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Narcissistic Personality Disorder 669 Differ ential Diagnosis Other personalit Y disorders and personal ity traits. Other personality disorders may be confused with histrionic personality disorder because they have certain features in common. It is therefore important to distinguish among these disorders based on diffe... |
670 Personality Disorders 6. Is interpersonally exploitative (i. e., takes advantage of others to achieve his or her own ends). 7. Lacks empathy: is unwilling to recognize or identify with the fe elings and needs of others. 8. Is often envious of others or believes that others are envious of him or her. 9. Shows arroga... |
Narcissistic Personality Disorder 671 others who talk about their own problems and concerns. These individuals may be oblivious to the hurt their remarks may inflict (e. g., exuberantly telling a former lover that "I am now in the relationshi p of a lifetime!"; boasting of health in front of someone who is sick). When ... |
672 Personality Disorder s common. It is, therefore, important to distinguish among these disorders based on differ ences in their characteristic features. However, if an individual has personalit y features that meet criteria for one or more personality disorders in addition to narcissistic person ality disorder, al... |
Avoidant Per sonality Disorder 673 2. Is unwilling to get involved with people unless certain of being liked. 3. Shows restri;iint within intimate relationships because of the fear of being shamed or ridiculed. ' 4. Is preoccupied with being criticized or rejected in social situations. 5. Is inhibited in new interperso... |
674 Personality Disorders "lonely," and "isolated. " The major problems associated with this disorder occur in social and occupational functioning. The low self-esteem and hypersensitivit y to rejection are associated with restricted interpersonal contacts. These individuals may become relatively isolated and usually d... |
Dependent Personality Disorder 675 order, all can be diagnosed. Both avoidant personality disorder and dependent personal ity disorder are haracterized by feelings of inadequacy, hypersensitivity to criticism, and a need for reassuran ce. Although the primary focus of concern in avoidant personality disorder is avoida... |
676 Personality Disorder s and submissive behaviors are designed to elicit caregiving and arise from a self-perception of being unable to function adequately without the help of others. Individuals with dependent personality disorder have great difficulty making every day decisions (e. g., what color shirt to wear to ... |
Dependent Personality Disorder 677 preoccupied with fears of being left to care for themselves (Criterion 8). They see themselves as so totally depfndent on the advice and help of an important other person that they worry about being abandoned by that person when there are no grounds to justify such fears. To be consid... |
678 Personality Disorders Other personality disorders and personality traits. Other personality disorders may be confused with dependent personality disorder because they have certain features in com mon. It is therefore important to distinguish among these disorders based on differences in their characteristic featur... |
Obsessiv e-Compulsive Personality Disorder 679 5. Is unable to discard worn-out or worthless objects even when they have no sentimental value. \ 6. Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things. 7. Adopts a miserly spending style toward both self and ... |
680 Personality Disorders the person's character. These qualities should not be accounted for by the individual's cul tural or religious identification. Individuals with this disorder may be unable to discard worn-out or worthless objects, even when they have no sentimental value (Criterion 5). Often these individuals... |
Obsessive-Compulsive Personality Disorder 681 have an increased likelihood of having a personality disturbance that meets criteria for ob sessive-compul ive personality disorder. Even so, it appears that the majority of individ uals with OCD do not have a pattern of behavior that meets criteria for this personalit y ... |
682 Personality Disorders Obsessive-compulsive personality traits in moderation may be especially adaptive, par ticularly in situations that reward high performance. Only when these traits are inflexible, maladapti ve, and persisting and cause significant functional impairment or subjective dis tress do they constitu... |
