Cluster A Personality Disorders

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Paranoid Schizotypal Schizoid
 

Cluster A

Paranoid PD

Diagnostic criteria of paranoid personality disorde

A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts. To qualify for a diagnosis, the patient must meet at least four out of the following criteria:

  1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving them.

  2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.

  3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against them.

  4. Reads hidden demeaning or threatening meanings into benign remarks or events.

  5. Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).

  6. Perceives attacks on their character or reputation that are not apparent to others and is quick to react angrily or to counterattack.

  7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.


Does not occur exclusively during the course of schizophrenia, bipolar disorder or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to the physiological effects of another medical condition.

 

*Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

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For Loved Ones

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Schizotypal PD

Diagnostic criteria of schizotypal personality disorde

A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Ideas of reference (excluding delusions of reference).

  2. Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”; in children and adolescents, bizarre fantasies or preoccupations).

  3. Unusual perceptual experiences, including bodily illusions.

  4. Odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped).

  5. Suspiciousness or paranoid ideation.

  6. Inappropriate or constricted affect.

  7. Behavior or appearance that is odd, eccentric, or peculiar.

  8. Lack of close friends or confidants other than first-degree relatives.

  9. Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self.

  10. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder.


Note: If criteria are met prior to the onset of Schizophrenia, add “Premorbid,” e.g., “Schizotypal Personality Disorder (Premorbid)The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose schizotypal personality disorder, the following criteria must be met:
Significant impairments in personality functioning manifest by:
1. Impairments in self functioning:

  • a. Identity: Confused boundaries between self and others; distorted self-concept; emotional expression often not congruent with context or internal experience.

  • b. Self-direction: Unrealistic or incoherent goals; no clear set of internal standards.


2. Impairments in interpersonal functioning:
a. Empathy: Pronounced difficulty understanding impact of own behaviors on others; frequent misinterpretations of others‟ motivations and behaviors.
b. Intimacy: Marked impairments in developing close relationships, associated with mistrust and anxiety.
B. Pathological personality traits in the following domains:
1. Psychoticism, characterized by:
a. Eccentricity: Odd, unusual, or bizarre behavior or appearance; saying unusual or inappropriate things.
b. Cognitive and perceptual dysregulation: Odd or unusual thought processes; vague, circumstantial, metaphorical, over-elaborate, or stereotyped thought or speech; odd sensations in various sensory modalities.
c. Unusual beliefs and experiences: Thought content and views of reality that are viewed by others as bizarre or idiosyncratic; unusual experiences of reality.

2. Detachment, characterized by:
a. Restricted affectivity: Little reaction to emotionally arousing situations; constricted emotional experience and expression; indifference or coldness.
b. Withdrawal: Preference for being alone to being with others; reticence in social situations; avoidance of social contacts and activity; lack of initiation of social contact.

3. Negative Affectivity, characterized by:
a.Suspiciousness: Expectations of –and heightened sensitivity to –signs of interpersonal ill-intent or harm; doubts about loyalty and fidelity of others; feelings of persecution.

The impairments in personality functioning and the individual's personality trait expression are relatively stable across time and consistent across situations.
The impairments in personality functioning and the individual's personality trait expression are not better understood as normative for the individual‟s developmental stage or socio-cultural environment.
The impairments in personality functioning and the individual's personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).

 

*Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

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For Loved Ones

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Schizoid PD

Diagnostic criteria of schizoid personality disorder

Detachment from social relationships with a restricted range of expression of emotions when they are in interpersonal settings. These begin in early adulthood and present in a variety of contexts, such as four of the following:

  1. Neither desires nor enjoys close relationships

  2. Chooses solitary activities

  3. None or little interest in having sexual experiences

  4. Takes pleasure in few activities

  5. Lacks close friends or confidants

  6. Appears indifferent to praise or criticism

  7. Shows emotional coldness, detachment, or flattened affectivity


Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder and is not attributable to the physiological effects of another medical condition

 

*Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

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For Loved Ones

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Resources

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