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Psychological Disorders
What are psychological disorders?
Maladaptive, harmful, unjustifiable, atypical, disturbing, and dysfunctioning behaviors or
emotions
that are infrequent (rare), severe, and persistent, causing significant problems in
occupational, social,
and interpersonal functioning.
Various perspectives on psychological disorders.
1.Medical perspective (i.e., genetic defects/deficiencies, brain damage, hormonal
imbalance, postpartum).
2. Psychodynamic perspective (i.e., unresolved wishes and desires).
3. Behavioral perspective (i.e., Maladaptive response to stimuli in the environments.
Learning from bad neighbors, friends, family members, TV).
4. Cognitive perspective (i.e., malfunctioning, distorted thoughts and processes).
5. Humanistic-Existential perspective (i.e., All humans have potential or power to
actualize themselves. And have needs to establish their own goals and make
constructive choices to reach them. Lack of acceptance of a person as a person
with worth. Failure to actualize self).
6. Bio-psycho-social perspective (all together).
Classification of psychological disorders.
-Diagnostic Statistical Manual-IV Edition (DSM-IV).
Types of psychological disorders.
Anxiety disorders.
Chapter 7. Anxiety Disorders
Two fundamental criteria for anxiety disorders
1. Panic Attack: A discrete period of intense fear or discomfort, in which four or more of
the following symptoms
developed abruptly and reached a peak within 10 minutes.
(a) Chest pain, (b) chills/hot flushes, (c) de-realization (feelings of
uncertainty)/depersonalization
(being detached from oneself), (d) fear of dying, (e) fear of losing control, (f) feeling
dizzy/faint, (g) feeling of choking,
(h) nausea, (i) paresthesias (numbness), (j) pounding heart, (k) shaking, (l) shortness of
breath, and (m) sweating.
2. Agoraphobia
(a) Anxiety about being in places or situations from which escape might be difficult or in
which help may not be available.
(b) The situations are intentionally avoided or else endured with marked distress
Panic disorder without Agoraphobia
1. Recurrent unexpected panic attacks and at least one-month duration of one or more of
the following symptoms.
2. Persistent concern about having additional attacks.
3. Worry about the implications of the attack or its consequences (i.e., going crazy, lose
control)
4. Significant behavior change related to the attacks.
5. No symptoms of agoraphobia
Panic disorder with agoraphobia
1. Recurrent panic attacks and at least one-month duration of one or more of the
following symptoms.
2. Persistent concern about having additional attacks.
3. Worry about the implications of the attack or its consequences (i.e., going crazy, lose
control)
4. Significant behavior change related to the attacks.
5. Presence of agoraphobia
Specific Phobia: Intensive, too frequent, severe, excessive, persistent fear of a specific
object or situation (Four subtypes:
(a) Animal (i.e., insects),
(b) natural environment (i.e., storms, heights, water),
(c) blood-injection-injury (i.e., invasive medical procedure), or
(d) situational (i.e., bridge, tunnels, elevators, public transportation) types.
Social Phobia
1. A marked and persistent fear of one or more social or performance situations in which
the person is exposed to unfamiliar people or to possible scrutiny by others (i.e., expects
that the person will act in a way that will be humiliating or embarrassing).
2. Exposure to the feared social situation almost invariably provokes anxiety.
3. The person recognizes the fear is excessive and unreasonable.
4. In individuals under 18, the duration is at least 6 month.
Obsessive-Compulsive Disorder (OCD):
Lady disinfecting her community. Guy at PCA.
1. Either Obsessions: (a) recurrent and persistent thoughts, impulses, images causing
marked anxiety or distress,
(b) the thoughts or images are not simply excessive worries about real-life problems (i.e.,
money, school, job),
(c) attempt to suppress or ignore the thoughts or images, and (d) recognition that the
obsessive thoughts are
a product of one’s own mind (not thought insertion by others) OR
2. Compulsions: (a) Repetitive behaviors (i.e., hand washing, ordering, checking) or
mental acts (i.e., praying, counting, repeating words silently) that the person feels driven
to perform in response to an obsession and
(b) The behaviors or mental acts are aimed to reduce or prevent distress caused by
obsessions.