Personality Change Due to Another Medical Condition 683 Subtypes The particular ersonality change can be specified by indicating the symptom presenta tion that predominates in the clinical presentation. Diag nos tic Featu res The essential feature of a personality change due to another medical condition is a persis t... |
684 Personality Disorder s Delirium or major neurocognitive disorder. Personality change is a frequently associated feature of a delirium or major neurocognitive disorder. A separate diagnosis of personal ity change due to another medical condition is not given if the change occurs exclusively during the course of a d... |
Paraphilic Disorders Para phili c disorder s included in this manual are voyeuristic disorder (spying on others in private activities), exhibitionistic disorder (exposing the genitals), frotteuristic disorder (touching or rubbing against a nonconsenting individual), sexual masochism disorder (undergoing humiliation, bo... |
686 Paraphilic Disorders others. A paraphilia is a necessary but not a sufficient condition for having a paraphilic dis order, and a paraphilia by itself does not necessarily justify or require clinical intervention. In the diagnostic criteria set for each of the listed paraphilic disorders, Criterion A specifies the ... |
Voyeuristic Disorder 687 In full remission: The individual has not acted on the urges with a nonconsenting per son, and there has been no distress or impairment in social, occupational, or other ar eas of functioning, for at least 5 years while in an uncontrolled environment. Spe cifier s The "in full remission" spec... |
688 Paraphilic Disorders tic sexual acts in nonclinical samples, the highest possible lifetime prevalence for voyeuris tic disorder is approximately 12% in males and 4% in females. Developm ent and Cou rse Adult males with voyeuristic disorder often first become aware of their sexual interest in secretly watching unsu... |
Exhibitionistic Disorder 689 Exhibition istic Disor der Dia gnos tic Criteria 302. 4 (F65. 2) A. Over a period of at least 6 months, recurrent and intense sexual arousal from the ex posure of one's genitals to an unsuspecting person, as manifested by fantasies, urges, or behaviors. B. The individual has acted on these... |
690 Paraphilic Disorders tasies about such sexual behavior and who report that known episodes of exposure were all accidental and nonsexual. Others may disclose past episodes of sexual behavior involv ing genital exposure but refute any significant or sustained sexual interest in such behav ior. Since these individua... |
Frotteuristic Disorder 691 Hence, antisocial personality disorder, alcohol use disorder, and pedophilic interest may be considered ri{;k factors for exhibitionistic disorder in males with exhibitionistic sexual preferences. Environmental. Childhood sexual and emotional abuse and sexual preoccupation/hyper sexuality ha... |
692 Paraphilic Disorders Specify if: In a controlled environment: This specifier is primarily applicable to individuals living in institutional or other settings where opportun ities to touch or rub against a noncon senting person are restricted. In full remission: The individual has not acted on the urges with a nonc... |
Frotteuristic Disorder 693 10%-14% of adult males seen in outpatient settings for paraphilic disorders and hypersex uality have a prsentation that meets diagnostic criteria for frotteuristic disorder. Hence, whereas the population prevalence of frotteuristic disorder is unknown, it is not likely that it exceeds the ra... |
694 Paraphilic Disorders disorders, bipolar disorders, anxiety disorders, and substance use disorders also co-occur. Potential differential diagnoses for frotteuristic disorder sometimes occur also as comor bid disorders. Therefore, it is generally necessary to evaluate the evidence for frotteuristic disorder and poss... |
Sexual Sadism Disorder 695 Dev elop ment and Cour se Community ind. ividuals with paraphilias have reported a mean age at onset for masoch ism of 19. 3 years, although earlier ages, including puberty and childhood, have also been reported for the onset of masochistic fantasies. Very little is known about persistence o... |
696 Paraphilic Disorders Diagno stic Featu res The diagnostic criteria for sexual sadism disorder are intended to apply both to individuals who freely admit to having such paraphilic interests and to those who deny any sexual interest in the physical or psychological suffering of another individual despite substantial ... |
Pedophilic Disorder 697 Dev elopme nt and Cou rse Individuals with sexual sadism in forensic samples are almost exclusively male, but a rep resentative sample of the population in Australia reported that 2. 2% of men and 1. 3% of women said they had been involved in bondage and discipline, "sadomasochism," or dom ina... |
