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Personality is a characteristic manner of thinking, feeling, behaving, and relating to self and others.

Personality disoder (PD) vs. oddball/fruitcake/kook

Everyone has personality quirks and peculiarities, but when personality traits are inflexible and maladaptive and cause significant functional impairment or cause subjective distress that they constitute a personality disorder.

Main distinction from diagnosis listed on Axis I: personality disorders must be present by late adolescence or early adulthood. 3 clusters are recognized:

Cluster A: "odd-eccentric" PDs including paranoid, schizoid, and schizotypal PDs

Cluster B: "dramatic-emotional-erratic" PDs including the antisocial,borderline, histrionic, and narcissistic PDs.

Cluster C: "fearful-anxious" type includes avoidant, dependent, nd obcessive-compulsive PDs.

Clinical Pearls

PDs are a combination of prevalent traits and changeable or reactive behaviors; when making a diagnosis, keep in mind, that some of the criteria of a PD may be situational or transient, while other criteria are pervasive and unchanging. AmJPsych 162(5) 2005


Personality disorder

Prevalent, unchanging traits

Intermittent behavioral and reactive criteria

Schizotypal PD

Paranoid ideations, unusual experiences, odd beliefs

Odd behavior, constricted affect

Borderline PD

Affective instability, anger, impulsivity

Self-injury, ‘defending against abandonment’ behaviors

Avoidant PD

Feeling inadequate, socially inept

Avoiding interpersonal jobs, potentially embarrassing situations

Obsessive-compulsive PD

Rigidity, problem delegating

Miserly behaviors, strict moral behaviors

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