3. Recognize that the obsessions or compulsions are excessive or unreasonable (i.e., take
more that 1 hour per day).
4. Specify “With Poor Insight.”
Posttraumatic Stress disorder (PTSD)
1. Has been exposed to a traumatic event (i.e., experienced, witnessed, or was confronted
with an event or events that involved actual or threatened death or serious injury, or a
threat to the physical integrity of self or others).
2. Negative Response to the event(s) involves intense fear, helplessness, or horror.
3. The traumatic event is persistently re-experienced in (a) dreams, images, thoughts,
and/or plays,
(b) acting/feeling as if the event were recurring, and (c) intense psychological distress at
exposure to internal or external cues symbolizing or resemble to the event.
4. Persistent avoidance of stimuli associated with the trauma (i.e., avoidance of
conversations, thoughts, and activities resembling the trauma, inability to remember the
trauma, feelings of detachment from others, restricted range of affect, and sense of
foreshortened future.
5. Persistent symptoms of increased arousal (i.e., sleep disturbance, irritability/anger
outburst, difficulty concentrating, hypervigilance, and exaggerated startle response.
6. At least one-month duration of the disturbance.
Treatment
1. Psychodynamic therapy
ID-Ego-Superego. Defense Mechanisms (i.e., reaction formation, undoing).
(EX) “I hate my children.” “I should not feel this way—Feel guilty and anxious” “To
reduce the anxiety, keep checking their children while they are sleeping.” Thus deal with
resentment toward her children.
2. Behavioral therapy
(a) Systematic desensitization: Systematically exposure to worry-provoking images and
real situations (in vivo exposure)
(b) Implosive therapy: Exposure to therapist-controlled images causing worry.
(c) Flooding: not gradually, but immediately exposure to high-intensity and prolonged
stimuli causing worry.
(d) Modeling: Help the patient learn social skills and acquire competence/self-efficacy.
3. Cognitive therapy
(a) Aaron Beck: Cognitive restructuring
-Mutually identify unrealistic/distorted thoughts (i.e., a negative view of the self, a
negative view of the world and others, a negative view of the future) and faulty
information processing (i.e., Arbitrary inference, selective abstraction, overgeneralization, magnification/minimization, personalization, absolustic/dichotomous
thinking, perfectionism, catastrophic thoughts) that are related to anxiety or occurring
during distress.
-Restructure their cognitions or information processing.
(b) Thought stopping: Ask the patient to focus on one’s obsessive thoughtsSTOP!
(c) Cognitive rehearsal: Cognitively rehearse adaptive approaches to problematic
situations.
(d) Worry exposure: Worst outcome?
4. Biological (Medications)
-Bi-directional (i.e., experience <-->biology)
-(EX) Limbic system: A doughnut-shaped neural system.
-Hypothalamus: Controls eating, drinking, body temperature, and also stimulates pituitary
gland to secrete hormones.
-Amygdala: Tow almond-shaped clusters that are components of limbic system. Controls
aggression and fear.
-Hippocampus: Controls memory.
-(EX) PTSD patients show decreases in blood flow in the limbic system while they were
exposed to slides or sounds related to traumatizing events (i.e., self-defensive
suppression?).
(a) Benzodiazepines: Tranquilizers (i.e., Librium, Valium) have most frequently
prescribed for treatment of anxiety disorders. Side effects: drowsiness, lethargy, motor
impairment, or lack of concentration.
(b) Alprazolam: Popular for treating panic disorders. Side effects: Drowsiness, or
withdrawal symptoms.
(c) Antidepressants (i.e., imipramine, clomipramine): Effective for treating OCD.
Why antidepressants? May be due to comorbidity (co-occurrence of more than a
disorder).
Psychotic disorders: Making incorrect inferences about reality on the basis of altered
perception, thoughts, or consciousness (i.e., delusions and hallucination) and believing
the inferences are real and actual.
*What causes Schizophrenia? (Too much dopamine at certain synapses, Larger cerebral
ventricles, Reduced brain volume, Low SES with schizophrenia, etc.).
