Summary
All of the following information was taken from the Diagnostic and Statistical Manual 5th Edition (American Psychiatric Association, 2013) unless otherwise noted.
Personality Disorders
Overview
A personality disorder refers to an enduring, pervasive pattern of thinking, behaving, and functioning that deviates remarkably from the expectations of a person’s culture and results in distress or functional impairment. The American Psychiatric Association (2013) differentiates ten specific personality disorders divided into three clusters and a category of unspecified personality disorders. Cluster A includes disorders that are characterized by eccentric or odd behavior and thinking. Cluster B encompasses personality disorders that involve emotional, dramatic, or erratic attitudes. Cluster C covers disorders that are marked by anxious or fearful behaviors. Personality disorders are considered to be caused by genetic and environmental factors. As a rule, they start to become evident in late adolescence or early adulthood and remain stable over time. With age, some symptoms or traits can become less severe.
Disorders
- Cluster A:
- A paranoid personality disorder is marked by pervasive distrust and suspicion of others.
- A schizoid personality disorder is defined by a lack of interest in social relationships and a limited range of emotional expression.
- Schizotypal personality disorder involves eccentricities of behavior, inappropriate emotional responses or lack thereof, discomfort with close relationships, and perceptual or cognitive distortions.
- Cluster B:
- An antisocial personality disorder is characterized by a disregard for the rights, feelings, needs, or safety of others.
- Borderline personality disorder involves instability and impulsivity in behavior, self-image, relationships, and mood.
- A histrionic personality disorder is marked by attention-seeking and excessive emotionality.
- Narcissistic personality disorder includes self-grandiosity, a need for admiration, as well as a lack of empathy and recognition of others’ feelings and needs.
- Cluster C:
- An avoidant personality disorder is characterized by avoidance of interpersonal contacts, the feeling of inadequacy, high sensitivity to negative evaluation, and social inhibition.
- Dependent personality disorder involves excessive dependence on others, clinging and submissive behavior, fear of providing self-care, and lack of self-confidence.
- An obsessive-compulsive personality disorder is marked by a preoccupation with orderliness, rules, and details, extreme perfectionism, and a desire to control everything, along with an inability to delegate tasks.
Risk and Prognostic Factors
Risk factors for avoidant personality disorder (AVPD) can be defined as genetic and physiological. First-degree biological relatives of people with AVPD are diagnosed with this disorder more often than the general population. Furthermore, the risk for relatives of females with an avoidant personality disorder is higher than that for relatives of males. Biological and adopted children of parents with AVDP both have a risk of developing this disorder, somatic symptom disorder, or substance use disorders. The environment of the adoptive family can be a risk factor for the disorder and related psychopathology.
Neurodevelopmental Disorders
Overview
Neurodevelopmental disorders refer to conditions that can be traced back to the developmental period. They are marked by developmental deficits that sometimes manifest before the person enters grad school and result in an impairment of social, personal, occupational, or academic functioning. Genetics plays a pivotal role in many neurodevelopmental disorders, such as intellectual disability, ADHD, and autism spectrum disorder. Diagnostic criteria vary among different conditions, and while some disabilities are permanent, certain behaviors and symptoms can change or evolve over time as a person grows older. Neurodevelopmental disorders can co-occur; furthermore, they can include both symptoms of excess and deficit and delays in reaching expected developmental milestones.
Disorders
- Intellectual disability, or intellectual developmental disorder, includes deficits in mental abilities, including judgment, abstract thinking, problem-solving, reasoning, academic learning, and others, which in turn result in the impairment of adaptive functioning. Intellectual disability is diagnosed when an individual does not meet standards in one or several aspects of daily life, such as social participation, communication, personal independence, social responsibility, and academic or occupational functioning.
- Communication disorders comprise a language, speech sound, and social communication disorders that are marked by deficits in language development and use. Another subcategory is childhood-onset fluency disorder which involves disturbances of the fluency and motor production of speech.
- Autism spectrum disorder refers to a persistent deficit in social communication and interaction, such as developing and understanding relationships, that occurs in multiple contexts. Furthermore, it involves repetitive patterns of behavior, activities, or interests.
- Attention-Deficit Hyperactivity Disorder (ADHD) is characterized by impairing inattention, hyperactivity-impulsivity, or disorganization.
- Neurodevelopmental motor disorders comprise developmental coordination, tic, and stereotypic movement disorders. Developmental coordination disorder involves inaccuracy or slowness while performing motor skills during daily tasks. Tic disorders are defined by sudden and recurrent motor or vocal tics. Stereotypic movement disorder includes repetitive and purposeless motor behaviors, such as body rocking, hand flapping, headbanging, and others.
- A specific learning disorder is defined by specific deficits in a person’s ability to perceive information accurately and efficiently, manifested through persistent difficulties with learning basic academic skills, such as reading, writing, or math.
Risk and Prognostic Factors
Risk and prognostic factors for intellectual developmental disorders are genetic and physiological. Prenatal causes include genetic syndromes, inborn errors related to maternal disease, brain malformations or metabolism, and environmental impacts, such as alcohol, drugs, or toxins. Perinatal risk and prognostic factors are associated with a brain disease resulting from events during labor and delivery. Postnatal determinants involve injuries, infections, seizure disorders, intoxications, or chronic and severe social deprivation.
Schizophrenia Spectrum
Overview
The schizophrenia spectrum refers to a category of mental health conditions that are characterized by psychosis as the primary symptom. The spectrum includes schizophrenia, other psychotic disorders, and schizotypal (personality) disorder. Such abnormalities mark these conditions as hallucinations, delusions, disorganized thinking or speech, abnormal motor behavior, and negative symptoms that include social withdrawal, disinterest in daily life, loss of motivation, and difficulty showing emotions, planning, and sustaining activities. Hallucinations refer to perception-like experiences that are not real, and delusions can be defined as persistent beliefs not based on reality.
Disorders
- Schizophrenia is defined by delusions, hallucinations, disorganized speech, diminished emotional expression, or highly disorganized behavior, which are not attributed to substance use or medical conditions and are present significantly during a one-month period.
- Other psychotic disorders include schizophreniform, schizoaffective, delusional, and brief psychotic disorders. Schizophreniform disorder is diagnosed when schizophrenia symptoms are present but last less than six months. Schizoaffective disorder combines the symptoms of schizophrenia and mood disorders, such as psychosis, depression, and mania. Delusional disorder is diagnosed when an individual who does not meet schizophrenia criteria experiences a delusion. Brief psychotic disorder refers to a sudden episode of psychotic behavior that lasts less than a month and is followed by remission.
- A schizotypal personality disorder is characterized by cognitive distortions of behavior, persistent social deficits, discomfort in social situations and relationships, and inappropriate emotional responses, while an individual may or may not experience brief episodes of psychosis.
Risk and Prognostic Factors
Risk and prognostic factors for schizoaffective disorder are genetic and physiological. First-degree relatives of people with schizophrenia, schizoaffective disorder, or bipolar disorder have an increased risk of developing a schizoaffective disorder.
Reference
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.