DSM-IV And DSM-5 Criteria For The Personality Disorders

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2012 American Psychiatric Association. All Rights Reserved.See Terms & Conditions of Use for more information.DSM-IV and DSM-5 Criteria for the Personality DisordersGeneral Criteria for a Personality DisorderGeneral Criteria for a Personality DisorderDSM-IVDSM-5 Criteria - Revised June 2011The essential features of a personality disorder are impairments inpersonality (self and interpersonal) functioning and the presence ofpathological personality traits. To diagnose a personality disorder,the following criteria must be met:A. An enduring pattern of inner experience and behavior the deviatesmarkedly from the expectations of the individual's culture. Thispattern 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, liability, andappropriateness of emotional response)3. Interpersonal functioning4. Impulse controlA. Significant impairments in self (identity or self-direction) andinterpersonal (empathy or intimacy) functioning.B. One or more pathological personality trait domains or trait facets.B. The enduring pattern is inflexible and pervasive across a broadrange of personal and social situations.C. The enduring pattern leads to clinically significant distress orimpairment in social, occupational, or other important areas offunctioning.D. The pattern is stable and of long duration, and its onset can betraced back at least to adolescence or early adulthood.E. The enduring pattern is not better accounted for as a manifestationor consequence of another mental disorder.F. The enduring pattern is not due to the direct physiological effectsof a substance (e.g., a drug abuse, a medication) or a generalmedical condition (e.g., head trauma).C. The impairments in personality functioning and the individual‟spersonality trait expression are relatively stable across time andconsistent across situations.D. The impairments in personality functioning and the individual‟spersonality trait expression are not better understood asnormative for the individual‟s developmental stage or sociocultural environment.E. The impairments in personality functioning and the individual‟spersonality trait expression are not solely due to the directphysiological effects of a substance (e.g., a drug of abuse,medication) or a general medical condition (e.g., severe headtrauma).

2012 American Psychiatric Association. All Rights Reserved.See Terms & Conditions of Use for more information.DSM-IV and DSM-5 Criteria for the Personality DisordersAntisocial Personality DisorderAntisocial Personality DisorderDSM-IV CriteriaDSM-5 Criteria - Revised April 2012The essential features of a personality disorder are impairments inpersonality (self and interpersonal) functioning and the presence ofpathological personality traits. To diagnose antisocial personalitydisorder, the following criteria must be met:A. There is a pervasive pattern of disregard for and violation of therights of others occurring since age 15 years, as indicated by three(or more) of the following: having hurt, mistreated, or stolen fromanother.1. Failure to conform to social norms with respect to lawfulbehaviors as indicated by repeatedly performing acts thatare grounds for arrest.2. Deceitfulness, as indicated by repeated lying, use of aliases,or conning others for personal profit or pleasure.A. Significant impairments in personality functioning manifest by:1. Impairments in self functioning (a or b):a. Identity: Ego-centrism; self-esteem derived frompersonal gain, power, or pleasure.b. Self-direction: Goal-setting based on personalgratification; absence of prosocial internalstandards associated with failure to conform tolawful or culturally normative ethical behavior.AND3. Impulsivity or failure to plan ahead.2. Impairments in interpersonal functioning (a or b):4. Irritability and aggressiveness, as indicated by repeatedphysical fights or assaults.5. Reckless disregard for safety of self or others.6. Consistent irresponsibility, as indicated by repeated failureto sustain consistent work behavior or honor financialobligations.7. Lack of remorse, as indicated by being indifferent to orrationalizing.a. Empathy: Lack of concern for feelings, needs, orsuffering of others; lack of remorse after hurting ormistreating another.b. Intimacy: Incapacity for mutually intimaterelationships, as exploitation is a primary means ofrelating to others, including by deceit and coercion;use of dominance or intimidation to control others.

