Counseling/Personality Disorder Cheat Sheet

Personality Disorder

Personality describes characteristic ways of thinking, feeling and behaving. A personality disorder describes a personality that is not necessarily disorganized, but has a way of being that is maladaptive. Personality disorders are divided into three groups or "clusters":

         Cluster A: is odd or eccentric personality disorders
         Cluster B: dramatic, emotional, or erratic personalities
         Cluster C: fearful and anxious personalities

The diagnosis of personalitiy disorders is highly controversial due to the lack of reliability in research and replication.

(Diagnostic Criteria, Polythetic Format, Personology and Psychiatry)

Cognition

• Interpersonal relationships
• Impulse control
• Affect

Characteristics of Personality Disorders

• Inflexible traits
• Maladaptive behavior
• Long-standing
• Pervasive
• Difficult to treat
• Ego syntonic

Types of Personality Disorders

• Schizoid
• Paranoid
• Schizotypal
• Narcissistic
• Histrionic
• Borderline
• Antisocial
• Avoidant
• Compulsive
• Dependent
• Depressive
• Negativistic

Schizoid

• Cluster A
• Odd beliefs and “magical thinking” that influences behavior and is inconsistent with cultural norms
• Odd, constricted affect; inappropriate or flat affect
• Apathetic, remote solitary, indifferent
• Little need for attachment
• Not aware of feelings
• Few drives or ambitions
• withdrawn, emotional suppression, spouses complain of lack of intimacy
• Develop anxiety, somatoform reactions, brief reactive psychosis

Avoidant

• Cluster C
• Hesitant, self-conscious, embarrassed
• Fears rejection, anxious
• Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, rejection, etc
• Inept, inferior, unappealing, lonely
• Hypersensitive to evaluation
• Profound feelings of inadequacy
• Sensitive to signs of disapproval
• Use fantasy as defense (if only…)
• Risk for developing social phobia

Depressive

• Somber, pessimistic, fatalistic, brooding
• Valueless, guilty, impotent
• Worthy of criticism and contempt
• New scale, not a lot of validity
• Gloomy, passive, quiet, pessimistic
• Down, hard to please, defeatist
• Difficulty expressing anger
• High scores could be due to major depression or dysthymia

Dependent

• Cluster C
• Difficulty making everyday decisions without an excessive amount of advice and reassurance from other
• Difficulty expressing disagreement or saying “no” because of fear of loss of support/approval
• Helpless, incompetent, submissive
• Irresponsible, weak, fragile
• Submissive, acquiescence, concerns about being abandoned, fears of rejection, self-blame, insecure
• Co-morbid with depression and anxiety

Histrionic

• Cluster B
• Uncomfortable in situations where s/he is not the center of attention
• Dramatic, seductive, shallow
• Interactions with others characterized by inappropriate sexual, seductive, and/or provocative behavior; very flirtatious
• Attention seeking, exhibitionistic, “attractive”, “charming”
• Colourful
• Center of attention
• Consistently uses physical appearance to draw attention to self
• Shallow emotions

Narcissistic

• Cluster B
• Has a strong sense of entitlement; tend to be interpersonally exploitative or manipulative
• Believes that s/he is special/unique and can only be understood or associate with other special or high-status people
• Egotistical, arrogant, entitled, grandiose
• Feelings that s/he is “Admirable”, “superior”
• Egocentricity, independence, grandiosity, feelings of superiority
• Self-centered, entitled, constant praise
• Bubble bursts… prone to depression, paranoia, substance abuse

Antisocial

• Cluster B
• Impulsivity or failure to plan ahead
• Deceitfulness, repeatedly lying, use of aliases or cons for personal gain
• Impulsive, irresponsible, deviant, unruly
• Lack of remorse, indifferent, or rationalizes behaviors
• Non-reflective, self-serving
• Disrespectful, free, independent
• Motivated to avoid control and domination
• Aggressive, hostile, reckless
• Reckless disregard for safety of self or others
• Competitive, blunt, intimidating
• Prone to legal, vocation and marital difficulties

Sadistic

(Not official PD, diagnosis – PD NOS)

• Hostile, abrasive, cruel, dogmatic
• Explosive, intimidating, dominating
• opinionated and close-minded
• Dominating, mean, cruel, aggressive
• Top Dog persona
• Publicly “ok” – successful
• Private “monster”
• Type A personalities

Compulsive

• Cluster C
• Pervasive pattern of preoccupation with orderliness, perfectionism, mental and interpersonal control at the expense of flexibility, openness, and efficiency
• Restrained, conscientious, respectful
• Rigid, conventional, regulated
• Reliable, efficient, productive
• Organized, perfectionistic, impatient, good morals, obedient behavior, suppression of emotions
• Overly conscientious, scrupulous, and inflexible about matters of morality, ethics, and values
• Fears disapproval
• Might be a style
• NOTE: This is different from true Obsessive-Compulsive Disorder.

Negativistic

• Resentful, skeptical, discontented
• Resisting, inefficient
• Angry, moody, irritable, sullen

Passive-aggressive negativistic

Not official, PD NOS

• Twisted, conflicted personalities
• Irritable, hostile, negativistic
• complaining, disgruntled
• feel unappreciated, pout
• disillusioned
• Vacillate from compliance to oppositional
• predictor of loss of control over emotions
• Indicator of serious psychiatric illness

Self-defeating (Masochistic)

• effacing, servile, blameful
• Defeatist, self-condemning
• Self-sacrificing, deserve to suffer
• Martyr-like, endures abuse
• Look for victimization
• Not a well-validated scale
• Not official anymore – PD NOS

Paranoid

• Cluster A
• Guarded, defensive, distrustful
• Feeling “persecuted”
• Suspects, without a sufficient basis, that others are exploiting, harming, or deceiving him/her*Hypervigilance
• Sensitivity
• Rigid and argumentative
• Annoyance with others
• Grandiosity
• Edgy defensiveness
• Secretive
• Preoccupied with unjustified doubts about the loyalty and trustworthiness of friends/associates

Schizotypal

• Eccentric, bizarre, absent
• Peculiar, odd, disconnected
• Cognitive impairments
• Self-absorbed in own thoughts
• Ideas of reference
• Detachment, social isolation
• Self-conscious and anxious

Borderline

• Cluster B
• Borderline between merely neurotic and fully psychotic
• Unpredictable, manipulative, unstable
• Feelings of emptiness
• Identity disturbance/lack of strong identity; unstable self-image or sense of self
• Fears abandonment
• Frantic efforts to avoid real or imagined abandonment
• Moody, contrary
• Unstable mood, anger, guilt, dependency seeking, Impulsive, self-damaging
• Suicidal
• Constantly seek approval
• Prone to brief psychotic reactions
• Poor sense of self and boundaries