Classification and introduction of personality disorders

Overall Diagnostic Criteria for Personality Disorders

To accurately diagnose a personality disorder, the following criteria must be met:

1. Significant Deviation: The individual's behavior significantly deviates from the sociocultural norms of their environment, exhibiting two or more of the following unusual patterns:

   • Cognitive Functioning: Perceptions of oneself, others, and events.
   • Affective Functioning: The expression, intensity, variability, and appropriateness of emotional responses.
   • Interpersonal Functioning: Ability to form and maintain relationships.
   • Impulse Control: Ability to control impulses effectively.

2. Persistence: The manifestations of these patterns are stable and long-lasting.

3. Impairment: The patterns lead to significant impairment in personal, social, or occupational functioning.

4. Onset: Symptoms can be traced back to adolescence or early adulthood.

5. Exclusion of Other Disorders: The disorder is not due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or another medical condition (e.g., head trauma).

6. Duration Requirement for Diagnosis Before Age 18: For a diagnosis of a personality disorder to be made before the age of 18, the above characteristics must have been present for at least one year. Individuals under 18 are generally not diagnosed with antisocial personality disorder.

According to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5), personality disorders are categorized into Cluster A (odd or eccentric disorders), Cluster B (dramatic, emotional, or erratic disorders), Cluster C (anxious or fearful disorders), and an unspecified category. Here are some examples with American names substituted for the original Chinese names:

Cluster A Personality Disorders

1. Paranoid Personality Disorder: Individuals with this disorder tend to distrust others and are suspicious, constantly worried that others will betray or deceive them.

   • Example: Mr. John Smith is always suspicious that his colleagues are talking about him behind his back and conspiring to get him fired, even though there is no actual evidence to support this.

2. Schizoid Personality Disorder: People with this disorder often appear detached and indifferent to social relationships, and they generally demonstrate a limited range of emotional expression in interpersonal settings.

   • Example: Ms. Emily Johnson shows no interest in forming relationships and often chooses to stay home alone, displaying indifference or detachment at social gatherings or family events.

3. Schizotypal Personality Disorder: This disorder is characterized by peculiar, eccentric behaviors and ways of thinking.

   • Example: Mr. Michael Williams frequently claims to communicate with aliens and believes he has a mission that he must fulfill.

Cluster B Personality Disorders

1. Antisocial Personality Disorder: Individuals with this disorder frequently disregard and violate the rights of others, do not conform to social norms, and are involved in deceitful and manipulative behaviors.

   • Example: Mr. Robert Harris often makes excuses not to go to work and is involved in multiple thefts and frauds, showing no regard for the feelings of his victims.

2. Borderline Personality Disorder: Patients with this disorder experience unstable moods and chaotic relationships, exhibiting self-harm behaviors and extreme black-and-white thinking.

   • Example: Emily often experiences intense emotional fluctuations; her relationships are highly unstable, often idealizing and then quickly devaluing the same friend within a single day.

3. Histrionic Personality Disorder (related to narcissistic traits): Characterized by an excessive desire for attention and admiration, lack of empathy, and self-aggrandizement.

   • Example: Mrs. Lisa Johnson always tries to be the center of attention at gatherings, often wearing very striking clothes or exaggerating her experiences to draw attention.

4. Narcissistic Personality Disorder: Individuals have an inflated sense of self-importance, a deep need for excessive admiration, and a lack of understanding of others' feelings.

   • Example: Mr. Daniel Lee believes he is the smartest and most capable person in any situation, constantly needing praise and recognition from others, and reacting strongly and defensively to criticism.