Dissociative Disorders PDF

DISSOCIATIVE DISORDERS 01. EXPERIENCES OF Inability to recall significant DEPERSONALIZATION AND autobiographical information Individuals feel detached from DEREALIZATION:...

DISSOCIATIVE DISORDERS 01. EXPERIENCES OF Inability to recall significant DEPERSONALIZATION AND autobiographical information Individuals feel detached from DEREALIZATION: (EITHER OR BOTH) that should be stored and freely themselves or their Depersonalization involves feeling recollected or should be surroundings, akin to dreaming detached from thoughts or actions, successfully stored in memory or living in slow motion. Derealization involves feeling detached under normal circumstances. Reactions to dissociative from surroundings, experiencing them Differs from amnesias caused experiences vary; some as unreal or distorted. (foggy-like) by neurobiological damage or individuals are not bothered, toxicity, which affect memory while others are. 02. INTACT REALITY TESTING storage or retrieval differently. Not due to drugs such as Reality testing remains intact during hallucinogens. depersonalization or derealization TYPES OF DISSOCIATIVE Not due to psychosis experiences. AMNESIA Depersonalization: 03. CLINICALLY SIGNIFICANT DISTRESS LOCALIZED AMNESIA Perception alters, leading to a OR IMPAIRMENT Involves the inability to recall temporary loss of one's own Symptoms cause clinically significant specific events or periods of reality. (Astral projection-like) distress or impairment in social, time, often centered around a Sensation is akin to observing occupational, or other important areas traumatic incident. oneself in a dream-like state. of functioning. SELECTIVE AMNESIA Derealization: can happen in other disorders Characterized by the ability to Perception of the external (Panic Attack, Acute Stress recall some, but not all, world's reality is lost. Disorder, PTSD) but if it is the aspects of a traumatic event or Surroundings may appear main symptom, it can be DDD. period. distorted, with changes in shape This tends to be CHRONIC or size, and individuals may Anxiety Mood and Personality GENERALIZED AMNESIA seem lifeless or mechanical. Disorders are commonly found Involves a broader memory in these individuals. loss encompassing significant DEPERSONALIZATION/ portions of an individual's life DEREALIZATION DISORDER DISSOCIATIVE AMNESIA history, including identity and (different from other amnesia) personal information. SYSTEMATIZED AMNESIA Sudden, unexpected travel with F44.1 With Dissociative Fugue: Refers to memory loss affecting memory loss for identity and Associated with apparently purposeful specific categories of past life events. travel or bewildered wandering information or related to a accompanied by amnesia for identity or particular theme. (one family 01. INABILITY TO RECALL IMPORTANT other important autobiographical member) INFORMATION information. Inability to recall significant CONTINUOUS AMNESIA autobiographical information, DISSOCIATIVE IDENTITY Ongoing inability to form new typically of a traumatic or DISORDER memories or recall recent stressful nature, inconsistent events, extending into the with ordinary forgetting. People can have multiple (2- present moment. May manifest as localized or 100) alters (average of 15) selective amnesia for specific Identities are complete - DISSOCIATIVE FUGUE events or generalized amnesia gestures, personality, (SUBTYPE) for identity and life history. handedness, sense of fashion, Sudden, unexpected travel with different gender. memory loss for identity and 02. EXCLUSION CRITERIA Some alters starts from voice in past life events. Disturbance not attributable to the head until it develops as substance use, neurological or alters. DISSOCIATIVE TRANCE medical conditions. Can be a response of stressful Dissociative trance is a Not better explained by other situation that the true self temporary altered state of mental disorders such as cannot deal with. consciousness triggered by dissociative identity disorder, stress, trauma, or intense posttraumatic stress disorder, Host Identity - the main patient who emotions, involving acute stress disorder, somatic seeks for treatment disconnection from symptom disorder, or maįor or The first personality to seek surroundings or self, and mild neurocognitive disorder. treatment is seldom the original memory gaps. (some are personality of the person. (alter religion-related) 03. SPECIFIERS: was made to seek help) F44.0 Without Dissociative Fugue: Cross-gendered alters are DISSOCIATIVE FUGUE Dissociative amnesia without apparent common (SUBTYPE) purposeful travel or bewildered wandering associated with amnesia. Switch - the transition from one person 