PERSONALITY DISORDERS 

A "personality disorder" is defined by the American Psychiatric Association 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"¹

The American Psychiatric Association publishes the DSM-IV-TR, cited below, in which they follow a diagnostic approach representing a "categorical perspective," which argues that "Personality Disorders are qualitatively distinct clinical syndromes" (p. 689).

They duly note, however, that there is controversy over this perspective, and that an alternative to the categorical approach is the dimensional perspective in which personality disorders represent 'maladaptive variants of personality traits that merge imperceptibly into normality and into one another" (pp. 689-690).

The dimensional approach to personality disorders is articulated in the Psychodynamic Diagnostic Manual (PDM), published by the Alliance of Psychoanalytic Organizations.²

1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington DC, 2000, p. 685.

2. PDM Task Force. Psychodynamic Diagnostic Manual. Silver Spring, MD: Alliance of Psychoanalytic Organizations, 2006.

According to the DSM-IV-TR, the 10 generally accepted Personality Disorders are:

* Paranoid, which is "a pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent."

* Schizoid, which is "a pattern of detachment from social relationships and a restricted range of emotional expression."

* Schizotypal, which is "a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior."

* Antisocial, which is "a pattern of disregard for, anviolation of, the rights of others."

* Borderline, which is "a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity."

* Histrionic, which is "a pattern of excessive emotionality and attention seeking."

*Narcissistic, which is "a pattern of grandiosity, need for admiration, and lack of empathy."

* Avoidant, which is "a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation."

* Dependent, which is "a pattern of submissive and clinging behavior related to an excessive need to be taken care of."

* Obsessive-Compulsive, which is "a pattern of preoccupation with orderliness, perfectionism, and control."

[See Obsessive-Compulsive Disorder on page 7 of this web site for the differences between OCD criteria and the Obsessive-Compulsive Personality Disorder criteria, which is depicted at the bottom of this page.]  

 OBSESSIVE COMPULSIVE PERSONALITY DISORDER

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

(1) Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.

(2) Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met).

(3) Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).

(4) Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification).

(5) Is unable to discard worn-out or worthless objects even when they have no sentimental value.

(6) Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.

(7) Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.

(8) Shows rigidity and stubbornness.

[Adapted from DSM-IV-TR, as cited above, p. 725.]

BORDERLINE PERSONALITY DISORDER DIAGNOSTIC QUESTIONNAIRE

Do you have a history of instability of your interpersonal relationships, your self-image, and your moods, as well as tendencies towards impulsivity, since early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) Frantic efforts to avoid real or magined abandonment. (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.)

Yes_____ No_____

(2) A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of overvaluing and devaluing the other person.

Yes_____ No_____

(3) Identity disturbance--confusion as to "who you really are."

Yes_____ No_____

(4) Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).

Yes_____ No_____

(5) Recurrent suicidal behavior, gestures or threats, or self-mutilating behavior, such as cutting self.

Yes_____ No_____

(6) Mood instability--an overly intense response to perceived slights or "things going wrong" (e.g., intense episodic irritability or anxiety usually lasting a few hours and only rarely more than a few days).

Yes_____ No_____

(7) Chronic feelings of emptiness.

Yes_____ No_____

(8) Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

Yes_____ No_____

(9) Occasional feelings of suspiciousness of others’ motives or behavior.

Yes_____ No_____

(10) Noticeable feelings of not being present, or of being in a dream.

Yes_____ No_____

[Adapted from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington DC, published by the American Psychiatric Association, 2000, p. 706.]