Classification Personality disorder

1 classification

1.1 general criteria
1.2 in icd-10

1.2.1 in icd-11


1.3 in dsm-5
1.4 personality clusters

1.4.1 cluster (odd or eccentric disorders)
1.4.2 cluster b (dramatic, emotional or erratic disorders)
1.4.3 cluster c (anxious or fearful disorders)


1.5 other personality types
1.6 millon s description
1.7 additional factors

1.7.1 severity
1.7.2 effect on social functioning
1.7.3 attribution

classification

the 2 major systems of classification icd-10 published world health organization , dsm-5 american psychiatric association. both have deliberately merged diagnoses extent, differences remain. example, icd-10 not include narcissistic personality disorder distinct category, while dsm-5 not include enduring personality change after catastrophic experience or after psychiatric illness. icd-10 classifies dsm-5 schizotypal personality disorder form of schizophrenia rather personality disorder. there accepted diagnostic issues , controversies regard distinguishing particular personality disorder categories each other.

general criteria

both diagnostic systems provide definition , 6 criteria general personality disorder. these criteria should met personality disorder cases before more specific diagnosis can made.

the icd-10 lists these general guideline criteria:

markedly disharmonious attitudes , behavior, involving several areas of functioning; e.g. affectivity, arousal, impulse control, ways of perceiving , thinking, , style of relating others;
the abnormal behavior pattern enduring, of long standing, , not limited episodes of mental illness;
the abnormal behavior pattern pervasive , maladaptive broad range of personal , social situations;
the above manifestations appear during childhood or adolescence , continue adulthood;
the disorder leads considerable personal distress may become apparent late in course;
the disorder usually, not invariably, associated significant problems in occupational , social performance.

the icd adds: different cultures may necessary develop specific sets of criteria regard social norms, rules , obligations.

in dsm-5, personality disorder diagnosis must meet following criteria:

an enduring pattern of inner experience , behavior deviates markedly expectations of individual’s culture. pattern manifested in 2 (or more) of following areas:



the enduring pattern inflexible , pervasive across broad range of personal , social situations.
the enduring pattern leads clinically significant distress or impairment in social, occupational, or other important areas of functioning.
the pattern stable , of long duration, , onset can traced @ least adolescence or adulthood.
the enduring pattern not better explained manifestation or consequence of mental disorder.
the enduring pattern not attributable physiological effects of substance (e.g., drug of abuse, medication) or medical condition (e.g., head trauma).

in icd-10

chapter v in icd-10 contains mental , behavioral disorders , includes categories of personality disorder , enduring personality changes. defined ingrained patterns indicated inflexible , disabling responses differ how average person in culture perceives, thinks, , feels, particularly in relating others.

the specific personality disorders are: paranoid, schizoid, dissocial, emotionally unstable (borderline type , impulsive type), histrionic, anankastic, anxious (avoidant) , dependent.

besides ten specific pd, there following categories:

other specific personality disorders (involves pd characterized eccentric, haltlose, immature, narcissistic, passive-aggressive, or psychoneurotic.)
personality disorder, unspecified (includes character neurosis , pathological personality ).
mixed , other personality disorders (defined conditions troublesome not demonstrate specific pattern of symptoms in named disorders).
enduring personality changes, not attributable brain damage , disease (this conditions seem arise in adults without diagnosis of personality disorder, following catastrophic or prolonged stress or other psychiatric illness).

in icd-11

in proposed revision of icd-11, discrete personality disorder diagnoses removed , replaced single diagnosis personality disorder . instead, there specifiers called prominent personality traits , possibility classify degrees of severity ranging mild , moderate , , severe based on dysfunction in interpersonal relationships , everyday life of patient.

in dsm-5

the recent fifth edition of diagnostic , statistical manual of mental disorders stresses personality disorder enduring , inflexible pattern of long duration leads significant distress or impairment , not due use of substances or medical condition.

dsm-5 lists ten specific personality disorders: paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent , obsessive-compulsive personality disorder.

the dsm-5 contains 3 diagnoses personality patterns not match these ten disorders, nevertheless exhibit characteristics of personality disorder:

personality change due medical condition – personality disturbance due direct effects of medical condition.
other specified personality disorder – general criteria personality disorder met fails meet criteria specific disorder, reason given.
unspecified personality disorder – general criteria personality disorder met personality disorder not included in dsm-5 classification.