95% of the cases are due to SCHIZOPHRENIA SPECTRUM to another. physical and sexual abuse AND OTHER PSYCHOTIC Occurs instantaneously. DISORDERS Most common with females Abused Children - used imagination (9:1) according to accumulated too much to the point they create new PSYCHOSIS data identity - “FANTASY WORLD” A loss of contact with reality Can last a lifetime in the absence of treatment. TREATMENT OF DISSOCIATIVE 1. DELUSIONS IDENTITY DISORDER 2. HALLUCINATIONS 01. DISRUPTION OF IDENTITY 3. DISORGANIZED THINKING Presence of distinct personality PSYCHOTHERAPY (SPEECH) states with marked discontinuity 4. DISORGANIZED BEHAVIOR in self and agency. Trauma-focused therapy 5. NEGATIVE SYMPTOMS Accompanied by alterations in Therapists use approaches such various aspects such as affect, as Trauma-Focused Cognitive DELUSIONS behavior, memory, and Behavioral Therapy (TF-CBT) Delusions are "fixed beliefs that perception. or Eye Movement are not amenable to change in Symptoms may be observed by Desensitization and light of conflicting evidence” others or reported by the Reprocessing (EMDR) to individual. address and process traumatic Delusions of grandeur- belief they experiences that may have led have exceptional abilities, wealth, or 02. RECURRENT GAPS IN MEMORY to the development of fame; belief they are God or other Recurrent gaps in the recall of dissociative symptoms. religious saviors everyday events, important Stabilization techniques Delusions of control- belief that personal information, or Focus on building coping skills, others control their thoughts traumatic events inconsistent emotion regulation strategies, /feelings/actions with ordinary forgetting. and grounding techniques to Delusions of thought broadcasting- manage distressing symptoms belief that one's thoughts are CAUSES OF DISSOCIATIVE and improve daily functioning. transparent and everyone knows what IDENTITY DISORDER they are thinking Delusions of persecution- belief they Trauma - high rate of childhood are going to be harmed, harassed, trauma plotted or discriminated against by Disorganized thinking (speech) Catatonic Behavior – even more either an individual or an institution; it is the external manifestation of striking behavioral disturbance. The is the most common delusion (Arango a disorder in thought form. decreased or complete lack of reactivity & Carpenter, 2010] to the environment. Delusions of reference- belief that Circumstantial or tangential.- specific gestures, comments, or even patients may give unnecessary details larger environmental cues are directed negativitism- resistance to instruction in response to a question before they mutism or stupor- complete lack of directly to them finally produce the desired response. verbal and motor responses Delusions of thought withdrawal- belief that one's thoughts have been While the question is eventually rigidity- maintaining a rigid or upright removed by another source answered in circumstantial speech posture while resisting efforts to be patterns, in tangential speech patterns moved HALLUCINATIONS the patient never reaches the point. posturing- holding odd, awkward A hallucination is a sensory experience that seems real to the postures for long periods Retardation- he individual may take person having it, but occurs in catatonic excitement- hyperactivity of a long time before answering a the absence of any external motor behavior, in a seemingly excited question. perceptual stimulus. delirious way. Hallucinations can occur in any of the Derailment - illogical connection in a NEGATIVE SYMPTOMS five senses: chain of thoughts; tendency to provide The inability or decreased bizarre explanations for things ability to initiate actions, hearing (auditory (illogicality). hallucinations) speech, express emotion, or feel seeing (visual hallucinations) DISORGANIZED BEHAVIOR pleasure smelling (olfactory hallucinations) Affective flattening- Reduction in Psychomotor symptoms can touching (tactile hallucinations) also be observed in individuals emotional expression; reduced display tasting (gustatory of emotional expression with schizophrenia. These hallucinations) behaviors may manifest as Alogia- Poverty of speech or speech DISORGANIZED THINKING awkward movements or even content ritualistic/repetitive behaviors. Anhedonia- Inability to experience pleasure Schizophreniform disorder is similar distinguishing feature between Apathy- General lack of interest to schizophrenia, except for the length schizoaffective disorder and major Asociality- Lack of interest in social of presentation of symptoms. depressive disorder with psychotic relationships Schizophreniform disorder is features. Avolition- Lack of motivation