Narcissistic, Avoidant, Dependent, Obsessive-Compulsive, PD-NOS (Passive-Aggressive, Sadistic, Sadomasochistic, Due to General Medical Condition)

1. PERSONALITY
DISORDERS

2. NARCISSISTIC
Diagnosis:
1. has a grandiose sense
of self-importance
2. preoccupied with
fantasies of unlimited
success, power, brilliance,
beauty or ideal love

3. NARCISSISTIC
Diagnosis:
3. believes that he or she is
unique and can only
associate with other
special or high-status
people (or institutions).
4. requires excessive admiration

4. NARCISSISTIC
Diagnosis:
5. has a sense of entitlement
6. interpersonally exploitative, i.e., takes advantage
of others to achieve his or her own ends

5. NARCISSISTIC
Diagnosis:
7. lacks empathy: unwilling to recognize or
identify with the feelings of others

6. NARCISSISTIC
Diagnosis:
8. often envious of others
or believes that others
are envious of him
or her
9. shows arrogant, haughty
behaviors or attitudes

7. NARCISSISTIC
Course and Prognosis:
Chronic and
difficult to treat
Aging is handled poorly

8. NARCISSISTIC
Treatment:
PSYCHOTHERAPY
-group therapy so patients can
learn how to share with others and
to develop empathic response
PHARMACOTHERAPY
-Lithium (Eskalith) for mood swings
and antidepressants—serotonic
drugs—because they’re susceptible
to depression

9. AVOIDANT
Diagnosis
1. avoids activities involving
interpersonal contact because
of fears of criticism, disapproval
and rejection
2. unwilling
to get involved
with people unless certain of
being liked

10. AVOIDANT
Diagnosis
3. restraint within
intimate relationships
for fear of being
ashamed or ridiculed
4. preoccupied with being
criticized or rejected in
social situations

11. AVOIDANT
Diagnosis
5. inhibited in new
interpersonal situations
because of feelings
of inadequacy
6. views self as socially
inept, personally
unappealing, or inferior
to others

12. AVOIDANT
Diagnosis
7. usually reluctant to take personal risks or
engage in any new activities because they
may prove embarrassing

13. AVOIDANT
Course and Prognosis
Many are able to function in a protected environment.
Should their support system
fail, they are subject to
depression, anxiety and
anger.
Phobic avoidance in common. Patients may give histories
of social phobia.

14. AVOIDANT
Treatment
PSYCHOTHERAPY
-solidifying alliance with
patients; therapist encourages a
patient to move out into the
world; assertiveness training- for
patient to express needs openly
PHARMACOTHERAPY
-serotonic drugs—help rejection sensitivity
-dopaminergic drugs—engender novelty-seeking
behavior

15. DEPENDENT
Diagnosis
1. difficulty making decisions
without an excessive amount
of advice and reassurance
from others
2. needs others to assume
responsibility for most
major areas of his or her life

16. DEPENDENT
Diagnosis
3. difficulty expressing disagreement
with others because of fear of loss
of support or approval
4. difficulty initiating
projects or doing things in
his/her own
5. goes to excessive lengths to obtain nurturance and
support from others, to the point of volunteering
things that are unpleasant

17. DEPENDENT
Diagnosis
6. feels uncomfortable or helpless
when alone because of
exaggerated fears of being unable
to care for himself or herself
7. urgently seeks another
relationship as a source of
care and support when
a close relationship ends
8. unrealistically preoccupied
with fears of being left to
take care of oneself

18. DEPENDENT
Course and Prognosis
Occupational functioning tends to
be impaired, because persons with
the disorder can’t act
independently and without
close supervision.

19. DEPENDENT
Treatment
PSYCHOTHERAPY
-the treatment is often successful
-behavioral therapy, assertiveness
training, family therapy,
group therapy
PHARMACOTHERAPY
-psychostimulants are used for
depression and withdrawal
symptoms

21. OBSESSIVE-COMPULSIVE
Diagnosis
1. preoccupied with details, rules,
lists, order, organization, or
schedules to the extent that the
major point of the activity is lost
2. shows perfectionism that
interferes with task completion
3. excessively devoted to work and productivity to the
exclusion of activities and friendships

22. OBSESSIVE-COMPULSIVE
Diagnosis
4. overconscientious, scrupulous,
inflexible about matters of morality,
ethics or values
5. unable to discard worn-out or
worthless objects even when they
have no sentimental value
6. reluctant to delegate tasks or
to work with others unless they
submit to exactly his/her way of doing things

23. OBSESSIVE-COMPULSIVE
Diagnosis
7. adopts a miserly spending style
toward both self and others;
money is viewed as something
to be hoarded for future
catastrophes
8. shows rigidity
and stubborness

24. OBSESSIVE-COMPULSIVE
Course and Prognosis
This personality
disorder is variable
and unpredictable.
Persons may develop
obsessions or
compulsions in the
course of their
disorder.

25. OBSESSIVE-COMPULSIVE
Treatment
Group therapy and
behavior therapy
occassionally offer
certain advantages.
PHARMACOTHERAPY
Clonazepam
Clomipramine
Nefazodone

26. Personality
Disorders not
Otherwise
Specified

27. PASSIVE-AGGRESSIVE
Diagnosis
• characteristically
procrastinate
• resist demands for
adequate
performance
• find excuses for
delays
• find fault with those
on whom they
depend

28. PASSIVE-AGGRESSIVE
Diagnosis
• lack assertiveness
• not direct about
their own needs
• fail to ask needed
questions
• become anxious
when forced to
succeed

29. PASSIVE-AGGRESSIVE
D i f f e r e n ti al D i a g n o s i s
Less
flamboyant, dramat
ic, affective and
openly aggressive
than those with
histrionic and
borderline
personality

30. DEPRESSIVE
Diagnosis
• lonely, solemn, gloomy, submissive, pessim
istic, self-deprecatory
• meticulous, perfectionistic, overconscientio
us, preoccupied with work
• easily discouraged, fearful of disapproval
• tend to suffer in silence, cry easily
• tendency to hesitation, indecision

31. DEPRESSIVE
Differential Diagnosis
Patients with avoidant
personality disorder are
introverted and
dependent, but they tend
to be more anxious than
depressed, compared
with persons with
depressive personality
disorder.

32. SADOMASOCHISTIC
Diagnosis
SADISM—desire to cause others pain –either
sexually abusive or generally physically or
psychologically abusive
MASOCHISM—achievement of sexual
gratification by inflicting pain on the self

33. SADISTIC
Diagnosis
• pervasive pattern of
cruel, demeaning, and
aggressive behavior that is
directed toward others
• humiliate or demean
persons in front of others
• treated or disciplined
uncommonly harshly
people, especially the
children

34. PERSONALITY CHANGE DUE TO A
GENERAL MEDICAL CONDITION
Diagnosis
• characterized by a marked change in personality
style and traits from a previous level of
functioning
• impaired control on the expression of emotions
• emotions are labile and shallow
• damage to the frontal lobe: prominent
indifference and apathy
• temporal lobe epilepsy:
humorlessness, hyperreligiosity, marked
aggressiveness during seizures
• clear sensorium