* How to treat them?
(a) Medications blocking postsynaptic receptors. Side effects: Tardive Dyskinesia:
involuntary movements.
(Seroquel, Risperdal, Zyprexa, Geodon, Abilify)
(b) Skills Training: self-care. Social skills (i.e., assertiveness)
(c) CBT: Verbal reasoning/restructuring and behavioral experimentation.
(d) Community Support Program (i.e., GAIN): medication management, social
activities, and financial management.
*Delusion: A false belief based on incorrect inference about external reality despite what
constitutes incontrovertible and obvious proof or evidence to the contrary.
(a) Bizarre: A delusional thought that is implausible in a culture.
(b) Delusional jealousy: Delusional thought that one’s partner is unfaithful.
(c) Erotomanic: A delusional thought that another person (i.e., higher status) is in
love with the person.
(d) Grandiose: A delusion of inflated worth, power, knowledge, identity, or
special relationship to a deity or famous person.
(e) Delusions of being controlled: Feelings, thoughts, or actions are experienced
as being under control of some external force.
(f) Delusions of reference: Events, objects, or other persons in one’s immediate
environment have a particular and unusual significance.
(g) Persecutory: A delusion in which one is being attacked, harassed, or cheated.
(h) Somatic: A delusion pertaining to one’s appearance or functioning of one’s
body---plastic surgery!!!
(i) Thought broadcasting: One’s thoughts are broadcasted out loud so that the
person’s thought can be perceived by others.
(j) Thought insertion: One’s thoughts are not one’s own, but inserted into one’s
own.
*Hallucination: A sensory perception without external stimulation of the relevant sensory
organ.
(a) Auditory:
(b) Gustatory:
(c) Olfactory:
(d) Somatic: The perception of a physical experience localized within the body (i.e., a
feeling of electricity).
(e) Tactile: Feeling being touched or something is under one’s skin.
(f) Visual:
*Illusions: A misperception or misinterpretation of a real external stimulus (i.e., hearing
the rustle of leaves as the sound of voices).
Diagnoses:
1. Schizophrenia Disorder: 2 or more of the following symptoms persisting at least 6
months (significant portion of time during a 1-month period).
(a) Delusions
(b) Hallucinations
(c) Disorganized speech (i.e., frequent Derailment such as a person’s ideas slip off
one track into another that is completely unrelated or Incoherent such as
derailment within a clause in contrast to between two clauses).
(d) Grossly disorganized or Catatonic (i.e., Motoric immobility such as stupor or
catalepsy, Excessive motor activity such as purposeless agitation, Extreme
negativism, Mutism, Stereotyped movements,/Echolalia/echopraxia) behavior
(e) Negative symptoms (i.e., affective flattening such as avoidance of eye contact,
immobile face, monotonous voice, apathy/non-interest, or lack of emotion, alogia
such as lack of content in speech, failure to answer, a long pause before answer,
or restriction of quantity of speech, and avolition such as lack of self-care/
goal-directed activity, inability to initiate, or little interest in social participation).
Subtypes of Schizophrenia
(a) Paranoid: Preoccupation with persecutory/grandiose/ delusions or hallucinations,
(b) Disorganized: derailments or incoherence, (c) Catatonic, (d) Undifferentiated:
Neither of a, b, and c, and
(f) Residual: Presence of 2 or more schizophrenia symptoms in an attenuated form
(i.e., odd beliefs, unusual
perceptual experiences) and negative symptoms (i.e., affective flattening).
2. Schizophreniform Disorder: Same as Schizophrenia except the duration (at least 1
month but less than 6 month).
3. Brief Psychotic disorder: Same as Schizophrenia but the duration is at least 1 day and
less than 1 month.
4. Schizoaffective Disorder:
(a) Either a Major depressive, a manic, or mixed episode concurrent with 2 or more
symptoms of delusions, hallucinations, disorganized speech, grossly disorganized
or catatonic behavior, or negative symptoms.
(b) Delusions or hallucinations for at least 2 weeks in the absence of prominent mood
symptoms.