2012 American Psychiatric Association. All Rights Reserved.See Terms & Conditions of Use for more information.DSM-IV and DSM-5 Criteria for the Personality DisordersB. The individual is at least age 18 years.B. Pathological personality traits in the following domains:1. Antagonism, characterized by:C. There is evidence of Conduct Disorder with onset before age 15years.a. Manipulativeness: Frequent use of subterfuge toinfluence or control others; use of seduction,charm, glibness, or ingratiation to achieve one„sends.D. The occurrence of antisocial behavior is not exclusively during thecourse of Schizophrenia or a Manic Episode.b. Deceitfulness: Dishonesty and fraudulence;misrepresentation of self; embellishment orfabrication when relating events.c. Callousness: Lack of concern for feelings orproblems of others; lack of guilt or remorse aboutthe negative or harmful effects of one„s actions onothers; aggression; sadism.d. Hostility: Persistent or frequent angry feelings;anger or irritability in response to minor slights andinsults; mean, nasty, or vengeful behavior.2.Disinhibition, characterized by:a. Irresponsibility: Disregard for – and failure tohonor – financial and other obligations orcommitments; lack of respect for – and lack offollow through on – agreements and promises.b. Impulsivity: Acting on the spur of the moment inresponse to immediate stimuli; acting on amomentary basis without a plan or considerationof outcomes; difficulty establishing and followingplans.c. Risk taking: Engagement in dangerous, risky, andpotentially self-damaging activities, unnecessarilyand without regard for consequences; boredomproneness and thoughtless initiation of activities to

2012 American Psychiatric Association. All Rights Reserved.See Terms & Conditions of Use for more information.DSM-IV and DSM-5 Criteria for the Personality Disorderscounter boredom; lack of concern for one„slimitations and denial of the reality of personaldangerC. The impairments in personality functioning and the individual‟spersonality trait expression are relatively stable across time andconsistent across situations.D.The impairments in personality functioning and the individual‟spersonality trait expression are not better understood asnormative for the individual‟s developmental stage or sociocultural environment.E. The impairments in personality functioning and the individual‟spersonality trait expression are not solely due to the directphysiological effects of a substance (e.g., a drug of abuse,medication) or a general medical condition (e.g., severe headtrauma).F. The individual is at least age 18 years.Avoidant Personality DisorderAvoidant Personality DisorderDSM-IV CriteriaDSM-5 Criteria - Revised June 2011The essential features of a personality disorder are impairments inpersonality (self and interpersonal) functioning and the presence ofpathological personality traits. To diagnose avoidant personalitydisorder, the following criteria must be met:A. A pervasive pattern of social inhibition, feelings of inadequacy, andhypersensitivity to negative evaluation, beginning by early adulthoodand present in a variety of contexts, as indicated by four (or more) ofthe following:A. Significant impairments in personality functioning manifest by:1. Impairments in self functioning (a or b):a. Identity: Low self-esteem associated with self-appraisalsocially inept, personally unappealing, or inferior;excessive feelings of shame or inadequacy.

2012 American Psychiatric Association. All Rights Reserved.See Terms & Conditions of Use for more information.DSM-IV and DSM-5 Criteria for the Personality Disorders1. Avoids occupational activities that involve significantinterpersonal contact, because of fears of criticism, disapproval,or rejection.b. Self-direction: Unrealistic standards for behaviorassociated with reluctance to pursue goals, take personalrisks, or engage in new activities involving interpersonalcontact.2. Is unwilling to get involved with people unless certain of beingliked.3. Shows restraint within intimate relationships because of the fearof being shamed or ridiculed.4. Is preoccupied with being criticized or rejected in socialsituations.5. Is inhibited in new interpersonal situations because of feelings ofinadequacy.6. Views self as socially inept, personally unappealing, or inferior toothers.7. Is unusually reluctant to take personal risks or to engage in anynew activities because they may prove embarrassing.AND2. Impairments in interpersonal functioning (a or b):a. Empathy: Preoccupation with, and sensitivity to, criticismor rejection, associated with distorted inference of others‟perspectives as negative.b. Intimacy: Reluctance to get involved with people unlessbeing certain of being liked; diminished mutuality withinintimate relationships because of fear of being shamed orridiculed.B. Pathological personality traits in the following domains:1. Detachment, characterized by:a. Withdrawal: Reticence in social situations; avoidance ofsocial contacts and activity; lack of initiation of socialcontact.b. Intimacy avoidance: Avoidance of close or romanticrelationships, interpersonal attachments, and intimatesexual relationships.c.Anhedonia: Lack of enjoyment from, engagement in, orenergy for life‟s experiences; deficits in the capacity to feelpleasure or take interest in things.

