Chapter 11 I Define the personality disorders Why are they on Axis II a Schizotypal b Paranoid c Schizoid d Antisocial A cluster A personality disorder involving a pervasive pattern of A cluster A personality disorder involving pervasive distrust and interpersonal deficits featuring acute discomfort with and reduced capacity for close relationships as well as cognitive or perceptual distortions and eccentricities of behavior Social and interpersonal difficulties that are due to social anxiety but also involves distorted views of the world and unusual behavior behavior and dress is odd and unusual inappropriate affect socially isolated and highly suspicious odd thinking and speech vague metaphorical overelaborate circumstantial magical thinking think they are telepathic ideas of reference meaningless events are related to them excluding delusions of reference illusions presence of ghost and spirits talk to themselves not hallucinations suspiciousness of others such that their motives are interpreted as malevolent the strong tendency to mistrust the motives of others leading to a high degree of suspiciousness assumes others are out to harm or trick them ideas of reference reads hidden threatening meaning into benign comments reluctant to confide in others for fear the information will be used against them persistently bears grudges unforgiving recurrent suspicions without justification regarding fidelity may be argumentative complain or could be quiet tense all the time ready to pounce hostile very sensitive to criticism of any type and need autonomy A cluster A personality disorder featuring a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions characterized by social detachment and a lack of emotional expression not due to social anxiety lack of interest to engage in social interactions no desire nor enjoyment in closeness with others has little if any interest in sexual experiences with another person indifferent to praise or criticism aloof indifferent cold A cluster B personality disorder involving a pervasive pattern of disregard for and violation of the rights of others characterized by behavior that shows limited regard for other people failure to comply with social norms repeatedly performing acts that are grounds for arrest irresponsible cant sustain a job or honor financial obligations impulsive irritable and aggressive repeated physical fights or assaults deceitful repeated lying aliases conning others for profit or pleasure lack of conscience empathy and remorse core feature long history of illegal acts no guilt or regret of actions reckless disregard for safety of self and others most abuse substances lie and cheat instability of interpersonal relationships self image affect and control over impulses characterized by a high level of unstable relationships and emotional outbursts poor self image and a difficulty controlling impulses fear of abandonment unstable and intense interpersonal relationships impulsivity in self damaging areas spending sex substance abuse reckless driving binge eating self mutilation and suicidal gestures lack control over their emotions core feature is dysfunction in emotions intense anger and difficulty controlling anger chronic feelings of emptiness comorbid with depression mania eating disorders and drug abuse A cluster B personality disorder involving a pervasive pattern of grandiosity in fantasy or behavior need for admiration and lack of empathy Pervasive belief that the individual is better than everyone else which leads to attention seeking and a lack of concern for others exaggerated and unreasonable A cluster B personality disorder involving a pervasive pattern of f Narcissistic e Borderline g Histrionic h Avoidant A cluster B personality disorder involving a pervasive pattern of A cluster C personality disorder featuring a pervasive pattern of social sense of self importance preoccupation with receiving attention lack sensitivity and compassion for others highly sensitive to criticism requires excessive admiration envious arrogant grandiosity exploit others need their needs met often depressed because they fail to live up to their own expectations they are preoccupied with fantasies of unlimited success power beauty ideal love brilliance excessive emotionality and attention seeking The tendency to display flamboyant emotions with the goal of seeking attention self dramatization theatricality and exaggerated expression of emotion uncomfortable in situations in which they are not the center of attention overly dramatic sensational sexually provocative often impulsive and need to be the center of attention viewed as shallow might appear as if they are acting concerned about appearance need reassurance and approval constantly think only in black and white exaggerate inhibition feelings of inadequacy and hypersensitivity to criticism Characterized by strong feelings of being inadequate which can result in inhibition in social situations and sensitivity to any negative feedback extreme sensitivity to the opinions of others avoids most interpersonal contact shows restraint within intimate relationships because of the fear of being shamed or ridiculed preoccupied with being criticized or rejected in social situations are interpersonally anxious and fearful of rejection low self esteem difficulty in school job believe they are inept incompetent personally unappealing or inferior to others would love social interactions but are just scared of rejection pessimistic about their future and excessive need to be taken care of a condition that leads to submissive and clinging behavior and fears of separation A strong need to be cared for by others including patterns of submissiveness and fear of separation rely on others to make major and minor life decisions unreasonable fear of abandonment clingy and submissive in interpersonal relationships always agree with others avoid rejection try to keep people wanting them around preoccupied with fears of being left to take care of themselves the type that would stay in a domestic violence relationship pattern of preoccupation with orderliness perfectionism and mental and interpersonal control at the expense of flexibility openness and efficiency Characterized by a desire for being perfect both mentally and interpersonally a need for orderliness and reduced flexibility and openness preoccupied with details rules lists order organization or schedules