Subtypes: (a) Depressive: If only major depressive episodes are part of the presentation
and
(b) Bipolar: If a manic or mixed episode is part of the presentation.
5. Delusional Disorder: Non-bizarre delusions (i.e., being followed, poisoned, infected,
loved at a distance, or deceived by spouse or lover) persisting at least 1 month and that its
impact is not seriously affecting functioning.
Subtypes:
(a) Erotomanic: The central theme of the delusions is that another person is in love
with the individual,
(b) Grandiose,
(c) Jealous,
(d) Persecutory: one is being conspired against, cheated, spied on, followed,
poisoned, maliciously maligned, (e) Somatic, (f) Mixed, and (g) Unspecified
6. Shared Psychotic disorder: A delusion develops in an individual in the context of a
close relationship with another person who has an already-established delusion. Delusion
is similar in content to that of the person who already has the established delusion.
7. Psychotic Disorder due to (General medical condition).
8. Substance Induced Psychotic Disorder.
Mood disorders
Vulnerability Risk Factors: Women in young adulthood, Men in early middle age,
Women than men (2 times),
Negative life events, A lack of social support, Loss of significant others,
Deficiencies(Depression)/Excess(Manic)
of serotinin or Dopamine in synapse.
Treatment:
(a) ECT
(b) Medications (medications working on levels of Dopamine, serotinin, acetylcholine, or
GABA)
-Tricyclic antidepressants (i.e., Elavil): By increasing functional levels of
dopamine or serotinin by
blocking reuptake of the neurotransmitters in the synapse.
-MAO inhibitors (i.e., Nardil): Break down chemicals such as Reserpi depleting
storage of
neurotransmitters.
-2nd generation heterocyclics (i.e., Wellbutrin, Prozac)
-Antimanic medications (i.e., Lithium, Tegretol)
(c) Psychodynamic (i.e., guilt or self-punishing over anger and aggression).
(d) Humanistic-Existential: Narrow a gap between ideal-self and real-self.
(e) Social skill training
(f) CBT
Key Diagnostic Criteria
1. Major Depressive Episode: 5 or more of the following symptoms during the same 2
week period.
Either (a) or (b) must be present.
(a) Depressed mood
(b) Markedly diminished interest or pleasure
(c) Diminished ability thinking or concentrating (i.e.,
(d) Fatigue or loss of energy.
(e) Psychomotor agitation (i.e., restlessness).
(f) Sleep disturbances (insomnia, hypersomnia) nearly everyday.
(g) Suicidal ideation or attempts.
(h) Weight loss.
(i) Worthlessness or inappropriate guilt.
2. Manic Episode: A distinct period of persistently elevated, expansive, or irritable mood
lasting at least 1 week,
manifested by 3 (4 if mood is irritable) or more of the following symptoms. The episode
is severe enough to
cause marked impairment in social and occupational functioning. Hospitalization may be
necessary to prevent
harm to self and others. May have some psychotic features. Not meet the criteria for a
Mixed Episode.
(a) Decreased need for sleep (i.e., feel rested after only few hours of sleep)
(b) Distractibility (i.e., attention too easily drawn to unimportant or irrelevant things).
(c) Excessive involvement in pleasurable activities that have a high potential for
painful harm
(i.e., unrestrained buying spree, sexual indiscretions, foolish business investments).
(d) Flight of ideas or racing thoughts.
(e) Increase in goal-directed activity (i.e., socially, occupationally, sexually, and
academically) or psychomotor agitation.
(f) Inflated self-esteem or grandiosity.
(g) More talkative than usual or pressure to keep talking.
3. Hypomanic Episode: A distinct period of persistently elevated, expansive, or irritable
mood lasting at least 4 days,
manifested by 3 or more of the following symptoms. The episode is not severe enough to
cause marked impairment in
social and occupational functioning. No hospitalization is necessary. No psychotic
features.
Same as Manic Episode
4. Mixed Episode
The criteria are met both for a Major Depressive Episode and for a Manic Episode nearly
everyday during at least 1 week period.
