Personality Disorders Overview - Defining Deviance
- Personality: Enduring patterns: perceiving, relating, thinking.
- Trait vs. Disorder: Traits inflexible, maladaptive, causing distress/impairment.
- General DSM-5 Criteria:
- Enduring, deviant pattern (≥2 areas: cognition, affect, interpersonal, impulse).
- Pervasive, inflexible.
- Significant distress/impairment.
- Stable, long duration; onset by adolescence/early adulthood.
- Not other disorder, substance, medical condition.
- 📌 Mnemonic: ENDURES (Enduring, Not other, Deviates, Pervasive, Early onset, Distress/Impairment, Stable).
⭐ Ego-syntonic: Individuals see traits as natural, not problems.
Cluster A Personalities - Odd & Eccentric Crew
📌 Mnemonic: Cluster A: 'PSSst... A weirdo!' (Paranoid, Schizoid, Schizotypal)
| Feature | Paranoid PD | Schizoid PD | Schizotypal PD |
|---|---|---|---|
| Core Feature | Distrust, Suspiciousness | Detachment, Restricted Emotion | Social discomfort, Cognitive/Perceptual distortions, Eccentricity |
| Interpersonal Style | Guarded, Argumentative | Aloof, Indifferent | Suspicious, Few friends |
| Affect | Hostile, Irritable | Cold, Detached, Flat | Inappropriate, Constricted |
| Cognition/Perception | Hidden meanings, Doubts loyalty | Lacks interest (sex/pleasure) | Magical thinking, Odd beliefs |
| Behavior | Secretive, Jealous | Solitary, Lacks friends | Odd speech/appearance, Social anxiety |
| Key Defense | Projection | Fantasy, Intellectualization | Undoing, Magical thinking |
Cluster B Personalities - Dramatic & Erratic Ensemble
📌 Mnemonic: Cluster B: 'Wild BAHN' (Borderline, Antisocial, Histrionic, Narcissistic)
| Feature | Antisocial (ASPD) | Borderline (BPD) | Histrionic (HPD) | Narcissistic (NPD) |
|---|---|---|---|---|
| Core Feature | Disregard rights; Conduct <15y, now ≥18y | Instability (mood, self, relations) | Excessive emotionality, attention-seek | Grandiose, needs admiration, lacks empathy |
| Interpersonal Style | Deceitful, manipulative | Intense, unstable; fears abandonment | Superficial, theatrical | Exploitative, entitled |
| Affect | Irritable, aggressive | Unstable, intense anger, empty | Rapidly shifting, shallow | Labile (if criticized) |
| Behavior | Impulsive, unlawful | Impulsive (self-damaging), suicidal gestures | Provocative, dramatic | Seeks admiration |
| Self-Image | Inflated | Unstable, poor | Vague, needs approval | Grandiose, fragile |
| Key Defense | Rationalization | Splitting | Repression | Idealization/Devaluation |
⭐ Splitting (viewing people/situations as all good or all bad) is a hallmark defense mechanism in Borderline Personality Disorder.
Cluster C Personalities - Anxious & Fearful Folks
📌 Mnemonic: CADet (Compulsive, Avoidant, Dependent) or Anxious CAD.
| Feature | Avoidant PD | Dependent PD | Obsessive-Compulsive PD (OCPD) |
|---|---|---|---|
| Core Feature | Social inhibition, inadequacy | Excessive need to be cared for | Preoccupation with order, perfection |
| Interpersonal | Fears criticism, rejection | Submissive, clinging, fears separation | Rigid, controlling |
| Affect | Anxious, fearful | Anxious, helpless when alone | Constricted, serious |
| Behavior | Avoids social interaction | Seeks reassurance, avoids decisions | Perfectionistic, inflexible |
| Self-Perception | Socially inept, inferior | Inadequate, helpless | Righteous, responsible |
| Key Defense | Fantasy, withdrawal | Introjection, idealization | Intellectualization, reaction formation |
Other PD Aspects - Nuances & Notes
- DSM-5 Alt. Model: Includes PD Trait-Specified.
⭐ The DSM-5 alternative model for personality disorders emphasizes impairments in personality functioning (self and interpersonal) and pathological personality traits.
- ICD-11 General PD: Core self/interpersonal dysfunction.
- ICD-11 Personality Difficulty: Subthreshold, causes distress.
High‑Yield Points - ⚡ Biggest Takeaways
- Personality Disorders (PDs) are classified using DSM-5 and ICD-11.
- PDs fall into three clusters: A (Odd/Eccentric), B (Dramatic/Erratic), C (Anxious/Fearful).
- Cluster A: Paranoid, Schizoid, Schizotypal.
- Cluster B: Antisocial, Borderline, Histrionic, Narcissistic.
- Cluster C: Avoidant, Dependent, Obsessive-Compulsive PD (OCPD).
- Characterized by pervasive, inflexible patterns from early adulthood, causing significant distress or functional impairment.
- Symptoms are typically egosyntonic (patient often unaware of problem) and stable over time.
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