DSM Personality Disorders

What is Criteria A of General Personality Disorder? How many pattens should be manifested and what are they?

Enduring patten of behavior that deviates from the expectations of the individuals culture. Two or more:

1. Cognition (ways of perceiving snd interpreting)

2. Affectivity (appropriateness of emotional response)

3. Interpersonal functioning

4. Impulse control

Criteria B, C, D, E, and F

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

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

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

E. The enduring pattern is not better explained as a manifestation or consequence of another mental disorder.

F. The enduring pattern is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., head trauma).

What is Criteria A of Paranoid Personality Disorder? At least how many symptoms?

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. Four or more of the ff:

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, in-

   juries, 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 or sexual partner

Criteria B for Paranoid Personality Disorder? if criteria are ,et prior to onset of schizophrenia?

B. Does not occur exclusively during schizophrenia, a bipolar disorder or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to the physiological effects of another medical condition.

Premorbid

What is Criteria A for Schizoid Personality Disorder? How many symptoms?

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:

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.

Criteria B of Schizoid? If criteria are met prior to the onset of schizophrenia, whats it called?

Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder and is not attributable to the physiological effects of another medical condition.

Premorbid

Criteria A of Schizotypal and how many symptoms?

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:

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, or “sixth sense”; in children and adolescents, bizarre fantasies or preoccupations).

3. Unusual perceptual experiences, including bodily illusions

4. Odd thinking and speech (e.g., vague, circumstantial, meta- phorical, overelaborate, 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 familiar-

ity and tends to be associated with paranoid fears rather than

negative judgments about self.

Criteria B of Schizotypal? If criteria are met prior to schizophrenia, whats it called?

Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder.

Premorbid

Criteria A of Antisocial? What age? at least how many?

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:

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 and aggressiveness, as indicated by repeated

physical fights or assaults.

5. Reckless disregard for safety of self or others.

5. 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 ratio-

nalizing having hurt, mistreated, or stolen from another.

Criteria B, C, and D of Antisocial

B. The individual is at least age 18 years.

C. There is evidence of conduct disorder with onset before age 15 years.

D. The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder

what is Criteria A of Borderline Personality Disorder? beginning when? At least how many symptoms?

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:

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

2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

3. Identity disturbance: markedly and persistently unstable self-image or sense of self.

4. 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.)

5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.

6. 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).

7. Chronic feelings of emptiness.

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

9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

Criteria A of Histrionic? Beginning when? At least how many symptoms?

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:

1. Is uncomfortable in situations in which he or she is not 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 lack-

ing in detail.

6. Shows self-dramatization, theatricality, and exaggerated expres-

sion of emotion.

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

8. Considers relationships to be more intimate than they actually are.

Criteria A of Narcissistic? Beginning when? At least how many symptoms?

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:

1. Has a grandiose sense of self-importance (e.g., exaggerates

achievements and talents, expects to be recognized as superior

without commensurate achievements).

2. Is preoccupied with fantasies of unlimited success, power, bril-

liance, beauty, or ideal love.

3. 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).

4. Requires excessive admiration.

5. Has a sense of entitlement (i.e., unreasonable expectations of

especially favorable treatment or automatic compliance with his

or her expectations).

6. Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).

7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs 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.

Criteria A of Avoidant Personality Disorder? Beginning when? At least how many symptoms?

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:

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 the 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 unusually reluctant to take personal risks or to engage in any

new activities because they may prove embarrassing

Criteria A of Dependent Personality Disorder?

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:

1. Has difficulty 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 or her life.

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

4. 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).

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 sup-

   port when a close relationship ends.

8. Is unrealistically preoccupied with fears of being left to take care

   of himself or herself.

Criteria A of Obsessive-Compulsive Personality Disorder? Beginning when? At least how many symptoms?

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:

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 (e.g., is 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 (not accounted for by obvious

economic necessity).

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 stubbornness.

Criteria A, B, C, D and E of Personality Change due to Another Medical Condition

A persistent personality disturbance that represents a change

from the individual’s previous characteristic personality pattern.

Note: In children, the disturbance involves a marked deviation from normal development or a significant change in the child’s

usual behavior patterns, lasting at least 1 year.

B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition.

C. The disturbance is not better explained by another mental disorder (including another mental disorder due to another medical condition).

D. The disturbance does not occur exclusively during the course of a delirium.

E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specifiers for Personality change due to medical condition

Labile type: If the predominant feature is affective lability.

Disinhibited type: If the predominant feature is poor impulse

control as evidenced by sexual indiscretions, etc.

Aggressive type: If the predominant feature is aggressive

behavior.

Apathetic type: If the predominant feature is marked apathy and

indifference.

Paranoid type: If the predominant feature is suspiciousness or

paranoid ideation.

Other type: If the presentation is not characterized by any of the

above subtypes.

Combined type: If more than one feature predominates in the

clinical picture.

Unspecified type

What is other specified personality disorder

• cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the personality disorders diagnostic class.

• clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any specific personality disorder.

What is unspecified personality disorder?

Cause significant distress and impairment but do not meet full criteria. Clinician chooses not to specify reason that the criteria didnt meet