Disorders of adult personality and behaviour ICD 10 F60

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International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) Version for 2010

Chapter V
Mental and behavioural disorders
(F00-F99)

Disorders of adult personality and behaviour
(F60-F69)

This block includes a variety of conditions and behaviour patterns of clinical significance which tend to be persistent and appear to be the expression of the individual's characteristic lifestyle and mode of relating to himself or herself and others. Some of these conditions and patterns of behaviour emerge early in the course of individual development, as a result of both constitutional factors and social experience, while others are acquired later in life. Specific personality disorders (F60.-), mixed and other personality disorders (F61.-), and enduring personality changes (F62.-) are deeply ingrained and enduring behaviour patterns, manifesting as inflexible responses to a broad range of personal and social situations. They represent extreme or significant deviations from the way in which the average individual in a given culture perceives, thinks, feels and, particularly, relates to others. Such behaviour patterns tend to be stable and to encompass multiple domains of behaviour and psychological functioning. They are frequently, but not always, associated with various degrees of subjective distress and problems of social performance.

F60Specific personality disorders

These are severe disturbances in the personality and behavioural tendencies of the individual; not directly resulting from disease, damage, or other insult to the brain, or from another psychiatric disorder; usually involving several areas of the personality; nearly always associated with considerable personal distress and social disruption; and usually manifest since childhood or adolescence and continuing throughout adulthood.

F60.0Paranoid personality disorder

Personality disorder characterized by excessive sensitivity to setbacks, unforgiveness of insults; suspiciousness and a tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous; recurrent suspicions, without justification, regarding the sexual fidelity of the spouse or sexual partner; and a combative and tenacious sense of personal rights. There may be excessive self-importance, and there is often excessive self-reference.

Personality (disorder):

• expansive paranoid
• fanatic
• querulant
• paranoid
• sensitive paranoid

Excl.:

paranoia (F22.0)

paranoia querulans (F22.8)

paranoid:

• psychosis (F22.0)
• schizophrenia (F20.0)
• state (F22.0)

F60.1Schizoid personality disorder

Personality disorder characterized by withdrawal from affectional, social and other contacts with preference for fantasy, solitary activities, and introspection. There is a limited capacity to express feelings and to experience pleasure.

Excl.:

Asperger syndrome (F84.5)

delusional disorder (F22.0)

schizoid disorder of childhood (F84.5)

schizophrenia (F20.-)

schizotypal disorder (F21)

F60.2Dissocial personality disorder

Personality disorder characterized by disregard for social obligations, and callous unconcern for the feelings of others. There is gross disparity between behaviour and the prevailing social norms. Behaviour is not readily modifiable by adverse experience, including punishment. There is a low tolerance to frustration and a low threshold for discharge of aggression, including violence; there is a tendency to blame others, or to offer plausible rationalizations for the behaviour bringing the patient into conflict with society.

Personality (disorder):

• amoral
• antisocial
• asocial
• psychopathic
• sociopathic

Excl.:

conduct disorders (F91.-)

emotionally unstable personality disorder (F60.3)

F60.3Emotionally unstable personality disorder

Personality disorder characterized by a definite tendency to act impulsively and without consideration of the consequences; the mood is unpredictable and capricious. There is a liability to outbursts of emotion and an incapacity to control the behavioural explosions. There is a tendency to quarrelsome behaviour and to conflicts with others, especially when impulsive acts are thwarted or censored. Two types may be distinguished: the impulsive type, characterized predominantly by emotional instability and lack of impulse control, and the borderline type, characterized in addition by disturbances in self-image, aims, and internal preferences, by chronic feelings of emptiness, by intense and unstable interpersonal relationships, and by a tendency to self-destructive behaviour, including suicide gestures and attempts.

Personality (disorder):

• aggressive
• borderline
• explosive

Excl.:

dissocial personality disorder (F60.2)

F60.4Histrionic personality disorder

Personality disorder characterized by shallow and labile affectivity, self-dramatization, theatricality, exaggerated expression of emotions, suggestibility, egocentricity, self-indulgence, lack of consideration for others, easily hurt feelings, and continuous seeking for appreciation, excitement and attention.

Personality (disorder):

• hysterical
• psychoinfantile

F60.5Anankastic personality disorder

Personality disorder characterized by feelings of doubt, perfectionism, excessive conscientiousness, checking and preoccupation with details, stubbornness, caution, and rigidity. There may be insistent and unwelcome thoughts or impulses that do not attain the severity of an obsessive-compulsive disorder.

