Ab Psych Chapter 12: Personality Disorders Clusters A & B

• Personality disorders - overly rigid and maladaptive patterns of behavior and ways of relating to others that reflect extreme variations on underlying personality traits

DSM Criteria for Personality Disorders:

• Cluster A: Odd, eccentric thinking or behavior

• Cluster B: Dramatic, overly emotional, unpredictable thinking or behavior

• Cluster C: Anxious, fearful thinking or behavior

Cluster A: Paranoid Personality Disorder --

• 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:

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

  • Preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates

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

  • Reads hidden demeaning or threatening meanings into benign remarks or events

  • Persistently bears grudges

  • Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counter-attack

  • Has recurrent suspicions, without justification, regarding infidelity of spouse or sexual partner

Cluster A: Schizoid Personality Disorder --

• 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 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

Cluster A: Schizotypal Personality Disorder --

• 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:

  • Ideas of reference (excluding delusions of reference)

  • Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitions, belief in clairvoyance, telepathy, or “sixth sense”; in children and adolescents, bizarre fantasies or preoccupations).

  • Unusual perceptual experiences, including bodily illusions

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

  • Suspiciousness or paranoid ideation

  • Inappropriate or constricted affect

  • Behavior or appearance that is odd, eccentric, or peculiar

  • Lack of close of friends or confidants other than first-degree relatives

  • 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 --

• 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:

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

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

  • Impulsivity or failure to plan ahead

  • Irritability and aggressiveness, as indicated by repeated physical fights or assaults

  • Reckless disregard for safety of self or others

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

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

• Antisocial personality disorder associated with an increased risk of criminality, however:

  • Not all criminals have antisocial personalities

  • Not all people with antisocial personality disorder become criminals

  • Antisocial personality as two independent dimensions: Personality dimension – do not become law breakers and Behavioral dimension – frequent problems with law

Cluster B: Borderline Personality Disorder --

• 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 5 (or more) of the following:

  • Frantic efforts to avoid real or imagined abandonment

  • A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of ideation and devaluation

  • Identity disturbance: Unstable self-image or sense of self

  • Impulsivity in at least two areas that are potentially self-damaging

  • Recurrent suicidal behavior, gestures, threats, or self-mutilating behavior

  • Affective instability due to a marked reactivity of mood

  • Chronic feelings of emptiness

  • Inappropriate intense anger or difficult controlling anger

  • Transient, stress-related paranoid ideation or severe dissociative symptoms

• Borderline Personality Disorder & Self-Mutilation:

  • People with BPD may engage in impulsive acts of self-mutilation such as cutting: as a means of temporarily blocking or escaping from deep, emotional pain, as an expression of anger or a means of manipulating others, or to counteract self-reported feelings of “numbness”

  • As well as other maladaptive impulse behaviors

Cluster B: Histrionic Personality Disorder --

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

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

  • Interactions 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

  • Style of speech that is excessively impressionistic and lacking in detail

  • Show self-dramatization, theatricality, & exaggerated expression of emotion

  • Is suggestible

  • Considers relationships to be more intimate than they actually are

Cluster B: Narcissistic Personality Disorder --

• 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:

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

  • Is 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 associate with, other special or high-status people (or institutions)

  • Requires excessive admiration

  • Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations)

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

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

  • Is often envious of others or believes that others are envious of him or her

  • Shows arrogant, haughty behaviors or attitudes