PERSONALITY DISORDERS

GENERAL PERSONALITY DISORDER

A. An enduring pattern of inner experience and behaviour that deviates
markedly from the expectations of the individuals culture. This pattern is
manifested in two (or more) of the following areas:
1. Cognition (i.e., ways of perceiving and interpreting self, other people, and
events)
2. Affectivity (i.e., 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 explained as a manifestation or
consequence of another mental disorder
F. The enduring pattern is not attributable to the physiological effects of a
substance (e.g., drug abuse or medications) or another medical condition
(e.g., head trauma).
Cluster A Personality Disorder: Odd or Eccentric Disorders
1. Paranoid Personality Disorder
Causes: The cause of paranoid personality is not known. However, it is
thought that paranoid personality is a combination of biological and
environmental factors. The disorder is present more often in families with a
history of schizophrenia. Early childhood trauma may be a contributing factor.
Diagnostic Criteria:
A. A pervasive distrust and suspiciousness of others such as their motives
are interpreted as malevolent, beginning by early adulthood and present
in a variety of contexts, as indicated by four (or more) of the following:
1. Suspects, without sufficient basis, that others are exploiting, harming,,
or deceiving him or her.
2. Is preoccupied with unjustified doubts about the loyalty or
trustworthiness of friends or associates.
3. Is reluctant to confide in others because of unwarranted fear that the
information will be used maliciously against him or her.
4. Reads hidden demeaning or threatening meanings into benign remarks
or events.
5. Persistently bears grudges (i.e., is unforgiving of insults, injuries, or
slights).

6. Perceives attacks on his or her character or reputation that are not

apparent to others and is quick to react angrily or to counterattack.
7. Have recurrent suspicions, without justification, regarding fidelity of
spouse or sexual partner.
B. Does not occur exclusively during the course of schizophrenia, a bipolar
disorder or depressive disorder with psychotic features, or another
psychotic disorder and is not attributable to the physiological effects of a
medication or caused by another medical condition.
Note: If criteria are met prior to the onset of schizophrenia, add
premorbid, (i.e., paranoid personality disorder (premorbid)).

Treatment: Treatment for PPD can be very successful. However, most

individuals with this condition have trouble accepting treatment. If an
individual is willing to accept treatment, talk therapy or psychotherapy will be
used. These methods will:

Help the individual learn how to cope with the disorder

Learn how to communicate with others in social situations
Help reduce feelings of paranoia

Medications can also be helpful, especially for severe symptoms of PPD.

Medications include:

Antidepressants
Benzodiazepines
Antipsychotics

Combining medication with talk therapy or psychotherapy can be very

successful.

2. Schizoid Personality Disorder

Causes: Most people with this condition have a relative with schizophrenia,
schizoid personality disorder, or schizotypal personality disorder.
Environmental factors can cause the disorder and seem to have the most
impact during childhood. Experiencing abuse or neglect as a child may
contribute to the condition. An emotionally detached parent may also be a
factor. This disorder occurs more commonly in men than women.
Diagnostic Criteria:
A. A pervasive pattern of detachment from social relationships and a
restricted range of expression of emotions interpersonal settings,

beginning by early adulthood and resent in a variety of contexts, as

indicated by four (or more) of the following:
1. Neither desires nor enjoys close relationships, including being part of a
family.
2. Almost always chooses solitary activities.
3. Has little, if any, interest in having sexual experiences with another
person.
4. Takes pleasure in few, if any, activities.
5. Lacks close friends or confidants other than first-degree relatives.
6. Appears indifferent to the praise or criticism of others.
7. Shows emotional coldness, detachment, or flattened affectivity.
B. Does not occur exclusively during the course of schizophrenia, a bipolar
disorder or depressive disorder with psychotic features, another psychotic
disorder, or autism spectrum disorder and is not attributable to the
physiological effects of a medication or caused by another medical
condition.
Note: if criteria are met prior to the onset of schizophrenia, add premorbid,
(i.e., schizoid personality disorder (premorbid)).
Treatment: Many people choose not to seek treatment because this includes
interacting with others. However, treatment can be successful if they are able
to agree to it. Cognitive behavioural therapy is designed to change the
behaviour. It can be successful in treating this condition because it teaches
them how to act in social situations. This may reduce anxiety and reluctance
to pursue social relationships. Group therapy is another option and can help
them practice their social skills. This will help them become more comfortable
in social situations.
Medications are generally not used unless other treatment methods are not
working. Bupropion may be used to increase feelings of pleasure.
Antipsychotic medications can be used to treat feelings of indifference. These
medications can also help encourage social interactions.
3. Schizotypal Personality Disorder
Causes: Tends to run in families with: schizophrenia, schizotypal personality
disorder, or other personality disorders. Environmental factors, especially
childhood experiences, may play a role in the development disorder. These
factors include: abuse, neglect, trauma or stress, and having a parent who is
emotionally detached.
Diagnostic Criteria:
A. 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 in a variety of
contexts, as indicated by five (or more) of the following:

1. Ideas of reference (excluding delusions of reference)

2. Odd beliefs or magical thinking that influences behaviour and is
inconsistent with subcultural norms (e.g., superstitiousness, belief in
clairvoyance, telepathy, or sixth sense, in children and adolescents,
bizarre fantasies or preoccupations).
3. Unusual perceptual experiences, including bodily illusions.
4. Odd thinking and speech (e.g., vague, circumstantial, metaphorical,
overelaborate, or stereotyped).
5. Suspiciousness or paranoid ideation.
6. Inappropriate or constricted affect
7. Behaviour or appearance that is odd, eccentric, or peculiar.
8. Lack of close friends or confidants other than first-degree relatives.
9. Excessive social activity that does not diminish with familiarity and
tends to be associated with paranoid fears rather than negative
judgements about self.
B. Does not occur exclusively during the course of schizophrenia, a bipolar
disorder or depressive disorder with psychotic features, another psychotic
disorder, or autism spectrum disorder.
Note: If criteria are met prior to the onset of schizophrenia, add premorbid,
(e.g., schizotypal personality disorder (premorbid)).
Treatment: There are no medications designed to treat this condition. Some
individuals benefit from antipsychotic or antidepressant medications. Several
types of therapy can help treat schizotypal personality disorder.
Psychotherapy, or talk therapy, can help them learn how to form
relationships. It may be combined with social skills training to help them feel
more comfortable in social situations. Cognitive behavioural therapy (CBT)
can help them address some of the undesirable behaviours associated with
this condition. This will help them learn how to act in social situations and
how to respond in social cues. CBT can also help them learn how to recognize
unusual or harmful thoughts and change them. Family therapy may be helpful
for those who live with other people. It may help in strengthening their
relationships with family members.
CLUSTER B: Dramatic Personality Disorders
1. Antisocial Personality Disorder
Diagnostic Criteria:
A. A pervasive pattern of disregard for and violation of the rights of
others, occurring since age 15, as indicated by three (or more) of the
following:
1. Failure to conform to social norms with respect to lawful behaviours,
as indicated by repeatedly performing acts that are grounds for
arrest.

2. Deceitfulness, as indicated by repeated lying, use of aliases, or

conning others for personal profit or pleasure.
3. Impulsivity or failure to plan ahead.
4. Irritability and aggressiveness, as indicated by repeated physical
fights or assaults.
5. Reckless disregard for safety of self or others.
6. Consistent irresponsibility, as indicated by being indifferent to or
rationalizing having hurt, mistreated, or stolen from another.
B. The individual is at least 18 years of age.
C. There is evidence of conduct disorder with onset before age 15.
D. The occurrence of antisocial behaviour is not exclusively during the
course of schizophrenia or bipolar disorder.
Treatment: Antisocial personality disorder is very difficult to treat.
People with this disorder may not even want treatment or think they
need it. But people with antisocial personality disorder need treatment
and close-up over the long term. People with this PD may also need
treatment for other conditions such as depression, anxiety or
substance-use disorders. Medical and mental health providers with
experience treating antisocial personality disorders and commonly
associated conditions are more likely to be helpful. The best treatment
or combination of treatments depends on each persons particular
situation and severity of symptoms.
Psychotherapy or talk therapy is sometimes used to treat antisocial
personality disorder. Its not always effective, especially if symptoms
are severe and the person cant admit that he or she contributes to the
problems. Psychotherapy may be provided in individual sessions, in
group therapy, or in sessions that include family or even friends.
There are no medications specifically approved by the Food and Drug
Administration to treat Antisocial Personality Disorder. However several
types of psychiatric medications may help with certain conditions
sometimes associated with antisocial personality disorder or with
symptoms such as aggression. These medications may include
antipsychotic, antidepressant or mood-stabilizing medications. They
must be prescribed cautiously because some have the potential for
misuse.
If you have a loved one with antisocial personality disorder, its critical
that you also get help for the patient. Mental health professionals with
experience managing this condition can help you teach