Personality (disorder):

• compulsive
• obsessional
• obsessive-compulsive

Excl.:

obsessive-compulsive disorder (F42.-)

F60.6Anxious [avoidant] personality disorder

Personality disorder characterized by feelings of tension and apprehension, insecurity and inferiority. There is a continuous yearning to be liked and accepted, a hypersensitivity to rejection and criticism with restricted personal attachments, and a tendency to avoid certain activities by habitual exaggeration of the potential dangers or risks in everyday situations.

F60.7Dependent personality disorder

Personality disorder characterized by pervasive passive reliance on other people to make one's major and minor life decisions, great fear of abandonment, feelings of helplessness and incompetence, passive compliance with the wishes of elders and others, and a weak response to the demands of daily life. Lack of vigour may show itself in the intellectual or emotional spheres; there is often a tendency to transfer responsibility to others.

Personality (disorder):

• asthenic
• inadequate
• passive
• self-defeating

F60.8Other specific personality disorders

Personality (disorder):

• eccentric
• "haltlose" type
• immature
• narcissistic
• passive-aggressive
• psychoneurotic

F60.9Personality disorder, unspecified

Character neurosis NOS

Pathological personality NOS

F61Mixed and other personality disorders

This category is intended for personality disorders that are often troublesome but do not demonstrate the specific pattern of symptoms that characterize the disorders described in F60.-. As a result they are often more difficult to diagnose than the disorders in F60.-.

Examples include:

• mixed personality disorders with features of several of the disorders in F60.- but without a predominant set of symptoms that would allow a more specific diagnosis
• troublesome personality changes, not classifiable to F60.- or F62.-, and regarded as secondary to a main diagnosis of a coexisting affective or anxiety disorder.

Excl.:

accentuated personality traits (Z73.1)

F62Enduring personality changes, not attributable to brain damage and disease

Disorders of adult personality and behaviour that have developed in persons with no previous personality disorder following exposure to catastrophic or excessive prolonged stress, or following a severe psychiatric illness. These diagnoses should be made only when there is evidence of a definite and enduring change in a person's pattern of perceiving, relating to, or thinking about the environment and himself or herself. The personality change should be significant and be associated with inflexible and maladaptive behaviour not present before the pathogenic experience. The change should not be a direct manifestation of another mental disorder or a residual symptom of any antecedent mental disorder.

Excl.:

personality and behavioural disorder due to brain disease, damage and dysfunction (F07.-)

F62.0Enduring personality change after catastrophic experience

Enduring personality change, present for at least two years, following exposure to catastrophic stress. The stress must be so extreme that it is not necessary to consider personal vulnerability in order to explain its profound effect on the personality. The disorder is characterized by a hostile or distrustful attitude toward the world, social withdrawal, feelings of emptiness or hopelessness, a chronic feeling of "being on edge" as if constantly threatened, and estrangement. Post-traumatic stress disorder (F43.1) may precede this type of personality change.

Personality change after:

• concentration camp experiences
• disasters
• prolonged:
  • captivity with an imminent possibility of being killed
  • exposure to life-threatening situations such as being a victim of terrorism
• torture

Excl.:

post-traumatic stress disorder (F43.1)

F62.1Enduring personality change after psychiatric illness

Personality change, persisting for at least two years, attributable to the traumatic experience of suffering from a severe psychiatric illness. The change cannot be explained by a previous personality disorder and should be differentiated from residual schizophrenia and other states of incomplete recovery from an antecedent mental disorder. This disorder is characterized by an excessive dependence on and a demanding attitude towards others; conviction of being changed or stigmatized by the illness, leading to an inability to form and maintain close and confiding personal relationships and to social iso-lation; passivity, reduced interests, and diminished involvement in leisure activities; persistent complaints of being ill, which may be associated with hypochondriacal claims and illness behaviour; dysphoric or labile mood, not due to the presence of a current mental disorder or antecedent mental disorder with residual affective symptoms; and longstanding problems in social and occupational functioning.

