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Personality Disorders

A Different Perspective

This page contains definitions and clinical criteria for Personality Disorders as defined by the American Psychiatric Association and the World Health Organization.

Understanding the clinical criteria for personality disorders is a good first step. However, learning how to cope with or live with a loved-one who suffers from a personality disorder is generally not covered in the diagnostic literature.

Therefore, rather than focusing exclusively on the clinical traits for diagnosis, it is our aim at Out of the FOG to approach personality disorders from the Non-PD’s point of view. In other words - what is it like to live with a person with NPD or BPD? What’s it like to have a parent with a Histrionic or Dependent Personality Disorder? How do you cope when caring for someone with a Dependent Personality Disorder? How do you protect yourself when living with a person who suffers from Antisocial Personality Disorder?

Here, at Out of the FOG, we have compiled a separate collection of Common Behaviors & Traits of Personality-Disordered Individuals which is written from a Non-PD's perspective and includes ideas for coping which you will not find in the clinical information on personality disorders listed on this page. You are encouraged to review the common behaviors page where you may find examples which match your own experiences.

Another effective way for Non-PD's to learn about personality disorders is to hear from other people who have faced similar circumstances. It can be a relief to discover that your situation is not unique. Therefore, we strongly encourage you to visit our Support Forum.


DSM-IV-TR Personality Disorder Definitions

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) divides personality disorders into 3 clusters and 10 distinct diagnoses:

Cluster A (odd or eccentric disorders)

  1. Paranoid personality disorder (PPD)
  2. Schizoid personality disorder (SPD)
  3. Schizotypal personality disorder (STPD)

Cluster B (dramatic, emotional, or erratic disorders)

  1. Antisocial personality disorder (ASPD)
  2. Borderline personality disorder (BPD)
  3. Histrionic personality disorder (HPD)
  4. Narcissistic personality disorder (NPD)

Cluster C (anxious or fearful disorders)

  1. Avoidant personality disorder (AVPD)
  2. Dependent personality disorder (DPD)
  3. Obsessive-compulsive personality disorder (OCPD)

These are definitions which have been created to give Psychiatrists, Psychologists and Therapists a set of “shorthand” labels to describe the pathology and behaviors of a particular category of patients. Click on the Links above to learn more about each condition.


ICD-10 Personality Disorder Definitions

The World Health Organization's International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) organizes personality disorder diagnoses in a different groupings compared to the DSM-IV-TR as follows:

(F60.) Specific Personality Disorders

(F61.) Mixed and Other Personality Disorders


How Common Are Personality Disorders?

A number of studies have been conducted in recent years to determine the prevalence of personality disorders in the general US population.

According to a 2007 study, 9.1% of the US population (about 1 in 11 people) meet the DSM-IV criteria for a personality disorder. Two previous smaller surveys have estimated the percentage between 9.0% and 15.7%.

Study: Samuels et al., 2002 Crawford et al., 2005 Lenzenweger et al., 2007
Instrument Used: IPDE SCID-II IPDE
Sample Size: (742) (644) (5692)
Cluster A
-Paranoid 0.7% 5.1% 2.3%
-Schizoid 0.9% 1.7% 4.9%
-Schizotypal 0.6% 1.1% 3.3%
Cluster B
-Antisocial 4.1% 1.2% 1.0%
-Borderline 0.5% 3.9% 1.6%
-Histrionic 0.2% 0.9% -
-Narcissistic - 2.2% -
Cluster C
-Avoidant 1.8% 6.4% 5.2%
-Dependent 0.1% 0.8% 0.6%
-Obsessive-Compulsive - 4.7% 2.4%
PD Unspecified - - 1.6%
Any PD 9.0% 15.7% 9.1%

Sources:

  1. Lenzenweger et al, 2007 - DSM-IV personality disorders in the National Comorbidity Survey Replication,
  2. Crawford et al. 2005 - Self-reported personality disorder in the children in the community sample: convergent and prospective validity in late adolescence and adulthood.
  3. Samuels et al, 2002 - Prevalence and correlates of personality disorders in a community sample.

Comorbidity

Definition:

Comorbidity is a psychological term used to describe the occurrence of more than one diagnosis in a single patient. Comorbidity is common in the diagnosis of psychological disorders.

Description:

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) Criteria for Personality Disorders are broad and imprecise and the APA acknowledges that diagnosis is a subjective art. A patient has to exhibit some, but not all of the traits of a particular disorder in order to be given that diagnosis. Additionally, there is a lot of overlap, known as "Comorbidity" between the different definitions.

So, for example, it is possible for a person who suffers from Narcissistic Personality Disorder to exhibit some of the traits listed in the criteria for Borderline Personality Disorder. Likewise, it is possible for a person with Dependent Personality Disorder to behave a lot like a person with Obsessive Compulsive Personality Disorder. You can click on the links above to read more about each disorder, traits, clinical treatment regimes etc. This overlapping nature of personality disorders is known as Comorbidity.

Click Here For More Information and Statistics on Personality Disorder Comorbidity.


Mental Health Axis System

The Diagnostic and Statistical Manual (DSM-IV) uses a 5-axis system to categorize clinical psychology. Personality disorders are included in Axis II. The five DSM axes are:

Axis I: Major mental disorders, clinical disorders, developmental disorders and learning disabilities.

Axis II: Underlying pervasive or personality conditions & mental retardation.

Axis III: Medical conditions contributing to the disorder.

Axis IV: Psychosocial and environmental factors contributing to the disorder.

Axis V: Global Assessment of Functioning on a scale from 0 to 100.


For More Information & Support...

If you suspect you may have a family member or partner who suffers from a personality disorder, we encourage you to learn all you can and surround yourself with support as you learn how to cope.

Submit feedback on this page here.

 
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