for goal- considered an "intermediate" disorder directed behavior between schizophrenia and brief DELUSIONAL DISORDER psychotic disorder as the symptoms are SCHIZOPHRENIA present for at least one month but not CLINICAL PRESENTATION longer than six months. CLINICAL PRESENTATION Requires the presence of at least one Another key distinguishing feature of delusion that lasts for at least one At least two of the following for at schizophreniform disorder is the lack of month in duration. least one month: delusions, criteria related to impaired functioning. hallucinations, disorganized speech, Erotomanic delusion - delusion of disorganized/abnormal behavior, or SCHIZOAFFECTIVE DISORDER another person being in love with them. negative symptoms. Grandiose delusion - conviction of CLINICAL PRESENTATION having great talent or insight. significant impairment in an Jealous delusion - conviction that individual's ability to engage in normal Schizoaffective disorder is one's spouse or partner is/has been daily functioning characterized by the psychotic unfaithful. symptoms included in schizophrenia Persecutory delusion - believing that presence of symptoms must persist for and a concurrent uninterrupted period they are being conspired against.. a minimum of 6 months including the of a major mood episode—either a somatic delusion - delusions regarding prodromal and residual phase. depressive or manic episode. bodily functions or sensations SCHIZOPHRENIFORM For individuals with schizoaffective DISORDER disorder, psychotic symptoms should continue for at least two weeks in the CLINICAL PRESENTATION absence of a major mood disorder (APA, 2013). This is the key SEXUAL DYSFUNCTION d. cultural/religious factors Generalized: Not limited to specific e. medical factors relevant to prognosis types of stimulation, situations, or These disorders are marked by or treatment partners. significant disturbances in Situational: Occurs only with certain sexual response or pleasure. * Cultural Consideration types of stimulation, situations, or Multiple dysfunctions can occur * Complex interactions of partners. simultaneously, requiring biopsychosocial factors comprehensive diagnosis. * Coexisting conditions such as aging Severity: Mild: Mild distress over symptoms. Onset: DELAYED EJACULATION Moderate: Modsymptomserate distress over. Lifelong Marked delay in ejaculation Severe: Severe or extreme distress over present from the first sexual symptoms. experiences Marked infrequency or absence of ejaculation ERECTILE DISORDER Acquired Symptoms must occur in - developed after normal functioning approximately 75%–100% of Must experience at least one of partnered sexual activities, the following on approximately Context: without the individual desiring 75%– 100% of sexual Generalized occasions: delay. Symptoms must have - Not limited to specific stimuli Marked difficulty in obtaining persisted for at least 6 months. an erection during sexual or partners activity. Marked difficulty in Situational Specify maintaining an erection until the - Occurs only with specific Onset: completion of sexual activity. stimuli or partners Lifelong: Present since the individual Marked decrease in erectile became sexually active. rigidity. Assessment Factors: Acquired: Began after a period of Symptoms must persist for at a. Partners factors least 6 months. normal sexual function. b. relationship factors Specify c. individual factors Context: Onset: Symptoms must persist for at Symptoms must persist for at Lifelong: Present since the individual least 6 months. least 6 months. became sexually active. Acquired: Began after a period of Specify Specify Onset: normal sexual function. Onset: Lifelong: Present since the individual Lifelong: Present since the individual became sexually active. Context: became sexually active. Acquired: Began after a period of Generalized: Not limited to specific Acquired: Began after a period of normal sexual function. types of stimulation, situations, or normal sexual function. partners. Specify Context: Situational: Occurs only with certain Context: Generalized: Not limited to specific types of stimulation, situations, or Generalized: Not limited to specific types of stimulation, situations, or partners. types of stimulation, situations, or partners. partners. Situational: Occurs only with certain Severity: Situational: Occurs only with certain types of stimulation, situations, or Mild: Mild distress over symptoms. types of stimulation, situations, or partners. Moderate: Moderate distress over partners. symptoms. Specify Severity: Severe: Severe or extreme distress over Additional Specification: Mild: Mild distress over symptoms. symptoms. Never experienced