F62.8Other enduring personality changes

Chronic pain personality syndrome

F62.9Enduring personality change, unspecified

F63Habit and impulse disorders

This category includes certain disorders of behaviour that are not classifiable under other categories. They are characterized by repeated acts that have no clear rational motivation, cannot be controlled, and generally harm the patient's own interests and those of other people. The patient reports that the behaviour is associated with impulses to action. The cause of these disorders is not understood and they are grouped together because of broad descriptive similarities, not because they are known to share any other important features.

Excl.:

habitual excessive use of alcohol or psychoactive substances (F10-F19)

impulse and habit disorders involving sexual behaviour (F65.-)

F63.0Pathological gambling

The disorder consists of frequent, repeated episodes of gambling that dominate the patient's life to the detriment of social, occupational, material, and family values and commitments.

Compulsive gambling

Excl.:

excessive gambling by manic patients (F30.-)

gambling and betting NOS (Z72.6)

gambling in dissocial personality disorder (F60.2)

F63.1Pathological fire-setting [pyromania]

Disorder characterized by multiple acts of, or attempts at, setting fire to property or other objects, without apparent motive, and by a persistent preoccupation with subjects related to fire and burning. This behaviour is often associated with feelings of increasing tension before the act, and intense excitement immediately afterwards.

Excl.:

fire-setting (by)(in):

• adult with dissocial personality disorder (F60.2)
• alcohol or psychoactive substance intoxication (F10-F19, with common fourth character .0)
• as the reason for observation for suspected mental disorder (Z03.2)
• conduct disorders (F91.-)
• organic mental disorders (F00-F09)
• schizophrenia (F20.-)

F63.2Pathological stealing [kleptomania]

Disorder characterized by repeated failure to resist impulses to steal objects that are not acquired for personal use or monetary gain. The objects may instead be discarded, given away, or hoarded. This behaviour is usually accompanied by an increasing sense of tension before, and a sense of gratification during and immediately after, the act.

Excl.:

depressive disorder with stealing (F31-F33)

organic mental disorders (F00-F09)

shoplifting as the reason for observation for suspected mental disorder (Z03.2)

F63.3Trichotillomania

A disorder characterized by noticeable hair-loss due to a recurrent failure to resist impulses to pull out hairs. The hair-pulling is usually preceded by mounting tension and is followed by a sense of relief or gratification. This diagnosis should not be made if there is a pre-existing inflammation of the skin, or if the hair-pulling is in response to a delusion or a hallucination.

Excl.:

stereotyped movement disorder with hair-plucking (F98.4)

F63.8Other habit and impulse disorders

Other kinds of persistently repeated maladaptive behaviour that are not secondary to a recognized psychiatric syndrome, and in which it appears that the patient is repeatedly failing to resist impulses to carry out the behaviour. There is a prodromal period of tension with a feeling of release at the time of the act.

Intermittent explosive disorder

F63.9Habit and impulse disorder, unspecified

F64Gender identity disorders

F64.0Transsexualism

A desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one's anatomic sex, and a wish to have surgery and hormonal treatment to make one's body as congruent as possible with one's preferred sex.

F64.1Dual-role transvestism

The wearing of clothes of the opposite sex for part of the individual's existence in order to enjoy the temporary experience of membership of the opposite sex, but without any desire for a more permanent sex change or associated surgical reassignment, and without sexual excitement accompanying the cross-dressing.

Gender identity disorder of adolescence or adulthood, nontranssexual type

Excl.:

fetishistic transvestism (F65.1)

F64.2Gender identity disorder of childhood

A disorder, usually first manifest during early childhood (and always well before puberty), characterized by a persistent and intense distress about assigned sex, together with a desire to be (or insistence that one is) of the other sex. There is a persistent preoccupation with the dress and activities of the opposite sex and repudiation of the individual's own sex. The diagnosis requires a profound disturbance of the normal gender identity; mere tomboyishness in girls or girlish behaviour in boys is not sufficient. Gender identity disorders in individuals who have reached or are entering puberty should not be classified here but in F66.-.

Excl.:

egodystonic sexual orientation (F66.1)

sexual maturation disorder (F66.0)

F64.8Other gender identity disorders

F64.9Gender identity disorder, unspecified

Gender-role disorder NOS

F65Disorders of sexual preference

Incl.:

paraphilias

F65.0Fetishism

Reliance on some non-living object as a stimulus for sexual arousal and sexual gratification. Many fetishes are extensions of the human body, such as articles of clothing or footwear. Other common examples are characterized by some particular texture such as rubber, plastic or leather. Fetish objects vary in their importance to the individual. In some cases they simply serve to enhance sexual excitement achieved in ordinary ways (e.g. having the partner wear a particular garment).

