Risk Factors:

 History of Abuse
Physical (Antisocial, borderline, dependent, schizoid)
Sexual (Borderline)
Childhood neglect: (antisocial, avoidant, borderline, dependent, narcissistic, paranoid, schizotypal
 Negative parenting interactions (harsh punishment, lack of affection)
 Family Hx of schizophrenia
 Emotional disorder in childhood

Cluster Type Diagnostic Criteria (DSM-IV-TR) Coping mechanism

Paranoia Projection (attribution of person’s
 Distrust and suspiciousness of others, whose motives are viewed as Hidden meaning in neutral actions, suspects harm/deception by unacknowledged feelings to other
malevolent clinician, suspects infidelity in partner people
Paranoid
 Suspicious and bears grudges Appears angry
 Perceives threats in neutral events Anxiety/Tension
Appears tense, hypervigilant
A: Odd/eccenteric
Restricted range of emotion
 Pattern of detachment in social relationships (loner)
 Detached and Delay seeking medical care because of unwanted contact and may
 Restricted emotional expression in interpersonal interactions
distrustful Schizoid appear cold/indifferent
 Solitary, indifferent toward others
Anxiety/Tension
 Affectively detached
Discomfort w/ social communication and physical exam
Magical thinking Projection
 Social and interpersonal deficits marked by discomfort w/ and  capacity for
Schizotypal Anxiety/Tension
close relationships
Discomfort w/ social communication and physical exam
Paranoia Splitting (black-or-white, all-or-
Paranoid thinking can emerge in response to stress nothing perceptions or thinking, in
 Instability of interpersonal relationships, self-image, and affects, and Episodic, intense anger states which people are divided into all-
impulsivity Unstable and intense mood states good idealized saviors or all-bad
Borderline  Intense anger and affective instability Occur in concert w/ idealization and devaluation of others evildoers)
 Recurrent suicidal behavior/gestures Chronic dysphoria
 Impulsive behavior w/ potential for self-harm Impulsive behavior
Impulsive, recurrent self-destructive behaviors (cutting, substance
abuse and drug overdose, sexual promiscuity)

B: Dramatic/erratic Irritable
 Disregard for and violation of rights of others beginning at age 15
Impulsive behavior
 Impulsivity
 Emotionally May appear cooperative and charming at first in an effort to obtain
Antisocial  Deceitfulness
unstable, desired outcome from clinician, but repeatedly acts w/ disregard for
 Lack of remorse
impulsive, and safety and rights of others w/ irresponsibility and lack of remorse
 Engages in acts that are illegal or show disrespect for social norms
intense Violence and substance abuse common
 Grandiosity (in fantasy and behavior), need for admiration, lack of empathy Grandiosity
 Views self as “special” and needs to be admired Need for admiration
Narcissistic
 Unwilling to recognize feelings of others
 Arrogant and interpersonally exploitative
 Excessive emotionality and attention-seeking Superficial and excessive emotionality
 Discomfort when not center of attention Anxiety/Tension
Histrionic  Shifting and shallow expression of emotions Becomes anxious w/ discussion of serious health issues or difficult
 Draws attention to self through physical appearance feelings
 Superficial
C: Anxious/fearful  Excessive need to be taken care of leading to submissive and clinging Anxiety/Tension
behavior Experiences significant difficulty when asked to engage in decision
Dependent
 Nervous and  Difficulty w/ decision making in absence of advice making
passive  Fears solitude due to fear of inability to take care for self Tries to enlist other to take responsibility for health issues
OR
 Social inhibition, feelings of inadequacy, hypersensitivity to negative Anxiety/Tension
 Rigid and
evaluation Fearful of rejection, unlikely to disagree w/ physician, socially anxious
preoccupied
Avoidant  Interpersonally inhibited and extremely reluctant to take personal risks, even
in occupation activities, due to fear of rejection
 Desires relationships w/ others (vs. schizoid)
Obsessive-  Preoccupation w/ orderliness, perfectionism, and mental/interpersonal Restricted range of emotion (rational)
Compulsive control (lack of flexibility, openness, and efficiency) Anxiety/Tension
 Overconscientious, stubborn, and excessively devoted to work Extreme concern about providing the “right” answers to questions