1. Personality Disorders
Chapter 11

2. Personality Disorder
Persistent pattern of emotions, cognitions, and behavior that results in enduring emotional distress for the person affected and/or others and may cause difficulties with work and relationships
May not feel subjective distress-others do because of the actions of the person with the disorder
Weird, Wacky and Worried
Weird: Cluster A: Paranoid, Schizoid, Schizotypal; appear odd/eccentric
Wacky: Cluster B: Antisocial, Borderline, Histrionic, and Narcissistic; appear dramatic, emotional, or erratic
Worried: Cluster C: Avoidant, Dependent, and Obsessive-Compulsive; appear fearful/anxious

3. Paranoid Personality Disorder
Distrust and suspiciousness of others- interpret motives as malevolent-
4 or more of the following
Others are exploiting, harming, or deceiving person
Preoccupied with unjustified doubts about loyalty and trustworthiness of friends
Reluctant to confide in others because of fear that info will be used maliciously
Reads hidden demeaning or threatening meanings into benign remarks/events
Persistently bears grudges; unforgiving of insults/slights
Perceives attacks that are not apparent to others, quick to react angrily or counterattack
Recurrent suspicions regarding fidelity of partner

4. Schizoid Personality Disorder
Pervasive pattern of detachment from social relationships and restricted range of expression of emotions in interpersonal settings
4 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 others
Shows emotional coldness, detachment, or flattened affectivity

5. Schizotypal Personality Disorder
Pervasive pattern of social and interpersonal deficits marked by acute discomfort with and reduced capacity for close relationships as well by cognitive or perceptual distortions and eccentricities of behavior
5 or more of the following:
Ideas of reference (events or coincidences as having significance)
Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms
Unusual perceptual experiences
Odd thinking and speech
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 tensd to be associated with paranoid fears rather than negative judgments about self

6. Antisocial Personality Disorder
A pervasive disregard for and violation of the rights of others
3 or more of the following:
Failure to conform to social norms with respect to lawful behaviors- repeated acts that are grounds for arrest
Deceitfulness- lying, use of aliases, conning
Impulsivity or failure to plan ahead
Irritability and aggressiveness, repeated physical fights or assaults
Reckless disregard for safety of self or others
Consistent irresponsibility- failure to sustain work behavior or honor financial obligations
Lack of remorse- indifferent to or rationalizing having hurt, mistreated or stolen from others
18yoa, evidence of Conduct Disorder before 15yoa

7. Psychopathy and Sociopathy
Hare- glibness/superficial charm, grandiose sense of self-worth, pathological lying, conning/manipulative, lack of remorse or guilt, callous lack of empathy
Actual inability to experience empathy
Because of situational factors- squashed ability to experience empathy
Recidivism
How to make staying lawful beneficial for them

8. Conduct Disorder Violation of rights of others or societal norms/rules
3 of following
Aggression to people or animals- 7 criteria including fights, bullying/threatening/intimidating, caused physical injury with a weapon, physically cruel to people/animals, stolen while confronting victim, forced sexual activity
Destruction of property- engaged in fire setting to do damage, destroyed others’ property
Deceitfulness or theft- broken into house/building/car, lies/cons to obtain goods or avoid obligations, stolen items of nontrivial value without confronting victim
Serious violation of rules: stay out despite parental prohibitions (before 13yoa), run away from home overnight at least twice without returning for lengthy period, truant from school (before 13yoa)

9. Borderline Personality Disorder
Pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity
5 or more of the following
Frantic efforts to avoid real or imagined abandonment
Pattern of unstable and intense interpersonal relationships- alternating between idealization and devaluation
Identity disturbance- unstable self-image or sense of self
Impulsivity in at least two areas that are self-damaging (spending, sex, substance abuse reckless driving, binge eating)
Recurrent suicidal behavior, gestures, threats, or self-mutilating behavior
Affective instability- marked reactivity of mood, intense but short
Chronic feelings of emptiness
Inappropriate or intense anger/difficulty controlling anger
Transient stress-related paranoid ideation or sever dissociative symptoms

10. Histrionic Personality Disorder
Pervasive pattern of emotionality and attention seeking
5 or more of the following
Uncomfortable in situations in which he or she is not the center of attention
Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior
Displays rapidly shifting and shallow expression of emotions
Consistently uses physical appearance to draw attention to self
Has a style of speech that is excessively impressionistic and lacking in detail
Shows self-dramatization, theatricality, and exaggerated expression of emotion
Is suggestible (i.e., easily influenced by others or circumstances)
Considers relationships to be more intimate than they actually are

11. Narcissistic Personality Disorder
Pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy
5 or more
Grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
Preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
Believes that he or she is “special” and unique and can only be understood by, or should be associated with, other special or high-status people/institutions
Requests excessive admiration
Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his/her expectations)
Interpersonally exploitative (takes advantage of others to achieve his or her own ends)
Lacks empathy; is unwilling to recognize or identify with the feelings and needs of others
Often envious of others or believes that others are envious of him/her
Shows arrogant, haughty behaviors or attitudes

12. Avoidant Personality Disorder
Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation
4 or more
Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection
Unwilling to get involved with people unless certain of being being liked
Shows restraint within intimate relationships because of fear of being shamed or ridiculed
Preoccupied with being criticized or rejected in social situations
Inhibited in new interpersonal situations because of feelings of inadequacy
Views self as socially inept, personally unappealing, or inferior to others
Unusually reluctant to take personal risks or to engage in new activiites because they may prove embarrasing

13. Dependent Personality Disorder
Pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation
5 or more
Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others
Needs others to assume responsibility for most major areas of his/her life
Has difficulty expressive disagreement with others because of fear of loss of support of approval (Not realistic fears of retribution)
Has difficulty initiating projects or doing things on his/her own (lack of self-confidence in judgment or abilities rather than lack of motivation or energy)
Goes to excessive lengths to obtain nurturance and support form others, to the point of volunteering to do things that are unpleasant
Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for him/herself
Urgently seeks another relationship as a source of care and support when a close relationship ends
Unrealistically preoccupied with fears of being left to take care of him/herself

14. Obsessive-Compulsive Personality Disorder
Pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency
4 or more
Preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost
Shows perfectionism that interferes with task completion (unable to complete a project because overly strict standards not met)
Excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by economic necessity)
Overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)
Unable to discard worn-out or worthless objects even when they have no sentimental value
Reluctant to delegate tasks or to work with others unless they submit to exactly his/her way of doing things
Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes
Shows rigidity and stubborness