A. Pervasive distrust and suspicious

-interpret motives as malevolent

-begin in early adulthood

4 or more symptoms:

• -suspect others will exploit, plot against, deceive, or harm w/o proof
• -preoccupied w/doubts of loyalty and trust of friends and associates
• -reluctant to confide in others - unwarranted fear info will be used against them
• -read malicious hidden meaning - in benign remarks/actions
• -persistently bears grudges - unforgiving
• -perceive character attack

B. Does not occur during other mental disorders

• hard to get along with
• problems with relationships
• argumentative, combative
• hypervigilant, cold, lack feeling
• hostile, stubborn, labile affect
• love to blame others, loners
• jealous, socially isolated, will sue others for minute reasons
• common in males, onset childhood/adolescence
• premorbid w/schizophrenia, delusional dis - if criteria is met prior to onset

A. pervasive pattern - detachmt fro social relationships

-restricted range of expressed emotions in interpersonal settings

-begin in early adulthood

 4 or more symptoms:

• lack desire for intimacy
• chose solitary activities - loner
• little interest in relations
• take pleasure in few activities
• lack close friends
• indifferent to praise/criticism of others
• cold, detach, flat affect

B. does not exclusively occur during schizophrenia, mood disorder/psychotic feature, etc.

• have problem expressing anger
• drifter, directionless
• impaired functioning
• may experience brief psychotic episodes -last few minutes
• have few friends
• premorbid schizophrenia, delusional disorder
• onset in childhood, adolescence - with poor peer relationship
• dx in males
• prefer mechanical/abstract tasks
• work well in isolation

A. pervasive pattern of unstable interpersonal relationships, self-image, affect

-marked impulsiveness

-cluster B disorder - dramatic and emotionally erratic

5 or more symptoms:

• fear of abndonment
• unstable pattern of intense terpersonal relationship
• may idealize potential caregivers share intimate info with spend lots of time with
• then switch quickly to devalue them b/c they dont care enough
• may have identity disturbance - persistent unstable - self image and sense of self
• impulsive - self-damaging in 2 areas:
• gambling, spenddrift, binge eating, drug use, unsafe sex, reckless driving

• recurrent suicidal behavior, gestures/threats, self-mutilating behavior
• display unstable affect due to reactive mood
• troubled with chronic feelings of emptiness
• frequently express, inappropriate and intense anger
• during extreme stress, paranoid ideation or dissociative symptoms, depersonalization may occur

• drop out of school
• destroy good relationships
• lost of employment
• 75% dx in females
• chronic unstable - early adulthood onset
• impairmt & risk of suicide
• wane with age gradually
• often lifelong - intense emotions, impulsive, relationships
• when treated show marked improvemt
• after 10yrs full remission
• may develop psychotic symptoms

A. pervasive pattern of social restraint, feeling inadequate, hypersensitivity - negative evaluation

-begin in early adulthood

4 or more symptoms:

1. avoid work/school activities that invole significant interpersonal contact b/c of criticism, disapproval, or rejection
2. avoid making new friends - unless liked and accepted w/o criticism
3. may act with restraint
4. preoccupied with being criticized or rejected in social situations
5. suppressed in new interpersonal situations b/c they feel inadequate and have low self-esteem
6. believe they are socially iept - personally unappealing/inferior to others
7. are unusually reluctant to take personal risks or to engage to in any new activitiesb/c these may prove embarassing

• fearful/tense demeanor
• very anxious, reactive to criticism
• shy, timid, lonely, isolated
• social/occupational functioning distressed
• hypersenstive to rejection
• do not have large social support network
• onset in infancy or childhood - with shy, isolated, fear of strangers
• shy/avoidant as adolescent/early adulthood
• remit with age

A. pervasive pattern disregard and violation of others rights occur since age 15yo

-begin in childhood or early adolescence

-continues into adulthood

3 or more symptoms

1. antisocial behavior pattern continues into adulthood - fail to conform to societal/social norms
2. frequently deceitful, manipulative in order to gain personal profit and pleasure
3. impulsive pattern due to failure to plan ahead
4. be irritable & aggressive - may get into repeated fights
5. display a reckless disregard for safety of themselves 7 others
6. tend to be persistent/extremely irresponsible
7. show little remorse for the consequences of their acts

B. individual at least 18ys

C. evidence of Conduct Disorder with onset prior to age 15yrs

D. occurrence of antisocial behavior is not exclusively during the course of schizophrenia or Manic episode

• lack empathy, callous, cynical
• contempt feeling for sufferings of others
• inflated ego, arrogant, cocky
• irresponsible, exploit others for sex
• hx of multiple partners
• comorbidity w/other disorders
• low SES status & urban settings
• more common in males
• chronic course - diminish with age
• not dx under 18yrs old

A. pervasive pattern of grandiosity, needed to be admired, lack empathy

-begin by early adulthood

5 or more symptoms:

1. client have grandiose sense of self-importance - overestmate their abilities - inflate their accomplishments
2. client are often proccupied w/fantasies of unlimited success, power, brillance, beauty, and ideal love
3. believe they are special, superior, unique & expect others to recognize them as such
4. client requires excessive admiring, self-esteem is fragile
5. client is constantly fishing for compliments;
6. have sense of entitlement and lack sensitivity
7. have lack of empathy; have difficulty recognizing the subjective feelings of others
8. often envious of others or believe others are envious of them
9. snobs, disdainful, or patronizing attitudes

• very sensitive to criticism
• they may feel humiliated, degraded, hollow empty
• they react with disdain, rage, or defiant counterattack
• they may withdraw socially
• interpersonal relationships impaired due to entitlemt issues, need to be admired
• low functioning - unwilling to compete fear defeat
• common in adolescent traits
• 50-75% dx in males

A. enduring pattern of inner experience/behavior deviates markly in individual's culture and expectations

2 or more symptoms:

1. cognition - ways of perceiving & interpreting self, others, events
2. affect - range, intensity, lability (open to change, adaptable) & appropriate emotional response
3. interpersonal functioning
4. impulsive control

B. enduring pattern - inflexible/pervasive across broad range of personal, social situations

C. enduring pattern - lead to clinical significant distress & impairment of social/work functioning

D. stable pattern at long duration - onset adolescence & early adulthood

E. enduring pattern - not better accounted for  by manifested consequences of another mental disorder

F. enduring pattern - not due to GMC or DRUG

• personality traits are enduring pattern of perceiving, relating, thinking about environmt and self in range of social/personal context
• inflexible & pervasive (maladaptive) - cause clinical significant distress/impaired functioning - then personality disorder is dx.
• look for long-term pattern of personality traits, mental states, functioning, and responses to stressors
• stable over time; differ in culture
• remit with age; less evident with age
• soften around middle age; self-awareness
• clrs must assess ethnic, cultural, social background
• PD features must be present for at least 1yr to be dx under 18yo except Antisocial PD