#prototypic descriptions

Prototypic descriptions are brief descriptions that “capture the essence of how a particular disorder commonly presents”, i.e., a summaryof the key features of the disorder. The following are the protoypic descriptions of the DSM-5-TR personality disorders, summarised from Sperry:

ASPD

Antisocials displayed symptoms of Conduct Disorderfromearly childhood, and their manipulativeandirresponsible behaviour continued into adulthood. They lack empathyanduse others for their own gain. Because they can’t tolerate boredom, they are reckless, impulsive thrill-seekers and disregard their safety and others’. ASPD is over-diagnosed in prisons and detention centres.

AVPD

Avoidants are frightenedandanxious, which makes them socially awkward. They are hypersensitive to criticism and rejection, and the fear of being embarrassed and humiliated causes them to withdraw and avoid social interaction. They crave connection with others, and may have trusted people with whom they can relax and feel safe.

BPD

Borderlines are terrified of being abandoned, which leads to intense relationships that often end in disappointment when they spliton their favourite person. They are prone to self-damaging behaviours, and self-harm and suicide attempts are common. They have a fragmented, confused sense of self. They are often impulsiveand prone to anger.

DPD

Dependents feel inadequate and fragile and need others to rely on. They struggle with being alone and find it nearly impossible to make their own decisions. They are submissive and are more than willing to put others’ needs and views above their own. They will do whatever it takes to get others to care for them, to give them affection, and give directionto their lives.

HPD

Histrionics are dramatic, charming and intense people. Their emotions are both intense and shallow at the same time. Their interests and attitudes are easily influenced by what others think and value. They need attention and reassurance thatthey are loved from others, so they often overestimate the intimacy of relationships.

NPD

Narcissists have a grandiose sense of self-importance, specialness and uniqueness that leads them to feel entitledandprivileged. They expect and need admiration and respect from others to fuel their self-esteem. They lack empathy, so they have difficulty recognising the needs, concerns, or feelings of others. Criticism, rejection and failure leads to massive feelings of shame which is often redirected into anger.

OCPD

Obsessive-compulsives are perfectionistsand need to get every detail right. As such, they are anxiousandwant to be in control of situations, so to avoid mistakes. They find comfort in schedules, rules and details, but their devotion to perfection interferes with their relationships and life outside of work or school. They have a tendency to hoard and are unusually tight with money, just in case.

PPD

Paranoids believe that the world is dangerous and that others will try to harm, exploit and deceive them if they open up. They are always on guard to any sign of threat. They hold on to grudges, never forget a slight, nor pass up a chance for revenge.

STPD

Schizotypals are eccentric, disorganised people whose emotions and speech are strange and blunted. Their strange beliefs are associated with ideas of referenceandmagical thinking, but don’t extend to full-blown psychosis. It’s not uncommon for schizotypals to be misdiagnosed as being autistic.

SZPD

Schizoids are uncomfortable being around others and just want to be left alone. Connection with others is scary and difficult, so they tend to keep to themselves. They come across as awkward, distant, and overly formal, and may be described as “cold fish”.

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