698 Spec ify if: Sexually attracted to males Sexually attracted to females Sexually attracted to both Speci fy if: Limited to incest Diagno stic Featu res Paraphilic Disorder s The diagnostic criteria for pedophilic disorder are intended to apply both to individuals who freely disclose this paraphilia and to individual... |
Pedophilic Disorder 699 Dev elopment and Course Adult males wi$ pedophilic disorder may indicate that they become aware of strong or preferential sexual interest in children around the time of puberty-the same time frame in which males who later prefer physically mature partners became aware of their sexual interest in... |
700 Paraphilic Disorders Differential Diagnosis Many of the conditions that could be differential diagnoses for pedophilic disorder also sometimes occur as comorbid diagnoses. It is therefore generally necessary to evaluate the evidence for pedophilic disorder and other possible conditions as separate questions. Antiso... |
Fetishistic Disorder 701 Spec ifier s Although indivi.,duals with fetishistic disorder may report intense and recurrent sexual arousal to inanimate objects or a specific body part, it is not unusual for non-mutually ex clusive combinations of fetishes to occur. Thus, an individual may have fetishistic disorder associa... |
702 Paraphilic Disorder s unavailable during foreplay or coitus. Some individuals with fetishistic disorder may pre fer solitary sexual activity associat ed with their fetishistic preferen ce(s) even while in volved in a meaningful reciprocal and affectionate relationship. Although fetishistic disorder is relatively ... |
Transvestic Disorder 703 Spe cifier s The presence of fetishism decreases the likelihood of gender dysphoria in men with trans vestic disorder. The presence of autogynephilia increases the likelihood of gender dyspho ria in men with transvestic disorder. Diagno stic Featu res The diagnosis of transvestic disorder doe... |
704 Paraphilic Disorders rectly to first ejaculation. In many cases, cross-dressing elicits less and less sexual ex citement as the individual grows older; eventually it may produce no discernible penile response at all. The desire to cross-dress, at the same time, remains the same or grows even stronger. Individuals ... |
Other Specified Paraphilic Disorder 705 Other Specified Paraphilic Disorder 302. 89 (F65. 89) This category applies to presentations in which symptoms characteristic of a paraphilic disor der that cause clinically significant distress or impairment in social, occupational, or other im portant areas of functioning pre... |
Other Men tal Disorders Four disorders are included in this chapter: other specified mental disorder due to another medical condition; unspecified mental disorder due to another medical condition; other specified mental disorder; and unspecified mental disorder. This residual category applies to presentations in which ... |
708 Other Mental Disorders Unspecifie d Mental Disor der Due to Ano ther Medical Cond ition 294. 9 (F09) This category applies to presentations in which symptoms characteristic of a mental dis order due to another med ical condition that cause clinically significant distress or impair ment in social, occupational, or... |
Medication-Induced Movemen t Disor ders and Other Adverse Effects of Medication Med ication-i nduc ed movement disorders are included in Section II because of their frequent importance in 1) the management by medication of mental disorders or oth er medical conditions and 2) the differential diagnosis of mental disord... |
710 Medication-Induced Movement Disorders Diagno stic Featu res Patients have generally been exposed to a dopamine antagonist within 72 hours prior to symptom developmen t. Hyperthermia (>100. 4°F or >38. 0°C on at least two occasions, measured orally), associated with profuse diaphoresis, is a distinguishing feature o... |
Medication-Induced Movement Disorders 711 Risk and Prognos tic Facto rs Neuroleptic malignant syndrome is a potential risk in any individual after antipsychotic drug administration. It is not specific to any neuropsychiatric diagnosis and may occur in individuals without a diagnosable mental disorder who receive dopami... |
712 Medication-Induced Movement Disorders Tard ive Dyskinesia 333. 85 (G24. 01) Tardive Dyskinesia Involuntary athetoid or choreiform movements (lasting at least a few weeks) generally of the tongue, lower face and jaw, and extremities (but sometimes involving the pharyngeal, diaphragmatic, or trunk muscles) developing... |