F65.1Fetishistic transvestism

The wearing of clothes of the opposite sex principally to obtain sexual excitement and to create the appearance of a person of the opposite sex. Fetishistic transvestism is distinguished from transsexual transvestism by its clear association with sexual arousal and the strong desire to remove the clothing once orgasm occurs and sexual arousal declines. It can occur as an earlier phase in the development of transsexualism.

Transvestic fetishism

F65.2Exhibitionism

A recurrent or persistent tendency to expose the genitalia to strangers (usually of the opposite sex) or to people in public places, without inviting or intending closer contact. There is usually, but not invariably, sexual excitement at the time of the exposure and the act is commonly followed by masturbation.

F65.3Voyeurism

A recurrent or persistent tendency to look at people engaging in sexual or intimate behaviour such as undressing. This is carried out without the observed people being aware, and usually leads to sexual excitement and masturbation.

F65.4Paedophilia

A sexual preference for children, boys or girls or both, usually of prepubertal or early pubertal age.

F65.5Sadomasochism

A preference for sexual activity which involves the infliction of pain or humiliation, or bondage. If the subject prefers to be the recipient of such stimulation this is called masochism; if the provider, sadism. Often an individual obtains sexual excitement from both sadistic and masochistic activities.

Masochism

Sadism

F65.6Multiple disorders of sexual preference

Sometimes more than one abnormal sexual preference occurs in one person and there is none of first rank. The most common combination is fetishism, transvestism and sadomasochism.

F65.8Other disorders of sexual preference

A variety of other patterns of sexual preference and activity, including making obscene telephone calls, rubbing up against people for sexual stimulation in crowded public places, sexual activity with animals, and use of strangulation or anoxia for intensifying sexual excitement.

Frotteurism

Necrophilia

F65.9Disorder of sexual preference, unspecified

Sexual deviation NOS

F66Psychological and behavioural disorders associated with sexual development and orientation

Note:

Sexual orientation by itself is not to be regarded as a disorder.

F66.0Sexual maturation disorder

The patient suffers from uncertainty about his or her gender identity or sexual orientation, which causes anxiety or depression. Most commonly this occurs in adolescents who are not certain whether they are homosexual, heterosexual or bisexual in orientation, or in individuals who, after a period of apparently stable sexual orientation (often within a longstanding relationship), find that their sexual orientation is changing.

F66.1Egodystonic sexual orientation

The gender identity or sexual preference (heterosexual, homosexual, bisexual, or prepubertal) is not in doubt, but the individual wishes it were different because of associated psychological and behavioural disorders, and may seek treatment in order to change it.

F66.2Sexual relationship disorder

The gender identity or sexual orientation (heterosexual, homosexual, or bisexual) is responsible for difficulties in forming or maintaining a relationship with a sexual partner.

F66.8Other psychosexual development disorders

F66.9Psychosexual development disorder, unspecified

F68Other disorders of adult personality and behaviour

F68.0Elaboration of physical symptoms for psychological reasons

Physical symptoms compatible with and originally due to a confirmed physical disorder, disease or disability become exaggerated or prolonged due to the psychological state of the patient. The patient is commonly distressed by this pain or disability, and is often preoccupied with worries, which may be justified, of the possibility of prolonged or progressive disability or pain.

Compensation neurosis

F68.1Intentional production or feigning of symptoms or disabilities, either physical or psychological [factitious disorder]

The patient feigns symptoms repeatedly for no obvious reason and may even inflict self-harm in order to produce symptoms or signs. The motivation is obscure and presumably internal with the aim of adopting the sick role. The disorder is often combined with marked disorders of personality and relationships.

Hospital hopper syndrome

Münchhausen syndrome

Peregrinating patient

Excl.:

factitial dermatitis (L98.1)

person feigning illness (with obvious motivation) (Z76.5)

F68.8Other specified disorders of adult personality and behaviour

Character disorder NOS

Relationship disorder NOS

F69Unspecified disorder of adult personality and behaviour



Source - http://apps.who.int/classifications/icd10/browse/2010/en#/F60

Email from PRC regarding Submission of Certificate of Authentication and Validation (CAV)

For those who already applied and got their NOA for the Psychometrician Licensure Exam, do check your email and spam mail box if you received an email like the above email. Particularly for those who did not comply with the CAV thing like me. Even if I have my NOA already,  PRC still wants me to comply with this missing requirement.

