Personality Disorders

Question 1

• Pervasive distrust and suspiciousness, intentions
interpreted as malevolent, indicated by >=4:

1. Suspects they’re being exploited or deceived
2. Preoccupied with unjustified doubts about loyalty
   or trustworthiness
3. Reluctant to confide in others for fear of
   information being used maliciously
4. Reads hidden threatening meaning in benign
   remarks or events
5. Persistently bears grudges
6. Perceives attacks on his character and quick to
   counterattack
7. Current suspicions regarding fidelity of spouse

• Not exclusively during course of schizophrenia,
bipolar or depression, or another psychotic
disorder

• Note: if criteria met before onset of schizophrenia,
add “premorbid”

Answer 1

Paranoid Personality Disorder

Question 2

• Pervasive pattern of detachment from social
relationships and restricted emotional expression,
beginning in early adulthood, indicated by >=4:

1. Neither desires nor enjoys close relationships
2. Chooses solitary activities
3. Little interest in sexual experiences
4. Takes pleasure in few activities
5. Lacks close friends other than first degree
6. Appears indifferent to praise or criticism
7. Shows emotional coldness, detachment, or
   flattened affectivity

• Not exclusively during the course of schizophrenia,
bipolar or depression, or another psychotic
disorder

Answer 2

Schizoid Personality Disorder

Question 3

• Pervasive pattern of social/interpersonal deficits, marked by acute discomfort and reduced capacity for close relationships, as well as cognitive/perceptual distortions and eccentricities of behavior, beginning in early adulthood and in a variety of context, >=5:

1. Ideas of reference (excluding delusions)
2. Odd beliefs or magical thinking
3. Unusually perceptual experiences
4. Odd thinking and speech
5. Suspicious or paranoid ideation
6. Inappropriate or constricted affect
7. Odd, eccentric or peculiar behavior or appearance
8. Lack of close friends
9. Excessive social anxiety that doesn’t diminish
   with familiarity

• Not exclusively during course of schizophrenia,
bipolar or depression, or another psychotic
disorder

Answer 3

Schizotypal Personality Disorder

Question 4

• Pervasive pattern of disregard and violation of rights of others, occurring
since age 15, >=3:

1. Failure to conform to social norms with respect to lawful behaviors
2. Deceitfulness
3. Impulsivity
4. Irritability and aggressiveness
5. Reckless disregard for safety of self and others
6. Consistent irresponsibility, repeated failure to sustain consistent work
   behavior or honor financial obligations
7. Lack of remorse

• Individual is >= 18 years old

• Evidence of conduct disorder with onset before age 15 years

• Antisocial behavior not exclusively during course of schizophrenia or bipolar

Answer 4

Antisocial Personality Disorder

Question 5

• Pervasive pattern of instability of interpersonal relationships, self-image,
affects, and marked impulsivity beginning by early adulthood in a variety of
contexts, >=5:

1. Frantic effort to avoid real or imagined abandonment (don’t include suicidal self-mutilating behavior covered below)
2. Pattern of unstable and intense interpersonal relationships, with alternating extremes of idealization and devaluation
3. Identity disturbance: unstable self-image and sense of self
4. Impulsivity in >=2 areas that are potentially self-damaging (don’t include
   suicidal behavior below)
5. Affective instability due to reactivity of mood
6. Chronic feelings of emptiness
7. Inappropriate, intense anger or difficulty controlling anger
8. Transient, stress-related paranoid ideation or severe dissociative symptoms

Answer 5

Borderline Personality Disorder

Question 6

• Pervasive pattern of excessive emotionality and attention seeking, starting in early adulthood in a variety of contexts >=5:

1. Uncomfortable in situations where they’re not center of attention
2. Interactions characterized by inappropriate sexually seductive or
   provocative behavior
3. Rapidly shifting or shallow expression of emotions
4. Uses physical appearance to draw attention to self
5. Speech that is impressionistic and lacking in detail
6. Self-dramatization, theatricality, exaggerated expression of emotion
7. Is suggestible
8. Considers relationships to be more intimate than they actually are

Answer 6

Histrionic Personality Disorder

Question 7

• Pervasive pattern of grandiosity, need for admiration, lack of empathy,
beginning in early adulthood and present in a variety of contexts, >=5:

1. Grandiose sense of self-importance
2. Preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
3. Believes he/she is “special” or unique and can only be understood by, or
   should associated with, other special or high-status people or institutions
4. Requires excessive admiration
5. Has a sense of entitlement
6. Interpersonally exploitative
7. Lacks empathy
8. Envious of others, or believes others are envious of them
9. Shows arrogant, haughty behaviors/attitudes

Answer 7

Narcissistic Personality Disorder

Question 8

• Pervasive pattern of social inhibition, feeling
inadequate, hypersensitive, beginning early
adulthood, >=4:

1. Avoids activities with interpersonal
   contact for fear of criticism, disapproval,
   rejection
2. Unwilling to get involved with people
   unless certain of being liked
3. Restraint with intimate relationships for
   fear of being shamed or ridiculed
4. Preoccupied with criticized or rejected in
   social situations
5. Inhibited in new situations because of
   feelings of inadequacy
6. Views self as socially inept, unappealing, or
   inferior
7. Reluctant to take risks or do new activities
   because they may be embarrassing

Answer 8

Avoidant Personality Disorder

Question 9

• Pervasive/excessive need to be taken care of,
leads to submissive and clingy behavior, fear
of separation, begins in early adulthood in a
variety of context, >=5:

1. Difficulty making decisions without
   excessive reassurance
2. Needs others to assume responsibility
3. Difficulty expressing disagreement for fear
   of loss of support
4. Difficulty initiating project
5. Excessive lengths to obtain nurturance
6. Feels helpless when alone
7. Urgently seeks another relationship when a close one ends
8. Unrealistically preoccupied with fears of
   being left to take care of self

Answer 9

Dependent Personality Disorder

Question 10

Pervasive pattern of preoccupation with
orderliness, perfectionism, control at
expense of flexibility, efficiency, beginning
in early adulthood in a variety of context,
>=4:

1. Preoccupied with rules, lists, order,
   schedules until point of activity is lost
2. Perfectionism interferes with task
   completion
3. Excessive devotion to work/productivity to exclusion of leisure and friends
4. Over conscientious, scrupulous, inflexible on matters of morality, ethics,
   or values
5. Unable to discard worn-out objects
6. Reluctant to delegate tasks or work with
   others
7. Miserly spending style
8. Rigid and stubborn

Answer 10

Obsessive-Compulsive Personality
Disorder