Actual/Official Diagnoses
1. Major Depressive Disorder, single episode.
(a) Presence of a single Major Depressive Episode
(b) There has never been a Manic, Mixed, or a Hypomanic Episode.
(c) Specify Severity (mild, moderate, severe without psychotic features, or severe
with psychotic features).
(d) Specify Features
-Catatonic (i.e., motoric immobility/stupor, excessive/purposeless motor activity,
extreme negativism/
motiveless resistance to all instructions, peculiarities of voluntary movements
such as stereotyped movements, or
echolaia/echopraxia).
-Melancholic (i.e., loss of pleasure in almost all activities, lack of reactivity to
usually pleasurable stimuli,
distinct quality of depressed mood, depression regularly worse in the morning,
early morning awakening,
psychomotor retardation or agitation, anorexia or weight loss, or excessive guilt).
-Atypical(Mood reactivity (i.e., mood brightness in response to actual or potential
events, significant
weight gain or increase in appetite, hypersomnia, leaden paralysis such as heavy
feelings in arms and legs,
interpersonal rejection sensitivity).
-Postpartum Onset (Onset of episode within 4 weeks postpartum).
-Chronic (last 2 years).
2. Major Depressive Disorder, Recurrent
(a) Presence of 2 or more Major Depressive Episodes.
(b) There has never been a Manic, Mixed, or a Hypomanic Episode.
(c) Specify Severity (mild, moderate, severe without psychotic features, or severe
with psychotic features).
(d) Specify Features
-Catatonic (i.e., motoric immobility/stupor, excessive/purposeless motor activity,
extreme negativism/motiveless
resistance to all instructions, peculiarities of voluntary movements such as
stereotyped movements,
or echolaia/echopraxia).
-Melancholic (i.e., loss of pleasure in almost all activities, lack of reactivity to
usually pleasurable stimuli,
distinct quality of depressed mood, depression regularly worse in the morning,
early morning awakening,
psychomotor retardation or agitation, anorexia or weight loss, or excessive guilt).
-Atypical(Mood reactivity (i.e., mood brightness in response to actual or potential
events, significant weight gain
or increase in appetite, hypersomnia, leaden paralysis such as heavy feelings in
arms and legs, interpersonal
rejection sensitivity).
-Postpartum Onset (Onset of episode within 4 weeks postpartum).
(e) Specify Chronic.
(f) With Seasonal pattern (i.e., fall)
(g) Specify longitudinal course specifiers (With Full Interepisode Recovery, Without
Interepisode Recovery).
3. Dysthymic Disorder
(a) Depressed mood for at least 2 years.
(b) Presence of 2 or more of hopelessness, insomnia/hypersomnia, low self-esteem,
low energy, poor appetite,
and poor concentration.
(c) No Major Depressive, Manic, Hypomanic, or Mixed Episode has been present for
the period.
(d) Specify Early Onset or Late Onset (age 21)
(e) Specify With Atypical Features.
4. Bipolar I Disorder, Single Manic Episode: Presence of Only one Manic Episode and no
past MDE.
5. Bipolar I Disorder, most Recent Episode Hypomanic: Currently in a Hypomanic. Past
Manic or Mixed.
6. Bipolar I Disorder, Most Recent Episode Manic: Currently in a Manic. Past MDE,
Manic, or Mixed.
7. Bipolar I Disorder, Most Recent Episode Mixed: Currently in a Mixed. Past MDE,
Manic, or Mixed.
8. Bipolar I disorder, Most Recent Episode Depressed: Currently in a MDE. Past Manic
or Mixed.
9. Bipolar I Disorder, Most Recent Episode Unspecified: Met criteria for a Manic,
Hypomanic, or
Mixed except the duration.
10. Bipolar II Disorder (Recurrent Major Depressive Episodes With Hypomanic
Episodes): Presence of
1 or more MDE and Hypomanic Episode. No past Manic or Mixed episode. Specify
currently
Hypomanic or Depressed types.
11. Cyclothymic Disorder: The presence of numerous hypomanic and numerous
Depressive Symptoms
for the last 2 years. No past MDE, Manic, Mixed for the first 2 years.