But in the email it cited Sec. 12-A (c) which applies for Psychologists, but since I received the email I will still comply just so I will be "included in the room assignment". The more appropriate provision for Psychometrician is below (but it seems they made a general email to all  licensure examination applications for Psychologists and Psychometricians who did not comply with the CAV):


Sec. 13-A. Documentary Requirements to the Licensure Examination of Psychometricians

c. Original and photocopy of transcript of records (with scanned picture) indicating the Special Order (S.O.) number, and where school is exempted from the issuance of an S.O., a Certificate of Authentication and Validation (CAV) from the CHED.


What is CAV? 

Per IRR of Psychology Act of 2009, CAV refers to Certificate of Authentication and Validation (CAV) issued by the Commission on Higher Education (CHED). But there is also other CAV or the Certification, Authentication and Verification (CAV), term also applies to those requirements when you want your documents authenticated and to have a red ribbon especially for those who applies for work abroad.  Well perhaps the purpose is to distinguish it from those fake documents issued in Recto and Quiapo.

CAV is the requirement I missed out in my application, I was confident that the SO from the school I graduated will not be questioned. But alas, with the email from PRC using a gmail account and without a signature (that looks very unofficial),  I have to apply for it again and secure it from CHED. The school registrar also informed me when I applied for my TOR that most of those who secured their documents for the licensure exam did not request for the CAV requirements, well perhaps, I graduated much earlier than most of the younger batch.

How to apply for CAV?

Some school have their liaison officer who facilitates the application for CAV on behalf of their students/alumni. It can take three (3) weeks before it is released. But in some school they allow their won students to do apply to CHED on their own, with the necessary endorsement from the school. If individual applies directly it may take a week for CHED to release the CAV.

The Case of Autumn Asphodel Overcoming Mental Disorders

While gathering videos on youtube about Personality Disorders that we put together as a playlist of a lecture by Dr. Rhoda Hahn we came across the video of Autumn Asphodel.

We asked permission to use this video as a case study of her own account of the mental health issues she gone through from childhood to her gender transition from male to female.

Her video is enlightening, giving a face and practical example to the theories described and lectured by Dr. Hahn. The theories becomes clearer with the personal and authentic account of  Ms. Asphodel experiences of the various symptoms of psychological disturbances she went through.

The thread of comments are equally interesting and worthy of further probing as to the mental health of the commentors.

The video was uploaded and published on Dec 21, 2013. She describe her video below:

The story of my past (childhood, teenage years, middle and high school) and the struggle I had at becoming my true self, through the mental disorders and trauma. It was a difficult journey as I struggled with my gender identity as a male to female and endured severe trauma from a very early age, including abandonment.

(This was the most difficult video I have done. A big thank you to anyone who watches the entire thing!)

Below is the outline and timing of the topics (running time - 38 mins):

0:54 - Childhood Years
8:32 - Preteen & Teen Years
12:04 - Middle School - Abuse
14:27 - Middle School - Anger
16:51 - High School - Abuse
24:25 - High School - Anger & Delusions
29:28 - High School - Aftermath
32:30 - Present Day


As a case study, we like you readers to reflect on the following and share with us your answers:

1) Identify her struggles during her childhood, teens and adulthood?

2) What were the psychopathology or abnormal behaviors she experienced?

3) Give examples of symptoms or dysfuntions that she manifested through her life?

4) Visit the you tube link ( https://www.youtube.com/all_comments?v=8dn0aYm3Mik ) and read through the comments. What lessons can you learn from those  comments?

5) In your assessment is Autumn telling the truth or lies? Why?

Frequently Asked Question: 3 Certificates of Good Moral Character

Implementing Rules and Regulations of Republic Act No. 10029, Known as the "Psychology Act of 2009"

Rule 5 - Licensure Examination

Sec 13-A. Documentary Requirements to the Licensure Examination of Psychometricians

e) Three (3) certificates of good moral character, preferably from school, employer, church, barangay captain duly signed by the issuing authority and duly notarized under oath.