personality clusters

the specific personality disorders grouped following 3 clusters based on descriptive similarities:

cluster (odd or eccentric disorders)


video explanation of cluster personality disorders

cluster personality disorders associated schizophrenia: in particular, schizotypal personality disorder shares of hallmark symptoms, e.g., acute discomfort in close relationships, cognitive or perceptual distortions, , eccentricities of behavior, schizophrenia. however, people diagnosed odd-eccentric personality disorders tend have greater grasp on reality diagnosed schizophrenia. patients suffering these disorders can paranoid , have difficulty being understood others, typically have odd or eccentric modes of speaking , unwillingness , inability form , maintain close relationships. though perceptions may unusual, important distinguish these anomalies delusions or hallucinations people suffering these diagnosed other conditions. there significant evidence suggests small proportion of people type personality disorders, schizotypal personality disorder, have potential develop schizophrenia , other psychotic disorders. these disorders have higher probability of occurring among individuals first-degree relatives have either schizophrenia or cluster personality disorder.

paranoid personality disorder: characterized pattern of irrational suspicion , mistrust of others, interpreting motivations malevolent.
schizoid personality disorder: lack of interest , detachment social relationships, apathy, , restricted emotional expression.
schizotypal personality disorder: pattern of extreme discomfort interacting socially, , distorted cognitions , perceptions.

cluster b (dramatic, emotional or erratic disorders)


video explanation of cluster b personality disorders




antisocial personality disorder: pervasive pattern of disregard , violation of rights of others, lack of empathy, bloated self-image, manipulative , impulsive behavior.
borderline personality disorder: pervasive pattern of abrupt mood swings, instability in relationships, self-image, identity, behavior , affect, leading self-harm , impulsivity.
histrionic personality disorder: pervasive pattern of attention-seeking behavior , excessive emotions.
narcissistic personality disorder: pervasive pattern of grandiosity, need admiration, , perceived or real lack of empathy.

cluster c (anxious or fearful disorders)


video explanation of cluster c personality disorders



avoidant personality disorder: pervasive feelings of social inhibition , inadequacy, extreme sensitivity negative evaluation.
dependent personality disorder: pervasive psychological need cared other people.
obsessive-compulsive personality disorder: characterized rigid conformity rules, perfectionism, , control point of satisfaction , exclusion of leisurely activities , friendships (distinct obsessive-compulsive disorder).

other personality types

some types of personality disorder in previous versions of diagnostic manuals have been deleted. examples include sadistic personality disorder (a pervasive pattern of cruel, demeaning, , aggressive behavior) , self-defeating personality disorder or masochistic personality disorder (characterised behaviour consequently undermining person s pleasure , goals). listed in dsm-iii-r appendix proposed diagnostic categories needing further study without specific criteria. psychologist theodore millon , others consider relegated diagnoses equally valid disorders, , may propose other personality disorders or subtypes, including mixtures of aspects of different categories of officially accepted diagnoses.

millon s description

psychologist theodore millon, has written numerous popular works on personality, proposed following description of personality disorders:

additional factors

in addition classifying category , cluster, possible classify personality disorders using additional factors such severity, impact on social functioning, , attribution.

severity

this involves both notion of personality difficulty measure of subthreshold scores personality disorder using standard interviews , evidence severe personality disorders demonstrate “ripple effect” of personality disturbance across whole range of mental disorders. in addition subthreshold (personality difficulty) , single cluster (simple personality disorder), derives complex or diffuse personality disorder (two or more clusters of personality disorder present) , can derive severe personality disorder of greatest risk.

there several advantages classifying personality disorder severity:

it not allows takes advantage of tendency personality disorders comorbid each other.
it represents influence of personality disorder on clinical outcome more satisfactorily simple dichotomous system of no personality disorder versus personality disorder.
this system accommodates new diagnosis of severe personality disorder, particularly dangerous , severe personality disorder (dspd).

effect on social functioning

social function affected many other aspects of mental functioning apart of personality. however, whenever there persistently impaired social functioning in conditions in not expected, evidence suggests more created personality abnormality other clinical variables. personality assessment schedule gives social function priority in creating hierarchy in personality disorder creating greater social dysfunction given primacy on others in subsequent description of personality disorder.

attribution

many have personality disorder not recognize abnormality , defend valiantly continued occupancy of personality role. group have been termed type r, or treatment-resisting personality disorders, opposed type s or treatment-seeking ones, keen on altering personality disorders , clamor treatment. classification of 68 personality disordered patients on caseload of assertive community team using simple scale showed 3 1 ratio between type r , type s personality disorders cluster c personality disorders being more type s, , paranoid , schizoid (cluster a) personality disorders more type r others.