Overview

• A series of maladaptive personality traits that interfere with normal function in life.
  • Cluster A (’Odd or Eccentric’) → paranoid, schizoid, schizotypal.
  • Cluster B (’Dramatic, Emotional, or Erratic’) → antisocial, borderline (emotionally unstable), histrionic, narcissistic.
  • Cluster C (’Anxious and Fearful’) → obsessive-compulsive, avoidant, dependent.
• Only diagnosed >18yo.

Making Diagnosis

Clinical Features

• Paranoid → hypersensitivity to insults.

• Schizoid → indifferent to praise and criticism. Preference for solitary activities, lack of interest in companionship or sexual interactions.

• Schizotypal → odd beliefs, lack of close friends.

  <aside> 💡 Schizoid → being like an android (robot). Schizotypal → having strange beliefs.

  </aside>

• Antisocial → failure to conform to social norms/rules, deception, impulsiveness, irritability, lack of remorse.

  • History of conduct disorder as child.

• Borderline (Emotionally Unstable) → history of recurrent self-harm and unstable interpersonal relationships which alternate between idealization and devaluation.

  • Treatment → dialectical behavioural therapy.
    • Teaches you how to accept who you are and how to deal with difficult emotions by recognising and challenging them.

• Histrionic → need to be centre of attention, rapidly shifting and shallow expression of emotions. Excessive displays of emotions and attention seeking behaviours.

• Narcissistic → grandiose sense of self-importance. Sense of entitlement, a need for admiration and a lack of empathy for others or believe others are jealous of them.

• Obsessive-Compulsive (Anankastic) → meticulous, scrupulous, and rigid about etiquettes of morality, ethics, or values.

  • Cardinal distinction between OCPD and OCD is the absence of distress over the obsession. OCD patients experience distress from repetitive thoughts, compulsive checking, and repetitive actions or routines. On the other hand, OCPD patients feel justified in their need for order and control (activities are seen as pleasurable and desirable).

• Avoidant (aka Anxious) → preoccupied with worries that they are being criticised or rejected in social situations.

• Dependent → difficulty making everyday decisions without excessive reassurance from others (lack initiative and struggle to make decisions independently).

Investigations