© 2012 American Psychiatric Association. All Rights Reserved. See Terms & Conditions of Use for more information. DSM-IV and DSM-5 Criteria for the Personality Disorders General Criteria for a Personality Disorder General Criteria for a Personality Disorder DSM-IV DSM-5 Criteria - Revised June 2011 The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose a personality disorder, the following criteria must be met: A. An enduring pattern of inner experience and behavior the deviates A. Significant impairments in self (identity or self-direction) and markedly from the expectations of the individual's culture. This interpersonal (empathy or intimacy) functioning. pattern is manifested in two (or more) of the following areas: 1. Cognition (i.e., ways of perceiving and interpreting self, other people and events) 2. Affectivity (i.e., the range, intensity, liability, and appropriateness of emotional response) 3. Interpersonal functioning 4. Impulse control B. One or more pathological personality trait domains or trait facets. B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. C. The impairments in personality functioning and the individual‟s C. The enduring pattern leads to clinically significant distress or personality trait expression are relatively stable across time and impairment in social, occupational, or other important areas of consistent across situations. functioning. D. The impairments in personality functioning and the individual‟s D. The pattern is stable and of long duration, and its onset can be personality trait expression are not better understood as traced back at least to adolescence or early adulthood. normative for the individual‟s developmental stage or socio- cultural environment. E. The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder. E. The impairments in personality functioning and the individual‟s personality trait expression are not solely due to the direct F. The enduring pattern is not due to the direct physiological effects physiological effects of a substance (e.g., a drug of abuse, of a substance (e.g., a drug abuse, a medication) or a general medication) or a general medical condition (e.g., severe head medical condition (e.g., head trauma). trauma). © 2012 American Psychiatric Association. All Rights Reserved. See Terms & Conditions of Use for more information. DSM-IV and DSM-5 Criteria for the Personality Disorders Antisocial Personality Disorder Antisocial Personality Disorder DSM-IV Criteria DSM-5 Criteria - Revised April 2012 The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose antisocial personality disorder, the following criteria must be met: A. There is a pervasive pattern of disregard for and violation of the A. Significant impairments in personality functioning manifest by: rights of others occurring since age 15 years, as indicated by three (or more) of the following: having hurt, mistreated, or stolen from 1. Impairments in self functioning (a or b): another. 1. Failure to conform to social norms with respect to lawful a. Identity: Ego-centrism; self-esteem derived from behaviors as indicated by repeatedly performing acts that personal gain, power, or pleasure. are grounds for arrest. b. Self-direction: Goal-setting based on personal gratification; absence of prosocial internal 2. Deceitfulness, as indicated by repeated lying, use of aliases, standards associated with failure to conform to or conning others for personal profit or pleasure. lawful or culturally normative ethical behavior. AND 3. Impulsivity or failure to plan ahead. 2. Impairments in interpersonal functioning (a or b): 4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults. a. Empathy: Lack of concern for feelings, needs, or suffering of others; lack of remorse after hurting or 5. Reckless disregard for safety of self or others. mistreating another. 6. Consistent irresponsibility, as indicated by repeated failure b. Intimacy: Incapacity for mutually intimate to sustain consistent work behavior or honor financial relationships, as exploitation is a primary means of obligations. relating to others, including by deceit and coercion; use of dominance or intimidation to control others. 7. Lack of remorse, as indicated by being indifferent to or rationalizing. © 2012 American Psychiatric Association. All Rights Reserved. See Terms & Conditions of Use for more information. DSM-IV and DSM-5 Criteria for the Personality Disorders B. The individual is at least age 18 years. B. Pathological personality traits in the following domains: 1. Antagonism, characterized by: C. There is evidence of Conduct Disorder with onset before age 15 years. a. Manipulativeness: Frequent use of subterfuge to influence or control others; use of seduction, D. The occurrence of antisocial behavior is not exclusively during the charm, glibness, or ingratiation to achieve one„s course of Schizophrenia or a Manic Episode. ends. b. Deceitfulness: Dishonesty and fraudulence; misrepresentation of self; embellishment or fabrication when relating events. c. Callousness: Lack of concern for feelings or problems of others; lack of guilt or remorse about the negative or harmful effects of one„s actions on others; aggression; sadism. d. Hostility: Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults; mean, nasty, or vengeful behavior. 2. Disinhibition, characterized by: a. Irresponsibility: Disregard for – and failure to honor – financial and other obligations or commitments; lack of respect for – and lack of follow through on – agreements and promises. b. Impulsivity: Acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of outcomes; difficulty establishing and following plans. c. Risk taking: Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard for consequences; boredom proneness and thoughtless initiation of activities to © 2012 American Psychiatric Association. All Rights Reserved. See Terms & Conditions of Use for more information. DSM-IV and DSM-5 Criteria for the Personality Disorders counter boredom; lack of concern for one„s limitations and denial of the reality of personal danger C. The impairments in personality functioning and the individual‟s personality trait expression are relatively stable across time and consistent across situations. D. The impairments in personality functioning and the individual‟s personality trait expression are not better understood as normative for the individual‟s developmental stage or socio- cultural environment. E. The impairments in personality functioning and the individual‟s personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma). F. The individual is at least age 18 years. Avoidant Personality Disorder Avoidant Personality Disorder DSM-IV Criteria DSM-5 Criteria - Revised June 2011 The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose avoidant personality disorder, the following criteria must be met: A. A pervasive pattern of social inhibition, feelings of inadequacy, and A. Significant impairments in personality functioning manifest by: hypersensitivity to negative evaluation, beginning by early adulthood 1. Impairments in self functioning (a or b): and present in a variety of contexts, as indicated by four (or more) of a. Identity: Low self-esteem associated with self-appraisal the following: socially inept, personally unappealing, or inferior; excessive feelings of shame or inadequacy. © 2012 American Psychiatric Association. All Rights Reserved. See Terms & Conditions of Use for more information. DSM-IV and DSM-5 Criteria for the Personality Disorders 1. Avoids occupational activities that involve significant b. Self-direction: Unrealistic standards for behavior interpersonal contact, because of fears of criticism, disapproval, associated with reluctance to pursue goals, take personal or rejection. risks, or engage in new activities involving interpersonal contact. 2. Is unwilling to get involved with people unless certain of being liked. AND 3. Shows restraint within intimate relationships because of the fear 2. Impairments in interpersonal functioning (a or b): of being shamed or ridiculed. a. Empathy: Preoccupation with, and sensitivity to, criticism or rejection, associated with distorted inference of others‟ 4. Is preoccupied with being criticized or rejected in social perspectives as negative. situations. b. Intimacy: Reluctance to get involved with people unless 5. Is inhibited in new interpersonal situations because of feelings of being certain of being liked; diminished mutuality within inadequacy. intimate relationships because of fear of being shamed or ridiculed. 6. Views self as socially inept, personally unappealing, or inferior to others. B. Pathological personality traits in the following domains: 1. Detachment, characterized by: 7. Is unusually reluctant to take