Personality Disorder Concepts: Defining Characteristics

These are the defining characteristics of PDs, each of which are different depending on the PD in question.

Triggering event(s).

The situations that triggeramaladaptive response that is reflected in the person’s behavioral, interpersonal, cognitive, and affective styles. Triggering events can be intrapersonal (e.g. failing an exam), or interpersonal (e.g. being criticised).

• ASPD: Social standardsandrules.
• AVPD:Close relationships; being social/in public.
• BPD: The expectationofmeeting goals; maintaining close relationships; real or imagined abandonment.
• DPD: The expectationthat they can rely on themselves; being alone.
• HPD:Relationships, particularly with those they’re attracted to.
• NPD:Self-evaluation, either by themselvesorothers.
• OCPD:Unstructured situations; meeting other’s standards(in all aspects of life: work, family, etc).
• PPD:Close relationships; personal questions.
• STPD:Close relationships.
• SZPD:Close relationships.

Behavioral style

The way in which the person reactsto a triggering event.

• ASPD: Impulsive, irritable, aggressive; irresponsibleandstruggles to keep commitments; relies on themselves, uses cunningand force; risk-taking and thrill-seeking.
• AVPD:Tenseandself-conscious; controlled speech & behaviour; appear apprehensiveand awkward; self-criticising and overly humble.
• BPD:Self-damaging behaviours (self-harm, self-sabotage, suicidal ideation); aggression;achieve less than they could (e.g. in work or school); chronic insomnia& irregular circadian rhythms (”body clocks”); feel helpless&emptyvoid.
• DPD:Docile,passive,non-assertive, insecure, and submissive; doubts themselves & lacks self-confidence.
• HPD:Charming, dramatic, expressive; demanding, self-indulgent, inconsiderate; attention-seeking, mood swings, impulsive, unpredictable, and superficial.
• NPD:Self-centred, egotistical, self-assured; dominates conversations; seeks approval and attention; impatient, arrogant, hypersensitive.
• OCPD:Perfectionists; workaholics; dependable, stubborn, possessive; indecisive, prone to procrastination.
• PPD: Always tenseandhypervigilant;defensive, argumentative, guarded.
• STPD:Eccentric, bizarre; strange speech;struggles with work and school and often become driftersand wanderers; avoids long-term commitment and looses touch with society’s expectations; dissociative.
• SZPD:Lethargic, inattentive, eccentric; slow and monotone speech; rarely spontaneous; indifferent.

Interpersonal style

The way they relate to others.

• ASPD:Deceitful;irritable, antagonistic and aggressive; disregards their and other’s safety; distrustful; lacks empathy; competitive.
• AVPD: Sensitive to rejection; want acceptancebut are too scared; withdraw and avoid when afraid; test people to see if they’re safe to interact with.
• BPD: “Paradoxical instability”;splitting(idealise& cling vs devalue& dismiss); sensitive to rejection; “abandonment depression” & separation anxiety; superficial yet quickly developed and intense relationships; “extraordinarily intolerant” of being alone.
• DPD:People-pleasers, self-sacrificing, clingy & needs reassurance; over-compliant & over-reliant on others; want others to be in control of their lives; avoids arguments; puts themselves down so they can receive the support of others; urgently seeks a new relationship when one ends.
• HPD:Needs attention; flirtatious, manipulative; lacks empathy; overestimates intimacy of relationships.
• NPD:Exploitative; self-indulgent; charming, pleasant & endearing;lacks empathy; irresponsible; jealous; needs approval and admiration.
• OCPD:Very aware of social hierarchy;deferentialto superiors and haughtyto subordinates; polite and loyal; insist that their way is the right way to do things, because they are anxious to ensure perfection; stubborn; devoted to work which interferes with relationships.
• PPD:Distrustful, secretive, suspicious, tend to isolate themselvesandavoid intimacy;hypersensitiveto criticism; bears grudges and blames others; reluctant to open up for fear of vulnerability.
• STPD:Loners; socially anxious, apprehensive, suspicious and paranoid, which doesn’t fade as they get to know people; tends to live on the margins of society and relationships; often choose jobs with minimal social interaction that are usually below their skill level; indifferent to social norms.
• SZPD:Aloof, loners, reserved, solitary; socially awkward; tend to fade into the background; happy to remain alone.

Cognitive style

How the person perceivesandthinksabout a problem and its solution.

