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The Definition of a Personality Disorder

Simone Hoermann, Ph.D., Corinne E. Zupanick, Psy.D. & Mark Dombeck, Ph.D. Updated: Dec 5th 2013

list with boxes checkedThe Diagnostic and Statistical Manual of the American Psychiatric Association,(abbreviated, DSM-5), captures these differences between healthy and unhealthy personalities that we have been discussing. According to the definition of personality disorders in DMS-5 (APA 2013), the key elements of a personality disorder are:

1. A personality disorder is enduring pattern of inner experience and behavior. This pattern manifests in two or more of the following areas:

a. Thinking
b. Feeling
c. Interpersonal relationships
d. Impulse control

2. This pattern deviates markedly from cultural norms and expectations.

3. This pattern is pervasive and inflexible.

4. It is stable over time.

5. It leads to distress or impairment

The Four Core Features of Personality Disorders1

The DSM-5 (APA, 2013) identifies and describes ten specific personality disorders. These ten diagnoses represent ten specific enduring patterns of thoughts, feelings, and behavior. However, each of these ten patterns can be distilled down to four core features of personality disorders:

1.    Rigid, extreme and distorted thinking patterns (thoughts)
2.    Problematic emotional response patterns (feelings)
3.    Impulse control problems (behavior)
4.    Significant interpersonal problems (behavior)

In fact, in order to diagnose a personality disorder a person must exhibit at least two of these four core features.

In this section we will review each of these four core features that are common to all personality disorders. Then in the next section, we will discuss the ten specific personality disorders diagnoses as described in DSM-IV-TR (APA, 2000). As you are reading about these disorders, you may find yourself wondering if they are accurate enough; if they have been defined with enough precision so as to easily distinguish between people who have personality disorders from those who do not.  As mentioned, personality disorders are a variant form of normal, healthy personality so such distinctions are often difficult.  If such thoughts occur to you, you are not alone.  Quite a few clinicians and researchers have raised concerns about this lack of specificity and precision.  Later, we will discuss alternatives to the current DSM diagnostic systems for the personality disorders that attempt to resolve this problem of imprecision.

Since the current diagnostic system for personality disorders is difficult to use for the reasons cited above, we want to caution you to refrain from trying to diagnose yourself, or someone else.  The diagnostic process for personality disorders is difficult enough, even for seasoned professionals; therefore, self-diagnosis is not recommended.  If you suspect a problem or interpersonal difficulty may be related to a personality disorder, we urge you to raise these concerns with a qualified mental health professional.  A professional experienced with the diagnosis and treatment of personality disorders is best able to make a correct diagnosis (having done it many times before).An experienced mental health professional will also be in the best position to recommend an effective treatment plan.. In the later part of this article, we will review effective, state-of-the-art treatments for personality disorders.


Reader Comments
Discuss this issue below or in our forums.

Schizophrenia - Mary Bonner - Dec 28th 2012

Can Schizophrenia be tranfered to a child from their mother, if not at birth then at what age. Can a child at 5 years of age have all her mothers mental health problems?


Paranoid Personality Disorder - Christina - Sep 8th 2011

I have a PPD and much of what you say is true and much of what you say about how wonderful people are is not. But I never read once about the life circumstances of a person diagnosed with PPD. Has anyone ever done a study on their appearance, their ethnic background, their socioeconomic background or are we just a bunch of gorgeous, white people who misread all the wonderful things thrown our way as threatening disasters?

cut off sister in law - charles - Apr 6th 2010

she is trying to mess with the minds of you and your son. your difficulty is that she is not classically insane i.e. delusional and babbling. but she may be far more dangerous to you than that. the fact that 1) she is a woman (women are not often violent and 2) she has already been violent towards an elder and presumably served time with other antisocials are major red flags. I can only assume you communicatewith her out of compassion. but she doesnt understand compassion, only sees it as weakness. and she is extremely unkely to ever change.

how has the last month been? did u come to a decision?

it never stops with an undiagnosed PD? help! - - Mar 31st 2010

i have a sister in law with a personality disorder. she has manipulated and bullied my brother and her children and her own family most of her adult life. she was finally stopped a bit, when she was found guilty of financial and elder abuse towards my demented mother, who has since passed away. she continues to try to stay involved with my son who is 18 and myself. i cut myself off from her and my brother, and will only talk through a mediator. she has lied and bullied and coerced and manipulated alot of people including me for years, till i had enough. should my son who is kind, and who she had tried to keep from seeing his cousins, have much to do with her? some people have said, maybe i should say something to him? i am interested in any opinions.

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