PDs as per DSM 5

Introduction to Personality Disorders

Personality disorders are a significant category of mental health disorders that impact an individual’s thinking, feeling, and behavior. They are characterized by enduring patterns of behavior, cognition, and inner experience that deviate markedly from the expectations of the individual's culture, leading to distress or impairment in social, occupational, or other important areas of functioning. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) provides a comprehensive framework for diagnosing and understanding personality disorders.

Definition of Personality Disorders (DSM-5)

The DSM-5 defines personality disorders as "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment." These patterns manifest in at least two of the following areas: cognition, affectivity, interpersonal functioning, or impulse control.

Classification of Personality Disorders (DSM-5)

The DSM-5 classifies personality disorders into three clusters, based on descriptive similarities among the disorders within each cluster:

Cluster A: Odd or Eccentric Disorders

These disorders are characterized by odd, eccentric thinking or behavior.

1. Paranoid Personality Disorder

   • Characterized by a pervasive distrust and suspiciousness of others, interpreting their motives as malevolent.

2. Schizoid Personality Disorder

   • Marked by a pattern of detachment from social relationships and a restricted range of emotional expression in interpersonal settings.

3. Schizotypal Personality Disorder

   • Characterized by acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities in behavior.

Cluster B: Dramatic, Emotional, or Erratic Disorders

These disorders are characterized by dramatic, overly emotional, or unpredictable thinking or behavior.

1. Antisocial Personality Disorder

   • Involves a pervasive pattern of disregard for and violation of the rights of others. Individuals often engage in deceit, manipulation, and lack of remorse for their actions.

2. Borderline Personality Disorder

   • Marked by instability in interpersonal relationships, self-image, and emotions, as well as impulsive behavior. Individuals may exhibit intense episodes of anger, depression, and anxiety.

3. Histrionic Personality Disorder

   • Characterized by excessive emotionality and attention-seeking behavior. Individuals often display rapidly shifting emotions and may seek to be the center of attention.

4. Narcissistic Personality Disorder

   • Involves a pervasive pattern of grandiosity, a need for admiration, and a lack of empathy. Individuals may have an exaggerated sense of self-importance and entitlement.

Cluster C: Anxious or Fearful Disorders

These disorders are characterized by anxious or fearful thinking or behavior.

1. Avoidant Personality Disorder

   • Marked by a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Individuals may avoid social situations due to fears of rejection or criticism.

2. Dependent Personality Disorder

   • Characterized by a pervasive and excessive need to be taken care of, leading to submissive and clinging behavior and fears of separation.

3. Obsessive-Compulsive Personality Disorder

   • Involves a preoccupation with orderliness, perfectionism, and control. Unlike obsessive-compulsive disorder (OCD), these behaviors are related to personality traits rather than anxiety-driven obsessions and compulsions.

Alternative DSM-5 Model for Personality Disorders

The DSM-5 also includes an Alternative Model for Personality Disorders in Section III, which is intended for further research and clinical practice. This model emphasizes a dimensional approach to personality disorders, assessing both personality functioning and the presence of pathological personality traits.

• Personality Functioning: This involves evaluating impairments in self (identity and self-direction) and interpersonal functioning (empathy and intimacy).

• Pathological Personality Traits: The model identifies five broad trait domains, which include Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism.