General Personality Disorder 647
D. The pattern is stable and of long duration, and its onset can be traced back at least to
adolescence or early adulthood.
E. The enduring pattern is not better explained as a manifestation or consequence of an-
other mental disorder.
F. The enduring pattern is not attributable to the physiological effects of a substance (e.g.,
a drug of abuse, a medication) or another  medical condition (e.g., head trauma).
Diagnostic Features
Personality traits  are enduring patterns of perceiving, relating to, and thinking about the en-
vironment and oneself that are exhibited in a wide range of social and personal contexts.
Only when personality traits are inflexible and maladaptive and cause significant func-
tional impairment or subjective distress do th ey constitute personality disorders. The essen-
tial feature of a personality disorder is an en during pattern of inner experience and behavior
that deviates markedly from the expectations of the individual’s culture and is manifested
in at least two of the following areas: cognition, affectivity, interpersonal functioning, or im-
pulse control (Criterion A). This  enduring pattern is inflexib le and pervasive across a broad
range of personal and social sit uations (Criterion B) and leads to clinically significant dis-
tress or impairment in social, occupational, or  other important areas of functioning (Crite-
rion C). The pattern is stable and of long duration, and its onset can be traced back at least
to adolescence or early adulthood (Criterion D). The pattern is not better explained as a
manifestation or consequence of another mental disorder (Criterion E) and is not attribut-
able to the physiological effects of a substanc e (e.g., a drug of abuse, a medication, exposure
to a toxin) or another medical condition (e.g., head trauma) (Criterion F). Specific diagnostic