• ASPD: Impulsive; realistic; very aware of social cues; prone to executive dysfunction.
• AVPD:Hypervigilant; distracted and preoccupied with their fears of rejection.
• BPD: Inflexible (splitting) & impulsive; difficulty learning from the past; external loss of control leads them to blame others to avoid feeling powerless;emotions fluctuate between hope and despair; unstable self-image andfragmented sense of self; unable to tolerate frustration; brief psychotic episodes;dissociation; intense rage; difficulty focusing & processing information.
• DPD:Suggestibleand persuadable; optimistic, sometimes to the point of naïveté; uncritical; minimises difficulties and are easily taken advantage of.
• HPD:Impulsive, dramatic; vague; suggestible; relies on intuition; avoids reflection and introspection as so to avoid realising their dependency on others; needs approval from others; has separate real/inner/private &constructed/outer/publicselves; tendency to mimicspeech patterns.
• NPD: Focuses on feelingsrather than facts; compulsive lying (to themselves as well as others); inflexible, impatient, persistent;superiority;unrealistic goals of success, power, ideal love.
• OCPD:Rule & detail oriented; difficulty with prioritising; inflexible, unimaginative; conflictedbetweenassertiveness & defiance vs obedience & pleasing people.
• PPD:Mistrustful;hypervigilant; focuses on feelings (of paranoia) rather than facts; brief psychotic episodes; their need to find evidence for their paranoid suspicions gives them a tendency for authoritarianism.
• STPD:Scattered; obsessive and tends to ruminate;superstitious, bizarre fantasies; vague ideas of reference (thinking things are about them when they’re not, e.g. someone laughing is directed at them) and magical thinking (thinking they caused something to happen by thinking about it); dissociative.
• SZPD:Distracted; difficulty organising their thoughts;vagueandindecisive; difficulty with introspectionandreflection.

Affective style

How the person expressesandexperiences emotions.

• ASPD:Superficially expresses emotions; avoids emotions that will make them vulnerable;rarely feels guilt, shame or remorse; unable to tolerate boredom,depression, & frustrationandneeds stimulation.
• AVPD:Shy & apprehensive; feels empty, sad, lonely & tense;depersonalisation.
• BPD:Mood swings; inappropriately intense anger; feelings of emptiness, boredom, a “void”; emotional dysregulation.
• DPD:Insecure & anxious;lacks self-confidence & fears being alone; fears abandonment & rejection; often sad or somber.
• HPD: Displays intense, extreme emotions but may only feel them shallowly; sensitive to rejection; mood swings;need reassurance that they are loved.
• NPD: Presents as self-confidentandnonchalant; when criticised or rejected (”narcissistic injury”) they experience extreme shame which is often redirected into anger (”narc rage”/shame redirect); splitting;lacks empathy and so has difficulty with commitments.
• OCPD: Somber, difficulty expressing feelings; avoids emotions that will make them vulnerable; comes across as stiffand stilted.
• PPD: Cold, aloof, humourless; difficulty expressing feelings; tendency for angerandjealousy.
• STPD: Cold, humourless, aloof; difficult to engage with;suspicious and mistrustful; hypersensitive; may react inappropriately for the situation or not at all.
• SZPD: Humourless, cold, aloof; indifferent; lacks empathy; emotionally and socially distant;difficulty responding to other people’s feelings.

Temperament

Theresponse pattern that reflects the person’s energy level, emotions andintensity of emotions, and how quickthey react.

• ASPD:Irresponsible, aggressive andimpulsive.
• AVPD:Irritable.
• BPD:Passive(dependent subtype); hyperreactive(histrionic subtype); irritable(passive-aggressive subtype).
• DPD:Low energy; fearful, sad or withdrawn; melancholic.
• HPD:Hyperresponsive;needs attention from others.
• NPD:Activeandresponsive; has special talents and developed language early.
• OCPD:Irritable, difficult, anxious.
• PPD:Activeandhyperresponsive(narcissistic subtype); irritable (obsessive-compulsive and passive-aggressive subtypes).
• STPD:Passive(schizoid subtype); fearful(avoidant subtype).
• SZPD:Passive, difficulty experiencing pleasureandmotivation(anhedonia).

Attachment style

Discussed in this post.

• ASPD:Fearful-dismissing.
• AVPD:Preoccupied-fearful.
• BPD:Disorganised.
• DPD:Preoccupied.
• HPD:Preoccupied.
• NPD:Fearful-dismissing.
• OCPD:Preoccupied.
• PPD:Fearful.
• STPD:Fearful-dismissing.
• SZPD:Dismissing.

Parental injunction

Theexpectation(explicit or implied) from caregivers for how the child should be oract.