Medication-Induced Movement Disorders 713 quently reported sensory and somatic symptoms include flashes of lights, "electric shock" sensations, nauea, and hyperresponsivity to noises or lights. Nonspec ific anxiety and feelings of dread may also be reported. Symptoms are alleviated by restarting the same medication or ... |
714 Medication-Induced Movement Disorders Anxiety and depressive disorders. Discontinuation symptoms often resemble symptoms of a persistent anxiety disorder or a return of somatic symptoms of depression for which the medication was initially given. Substance use disorders. Antidepressant discontinuation syndrome diffe... |
Other Con dition s That May Be a Focus of Clinical Atten tion This di SCUSSion covers other conditions and problems that may be a focus of clini cal attention or that may otherwise affect the diagnosis, course, prognosis, or treatment of a patient's mental disorder. These conditions are presented with their correspond... |
716 Other Conditions That May Be a Focus of Clinical Attention V61. 8 (Z62. 891) Sibling Relational Problem This category should be used when the focus of clinical attention is a pattern of interaction among siblings that is associated with significant impairment in individual or family function ing or with developmen... |
Other Conditions That May Be a Focus of Clinical Attention 717 ings of sadness and associated symptoms such as insomnia, poor appetite, and weight loss. The bereaed individual typically regards the depressed mood as "normal," al though the individual may seek professional help for relief of associated symptoms such as... |
718 Other Conditions That May Be a Focus of Clinical Attention Other Circumstances Related to Child Physical Abuse V61. 21 (Z69. 01 0) Encounter for mental health services for victim of child abuse by parent V61. 21 (Z69. 020) V15. 41 (Z62. 81 0) V61. 22 (Z69. 011) V62. 83 (Z69. 021) Encounter for mental health service... |
Other Conditions That May Be a Focus of Clinical Attention Child Neglect, Suspected 995. 52 (176. 0) Initial encounter 995. 52 (176. 02XD ) Subsequent encounter Other Circumstances Related to Child Neglect 719 V61. 21 (Z69. 01 0) Encounter for mental health services for victim of child neglect by parent V61. 21 (Z69. 0... |
720 Other Conditions That May Be a Focus of Clinical Attention Adult Maltreatment and Neglect Problems Spous e or Partner Violence, Physical This category should be used when nonaccidental acts of physical force that result, or have reasonable potential to result, in physical harm to an intimate partner or that evoke s... |
Other Conditions That May Be a Focus of Clinical Attention 721 Spouse or Partner Negle ct Partner neglect is any egregious act or omission in the past year by one partner that de prives a dependent partner of basic needs and thereby results, or has reasonable potential to result, in physical or psychological harm to t... |
722 V15. 42 (Z91. 411 ) V61. 12 (Z69. 12) Other Conditions That May Be a Focus of Clinical Attention Personal history (past history) of spouse or partner psychological abuse Encounter for mental health services for perpetrator of spouse or part ner psychological abuse Adult Abuse by Nonspous e or Non partner These cat... |
Other Conditions That May Be a Focus of Clinical Attention 723 Educational and Occu pationa l Problems \ Educ ational Problems V62. 3 (Z55. 9) Academic or Educational Problem This category should be used when an academic or educational problem is the focus of clinical attention or has an impact on the individual's diag... |
724 Other Conditions That May Be a Focus of Clinical Attention V60. 6 (Z59. 3) Prob lem Related to Living in a Residential Institution This category should be used when a problem (or problems) related to living in a residen tial institution is a focus of clinical attention or has an impact on the individua l's treatme... |
Other Conditions That May Be a Focus of Clinical Attention 725 membership) in a specific category. Typically, such categories include gender or gender identity, race, et):micity, religion, sexual orientation, country of origin, political beliefs, dis ability status, caste, social status, weight, and physical appearanc... |
726 V15. 49 (Z91. 49) V15. 59 (Z91. 5) V62. 22 (Z91. 82) V15. 89 (Z91. 89) Other Conditions That May Be a Focus of Clinical Attention Other Circums tances of Personal History Other Personal History of Psychological Trauma Personal Histor y of Self-Harm Personal Histor y of Military Deployment Other Per sonal Risk Facto... |
