in males because of social stereotypes about typical gender roles and behaviors.
Differential Diagnosis
Other mental disorders and personality traits. Many of the specific criteria for the per-
sonality disorders describe features (e.g., su spiciousness, dependency, insensitivity) that
are also characteristic of episo des of other mental disorders. A personality disorder should
be diagnosed only when the defining characte ristics appeared before  early adulthood, are
typical of the individual’s long-term function ing, and do not occur exclusively during an
episode of another mental diso rder. It may be particularly difficult (and not particularly
useful) to distinguish personality disorders from persistent mental disorders such as per-
sistent depressive disorder that have an ea rly onset and an enduring, relatively stable
course. Some personality diso rders may have a “spectrum” relationship to other mental
disorders (e.g., schizotypal personality disord er with schizophrenia; avoidant personality
disorder with social anxiety disorder [social phobia]) based on phe nomenological or bio-
logical similarities or familial aggregation.
Personality disorders must be distinguished from personality traits that do not reach
the threshold for a personality disorder. Person ality traits are diagnosed as a personality
disorder only when they are inflexible, maladaptive, and persisting and cause significant
functional impairment or subjective distress.
Psychotic disorders. For the three personality disorders that may be related to the psy-
chotic disorders (i.e., paranoid, schizoid, and schizotypal), there is an exclusion criterion
stating that the pattern of behavior must no t have occurred exclusively during the course
of schizophrenia, a bipolar or depressive disorder with psycho tic features, or another psy-
chotic disorder. When an individual has a pers istent mental disorder  (e.g., schizophrenia)