12. Mood Disorder Due to a General Medical condition (i.e., cancer). 13. Substance
Induced M/D
Personality disorders
-Diagnosed on the Axis II, along with MR.
-Definitions: An enduring pattern of cognition, affectivity, interpersonal functioning,
and/or impulse
control that deviates form the expectations of the individual’s culture.
-Not dramatic or severely incapacitating, but long-standing, maladaptive, inflexible, and
habitual
ways of living or functioning. Hard to change it.
-Unclear about a point at which personality style becomes a personality disorder.
Possibly when personality style
causes clinically significant distress or impairment in social important problems in social,
occupational situations,
or other important areas of functioning.
-Early onset, pervasive, stable.
Cluster A Personality Disorders (odd and eccentric)
1. Paranoid Personality Disorder
A pervasive distrust and suspiciousness of others manifested by 4 or more of the
following:
(a) Interpret other’s motives as malevolent,
(b) Suspect that others are exploiting, harming, or hurting,
(c) Preoccupied with unjustified doubts about the royalty/trustworthiness of friends
or associates,
(d) Reluctant to confide in others due to unwarranted fear,
(e) Read hidden demeaning or threatening meanings into benign remarks or events,
(f) Persistently bears grudges,
(g) Perceives attacks on one’s character without apparent reasons,
(h) Recurrent suspicions without justifications regarding fidelity of spouse or sexual
partner).
2. Schizoid Personality disorder
A pervasive pattern of detachment from social relationship and a restricted range of
expression of emotions in
interpersonal settings manifested by 4 or more of the following:
(a) Neither desires nor enjoys close relationships
(b) Almost always chooses solitary activities
(c) Having little, if any, interest in sexual experiences
(d) Takes please in few, if any, activities.
(e) Lacks close friends or confidants other than 1st degree relatives
(f) Appears to indifferent to the praise or criticisms of others
(g) Shows emotional coldness, detachment, or flattened affect.
3. Schizotypal Personality disorder
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, indicated by
5 or more of the following:
(a) Ideas of reference (i.e., The feeling that casual incidents or events have a
particular or unusual meaning
that is specific to the person)
(b) Odd beliefs or magical thinking (i.e., the erroneous belief that one’s thoughts,
words, or actions will
cause or prevent a specific outcome in some way that defies commonly understood
laws of cause and effect).
(c) Unusual perceptual experiences (i.e., bodily illusions)
(d) Odd thinking or speech (i.e., vague, metaphorical, circumstantial, over-elaborate,
or stereotyped)
(e) Paranoid ideation
(f) Inappropriate or restricted affect
(g) Odd or eccentric behavior or appearance
(h) Lack of desire for close relationships
(i) Excessive social anxiety
Cluster B Personality Disorders (dramatic-emotional)
4. Antisocial Personality disorder
A pervasive pattern of disregard for, and of the rights of others occurring since age 15, as
indicated by
3 or more of the following:
(a) Consistent irresponsibility (i.e., no financial obligation, unstable work)
(b) Deceitfulness (repeated lying, use of aliases, conning others)
(c) Failure to conform to social norms (i.e., repetitive arrests)
(d) Failure to plan ahead (i.e., impulsivity)
(e) Irritability and aggressiveness (i.e., physical fights and assaults)
(f) Lack of remorse.
(g) Reckless disregard for safety of self and others.
(h) At least age 18
(i) Evidence of conduct disorder before age 15.
5. Borderline Personality disorder
A pervasive pattern of instability of interpersonal relationships, self-image and affects,
and marked impulsivity,
as indicated by 5 or more of the following:
(a) Identity disturbance (i.e., marked and unstable self-identity or sense of self)
(b) Chronic emptiness
(c) Frantic effort to avoid real or imagined abandonment
(d) Affective instability (i.e., irritability, intense dysphoria, anxiety).
(e) Inappropriate, intense anger or difficulty controlling anger
(f) Self-damaging impulsivity (i.e., binge eating, drug, reckless driving, spending,
sex).
(g) A pattern of unstable and intense interpersonal relationships (i.e., alternating
between extremes of
idealization and devaluation).