• ASPD: “The end justifies the means.”
• AVPD: “We don’t accept you, and probably nobody else will either.”
• BPD: “If you grow up,bad things will happen to me [caregiver].”; overprotective,demandingorinconsistentparenting.
• DPD: “You can’t do it by yourself.”
• HPD: “I’ll give you attention when you do what I want.”
• NPD: “Grow up and be wonderful, for me.”
• OCPD: “You must do/be better to be worthwhile.”
• PPD: “You’re different.Keep alert.Don’t make mistakes.”
• STPD: “You’re a strange bird.”
• SZPD: “Who are you, what do you want?”

Self view

The way they viewandconceptualise themselves.

• ASPD:Cunning&entitled.
• AVPD:Inadequate&frightened of rejection.
• BPD:Identity problems involving gender, career, loyalties, and values; self-esteem fluctuates with emotions.
• DPD:Pleasantbut inadequate, fragile.
• HPD:Needs to be noticed.
• NPD:Special, unique and entitled; relies on others for self-esteem.
• OCPD:Responsiblefor anything that goes wrong, so they must be perfect.
• PPD: They’re alone and disliked because they’re differentand better than others.
• STPD:Differentthan other people.
• SZPD:Differentfrom others; self-sufficient; indifferentto everything.

World view

The way they view the world, others, and life in general.

• ASPD:Life is dangerousandrules get in the way of their needs. They won’t be controlledordegraded.
• AVPD:Life is unfair; even though they want to be accepted, people will reject them, so they’ll be vigilant&demand reassurance; escapes using fantasiesanddaydreams.
• BPD:Splitsbetween people and the world as either all-good or all-bad, resulting in commitment issues.
• DPD: Other people need to take care of thembecausethey are unable to.
• HPD: Life makes them nervous, so they need attention and reassurance that they’re loved.
• NPD: Life is full of opportunities; they expect admiration and respect.
• OCPD: Life is unpredictableandexpects too much, so they manage this by being in control and being perfectionists.
• PPD: Life is unfair, unpredictable, demanding, and dangerous; they need to be suspiciousandon guard against others, who are to blame for failures.
• STPD: Life is strangeandunusual; others have special magic intentions, so they are curiousbut also cautiouswhen interacting with the world.
• SZPD: Life is difficultanddangerous; if they trust no oneandkeep their distance from others, they won’t get hurt.

Maladaptive schema

Discussed in this post.

• ASPD:Mistrust/abuse;entitlement; insufficient self-control;defectiveness;emotional deprivation; abandonment; social isolation.
• AVPD:Defectiveness; social isolation; approval-seeking; self-sacrifice.
• BPD:Abandonment;defectiveness;abuse/mistrust; emotional deprivation; social isolation; insufficientself-control.
• DPD:Defectiveness; self-sacrifice; approval-seeking.
• HPD:Approval-seeking; emotional deprivation; defectiveness.
• NPD:Entitlement; defectiveness; emotional deprivation; insufficientself-control;unrelentingstandards.
• OCPD:Unrelenting standards; punitiveness; emotional inhibition.
• PPD:Abuse/mistrust; defectiveness.
• STPD:Alienation;abandonment; dependence; vulnerability to harm.
• SZPD:Social isolation; emotional deprivation; defectiveness; subjugation; undeveloped self.

Optimal diagnostic criterion

One key criterion for each personality disorder, based on its ability to summarise all criteria for that PD,accurate description of behaviour, and the predictive value (ability to predict if the person has the PD or not).

• ASPD:Aggressive, impulsive, irresponsible behavior.
• AVPD:Avoidsactivities that involve being socialout of fear of criticism, disapproval, or rejection.
• BPD: Frantic efforts to avoid real or imagined abandonment.
• DPD:Needs other people to be responsible for most major parts of their lives.
• HPD:Uncomfortable not being the centre of attention.
• NPD:Grandiose sense of self-importance.
• OCPD: Perfectionism that interferes with life.
• PPD:Paranoia, without evidence, that others are trying to harm, exploit or deceive them.
• STPD:Thinking, speech, behavior, or appearance that is odd, eccentric, or peculiar.
• SZPD: Doesn’t want or enjoy close relationships.

- From Sperry, Handbook of Diagnosis and Treatment of DSM-5 Personality Disorders(2016)

Hello all! Mod Al, @amassivecosmicgay , and I have set up a new Discord server for those of us with cluster c disorders to hang out and chat with each other!

The server is self-dx friendly! Inclusive! Pro-recovery! We also have voice chat nights and are planning to perhaps implement down the line things like movie, game, and art nights. 

If you’re interested in joining, here’s the link!

https://discord.gg/cvWbyzf