2012 American Psychiatric Association. All Rights Reserved.See Terms & Conditions of Use for more information.DSM-IV and DSM-5 Criteria for the Personality Disorders2. Negative Affectivity, characterized by:a. Anxiousness: Intense feelings of nervousness, tenseness,or panic, often in reaction to social situations; worry aboutthe negative effects of past unpleasant experiences andfuture negative possibilities; feeling fearful, apprehensive,or threatened by uncertainty; fears of embarrassment.C. The impairments in personality functioning and the individual‟spersonality trait expression are relatively stable across time andconsistent across situations.D. The impairments in personality functioning and the individual‟spersonality trait expression are not better understood as normativefor the individual‟s developmental stage or socio-culturalenvironment.E. The impairments in personality functioning and the individual‟spersonality trait expression are not solely due to the directphysiological effects of a substance (e.g., a drug of abuse,medication) or a general medical condition (e.g., severe headtrauma).Borderline Personality DisorderBorderline Personality DisorderDSM-IV CriteriaDSM-5 Criteria - Revised June 2011The essential features of a personality disorder are impairments inpersonality (self and interpersonal) functioning and the presence ofpathological personality traits. To diagnose borderline personalitydisorder, the following criteria must be met:A. A pervasive pattern of instability of interpersonal relationships, selfimage, and affects, and marked impulsivity beginning by earlyadulthood and present in a variety of contexts, as indicated by fiveA. Significant impairments in personality functioning manifest by:1. Impairments in self functioning (a or b):a. Identity: Markedly impoverished, poorly developed, or

2012 American Psychiatric Association. All Rights Reserved.See Terms & Conditions of Use for more information.DSM-IV and DSM-5 Criteria for the Personality Disorders(or more) of the following:1. Frantic efforts to avoid real or imagined abandonment. Note: Donot include suicidal or self-mutilating behavior covered inCriterion 5.unstable self-image, often associated with excessive selfcriticism; chronic feelings of emptiness; dissociative statesunder stress.b. Self-direction: Instability in goals, aspirations, values, orcareer plans.2. A pattern of unstable and intense interpersonal relationshipscharacterized by alternating between extremes of idealizationand devaluation.3. Identity disturbance: markedly and persistently unstable selfimage or sense of self.4. Impulsivity in at least two areas that are potentially selfdamaging (e.g., spending, sex, substance abuse, recklessdriving, binge eating). Note: Do not include suicidal or selfmutilating behavior covered in Criterion 5.5. Recurrent suicidal behavior, gestures, or threats, or selfmutilating behavior.6. Affective instability due to a marked reactivity of mood (e.g.,intense episodic dysphoria, irritability, or anxiety usually lasting afew hours and only rarely more than a few days).7. Chronic feelings of emptiness.8. Inappropriate, intense anger or difficulty controlling anger (e.g.,frequent displays of temper, constant anger, recurrent physicalfights).AND2. Impairments in interpersonal functioning (a or b):a. Empathy: Compromised ability to recognize the feelingsand needs of others associated with interpersonalhypersensitivity (i.e., prone to feel slighted or insulted);perceptions of others selectively biased toward negativeattributes or vulnerabilities.b. Intimacy: Intense, unstable, and conflicted closerelationships, marked by mistrust, neediness, and anxiouspreoccupation with real or imagined abandonment; closerelationships often viewed in extremes of idealization anddevaluation and alternating between over involvement andwithdrawal.B. Pathological personality traits in the following domains:1. Negative Affectivity, characterized by:a. Emotional liability: Unstable emotional experiences andfrequent mood changes; emotions that are easily aroused,intense, and/or out of proportion to events andcircumstances.b.Anxiousness: Intense feelings of nervousness,tenseness, or panic, often in reaction to interpersonalstresses; worry about the negative effects of pastunpleasant experiences and future negative possibilities;feeling fearful, apprehensive, or threatened by uncertainty;fears of falling apart or losing control.c.Separation insecurity: Fears of rejection by – and/or9. Transient, stress-related paranoid ideation or severedissociative symptoms.