(h) Transient, stress-related paranoid ideation or severe dissociative symptoms.
(i) Recurrent suicidal behaviors, gestures, or threats, or self-mutilating behavior.
6. Histrionic Personality disorder
A pervasive pattern of excessive emotionality and attention seeking, as indicated by 5 or
more of the following:
(a) Uncomfortable in situations in which he or she is not the center of attention
(b) Consistently use physical appearance to draw attention to self.
(c) Inappropriate sexually seductive or provocative behavior
(d) A style of speech that is excessively impressionistic and lacking in detail
(e) Self-dramatization or exaggerated expression of emotion
(f) Displays rapidly shifting and shallow expression of emotions.
(g) Considers relationships to be more intimate that they actually are
(h) Very suggestible
7. Narcissistic Personality disorder
A pervasive pattern of grandiosity, need for admiration, and lack of empathy, as indicate
by 5 or more of the following:
(a) Believes that she or he is special, unique, and can be understood by special or
high-status people.
(b) Preoccupied with fantasies of unlimited success, power, beauty, or ideal love.
(c) A grandiose sense of self-importance (i.e., exaggerates achievements and expects
to be recognized as superior).
(d) Requires excessive admiration
(e) Has a sense of entitlement
(f) Interpersonally exploitative
(g) Often envious of others or believes that others are envious of him or her
(h) Lacks empathy
(i) Shows arrogant, haughty behaviors or attitudes
Cluster C Personality Disorders (anxious-fearful)
8. Avoidant Personality disorder
A pervasive pattern of feelings of inadequacy, hypersensitivity to negative evaluations,
and social inhibition,
as indicated by 4 or more of the following:
(a) Preoccupied with being criticized, rejected, ridiculed, disapproved, or shamed in
social situations
(b) Views self as socially inept, unappealing, or inferior to others
(c) Avoids occupational activities involving significant interpersonal contact
(d) Unwilling to get involved with people unless certain of being liked
(e) Inhibited in new interpersonal situations
(f) Shows restraint within intimate relationships
(g) Unwilling to take personal risks or to engage in any new activities because they
may prove embarrassing.
9. Dependent Personality disorder
A pervasive and excessive need to be taken care of that leads to submissiveness, clinging
behavior and fear of separation,
as indicated by 5 or more of the following:
(a) Excessively feels uncomfortable or helpless when alone (i.e., fear of being unable
to care for oneself)
(b) Unrealistically preoccupied with fears of being left to take care of oneself
(c) Needs others to assume responsibility for most major areas of one’s life
(d) Urgently seeks another relationship as a source of care and support when a
relationship ends
(e) Goes to excessive lengths to obtain nurturance and support from others to the
point of volunteering to
do things that are unpleasant
(f) Has difficulty expressing disagreement
(g) Has difficulty initiating projects or doing things on one’s own (i.e., lack of
confidence in judgment or abilities)
(h) Has difficulty making everyday decisions
10. Obsessive-Compulsive Personality disorder
A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and
interpersonal control,
at the expense of flexibility, openness, and efficiency, as indicated by 4 or more of the
following:
(a) Preoccupied with details, rules, lists, order, organization, or schedules to the
extent that the major point of
the activity is lost
(b) Shows perfectionism that interferes with task completion
(c) Over-conscientious, scrupulous, and inflexible about matters of morality, ethics,
or values
(d) Excessively devoted to work and productivity to the exclusion of leisure activities
and friendships
(e) Unable to discard worn-out or worthless objects even when they have no
sentimental value
(f) Reluctant to delegate tasks or to work with others unless they submit to exactly
one’s own way of doing things
(g) Adopts a miserly spending toward both self and others
(h) Shows rigidity and stubbornness
-Measures: MMPI-II, MCMI-II (Millon Clinical Multiaxial Inventory).
-More prevalent in men: Antisocial, Narcissistic, Schizoid.
-More prevalent in women: Histrionic, dependent, Borderline.
-Relatively more prevalent personality disorders in both men and women are Dependent,
Borderline, and Compulsive.