an orgasm: Moderate: Moderate distress over Indicate if the individual has never symptoms. FEMALE ORGASMIC DISORDER experienced an orgasm under any Severe: Severe or extreme distress over situation. symptoms. Must experience either of the following on approximately Specify severity: GENITO-PELVIC 75%– 100% of sexual Mild: Mild distress over symptoms. PAIN/PENETRATION DISORDER occasions: Moderate: Moderate distress over Marked delay in, marked symptoms. Persistent or recurrent difficulties infrequency of, or absence of Severe: Severe or extreme distress over with one more of the following: orgasm. Markedly reduced symptoms. intensity of orgasmic Vaginal penetration during sensations. FEMALE SEXUAL intercourse. INTEREST/AROUSAL DISORDER  Marked vulvovaginal or pelvic fantasies and desire for sexual Persistent or recurrent pattern of pain during vaginal intercourse activity. Judgment of deficiency ejaculation occurring during or penetration attempts. Marked is made by the clinician, partnered sexual activity within fear or considering factors such as age, approximately 1 minute anxiety about vulvovaginal or and the individual’s general and following vaginal penetration pelvic pain in anticipation of, sociocultural context. and before the individual wishes during, or as a result of vaginal it. penetration. Marked tensing or Symptoms must persist for at least 6 tightening of the pelvic floor months. Specify Onset: Symptoms must be present for at muscles during attempted Lifelong: Present since the individual least 6 months and occur on vaginal penetration. became sexually active. Acquired: approximately 75%–100% of Began after a period of normal sexual occasions of sexual activity. Symptoms must persist for at least 6 function. Specify Onset: months. Specify Onset: Lifelong: Present since the Lifelong: Present since the individual Specify Context: individual became sexually active. became sexually active. Generalized: Not limited to specific Acquired: Began after a period of Acquired: Began after a period of types of stimulation, situations, or normal sexual function. normal sexual function. partners. Situational: Occurs only with certain Specify Context: Specify Severity: types of stimulation, situations, or Generalized: Not limited to specific Mild: Mild distress over symptoms. partners. types of stimulation, situations, or Moderate: Moderate distress over partners. symptoms. Specify Severity: Situational: Occurs only with certain Severe: Severe or extreme distress over Mild: Mild distress over symptoms. types of stimulation, situations, or symptoms. Moderate: Moderate distress over partners. symptoms. MALE HYPOACTIVE SEXUAL Severe: Severe or extreme distress over Specify severity: DESIRE DISORDER symptoms. Mild: Ejaculation occurring within approximately 30 seconds to 1 minute Persistently or recurrently PREMATURE (EARLY) of vaginal penetration. deficient (or absent) EJACULATION Moderate: Ejaculation occurring sexual/erotic thoughts or within approximately 15–30 seconds of vaginal penetration. Severe: Ejaculation occurring prior to sexual 01. Severe temper outburts (verbal or interest/pleasure. activity, at the start of sexual activity, behavioral) 3+ times / week, grossly or within approximately 15 seconds disproportionate to situation a. DEPRESSED MOOD of vaginal penetration. (SUBJECTIVE OR OBSERVED). 02. Outbursts inconsistent with LOSS OF PSYCHOLOGICAL FACTORS developmental level b. INTEREST/PLEASURE IN MENTAL HEALTH DISORDERS 03. Persistent irritability/anger most of ACTIVITIES. SIGNIFICANT * Depression, anxiety, and other day, nearly every day. WEIGHT psychiatric conditions can lead to decreased sexual desire and 04. Symptoms persist for ≥12 months c. CHANGE OR APPETITE performance. without 3+ month break. DISTURBANCE. SLEEP DISTURBANCE STRESS 05. Symptoms present in ≥2 of 3 * High levels of stress from work, settings, severe in at least one. d. (INSOMNIA/HYPERSOMNIA). financial issues, or other sources can negatively affect sexual function. 06. Onset before age 6, history before e. PSYCHOMOTOR age 10. AGITATION/RETARDATION. TRAUMA FATIGUE OR LOSS OF * History of sexual abuse or trauma can 07. No manic/hypomanic episodes >1 lead to sexual dysfunction. day. f. ENERGY. FEELINGS OF WORTHLESSNESS OR BODY IMAGE 08. Symptoms not during major EXCESSIVE GUILT. * Poor self-esteem and body image depressive episode or explained by issues can reduce sexual desire and other mental disorder. g. DIMINISHED satisfaction. CONCENTRATION/INDECISIVE 09. Not due to substance or medical NESS. RECURRENT condition. h. THOUGHTS OF DEPRESSIVE DISORDERS MAJOR DEPRESSIVE DISORDER DEATH/SUICIDAL IDEATION/BEHAVIOR. DISRUPTIVE MOOD 1) 5+ symptoms present for 2 weeks, DYSREGULATION DISORDER including depressed mood or loss of PERSISTENT DEPRESSIVE 07. symptoms cause clinically joint/muscle pain, bloating, weight DISORDER (DYSTHYMIA) significant distress or impairment. gain). 