2012 American Psychiatric Association. All Rights Reserved.See Terms & Conditions of Use for more information.DSM-IV and DSM-5 Criteria for the Personality Disordersseparation from – significant others, associated with fearsof excessive dependency and complete loss of autonomy.d. Depressivity: Frequent feelings of being down, miserable,and/or hopeless; difficulty recovering from such moods;pessimism about the future; pervasive shame; feeling ofinferior self-worth; thoughts of suicide and suicidalbehavior.2. Disinhibition, characterized by:a. Impulsivity: Acting on the spur of the moment in responseto immediate stimuli; acting on a momentary basis withouta plan or consideration of outcomes; difficulty establishingor following plans; a sense of urgency and self-harmingbehavior under emotional distress.b. Risk taking: Engagement in dangerous, risky, andpotentially self-damaging activities, unnecessarily andwithout regard to consequences; lack of concern for one‟slimitations and denial of the reality of personal danger.3. Antagonism, characterized by:a. Hostility: Persistent or frequent angry feelings; anger orirritability in response to minor slights and insults.C. The impairments in personality functioning and the individual‟spersonality trait expression are relatively stable across time andconsistent across situations.D. The impairments in personality functioning and the individual‟spersonality trait expression are not better understood as normativefor the individual‟s developmental stage or socio-culturalenvironment.E. The impairments in personality functioning and the individual‟spersonality trait expression are not solely due to the directphysiological effects of a substance (e.g., a drug of abuse,medication) or a general medical condition (e.g., severe head

2012 American Psychiatric Association. All Rights Reserved.See Terms & Conditions of Use for more information.DSM-IV and DSM-5 Criteria for the Personality Disorderstrauma).Narcissistic Personality DisorderNarcissistic Personality DisorderDSM-IV CriteriaDSM-5 Criteria - Revised June 2011The essential features of a personality disorder are impairments inpersonality (self and interpersonal) functioning and the presence ofpathological personality traits. To diagnose narcissistic personalitydisorder, the following criteria must be met:A. A pervasive pattern of grandiosity (in fantasy or behavior), need foradmiration, and lack of empathy, beginning by early adulthood andpresent in a variety of contexts, as indicated by five (or more) of thefollowing:1. Has a grandiose sense of self-importance (e.g., exaggeratesachievements and talents, expects to be recognized as superiorwithout commensurate achievements).2. Is preoccupied with fantasies of unlimited success, power,brilliance, beauty, or ideal love.3. Believes that he or she is “special” and unique and can only beunderstood by, or should associate with, other special or highstatus people (or institutions).4. Requires excessive admiration.5. Has a sense of entitlement, i.e., unreasonable expectations ofespecially favorable treatment or automatic compliance with hisor her expectations.6. Is interpersonally exploitative, i.e., takes advantage of others toachieve his or her own ends.7. Lacks empathy: is unwilling to recognize or identify with thefeelings and needs of others.A. Significant impairments in personality functioning manifest by:1. Impairments in self functioning (a or b):a. Identity: Excessive reference to others for self-definitionand self-esteem regulation; exaggerated self-appraisalmay be inflated or deflated, or vacillate between extremes;emotional regulation mirrors fluctuations in self-esteem.b. Self-direction: Goal-setting is based on gaining approvalfrom others; personal standards are unreasonably high inorder to see oneself as exceptional, or too low based on asense of entitlement; often unaware of own motivations.AND2. Impairments in interpersonal functioning (a or b):a. Empathy: Impaired ability to recognize or identify with thefeelings and needs of others; excessively attuned toreactions of others, but only if perceived as relevant to self;over- or underestimate of own effect on others.b. Intimacy: Relationships largely superficial and exist toserve self-esteem regulation; mutuality constrained by littlegenuine interest in others‟ experiences and predominanceof a need for personal gainB. Pathological personality traits in the following domain:1. Antagonism, characterized by:a. Grandiosity: Feelings of entitlement, either overt or covert;

2012 American Psychiatric Association. All Rights Reserved.See Terms & Conditions of Use for more information.DSM-IV and DSM-5 Criteria for the Personality Disorders8. Is often envious of others or believes that others are envious ofhim or her.9. Shows arrogant, haughty behaviors or attitudes.self-centeredness; firmly holding to the belief that one isbetter than others; condescending toward others.b. Attention seeking: Excessive attempts to attract and bethe focus of the attention of others; admiration seeking.C. The impairments in personality functioning and the individual‟spersonality trait expression are relatively stable across time andconsistent across situations.D. The impairments in personality functioning and the individual‟spersonality trait expression are not better understood as normativefor the individual‟s developmental stage or socio-culturalenvironment.E. The impairments in personality functio

DSM-IV and DSM-5 Criteria for the Personality Disorders Antisocial Personality Disorder Antisocial Personality Disorder DSM-IV Criteria DSM-5 Criteria - Revised April 2012 A. There is a pervasive pattern of disregard for and violation of the rights of o

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