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Personality disorders

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Personality disorders form a class of mental disorders that are characterized by long-lasting rigid patterns of thought and actions. Because of the inflexibility and pervasiveness of these patterns, they can cause serious problems and impairment of functioning for the persons who are afflicted with these disorders.

Personality disorders are seen by the American Psychiatric Association as an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it. These patterns are inflexible and pervasive across many situations. The onset of the pattern can be traced back at least to the beginning of adulthood. To be diagnosed as a personality disorder, a behavioral pattern must cause significant distress or impairment in personal, social, and/or occupational situations.

DSM criteria[]

Personality disorders are noted on Axis II of the diagnostic manual of the American Psychiatric Association, the Diagnostic and Statistical Manual of Mental Disorders (DSM, or DSM-IV-TR as it is currently in its fourth edition with a text revision). (Note: Mental Retardation is also noted on Axis II).

General diagnostic criteria[]

To make a diagnosis of a personality disorder, these criteria must be satisfied in addition to the specific criteria listed under the individually named personality disorders.


A. Experience and behavior that deviates markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas:

  1. cognition (perception and interpretation of self, others and events)
  2. affect (the range, intensity, lability, and appropriateness of emotional response)
  3. interpersonal functioning
  4. impulse control

B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.

C. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The pattern is stable and of long duration and its onset can be traced back at least to adolescence or early adulthood.

E. The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder.

F. The enduring pattern is not due to the direct physiological effects of a substance or a general medical condition such as head injury.

People under 18 years old who fit the criteria of a personality disorder are usually not diagnosed with such a disorder, although they may be diagnosed with a related disorder. Antisocial personality disorder cannot be diagnosed at all in persons under 18.

List of DSM personality disorders[]

The DSM-IV lists ten personality disorders, which are grouped into three clusters:

Cluster A (odd or eccentric disorders)[]

Cluster B (dramatic, emotional, or erratic disorders)[]

Cluster C (anxious or fearful disorders)[]

The DSM-IV also contains a category for behavioural patterns that do not match these ten disorders, but nevertheless have the characteristics of a personality disorder; this category is labeled Personality Disorder NOS (Not Otherwise Specified). The previous version of the DSM also contained the Passive-Aggressive Personality Disorder and the Self-Defeating Personality Disorder. Passive-Aggressive Personality Disorder is a pattern of negative attitudes and passive resistance in interpersonal situations. Self-defeating personality disorder is characterised by behaviour that consequently undermines the person's pleasure and goals. These categories were removed in the current version of the DSM, because it is questionable whether these are separate disorders. Passive-Aggressive Personality Disorder and Depressive personality disorder were placed in an appendix of DSM-IV for research purposes. Sadomasochistic personality may be included here.

List of personality disorders defined in ICD-10 (F60-F69)[]

Revisions and exclusions from past DSM editions[]

The revision of the previous edition of the DSM, DSM-III-R, also contained the Passive-Aggressive Personality Disorder, the Self-Defeating Personality Disorder, and the Sadistic Personality Disorder. Passive-Aggressive Personality Disorder is a pattern of negative attitudes and passive resistance in interpersonal situations. Self-defeating personality disorder is characterised by behaviour that consequently undermines the person's pleasure and goals. Sadistic Personality Disorder is a pervasive pattern of cruel, demeaning, and aggressive behavior. These categories were removed in the current version of the DSM, because it is questionable whether these are separate disorders. Passive-Aggressive Personality Disorder and Depressive personality disorder were placed in an appendix of DSM-IV for research purposes.[How to reference and link to summary or text]


Controversy over definitions[]

The DSM attempts to represent a consensus view of the members of the American Psychiatric Association. However, more so than in other parts of the DSM, the classification of Axis II personality disorders—deeply ingrained, maladaptive, lifelong behaviour patterns—has come under sustained and serious criticism from its inception

Main article: Personality disorder - Definition problem

History[]

Main article: Personality disorder - History


Biological approaches[]

Main article: Personality disorder - Biological perspective
Main article: Personality disorder - Genetic perspective
Main article: Personality disorder - Evolutionary perspective


Theoretical approaches[]

Main article: Personality disorder - Theoretical approaches

Developmental aspect[]

Main article: Personality disorder - Developmental perspective

Epidemiology[]

Main article: Personality disorder - Epidemiology

Risk factors[]

Main article: Personality disorder - Risk factors

Causes[]

Main article: Personality disorder - Etiology

Comorbidity[]

Main article: Personality disorder - Comorbidity

Assessment[]

Main article: Personality disorder - Assessment

Treatment[]

Main article: Personality disorder - Treatment

User information[]

Main article: Personality disorder - User information

Carer information[]

Main article: Personality disorder - For their carers


See also[]

Bibliography[]

Key texts – Books[]

  • American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders. 4th ed. (text revision). (DSM-IV-TR). Arlington, VA.
  • Marshall, W. & Serin, R. (1997) Personality Disorders. In Sm.M. Turner & R. Hersen (Eds.) Adult Psychopathology and Diagnosis. New York: Wiley. 508-541
  • Millon, Theodore (and Roger D. Davis, contributor) - Disorders of Personality: DSM IV and Beyond - 2nd ed. - New York, John Wiley and Sons, 1995 ISBN 0-471-01186-X

Additional material – Books[]

Key texts – Papers[]

  • National Institute for Mental Health of England (2003).Personality disorder: No longer a diagnosis of exclusion. London: Department of Health.
  • NIMHE (2003) training guidelines: Breaking the Cycle of Rejection: The Personality Disorder Capabilities Framework.London: Department of Health.

Additional material - Papers[]

  • Google Scholar
  • Ausubel, D.P. (1961) Personality disorder as disease,American Psychologist 16: 69-74.



External links[]

External links[]

Instructions_for_archiving_academic_and_professional_materials Personality disorder: Academic support materials

  • Personality disorder: Lecture slides
  • Personality disorder: Lecture notes
  • Personality disorder: Lecture handouts
  • Personality disorder: Multimedia materials
  • Personality disorder: Other academic support materials
  • Personality disorder: Anonymous fictional case studies for training


Personality Disorder
Personality disorder | Psychopathy 

DSM-IV Personality Disorders

Cluster A (Odd) - Schizotypal, Schizoid, Paranoid
Cluster B (Dramatic) - Antisocial, Borderline, Histrionic, Narcissistic
Cluster C (Anxious) - Dependent, Obsessive-Compulsive, Avoidant
Personality disorder not otherwise specified
Assessing Personality Disorder
MCMI | MMPI | Functional assessment
Treating Personality Disorder
DBT | CBT | Psychotherapy |Mindfulness-based Cognitive Therapy
Prominent workers in Personality Disorder
Millon | Linehan

DSM-IV Personality Disorders edit

Cluster A (Odd) - Schizotypal, Schizoid, Paranoid
Cluster B (Dramatic) - Antisocial, Borderline, Histrionic, Narcissistic
Cluster C (Anxious) - Dependent, Obsessive-Compulsive, Avoidant




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