DSM-IV-TR criteria

Personality disorders are noted on Axis II of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-IV-TR (fourth edition, text revision), of the American Psychiatric Association.

[edit] General diagnostic criteria
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Diagnosis of a personality disorder must satisfy the following general criteria in addition to the specific criteria listed under the specific personality disorder under consideration. A. Experience and behavior that deviates markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas:
1. cognition (perception and interpretation of self, others and events) 2. affect (the range, intensity, lability, and appropriateness of emotional response)

3. interpersonal functioning
4. impulse control

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 accounted for as a manifestation or consequence of another mental disorder. F. The enduring pattern is not due to the direct physiological effects of a substance or a general medical condition such as head injury. People under 18 years old who fit the criteria of a personality disorder are usually not diagnosed with such a disorder, although they may be diagnosed with a related disorder. In order to diagnose an individual under the age of 18 with a personality disorder, symptoms must be present for at least one year. Antisocial personality disorder, by definition, cannot be diagnosed at all in persons under 18.

[edit] List of personality disorders defined in the DSM
The DSM-IV lists ten personality disorders, grouped into three clusters. The DSM also contains a category for behavioral patterns that do not match these ten disorders, but nevertheless exhibit characteristics of a personality disorder. This category is labeled Personality Disorder NOS (Not Otherwise Specified). Cluster A (odd or eccentric disorders)

Paranoid personality disorder: characterized by irrational suspicions and mistrust of others

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Schizoid personality disorder: lack of interest in social relationships, seeing no point in sharing time with others Schizotypal personality disorder: also avoids social relationships, though out of a fear of people Antisocial personality disorder: "pervasive disregard for the law and the rights of others." Borderline personality disorder: extreme "black and white" thinking, instability in relationships, self-image, identity and behavior Histrionic personality disorder: "pervasive attention-seeking behavior including inappropriate sexual seductiveness and shallow or exaggerated emotions" Narcissistic personality disorder: "a pervasive pattern of grandiosity, need for admiration, and a lack of empathy" Avoidant personality disorder: social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation and avoidance of social interaction Dependent personality disorder: pervasive psychological dependence on other people. Obsessive-compulsive personality disorder (not the same as Obsessivecompulsive disorder): characterized by rigid conformity to rules, moral codes, and excessive orderliness

Cluster B (dramatic, emotional, or erratic disorders)
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Cluster C (anxious or fearful disorders)
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[edit] List of personality disorders defined in ICD-10 (F60F69)

(F60.) Specific personality disorders
○ ○ ○ ○ ○ ○ ○ ○ ○

(F60.0) Paranoid personality disorder (F60.1) Schizoid personality disorder (F60.2) Dissocial personality disorder (F60.3) Emotionally unstable personality disorder (F60.4) Histrionic personality disorder (F60.5) Anankastic personality disorder (F60.6) Anxious (avoidant) personality disorder (F60.7) Dependent personality disorder (F60.8) Other specific personality disorders

[edit] Revisions and exclusions from past DSM editions
The revision of the previous edition of the DSM, DSM-III-R, also contained the PassiveAggressive Personality Disorder, the Self-Defeating Personality Disorder, and the Sadistic Personality Disorder. Passive-Aggressive Personality Disorder is a pattern of negative attitudes and passive resistance in interpersonal situations. Self-defeating personality disorder is

characterised by behaviour that consequently undermines the person's pleasure and goals. Sadistic Personality Disorder is a pervasive pattern of cruel, demeaning, and aggressive behavior. These categories were removed in the current version of the DSM, because it is questionable whether these are separate disorders. Passive-Aggressive Personality Disorder and Depressive personality disorder were placed in an appendix of DSM-IV for research purposes.
[citation needed]

[edit] History
The concept of personality disorders goes back to at least the ancient Greeks,[2] and even earlier to the ancient Egyptians, such as the Ebers papyrus.[3] Various types of personality disorders were later described by medieval Arabic psychological thinkers,[4][5] and many more have been discovered in modern times.

[edit] Studies on clusters
A study of almost 600 male college students, averaging almost 30 years of age and who were not drawn from a clinical sample, examined the relationship between childhood experiences of sexual and physical abuse and presently reported personality disorder symptoms. Childhood abuse histories were found to be definitively associated with greater levels of symptomatology. Severity of abuse was found to be statistically significant, but clinically negligible, in symptomatology variance spread over Cluster A, B and C scales.[6] Child abuse and neglect consistently evidence themselves as antecedent risks to the development of personality disorders in adulthood.[citation needed] In this particular study, efforts were taken to match retrospective reports of abuse with a clinical population that had demonstrated psychopathology from childhood to adulthood who were later found to have experienced abuse and neglect. The sexually abused group demonstrated the most consistently elevated patterns of psychopathology. Officially verified physical abuse showed an extremely strong role in the development of antisocial and impulsive behavior. On the other hand, cases of abuse of the neglectful type that created childhood pathology were found to be subject to partial remission in adulthood.[7] In 2005, psychologists Belinda Board and Katarina Fritzon at the University of Surrey, UK, interviewed and gave personality tests to high-level British executives and compared their profiles with those of criminal psychiatric patients at Broadmoor Hospital in the UK. They found that three out of eleven personality disorders were actually more common in managers than in the disturbed criminals:
• • •

histrionic personality disorder: including superficial charm, insincerity, egocentricity and manipulation narcissistic personality disorder: including grandiosity, self-focused lack of empathy for others, exploitativeness and independence. obsessive-compulsive personality disorder: including perfectionism, excessive devotion to work, rigidity, stubbornness and dictatorial tendencies.

They described the business people as successful psychopaths and the criminals as unsuccessful psychopaths.[8]