Other Conditions That May Be a Focus of Clinical Attention 727 sent adaptive behavior-for example, feigning illness while a captive of the enemy during wartime. Malirigering should be strongly suspected if any combination of the following is noted: 1. Medicolegal context of presentation (e. g., the individual is referr... |
SECTION Ill Em erging Meas ures and Mode ls Asse ssment Measures....................................... 733 Cross-Cutting Sym ptom Measures........................... 734 DSM-5 Self-R ated Level 1 Cross-Cutting Symptom Measure-A dult............................. 738 Parent/Guard ian-R ated DSM-5 Level 1 Cross-Cut ting ... |
This sec tion contains tools and techniques to enhance the clinical deci sion-making process, understand the cultural context of mental disorders, and recognize emerging diagnoses for further study. It provides strategies to en hance clinical practice and new criteria to stimulate future research, represent ing a dy... |
Assessmen t Measures A growing body of scientific evidence favors dimensional concepts in the diagnosis of mental disorders. The limitations of a categorical approach to diagnosis include the fail ure to find zones of rarity between diagnoses (i. e., delineation of mental disorders from one another by natural boundari... |
734 Assessment Measures The World Health Organization Disability Assessment Schedule, Version 2. 0 (WHODAS 2. 0) was developed to assess a patient's ability to perform activities in six areas: understanding and communicat ing; getting around; self-care; getting along with people; life activities (e. g., household, work... |
Assessment Measures 735 TABLE 1 Ault DSM-5 Self-Rated Level1 Cross-C utting Symptom Measure: 13 domains, thresholds for further inquiry, and associated DSM-5 Level 2 measures Thre shold to guide DSM-5 Level 2 Cross-Cutting Symptom Domain Domain name further inquiry Measure8 I. Depression Mild or greater Level2-Depressi... |
736 Assessment Measures TABLE 2 Parent/guardian-r ated DSM-5 Level1 Cross-Cutting Symptom Mea sure for child age 6--17: 12 domains, thresholds for further inquiry, and associa ted Level 2 measures Threshold to guide DSM-5 Level 2 Cros s-Cutting Symptom Domain Domain name further inquiry Measurea I. Somatic symptoms Mil... |
Assessment Measures 737 Leve l 2 Cross-Cu tting Sym ptom Mea sures Any threshold stores on the Levell Cross-Cutting Symptom Measure (as noted in Tables 1 and 2 and described in "Scoring and Interpretation" indicate a possible need for detailed clinical inquiry. Level2 Cross-Cutting Symptom Measures provide one method o... |
DSM-5 Self-Rated Leve l 1 Cross-Cutting Symptom Measu re-Adult NMne:. ______________________________________________ __ Age: Sex: [ ] Male [ ] Female If the measure is being completed by an informan t, what is your relationship with the indi vidual?:--------------------In a typical week, approximately how much time do ... |
vn. 12. Hearing things other people couldn't hear, such as voices even when no one was around? 13. Feeling that someone could hear your thoughts, or that you could hear what another person was thinking? VIII. 14. Problems with sleep that affected your sleep quality over all? IX. 15. Problems with memory (e. g., learnin... |
Parent/ Guar dian-Rated DSM-5 Level 1 Cros s-Cu tting Sym ptom Mea sure-C hild Age 6-1 7 Child's Name:. ________ ____ _ _ _ __ _ Age:----Sex: [ ] Male [ ] Female Date: ____ _ _ Relationship to the child:--------------Instructions (to parent or guardian of child): The questions below ask about things that might have bot... |
IX. 14. Said that he/she heard voices-when there was no one there-0 speaking about him/her or telling him/her what to do or say-ing bad things to him/her? 15. Said that he/ she had a vision when he/ she was completely awake-0 that is, saw something or someone that no one else could see? X. 16. Said that he/she had thou... |
742 Assessment Measures Clinician-Rated Dimensions of Psychosis Sym ptom Severity As described in the chapter "Schizophrenia Spectrum and Other Psychotic Disorders," psychotic disorders are heterogeneous, and symptom severity can predict important as pects of the illness, such as the degree of cognitive and/ or neurob... |
Clini cian-R ated Dimensions of Psy chosis Symptom Seve rity Name: ____________________ _ Age :----Sex: [] Male [ ] Female Date:. ______ _ Instructions: Based on all the information you have on the individual and using your clinical judgment, please rate (with checkmark) the presence and severity of the following sympt... |
Domain 0 VI. Impaired cognition 0 Not present vn. Depression 0 Not present VIII. Mania 0 Not present 1 0 Equivocal (cognitive function not clearly outside the range expected for age or SES; i. e., within 0. 5 SD of mean) 0 Equivocal (occasion-ally feels sad, down, depressed, or hope-''less; concerned about having faile... |