Source - http://prc.gov.ph/uploaded/documents/BoardofPsychology-IRR.pdf

Personality Disorders:Video Playlist and DSM Description

Image source - http://unitycounsellingservice.co.uk/wp-content/uploads/2014/07/RDHTTVOV12_P111.jpg

Note the link of the video playlist below was uploaded in 2009, before the DSM 5 publication. So largely what is being discussed are those of  DSM4-TR.

 


Personality Disorders & DSM 4

Personality disorders
Cluster A (odd)
Paranoid    Schizoid    Schizotypal
Cluster B (dramatic)
Antisocial   Borderline   Histrionic    Narcissistic
Cluster C (anxious)
Avoidant   Dependent   Obsessive–compulsive
Not specified
Depressive    Passive-aggressive  Sadistic    Self-defeating    Psychopathy

Personality disorders are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's culture. These patterns develop early, are inflexible and are associated with significant distress or disability.^[1] The definitions may vary some according to other sources.^[2][3]

Official criteria for diagnosing personality disorders are listed in the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, and in the mental and behavioral disorders section of the International Statistical Classification of Diseases and Related Health Problems, published by the World Health Organization. The DSM-5 published in 2013 now lists personality disorders in exactly the same way as other mental disorders, rather than on a separate 'axis' as previously.^[4]

The Diagnostic and Statistical Manual of Mental Disorders (currently the DSM-5) provides a definition of a General personality disorder that stress such disorders are an enduring and inflexible pattern of long duration that lead to significant distress or impairment and are not due to use of substances or another medical condition. DSM-5 lists ten personality disorders, grouped into three clusters. The DSM-5 also contains three diagnoses for personality patterns that do not match these ten disorders, but nevertheless exhibit characteristics of a personality disorder.^[18]

Cluster A (odd disorders)

• Paranoid personality disorder: characterized by a pattern of irrational suspicion and mistrust of others, interpreting motivations as malevolent
• Schizoid personality disorder: lack of interest and detachment from social relationships, and restricted emotional expression
• Schizotypal personality disorder: a pattern of extreme discomfort interacting socially, distorted cognitions and perceptions

Cluster B (dramatic, emotional or erratic disorders)

• Antisocial personality disorder: a pervasive pattern of disregard for and violation of the rights of others, lack of empathy
• Borderline personality disorder: pervasive pattern of instability in relationships, self-image, identity, behavior andaffects often leading to self-harm and impulsivity
• Histrionic personality disorder: pervasive pattern of attention-seeking behavior and excessive emotions
• Narcissistic personality disorder: a pervasive pattern of grandiosity, need for admiration, and a lack of empathy

Cluster C (anxious or fearful disorders)

• Avoidant personality disorder: pervasive feelings of social inhibition and inadequacy, extreme sensitivity to negative evaluation
• Dependent personality disorder: pervasive psychological need to be cared for by other people.
• Obsessive-compulsive personality disorder (not the same as obsessive-compulsive disorder): characterized by rigid conformity to rules, perfectionism and control

Other personality disorders

• Personality change due to another medical condition – is a personality disturbance due to the direct effects of a medical condition
• Other specified personality disorder – symptoms characteristic of a personality disorder but fails to meet the criteria for a specific disorder, with the reason given
• Personality disorder not otherwise specified

Signs and symptoms

In the workplace

Depending on the diagnosis, severity and individual, and the job itself, personality disorders can be associated with difficulty coping with work or the workplace - potentially leading to problems with others by interfering with interpersonal relationships. Indirect effects also play a role; for example, impaired educational progress or complications outside of work, such as substance abuse and co-morbid mental diseases, can plague sufferers. However, personality disorders can also bring about above-average work abilities by increasing competitive drive or causing the sufferer to exploit his or her co-workers.^[41][42]

In 2005, psychologists Belinda Board and Katarina Fritzon at the University of Surrey, UK, interviewed and gave personality tests to high-level British executives and compared their profiles with those of criminal psychiatric patients at Broadmoor Hospital in the UK. They found that three out of eleven personality disorders were actually more common in executives than in the disturbed criminals:

• Histrionic personality disorder: including superficial charm, insincerity, egocentricity and manipulation
• Narcissistic personality disorder: including grandiosity, self-focused lack of empathy for others, exploitativeness and independence.
• Obsessive-compulsive personality disorder: including perfectionism, excessive devotion to work, rigidity, stubbornness and dictatorial tendencies.^[43]

According to leading leadership academic Manfred F.R. Kets de Vries, it seems almost inevitable these days that there will be some personality disorders in a senior management team.^[44]

Relationship with other mental disorders

The disorders in each of the three clusters may share some underlying common vulnerability factors involving cognition, affect and impulse control, and behavioral maintenance or inhibition, respectively, and may have a spectrum relationship to certain syndromal mental disorders:^[45]

• Paranoid or schizotypal personality disorders may be observed to be premorbid antecedents of delusional disorders orschizophrenia.

