CLUSTER A:

odd, eccentric 

CLUSTER B:

dramatic, emotional

CLUSTER C:

anxious, fearful

1. PARANOID 

•persistent, inappropriate mistrust, hostile

•guarded, tense, hypervigilant, blames others

•incr h/o abuse in childhood

Dx: ++ of suspicions, preoccup w/unjustified doubts,

reluctance to confide due to unwarranted fear,

benign events/remarks→threatening, grudges,

recurrent suspicions about spouse's fidelity

Tx: usually resistant to cog-behav Tx

•maintain respectful, unintrusive style

•antipsychotic for acute decompensations

2. SCHIZOD 

•cold, detached, aloof, "shut-in", "autistic PD"

•incr h/o cold, neglectful childhood relationships

Dx: pervasive detachment from social relationships, 4+ of  ►Ødesire/enjoy close relationships

►choses solitary activities      ►Øclose friends

►Øinterest in social rel.

►Øpleasure in activities   

►indifferent to others' comments

►cold, detached, flat

Tx: interested, caring attitude to pt.

•use art/writing to ease into insight-oriented psych Tx

3. SCHIZOTYPAL 

•"weirdos", distortions w/o psychosis

•related to Axis I schizophrenia, similar bio traits

Dx: pervasive social & interpersonal deficits, decr close relationships & 5+ of the following: ►ideas of reference, ►odd/magical beliefs, ►unusual perceptual experiences, ►odd thinking, ►suspicious/paranoid, ►decr affect, ►no close friends, ►social anxiety

Tx: cog-behav., structured, edu groups, low-dose antipsychotics, fluoxetine

1. ANTISOCIAL 

•"the psychopath", criminal, no empathy

•incr conduct d/o in childhood, dysfunctional parents

Dx: Disregard & violation of others' rights since

age 15 and 3+ of:

►failure in social norms, ►lying, ►impulsivity, ►recklessness, ► irresponsibility, lack of remorse

Tx: confined settings (military/prison?) to realize behaviors

2. BORDERLINE 

•unstable, dysfunctional attachment & separation

•most common! 2-3% of general population, +suicide

•incr h/o dysfunctional mothers, abuse, abandonment,

inability to form stable sense of self

Dx: Pervasive unstable relationships, self-image, affects, impulsivity in early adulthood: 5+ of:

►frantic effors to avoid abandonment, ►unstable relationships, ►identity disturbances, ►impulsivity, ►suicidal gestures, ►mood instability, ►"emptiness" & inappropriate anger, ►dissociative symptoms

Tx: form stable Tx relationship, dialectical behavior therapy, SSRIs

3. HISTRIONIC 

•"hysterical", caricature of stereotypic femininity

Dx: excessive emotionality & attn seeking with 5+ of: ►needs to be center of attention, ►sexual/provocative behav rapid emotion shifting, ►attention to physical appearance, ►impressionistic speech, ►theatrical, ►influenced by others

Tx: individual psychodynamic therapy

4. NARCISSISTIC 

Dx: pattern of grandiosity, need for admiration, lack of empathy fantasies of unlimited success/power/brilliance/beauty/love, sense of entitlement interpersonally exploitive

Tx: indiv. psychodynamic psychotherapy

1. AVOIDANT 

•"phobic" character, ddx: social phobia!

•parental or peer rejection or censure

Dx: social inhibition + feelings of inadequacy + hypersensitivity to neg eval + 4 or more of: ►avoid activities w/contact for fear of rejection or criticism, ►unwilling to get involved w/people, ►Øintimate, ►fear of rejection, ►views self as inept, reluctant

Tx: supportive sensitivity, social skill training

2. DEPENDENT 

•"clingy", over/under-indulgence in birth to age 2

Dx: excessive need to be taken care of + submissive/clingy behavior + fears of separation + 5 or more of: ►needs reassurance, other take responsibility, ►difficulty initiation projects, ►excessive lengths to obtain nurturance, afraid of being alone or left alone.

Tx: careful, not over-protective, Tx to incr self-esteem, effectiveness, independence

3. OBSESSIVE-COMPULSIVE 

•"anal-retentive" perfectionist

•excessive parental control, criticism, shaming

Dx: preoccupation w/orderliness, perfectionism, control, decr flexibility/openness/efficiency, and 4+ of: ►lose big picture to preoccup of details, ►perfectionism ►interferes w/task completion, ►workaholic, ►inflexible about moral/ethics/values, ►pack rat, ►reluctant to delegate, ►miser, ►rigid, ►stubborn

Tx: avoid excessive intellectualization, focus on feelings, esp. in cognitive Tx.