Assessment Measures 745 World Health Organization Disability Assessmen t Sched ule 2. 0 The adult self-administered version of the World Health Organization Disability Assessment Schedule 2. 0 (WHODAS 2. 0) is a 36-item measure that assesses disability in adults age 18 years and older. It assesses disabilit y across si... |
746 Assessment Measures able, he or she may indicate a corrected score in the raw item score box. Based on findings from the DSM-5 Field Trials in adult patient samples across six sites in the United States and one in Canada, DSM-5 recommends calculation and use of average scores for each domain and for general disabil... |
Assess men t Measu res WHODASZ. O World Health Orga nization Disability Assessment Schedule 2. 0 36-item version, self-a dministered Patient Name:--------A ge: __ Sex: 0 Male 0 Female Date: ____ _ This que stionnair e asks about diff iculties due to health/mental health conditions. Health conditions include diseases or... |
748 Assessment Measures Clinkiitm Uie Numeric i CONSassflned to each of the ltems: In the last 30 das. how much difficulty did you have in: Life activit ies-Household . 1 aklng care of your b!i!usehglg WDQMibilltie?: ·. D5. 2 Doing most importa nt household tasks well? ·. all of the hoold w Ork thatyou \Q d()?-.. D5. 4... |
Cultural Formulation Under standing the cultural context of illness experience is essential for effec tive diagnostic assessment and clinical management. Culture refers to systems of knowl edge, concepts, rules, and practices that are learned and transmitted across generations. Culture includes language, religion and... |
750 Cultural Formulation sources, and developmental and current challenges, conflicts, or predicaments. For im migrants and racial or ethnic minorities, the degree and kinds of involvement with both the culture of origin and the host culture or majority culture should be noted separately. Language abilities, preferenc... |
Cultural Formulation 751 The CFI is a brief semistructured interview for systematically assessing cultural factors in the clinical em;punter that may be used with any individual. The CFI focuses on the in dividual's experience and the social contexts of the clinical problem. The CFI follows a per son-centered approac... |
752 Cultural Formulation Cultural Formulation Interview (CFI) Supplementary modules used to expand each CFI subtopic are noted in parentheses. GUIDE TO INTER VIEWER The following questions aim to clarify key aspects of the presenting clinical problem from the point of view of the individual and other members of the ind... |
Cultural Formulation 753 Cultural Formulation Interview (CFI) (continued) Supplementary modules used to expand each CFI subtopic are noted in parentheses. INSTRUCTIONS TO THE INTERVI EWER ARE GUIDE TO INTERVIEWER ITALICIZED. STRESSORS AND SUPPORTS (Social Network, Caregivers, Psychosocial Stressors, Religion and Spirit... |
754 Cultural Formulation Cultural Formulation Interview (CFI) (continued) Supplementary modules used to expand each CFI subtopic are noted in parentheses. INSTRUC TIONS TO THE INTERVI EWER ARE GUIDE TO INTERVIEWER ITALICIZED. PAST HELP SEEKING (Coping and Help Seeking, Religion and Spirituality, Older Adults, Caregiver... |
Cultural Formulation 755 Cultural Form ulation Interview (CFI)-Informant Version \ The CFI-Informant Version collects collateral information from an informant who is knowledgeable about the clinical problems and life circumstances of the identified indi vidual. This version can be used to supplement information obtain... |
756 Cultural Formulation Cultural Formulation Interview (CFI)-Informant Version (continued) GUIDE TO INTERVIEWER INSTRUCTIONS TO THE INTERVI EWER ARE ITALICIZED. CUL TURAL PERCEP TIONS OF CAUSE, CONTEXT, AND SUPP ORT CAUSES This question indicates the meaning of the condition 5. for the informant, which may be releva n... |
Cultural Formulation 757 Cultural Formul. ation Interview (CFI)-Informant Version (continued) \ GUIDE TO INTER VIEWER INSTRUC TIONS TO THE INTERVI EWER ARE ITALICIZED. CUL TURAL FACTO RS AFFECTI NG SELF-C OPING AND PAST HELP SEEKING SELF-COPING Clarify individua l's self-coping for the problem. 12. Sometimes people hav... |
758 Cultural Formulation Cultural Concep ts of Distress Cultural concepts of distress refers to ways that cultural groups experience, understand, and communicate suffering, behavioral problems, or troubling thoughts and emotions. Three main types of cultural concepts may be distinguished. Cultural syndromes are cluster... |
