Module 7 - Personality Disorders

Diagnostic Criteria for Personality Disorder

Personality is the particular combination of emotional, attitudinal, and behavioral response patterns of an individual, and these patterns may be adaptive or maladaptive to the person’s circumstances. Personality disorders may be present when the individual is unable to move out of a particular pattern of responding when this is not appropriate to their situation, and where this causes distress to them or others. Therefore, disorders of personality are associated with ways of thinking and feeling about oneself and others that significantly and adversely affect how an individual functions in many aspects of life.

DSM Criteria

In the DSM-IV, personality disorders were placed on a separate axis to the major mental illnesses (Axis II); the same axis as intellectual disability. However, this has been changed in the recent DSM-V revision, and all the first three axes have been combined into one. The DSM-V states that the essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose a personality disorder, the following general criteria must be met: A. Significant impairments in self (identity or self-direction) and interpersonal (empathy or intimacy) functioning. B. One or more pathological personality trait domains or trait facets. C. The impairments in personality functioning and the individual’s personality trait expression are relatively stable across time and consistent across situations. D. 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 sociocultural environment. E. 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). A person must fulfil these general criteria to have a diagnosis of personality disorder. Once that has been established the type of personality disorder can be diagnosed depending on the specific symptoms and features present. The types (or clusters) of personality disorder are described on the next page. Borderline and antisocial personality disorders will be described later in greater depth.