01. Depressed mood most of the day, PREMENSTRUAL DYSPHORIC 04. Symptoms present in most for more days than not, for at least 2 DISORDER menstrual cycles over the past year. years (1 year in children/adolescents), subjective or observed. 01. At least five symptoms present in 05. Symptoms cause distress or the week before menses, improving interference with daily functioning. 02. Presence of two or more of the after menses. following while depressed: 06. Not merely exacerbation of another 02. One or more of the following mood disorder. a. appetite disturbance symptoms: b. sleep disturbance 07. confirmation via prospective daily c. fatigue or low energy a. affective lability (mood swing) ratings during two symptomatic cycles. d. low self-esteem b. irritability, anger, or conflicts, (provisional diagnosis possible prior to e. poor concentration or indecisiveness disturbance confirmation.) f. feelings of hopelessness c. depressed mood or self-deprecating thoughts 08. not due to substance or medical 03. Symptoms persist for 2 years, with d. anxiety, tension, or feeling on edge condition. no symptom- free period lasting more than 2 months. 03. additional symptoms to reach five total: 04. Major depressive disorder criteria PARAPHILIC DISORDER may be continuously present for 2 a. decreased interest in usual activities. years. b. difficulty concentrating. PARAPHILIA (PERVERSION) c. lethargy, fatigue, or lack of energy. 05. No manic or hypomanic episodes. d. change in appetite or food cravings. Derived from the Greek words: e. hypersomnia or insomnia.. feeling * “para”- next to 06. symptoms not due to another overwhelmed or out of control. * “philia”- love mental disorder or substance/medical g. physical symptoms (e.g.,breast condition. tenderness, The etymological definition of paraphilia is “next to or along side of love”  Recurrent, intense sexually obsessed that if the individual associated with a pleasurable arousing fantasies, sexual urges, cannot get to their desired sexual activity. or behaviors generally involving object, they get stressed a.) non-human objects, It causes intense personal SITUATION OR CAUSES THAT b.) the suffering or humiliation distress or impairment in social, MIGHT LEAD SOMEONE IN A of oneself or one’s partner, or work and other areas of life PARAPHILIC DIRECTION c.) children or other non- functioning. Paraphilias consenting persons that occur commonly involve sexual PARENTAL HUMILIATION over a period of time of at least arousal and orgasm usually DUE TO ERECTED PENIS 6months. achieved through masturbation YOUNG CHILD WHO IS and fantasy SEXUALLY ABUSED DSM-5TR CRITERIA FOR FEAR OF SEXUAL PARAPHILIC DISORDER ETIOLOGY PERFORMANCE OR INTIMACY CRITERION A - The etiology of paraphilia is EXCESSIVE ALCOHOL * Specifies the qualitative nature of the unknown Psychoanalytical INTAKE/ MARIJUANA USE paraphilia Theory PHYSIOLOGICAL PROBLEMS CRITERION B These conditions represent a SOCIOCULTURAL * Specifies the negative consequence regression to or fixation at an FACTORS earlier level of psychosexual PSYCHOSEXUAL TRAUMA Beside normal sexual development, resulting in a behaviour, paraphilic disorder repetitive pattern of sexual involves aggression, behavior that is not mature in its victimization and extreme one- application and expression. VOYEURISTIC DISORDER sidedness. The behaviors exclude or harm - Behavioral Theory 01. OBSERVING AN others and disrupt the potential UNSUSPECTING NAKED PERSON for bonding between persons. The paraphilia begins via Intense and recurring sexual arousal Usually lasts for 6 months process of conditioning. occurs for at least 6 months when Always Nonsexual objects can become observing someone who is naked, thinking to carry out their sexually arousing if they are undressing, or engaged in sexual unusual behavior Overly frequently and repeatedly activity, demonstrated through 01. EXPOSURE OF ONE’S - Masturbation to orgasm usually fantasies, urges, or behaviors. GENITALS TO AN acccompanies or follows the UNSUSPECTING PERSON event 02. ACTED ON A Intense and recurring sexual arousal - The dynamic of men with NONCONSENTING PERSON occurs for at least 6 months from exhibitionism is to assert their The individual either acts on these exposing one's genitals to an masculinity by showing their sexual urges without consent from the unsuspecting person, evident through penises and by watching the observed person, or experiences fantasies, urges, or behaviors. victim’s reactions - fright, significant distress or impairment in surprise and disgust social, occupational, or other 02. ACTED ON A important areas of functioning due to NONCONSENTING PERSON FROTTEURISTIC DISORDER these urges or fantasies. The individual either acts on these sexual urges without consent from the 01. TOUCHING OR RUBBING 03. AT LEAST 18 YEARS OF AGE observed person, or experiences AGAINST A The individual experiencing the arousal significant distress or impairment in NONCONSENTING PERSON, and/or acting on the urges is at least 18 social, occupational, or other Intense and recurring sexual years of age. important areas of functioning due to arousal occurs for at least 6 months these urges or fantasies. from touching or rubbing against a The word comes from the term nonconsenting person, as evidenced VOIR, meaning “To see” AKA. SPECIFIER by fantasies, urges, or behaviors. Scopophilia Onset is usually before the age of 15. Sexually aroused by exposing 02. ACTED ON A This disorder is more common genitals to prepubertal children NONCONSENTING PERSON in men Masturbation to orgasm Sexually aroused by exposing The individual either acts on these usually acccompanies or genitals to physically mature sexual urges without consent from follows the event The voyeur individuals Sexually aroused by the observed person, or experiences feels frustrated and incapable of exposing genitals to prepubertal significant distress or impairment establishing a regular sexual children and to physically in social, occupational, or other relationship with the person he mature individuals important areas of functioning due observes to these urges or fantasies. - AKA Flashing or Indecent EXHIBITIONISTIC DISORDER Exposure - Occurs predominantly in men SEXUAL MASOCHISM SEXUAL SADISM DISORDER sexual activity with a prepubescent DISORDER child or children (generally age 13 Obtaining sexual enjoyment years or younger)., as demonstrated by 01. SEXUAL AROUSAL FROM from inflicting cruelty Requires fantasies, urges, or behaviors. HUMILIATION OR SUFFERING a partner to enact sadistic Intense and recurring sexual arousal fantasies Most person with 02. ACTED ON A occurs for at least 6 months from being sexual sadism are male NONCONSENTING PERSON humiliated, beaten, bound, or otherwise The individual either acts on these made to suffer, as evidenced by 01. SEXUAL AROUSAL FROM sexual urges without consent from the fantasies, urges, or behaviors. ANOTHER'S SUFFERING observed person, or experiences Intense and recurring sexual arousal significant distress or impairment in 02. ACTED ON A occurs for at least 6 months from the social, occupational, or other NONCONSENTING PERSON physical or psychological suffering of important areas of functioning due to The individual either acts on these another person, as demonstrated by these urges or fantasies. sexual urges without consent from the fantasies, urges, or behaviors. observed person, or experiences 03. AGE DISCREPANCY significant distress or impairment in 02. ACTED ON A The individual is at least age 16 years social, occupational, or other NONCONSENTING PERSON and at least 5 years older than the child important areas of functioning due to The individual either acts on these or children in Criterion A. these urges or fantasies. sexual urges without consent from the observed person, or experiences Note: Do not include an individual in SPECIFIER: significant distress or impairment in late adolescence involved in an * WITH ASPHYXIPHILIA social, occupational, or other ongoing sexual - If the individual engages in the important areas of functioning due to practice of achieving sexual arousal these urges or fantasies. relationship with a 12- or 13-year-old. related to restriction of breathing. - LEGAL CASE PEDOPHILIC DISORDER A masochist is someone who FETISHISTIC DISORDER seeks pleasure from being 01. SEXUAL ACTIVITY WITH A subjected to pain The three PREPUBESCENT CHILD OR 01. SEXUAL AROUSAL FROM main characteristics of CHILDREN NONLIVING OBJECTS OR masochism are: pain, loss of Intense and recurring sexual arousal NONGENITAL BODY PARTS control, humiliation occurs for at least 6 months from the Intense and recurring sexual arousal 01. SEXUAL AROUSAL FROM PERSONALITY DISORDER for at least 6 months arises from either CROSS-DRESSING the use of nonliving objects or a highly Intense and recurrent sexual arousal OVERVIEW OF PERSONALITY specific focus on non-genital body for at least 6 months arises from cross- DISORDERS parts. This arousal is evidenced by dressing, evident through fantasies, fantasies, urges, or behaviors. urges, or behaviors. A personality disorder is a persistent pattern of emotions, 02. ACTED ON A 02. ACTED ON A