Cultural Formulation 759 problem or assign the wrong diagnosis (e. g., unfamiliar spiritual explanations may be misundersto as psychosis). To obtain useful clinical information: Cultural variations in symptoms and attribu tions may be associated with particular features of risk, resilience, and outcome. To improve cli... |
Altern ative DSM-5 Model for Person ality Disorders The current approac h to personality disorders appears in Section II of DSM-5, and an alternative model developed for DSM-5 is presented here in Section III. The inclu sion of both models in DSM-5 reflects the decision of the AP A Board of Trustees to pre serve cont... |
762 Alternative DSM-5 Model for Personality Disorders A diagnosis of a personality disorder requires two determinations: 1) an assessment of the level of impairment in personality functioning, which is needed for Criterion A, and 2) an evaluation of pathological personality traits, which is required for Criterion B. Th... |
Alternative DSM-5 Model for Personality Disorders 763 facets, based on meta-analytic reviews and empirical data on the relationships of the traits to DSM-IV persqnality disorder diagnoses. Criteria C and D: Perv asiveness and Stability Impairments in personality functioning and pathological personality traits are relat... |
764 Alternative DSM-5 Model for Personality Disorder s Typical features of obsessi ve-compulsive personality disorder are difficulties in estab lishing and sustaining close relationships, associated with rigid perfectionism, inflexi bility, and restricted emotional expression. Typical features of schizotypal personal... |
Alternative DSM-5 Model for Personality Disorders 765 7. Irres ponsibi lity (an aspect of Disinhibition): Disregard tor-and failure to honor financial l(lnd other obligations or commitments; lack of respect for-and lack of fol low-through on-agreements and promises. Note. The individual is at least 18 years of age. S... |
766 Alternative DSM-5 Model for Personality Disorders feeling fearful, apprehensive, or threatened by uncertainty; fears of embarrass ment. 2. Withdra wal (an aspect of Detachment): Reticence in social situations; avoidance of social contacts and activity; lack of initiation of social contact. 3. Anhedonia (an aspect ... |
Alternative DSM-5 Model for Personality Disorders 767 ties; feeling fearful, apprehensive, or threatened by uncertainty; fears of falling apart or IQsing control. 3. Separation insecurity (an aspect of Negative Affectivity): Fears of rejection by and/or separation from-significant others, associated with fears of exce... |
768 Alternative DSM-5 Model for Personality Disorders B. Both of the following pathological personality traits: 1. Grandiosity (an apect of Antagonism): Feelings of entitlement, either overt or co vert; self-centeredness; firmly holding to the belief that one is better than oth ers; condescension toward others. · 2. A... |
Alternative DSM-5 Model for Personality Disorders 769 4. Restricted affectivity (an aspect of Detachment): Little reaction to emotionally arousing ituations; constricted emotional experience and expression; indifference or coldness. Specifiers. Trait and personality functioning specifiers may be used to record addition... |
770 Alternative DSM-5 Model for Personality Disorders Specifiers. Trait and personality functioning specifiers may be used to record additional personality features that may be present in schizotypal personality disorder but are not re quired for the diagnosis. For example, traits of Negative Affectivity (e. g., depre... |
Alternative DSM-5 Model for Personality Disorders Specifiers. The specific personality features of individuals are always recorded in eval uating Criterion ', so the combination of personality features characterizing an individual directly constitutes the specifiers in each case. For example, two individuals who are b... |
772 Alternative DSM-5 Model for Personality Disorders Self-and Inter personal Functi oning Dimensional Defi nition Generalized severity may be the most important single predictor of concurrent and pro spective dysfunction in assessing personality psychopathology. Personality disorders are optimally characterized by a ... |
Alternative DSM-5 Model for Personality Disorders 773 than being present versus absent. Moreover, personality traits, including those identified specifically in te Section III model, exist on a spectrum with two opposing poles. For ex ample, the opposite of the trait of callousness is the tendency to be empathic and k... |
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