• Borderline personality disorder is seen in association with mood and anxiety disorders and with impulse control disorders, eating disorders, ADHD, or a substance use disorder.

• Avoidant personality disorder is seen with social anxiety disorder.

Diagnosis

The DSM-IV lists General diagnostic criteria for a personality disorder, which must be met in addition to the specific criteria for a particular named personality disorder. This requires that there be (to paraphrase):^[46]

• An enduring pattern of psychological experience and behavior that differs prominently from cultural expectations, as shown in two or more of: cognition (i.e. perceiving and interpreting the self, other people or events); affect (i.e. the range, intensity, lability, and appropriateness of emotional response); interpersonal functioning; or impulse control.
• The pattern must appear inflexible and pervasive across a wide range of situations, and lead to clinically significant distress or impairment in important areas of functioning.
• The pattern must be stable and long-lasting, have started as early as at least adolescence or early adulthood.
• The pattern must not be better accounted for as a manifestation of another mental disorder, or to the direct physiological effects of a substance (e.g. drug or medication) or a general medical condition (e.g. head trauma).

The ICD-10 'clinical descriptions and diagnostic guidelines' introduces its specific personality disorder diagnoses with some general guideline criteria that are similar. To quote:^[47]

• Markedly disharmonious attitudes and behavior, generally involving several areas of functioning; e.g. affectivity, arousal, impulse control, ways of perceiving and thinking, and style of relating to others;
• The abnormal behavior pattern is enduring, of long standing, and not limited to episodes of mental illness;
• The abnormal behavior pattern is pervasive and clearly maladaptive to a broad range of personal and social situations;
• The above manifestations always appear during childhood or adolescence and continue into adulthood;
• The disorder leads to considerable personal distress but this may only become apparent late in its course;
• The disorder is usually, but not invariably, associated with significant problems in occupational and social performance.

The ICD adds: "For different cultures it may be necessary to develop specific sets of criteria with regard to social norms, rules and obligations."

Source - http://en.wikipedia.org/wiki/Personality_disorder 


Personality Disorders & DSM 5

Personality disorders are associated with ways of thinking and feeling about oneself and others that
significantly and adversely affect how an individual functions in many aspects of life. They fall within
10 distinct types: paranoid personality disorder, schizoid personality disorder, schizotypal personality
disorder, antisocial personality disorder, borderline personality disorder, histrionic personality, narcissistic personality disorder, avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder.

DSM-5 moves from the multiaxial system to a new assessment that removes the arbitrary boundaries
between personality disorders and other mental disorders. A hybrid model that included evaluation of impairments in personality functioning (how an individual typically experiences himself or herself as well as others) plus five broad areas of pathological personality traits. Although this hybrid proposal was not accepted for DSM-5’s main manual, it is included in Section III for further study. Using this alternate methodology, clinicians would assess personality and diagnose a personality disorder based on an individual’s particular difficulties in personality functioning and on specific patterns of those pathological traits.

The hybrid methodology retains six personality disorder types:
• Borderline Personality Disorder
• Obsessive-Compulsive Personality Disorder
• Avoidant Personality Disorder
• Schizotypal Personality Disorder
• Antisocial Personality Disorder
• Narcissistic Personality Disorder

Each type is defined by a specific pattern of impairments and traits. This approach also includes a diagnosis of Personality Disorder—Trait Specified (PD-TS) that could be made when a Personality Disorder is
considered present, but the criteria for a specific personality disorder are not fully met. For this diagnosis,
the clinician would note the severity of impairment in personality functioning and the problematic
personality trait(s). This hybrid dimensional-categorical model and its components seek to address existing issues with the categorical approach to personality disorders.

Source - http://www.dsm5.org/Documents/Personality%20Disorders%20Fact%20Sheet.pdf