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Axis II Personality disorders.


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A comprehensive description of Personality Disorders.

Personality Disorders

Personality is the qualities and traits of being a specific and unique individual. It is the enduring pattern of our thoughts, feelings, and behaviors -- it is how we think, feel, make decisions and take actions. Personality is determined, in part, by our genetics and also, by our environment. It is the determining factor in how we live our lives.

Individuals with personality disorders have more difficulty in every aspect of their lives. Their individual personality traits reflect ingrained, inflexible, and maladaptive patterns of behaviors that cause discomfort and impair an individual's ability to function. They are

less likely to have happy marraiges
less likely to be successful parents
less likely to function as an effective teamm player at work
more likely to have psychiatric and medical disorders
more likely to have a poor response to psychiatric and medical treatment
more likely to get in trouble with the law
more likely to be generally miserable
According to the Diagnositc Statistical Manual (DSM IV), you have a Personality Disorder if:

You have an enduring pattern of inner experience and behavior that puts you at odds with the expectations of the world around you. This shows itself in the following ways:
How you perceive and understand yourself and others
How you respond emotionally
How you interact with people
How you control your impulses

You are unbending and inflexible and cannot adjust your behavior to the needs of a particular situation, activity, or relationship.

Your personality problem started early in life (by adolescence or early adulthood) and has persisted in a pretty stable manner over time.

Your personality is upsetting you you or limits your success at school, at work, or in relationships.

The behavior is long-standing and is not caused bya nother chronic or recurrent psychiatric disorder, by a medical condition, or by substance use.

Having a personality disorder means you are not the kind of person who can adapt smoothly to the normal give-and-take of everyday life. Instead, you expect the world and people to change for you rather than being able to adjust to the requirements of different situations and relationship. You behave in a rigid an dinflexible way that perpetuates vicious cycles and fulfills your worst prophecies.

Having a closed mind means that you misperceive or filter out new information that does not support your expectations. Then you act in a way that elicits just those responses from others that will make your negative expectations a reality. You generally do not take responsiblity for your own life and feelings, instead you tend to blame others. You lack sufficient coping mechanisms to be adaptive and deal with everyday problems and stressors. Having a personality disorder means that you get in the same fix over and over again and can never figure out quite why or how. Pesonality Disorders create stormy relationships and unfulfilled hopes and dreams.


Cluster A
Personality Disorders

People with Cluster A disorders are often viewed as Odd or Eccentric. They have abnormal cognitions or ideas, they speak and act in strange ways, and they have difficulty relating to others.

The Cluster A Disorders and common characteristics are:

Paranoid Personality Disorder (301.0)

Resentful of Authority
Blame Avoiding
Excessively Certain
Rigid Cognitive Style

Schizoid Personality Disorder (301.20)
Indifferent to Social Relationships
Avoid Interpersonal Interactions
Lacks Empathy
Difficulty with Emotional Expression

Schizotypal Personality Disorder (301.22)
Cognitive Slippage (i.e. perceptual dysfunction)
Schizotypal Cognitions (i.e. magical thinking, ideas of reference)

Cluster B
Personality Disorders
People with Cluster B Personality Disorders tend to act in Dramatic, Emotional and Erratic fashion. People with Cluster B disorders tend to have difficulty with impulsive behavior, they often violate social norms, and act out. They can be self-abusive and hostile to others.

The Cluster B Personality Disorders and common characteristics are:

Antisocial Personality Disorder (301.7)

No superego or conscious (no sense of right and wrong)
Willing to Lie
Not bound by Social Norms
Can be pleasant/polished/slick
Possible criminal record
Potential for Violence
Enjoys humiliating and demeaning others

Narcissistic Personality Disorder (301.81)
Grandiosity, Exhibitionism
Lack of Empathy
Unrealistic self evaluation
Hypersensitivity to Criticism
Need for constant approval

Histrionic Personality Disorder (301.50)
Overly Dramatic, Theatrical
Needs to be center of attention
Attention seeking
Excessive concern with physical appearance
Demanding, manipulative
Frequent Tantrums
Need continual stimulation
Sexually provocative
DSM Criteria

Borderline Personality Disorder (301.83)
Emotional and Interpersonal Instability
Rapid mood swings between ups and downs
Reacting strongly to separations
No clear goals or direction
Frequently considers self-harm

Cluster C
Personality Disorders
People with Cluster C Personality Disorders are often viewed as anxious and fearful. People with these disorders are excessively afraid of social relations and of feeling out of control.

The Cluster C Personality Disorders and common characteristics are:
Obsessive-Compulsive Personality Disorder (301.4)
(note that this is different from Obsessive-Compulsive Disorder)

Difficulty Completing Tasks
Focuses on Minute Detail
Unwillingness to Compromise
Need for control

Avoidant Personality Disorder (301.82)
Hypersensitivity to Rejection
Apprehension and Mistrust
Social Awkwardness

Dependent Personality Disorder (301.6)
Pervasive and excessive need to be taken care of
Difficulty with everyday decisions

(Resources: Your Mental Health: A Layman's Guide to the Psychiatrist's Bible by Allen Frances, MD and Michael B. First, MD, 1998, Scibner; Mental Health Net at http://mentalhelp.net; The Social Work Dictionary by Robert L. Barker, 1995, NASW, Press; Excite Medical Encyclopedia at http://adam.excite.com)

Information and or Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.

This information is not intended to replace "traditional" mental health therapy. If you have questions or concerns about your physical and/or mental health ... contact your family physician and/or mental health professional in your area.