cognitions, and behavior that NONCONSENTING PERSON NONCONSENTING PERSON results in enduring emotional The fantasies, sexual urges, or The fantasies, sexual urges, or distress for the person affected behaviors lead to clinically significant behaviors lead to clinically significant and/or for others and may cause distress or impairment in social, distress or impairment in social, difficulties with work and occupational, or other important areas occupational, or other important areas relationships (APA,2013). of functioning. of functioning. Personality disorders are chronic; they do not come and 03. EXCLUSION OF SPECIFIC SPECIFY IF: go but originate in childhood FETISH OBJECTS With fetishism: If sexually aroused by and continue throughout The fetish objects are not limited to fabrics, materials, or garments. adulthood. articles of clothing used in cross- With autogynephilia: If sexually dressing (as seen in transvestic aroused by thoughts or images of self PERSONALITY DISORDERS disorder) or devices explicitly designed as a woman. CLUSTERS for tactile genital stimulation (e.g., vibrators). Cluster A: Odd, eccentric Cluster B: Dramatic, Emotional, TRANSVESTIC DISORDER erratic Cluster C: Anxious The literal meaning of the word transvestism is to wear the COMORBIDITY: clothing of the opposite sex * A major concern with the Sometimes accompanied by personality disorders is that people masturbation Rare in female. tend to be diagnosed with more than one. Overlapping of symptoms are common Complicating this  issue is the phenomenon that people recorded, followed by relationships, self-image issues, will change diagnoses over time “premorbid” and impulsive actions. Histrionic Personality GENERAL PERSONALITY Cluster A (Odd/Eccentric): Disorder: Attention-seeking, DISORDER dramatic, and superficial Paranoid Personality emotional expression. Deviation from cultural expectations Disorder: Excessive mistrust Narcissistic Personality and suspicion of others. Disorder: Grandiosity, self- Cognition Symptoms include interpreting centeredness, and lack of - Abnormal ways of perceiving and benign remarks as threats and empathy for others. interpreting self, others, and events. holding grudges. Affectivity Schizoid Personality Disorder: Cluster C (Anxious/Fearful): - Abnormal range, intensity, lability, Prefers isolation, shows limited and appropriateness of emotional emotional range, and has little Avoidant Personality responses. desire for relationships. Disorder: Social inhibition, fear Interpersonal Functioning Schizotypal Personality of rejection, feelings of - Difficulty in forming and maintaining Disorder: Peculiar thoughts, inadequacy. relationships. beliefs, and behaviors, such as Dependent Personality Impulse Control ideas of reference or magical Disorder: Over-reliance on - Difficulty controlling urges and thinking. Often seen as a mild others, fear of being alone, behaviors. form of schizophrenia. difficulty making decisions. Obsessive-Compulsive Recognizable during Cluster B Personality Disorder (OCPD): adolescence or early adult life (Dramatic/Emotional/Erratic): Preoccupation with rules, For PD to be diagnosed in an perfectionism, and control at the individual younger than 18 Antisocial Personality expense of flexibility. years old, it has to be present Disorder: Lack of empathy, for at least 1 year disregard for rules and the rights When an individual has a of others, impulsive behavior. persistent mental disorder that Borderline Personality was preceded by a preexisting Disorder: Fear of PD, the PD must also be abandonment, unstable  CLUSTER A: (ODD OR CLUSTER B: (DRAMATIC, EMOTIONAL OR ECCENTRIC) ERRATIC) Paranoid Antisocial Disregard for others' rights, impulsivity, and lack of Distrustful, suspicious, and prone to interpreting Personality Disorder empathy. Personality others' actions as malicious. Disorder Borderline Instability in relationships, self-image, and affect, with Personality Disorder impulsivity and fear of abandonment Schizoid Personality Detached and indifferent towards social relationships, with limited emotional expression Histrionic Disorder Excessive emotionality, attention-seeking behavior, Personality Disorder and shallow relationships. Schizotypal Personality Eccentric and socially isolated, with unusual Narcissistic Grandiosity, need for admiration, and lack of empathy. beliefs and perceptual experiences. Personality Disorder Disorder CLUSTER C: (ANXIOUS OR FEARFUL) Avoidant Personality Social inhibition, feelings of inadequacy, and Disorder hypersensitivity to negative evaluation Dependent Personality Excessive need for care and support, leading to Disorder submissive behavior and fear of separation. Obsessive- