Personality disorders
Broad outlines

For the DSM IV, there are ten (10) personality disorders

1. "Paranoid Personality" is characterized by a pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent. (lack of confidence)
2. "Schizoid Personality" is characterized by a detachment from social relationships and an "emotional coldness" (alone without real friends)
3. "Schizotypal Personality" is characterized by relationship problems, by cognitive or perceptual distortions and eccentricities of behavior (imaginary world)
4. "Antisocial Personality" is characterized by disregard for and violation of the rights of others (psychopathy)
5. "BorderIine Personality" is characterized by problems to control their emotion, impulsivity, interpersonal relationships, self-image. ("over-emotional")
6. "Histrionic Personality" is characterized by excessive emotionality and attention seeking. ("look at me")
7. "Narcissistic Personality" is characterized by grandiosity (in fantasy or behavior), need for admiration, and lack of empathy(love himself)
8. "Avoidant Personality" is characterized by social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation (don't match up)
9. "Dependent Personality" is characterized by excessive need to be taken care of that leads to submissive behavior. (not really independent)
10. "Obsessive-Compulsive Personality " is characterized by preoccupation with orderliness, perfectionism, and mental and interpersonal control. (prisoner of behaviors)

"Passive aggressive" is characterized by passive resistance to demands

• Paranoid Personality Disorder
A feeling of distrust.
For him the doubt is not allowed.
"The other" disturbs, disorganizes, manipulate.
"The other" is a sly person, the other betray whereas there is no objective proof.
"Kindness cannot exist, that's hiding something".
The paranoiac is secret because any weakness could be used against him.
He tends to make paranoiac its circle.
The critic reinforces him in its beliefs.
He is at the head of its group, its "sect" which does not criticize him whereas the whole world condemns him.
The model is "suffering, serious, sermon and complaint".
Unlike the borderline which has up and downs (a little like the bipolar), laugh, joy, all which allow to open with the others... is banished with the paranoid.
Unlike the borderline, he has a flattering image of himself.  He believe that he is logical but in a partial logic which dissociates facts and reality, a deviating logic.
He think that he is honest, right, innocent, noble while he is all the opposite retorse, complicated, vicious and aggressive.  he lies, he fools.  But he sees these flaws only with others.
Its target?  The supposed "weak" because the "strong", he respects them, admires them and is jealous of them.
It would seem that the purpose of this attitude is to avoid the shame and humiliation of an adversity  inflicted during childhood.
The borderline has sometimes (often?)  tendency to be "paranoid" but he does not have such a developed self-image (euphemism).  These two disorders thus seem "incompatible".
A noter de plus qu'il est quasi du domaine de l'impossible qu'un paranoiaque non traité puisse se reconnaitre comme tel du fait de sa parano, cela remettrait en question toutes ses théories. Mais il en est tout autrement de son entourage qui pourra le reconnaitre
Beck's beliefs
DSM Definition..
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• Schizoid Personality Disorder
The schizoid is rather a solitary person, a slackness, a cold which seems not to suffer.
Unlike the borderlines which we could describe as hyper-emotionals, the schizoide seems not to feel emotions.
He has a distance towards human beings, probably by lack of desire.
Again unlike the borderlines, he does not have sudden mood swings.
He seems haughty but has a bad image of himself (lifeless, boring, looser).
The borderline can sometimes make think wrongly that he has schizoid tendencies, in particular when he is tryin to control its emotions.  We will be able to think that he is "heartless" facing a drama whereas in fact he is tryng to control emotions to contain tears, therefore all the opposite. These two disorders thus seem "incompatible"
Beck's beliefs
DSM Definition..

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• Schizotypal Personality Disorder
The DSM speaks about uncontrollables strange beliefs and perceptual distortions .
He is often eccentric, odd.
He has a distance towards the human beings but this distance is the result of other's incomprehension with its ways of thinking
He can be cyclic in its relationships, being alone or totally opened up.
Like the borderline he has incomprehensible sudden changes of mood, but rather fruits of its inner life that external stimuli.
he does not know too much who he is and feels like an alien in this world.
he gives meaning to irrational (telepathy, ghosts, astrology, sixth sense...).
He can be some confusion with the borderline disorder but, in offhand, the borderline do not live in its own world, even if he has sometimes "tricks" to reassure himself.
The borderline will be able to sometimes also suffer from this disorder. (study)
Beck's beliefs
DSM Definition..
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• Antisocial Personality Disorder or psychopathy
The psychopath is acting out.  The act (impulsive), often violent one, is present to solve its problems.
Unlike the borderline which is under the influence of its emotions and suffers, the psychopath suppress and ignore its emotions and ignore the suffering.
Unlike the borderline, he believes that he is strong, dominating, for him others are only tools (using, charming, destroying them according to its goodwill).
Unlike the borderline, he does not feel shame and culpability and does not take any newlook at hilmself.
Privation and bullying during childhood could be at the origin of this pathology.
Except in the event of serious dissociation, the borderline, when he is acting in a "nutcase" way, knows this, even if he can't prevent it.
If I'm not mistaken the psychopath and the borderline are the exact opposite, the borderline is full of emotions, he feels suffering, culpability... the psychopath is acting out, that's all. Some studies seem to affirm the opposite, saying that one person can be at the same time borderline and antisocial, that seems to me "curious" and to be honest, totally "incompatible"
Aapel :
"I have read that there is sometimes comorbidity with APD (antisocial). I totally disagree with that because bpd people does not like him, feel guilty, shame, don't know who he is (self-image)...
How in this way he can be also antisocial ?"
Answer of Daniel C. Claiborn :
"I tend to agree with you, though Antisocial people can appear (and be) impulsive, angry, and abusers of substances, and they can overreact to perceived rejection and devaluation"

* Zlotnick C. - Department of Psychiatry and Human Behavior, Brown University, Providence, RI USA.
1999 J Personal Disord - Antisocial personality disorder among incarcerated women.
After controlling for BPD, recent self mutilation was not significantly related to ASPD. Likewise, a history of childhood abuse was not significantly associated with ASPD.  (AAPEL: Whereas self-mutilation and abuses are frequent in the borderline disorder - studies)

* Hatzitaskos PK, Soldatos CR, ... Department of Psychiatry, Hospital of Hellenic Air Force, Athens, Greece.
1997  J Nerv Ment Dis - Discriminating borderline from antisocial personality disorder  - study 85 male young adults, 41 borderlines, 44 antisocial DSM III
Conclusions:
- Psychopathology  : Borderlines = higher levels of overall psychopathology and depression
- Anxiety : Equally high anxiety in both groups
- Hostility : BPD patients had more introverted hostility and APD patients had more extroverted hostility
- Cause of Hostility : With borderlines, related to overall psychopathology, depression, and trait anxiety
...........................................With antisocial no significant relationship of any type of hostility to various dimensions of psychopathology was observed.

Beck's beliefs
DSM Definition..
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• Borderline Personality Disorder
The borderline is characterized by problems to control their emotions (intensity, instability). It’s like you’re in the back seat of the car and your emotions are driving.
He has sudden changes of mood (up and down) , impulsivity, anger, emptiness, sadness, anxiety, sometimes strange behaviors
He has problems with relationalships.
Also present, black and white thinking, the way to see others in "all good", "all bad", with a status of "victim", unable to accept responsibility
He doesn't know who he is and has an unstable self-image, overall very negative (able to alternate with a very positive image).
He feels the suffering at the point to have self-destructive conduits.
The risk of suicide gives to this disorder a real gravity.
One of the onset factors draws its origins in the early childhood. Summary of the disorder
Am I borderline ?.. Beck's beliefs
DSM Definition..
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• Histrionic Personality Disorder
Sa stratégie est la séduction.
Il ne peut vivre sans le regard de l'autre sur lui et ne recule devant rien pour cela (un peu comme le narcissique mais pas pour les mêmes raisons).
Quand le borderline est en quête d'identité, l'hystrion est en quête d'atttention.
A la différence du borderline qui ment pour se protéger, l'histrion a tendance à enjoliver une situation et ment pour séduire.
Elle passe sans cesse de l'enthousiasme à la déception.
Elle a des problèmes d'apprentissage, de concentration, d'attention.
Elle a une mauvaise estime d'elle-même et fait tout pour donner une image totalement contraire.
Le borderline peut parfois avoir des traits ou souffrir de ce trouble mais dans ce cas c'est certainement plus une façade qu'une réalité.
Beck's beliefs
DSM Definition..
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• Narcissistic Personality Disorder
C'est simple, à la différence du borderline qui bien souvent ne s'aime pas, qui ne sait pas qui il est, le narcissique s'aime lui-même, n'a aucune doute quant à sa valeur hors du commun
Il a la folie des grandeurs, il pense faire parti des "élus", ceux à qui tout est du
Pour lui, l'autre n'a que peu de valeur, tout juste un outils pour flatter son égo démesuré
Il est arrogant, n'a pas ou peu d'empathie... La remise en question de lui-même "c'est pas son truc"
The NPD is best discriminated from the ASPD by their grandiosity, that is, the tendency to exaggerate their talents, and to regard themselves as more unique and superior. (Gunderson 2001)
Le borderline peut parfois par ses attitudes faire penser qu'il est narcissique mais alors que le narcissique ne doute pas, le borderline n'est que "doutes". Ces deux troubles semblent donc "incompatibles".
Se faire du mal et se suicider quand on s'aime trop n'est pas compatible
Lifetime prevalence rate of NPD is approximately 0.5-1 percent (APA)
Beck's beliefs
DSM Definition..
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• Avoidant Personality Disorder
L'évitement est sa stratégie, son but étant de rester dans l'ombre
On pourrait parler de timidité maladive
Solitude, effacement, célibat, faible estime de soi
"trop" gentille
La personne évitante fuit les émotions, aussi bien le plaisir que la douleur et se fabrique une vie imaginaire
A la différence du trouble borderline, les personnes évitantes ne subissent pas de sautes d'humeur et d'impulsivité
On pourrait dire que certains borderline, à force d'échecs et de souffrances se "réfugient" dans ce trouble pour moins souffrir
Beck's beliefs
DSM Definition..
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• Dependent Personality Disorder
La personne est incapable de prendre des décisions pour elle-même et s'en remet à un tiers
De nombreux borderline du fait de leur peur maladive de l'abandon, mais aussi de problèmes de construction de leur identité durant l'enfance, développent ce trouble
Soumission, passivité, peur de la solitude, peur de la rupture, anxiété
Faible image de soi dans la constance
A la différence du trouble borderline, les personnes dépendantes ne subissent pas de sautes d'humeur et d'impulsivité et ne subissent pas leurs émotions
De nombreux borderlines sont aussi dépendants notamment du fait de leur image d'eux-mêmes et de leur peur de l'abandon
(je ne sais pas si les personnalités dépendantes provoquent l'abandon de peur de se faire abandonner)
Beck's beliefs
DSM Definition..
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• Obsessive-Compulsive Personality Disorder
L'obsessionnel veut être parfait dans tous les domaines au point de perdre de vue l'objectif initial
On peut difficillement le qualifier de "jouisseur"
Il redoute les émotions et fait tout pour les contenir
Il est totalement psychorigide ("un balais dans le c..")
Ne fait pas confiance pour déléguer
A la différence d'un borderline qui ne contrôle pas grand choses (émotions,...), l'obsessionnel fait en sorte de garder la maîtrise de tout
Certains borderline ont une tendance à l'obsession, notamment parce qu'ils savent qu'ils peuvent se noyer dans un verre d'eau, ainsi en contrôlant un maximum, ils espèrent se mettre à l'abri d'émotions.
Il semble que l'obsessionnel est trop "constant" pour pouvoir être Borderline, c'est trop "épuisant" pour une personne borderline
Beck's beliefs
DSM definition..
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• Passive aggressive Personality Disorder
Passive resistance to demands for adequate social and occupational performance

Beck. Cognitive Effects and typical beliefs in personality disorders
(Cognitive Therapy of Personality Disorders)

• Beck's Paranoid Personality Disorder, typical beliefs
People are potential adversaries
I cannot trust other people.
Other people have hidden motives.
I have to be on guard at all times.
It isn't safe to confide in other people.
People will take advantage of me if I give them the chance.
Other people will deliberately try to demean me.
I will be in serious trouble if I let other people think they can get away with mistreating me.
If other people find out things about me, they will use them against me paranoid .
• Beck's Schizoid Personality Disorder, typical beliefs
I need plenty of space
Relationships are problematic.
Life is less complicated without other people.
I am empty inside.
It is better for me to keep my distance and maintain a low profile.
I am a social misfit.
Life is bland and unfulfilling. schizoid .
• Beck's Schizotypal Personality Disorder, typical beliefs
II need to consider only my own views; I must not be influenced by anyone
I feel like an alien in a frightening environment.
Since the world is dangerous, you have to watch out for yourself at all times.
There are reasons for everything. Things don't happen by chance.
Sometimes my inner feelings are an indication of what is going to happen.
Relationships are threatening.
I am defective schizotypal .
• Beck's Antisocial Personality Disorder, typical beliefs
People are there to be taken
Force or cunning is the best way to get things done.
We live in a jungle and the strong person is the one who survives.
People will get at me if I don't get them first.
It is not important to keep promises or honor debts.
Lying and cheating are OK as long as you don't get caught.
I have been unfairly treated and am entitled to get my fair share by whatever means I can.
If people can't take care of themselves, that's their problem antisocial .
• Beck's Borderline Personality Disorder, typical beliefs
Other people must satisfy my needs
No one would love me or want to be close to me if they really got to know me.
I can't cope on my own. I need someone to rely on.
I must subjugate my wants to the desires of others or they'll abandon me or attack me.
People will hurt me, attack me, take advantage of me. I must protect myself.
It isn't possible for me to control myself or discipline myself.
I must control my emotions or something terrible will happen.
No one is ever there to meet my needs, to be strong for me, to care for me borderline .
• Beck's Histrionic Personality Disorder, typical beliefs
I need to impress
In order to be happy I need other people to pay attention to me.
Unless I entertain or impress people, I am nothing.
If I don't keep others engaged with me, they won't like me.
The way to get what I want is to dazzle or amuse people.
It is awful for people to ignore me.
I should be the center of attention.
If I entertain people, they will not notice my weaknesses.
People will pay attention only if I act in extreme ways histrionic .
• Beck's Narcissistic Personality Disorder, typical beliefs
I am special
Since I am so superior, I am entitled to special treatment and privileges.
I don't have to be bound by the rules that apply to other people.
If others don't respect my status, they should be punished.
Other people should satisfy my needs.
Other people should recognize how special I am.
Since I am so talented, people should go out of their way to promote my career.
No one's needs should interfere with my own narcissistic .
• Beck's Avoidant Personality Disorder, typical beliefs
I may get hurt
I am socially inept and socially undesirable in work or social situations.
Other people are potentially critical, indifferent, demeaning, or rejecting.
If people get close to me, they will discover the "real" me and reject me.
Being exposed as inferior or inadequate will be intolerable.
I should avoid unpleasant situations at all costs.
Unpleasant feelings will escalate and get out of control.
If I ignore a problem, it will go away. avoidant .
• Beck's Dependent Personality Disorder, typical beliefs
I am helpless
I am needy and weak.
I need somebody around available at all times to help me carry out what I need to do or in case something bad happens.
I am helpless when I am left on my own.
I am basically alone--unless I can attach myself to a stronger person.
The worst possible thing would be to be abandoned.
I must do nothing to offend my supporter or helper.
I must be subservient in order to maintain his or her good will.
I need others to help me make decisions or tell me what to do dependent .
• Beck's Obsessive-Compulsive Personality Disorder, typical beliefs
Errors are bad. I must not err
I have to depend on myself to see that things get done.
Others tend to be too casual, often irresponsible, self-indulgent, or incompetent.
It is important to do a perfect job on everything.
If I don't have systems, everything will fall apart.
Any flaw or defect of performance may lead to a catastrophe.
I need to be in complete control of my emotions.
People should do things my way obsessive

Book that it is possible to order with our partner "Les personnalités pathologiques" Q.Debray and D.Nollet