-image and in relationships with others
extreme impulsivity in various contexts
alcohol abuse, binge eating, spending sprees, sexual escapades
self-harming behaviors such as self-mutilation or suicide attempts
“love/hate” relationships
extreme fear of abandonment
extremely moody and temperamental

10. Cluster B disorders (dramatic, emotional, erratic)
Histrionic
exaggerated attention seeking and exaggerated display of emotion
intense need to be the center of attention
use of physical appearance to draw attention
has a seductive and sexually provocative style
“drama queens” (or “drama kings”) whose emotions are actually shallow and rapidly changing
tend to consider casual acquaintances as being much closer than is actually the case

11. Cluster B disorders (dramatic, emotional, erratic)
Narcissistic
grandiose sense of self
exaggerated sense of innate personal worth and entitlement
selfish lack of concern for others’ needs
arrogant and exploitative
fantasizes having fame, power, wealth, and universal admiration, and envies people who have these things

12. Cluster C disorders (anxious, fearful)
Avoidant
extremely shy and socially inhibited
plagued by feelings of inadequacy and oversensitivity to possible negative evaluation by others
strong fears of criticism, disapproval, or rejection
low self-esteem
wants social contact but is afraid of rejection

13. Cluster C disorders (anxious, fearful)
Dependent
excessive need to be taken care of
submissive, clinging behavior
fears of separation
strong need for advice and reassurance
need other people to take responsibility for important features of their lives
feel unable to take care of themselves when alone
will desperately seek a new “security blanket” relationship if the previous one is lost

14. Cluster C disorders (anxious, fearful)
Obsessive-compulsive
extreme preoccupation with orderliness, perfection, and control
so obsessed with getting the details right that sometimes the entire point of the activity is lost
so perfectionistic and rule-bound that they have difficulty delegating and completing projects on time
tend to put perfectionistic goals ahead of personal relationships
stubborn, inflexible, and likely to hoard money and objects

16. Disorders considered for inclusion in the DSM-IV but rejected
Description
Depressive
Chronic unhappiness, low self-esteem, and pessimism
Passive-aggressive (negativistic)
Excessively negative attitudes and passive resistance to others’ requests
Sadistic
Cruelty and fascination with violence
Self-defeating
Undermines own happiness and repeatedly enters harmful situations and relationships

17. Other personality-related disorders not included in the DSM-IV
Description
Attention-deficit hyperactivity disorder
Extreme inattention, impulsivity, and hyperactivity
Separation anxiety
Excessive anxiety and fear about separation from one’s attachment figure
Oppositional defiant disorder
Extreme hostility, defiance, anger, and disobedience
Specific phobia
Excessive fear of some class of objects or situations (blood, animals, heights, etc.)

18. Problems with the concept of personality disorders
Symptoms of a given disorder do not necessarily “go together.”
Two disorders may have overlapping symptoms, and may tend to be diagnosed together (the issue of “comorbidity”).
“Clusters” of disorders do not match factor analytic results.
A personality disorder should be seen as a continuum, not as a category.
Disorders with a clear personality basis are excluded if those disorders are observed in children.
Some disorders have their origins in sexist stereotypes.