Diagnosis and Classification of Personality Disorders

cont. from

There are no specific tests for personality disorders. Diagnosis is based on observing repetitive patterns of behavior or perception that cause distress and impair social functioning, even when the patient lacks insight about these patterns and despite the fact that the patient often resists change.

Doctors regard the diagnosis of most personality disorders in adolescents as premature. That's because what appear to be signs or symptoms of personality disorders often disappear as adolescents grow older. However, signs and symptoms of antisocial personality disorder become evident before age 15.

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), divides personality disorders into three clusters: A) odd/eccentric, B) dramatic/erratic, and C) anxious/inhibited.

Cluster A (odd/eccentric): Paranoid, Schizoid, Schizotypal Personality Disorders

Paranoid personality: Persons with this personality disorder are generally cold and distant in interpersonal relationships or are controlling and jealous if they become attached. They tend to react with suspicion to changes in situations and to find hostile and malevolent motives behind other people's trivial, innocent, or even positive acts. Often these hostile motives represent projections of their own hostilities onto others. When they believe they have confirmed their suspicions, they sometimes react in ways that surprise or scare others. They then use the resulting anger of or rejection by others (ie, projective identification) to justify their original feelings. Paranoid persons tend to take legal action against others, especially when they feel a sense of righteous indignation. However, they cannot see their role in a conflict. In their occupations, these persons may be highly efficient and conscientious, although they usually need to work in relative isolation.

Paranoid tendencies may develop among persons who feel particularly alienated because of a defect or handicap. For example, a person with chronic deafness may mistakenly think he is being talked about or laughed at.

Schizoid personality: Persons with this personality disorder are introverted, withdrawn, solitary, emotionally cold, and distant. They are most often absorbed in their own thoughts and feelings and fear closeness and intimacy with others. They are reticent, are given to daydreaming, and prefer theoretic speculation to practical action.

Schizotypal personality: Like schizoid persons, persons with this personality disorder are socially isolated and emotionally detached, but in addition, they express oddities of thinking, perception, and communication, such as magical thinking, clairvoyance, ideas of reference, or paranoid ideation. These oddities suggest schizophrenia but are never severe enough to meet its criteria. Nonetheless, persons with this personality disorder are believed to have a muted phenotypic expression (spectrum variant) of the genes that cause schizophrenia.

continue: Cluster B Personality Disorders

top . pages 1 2 3 4 5 . send to friend . personality disorders site map

Reviewed: 04/2006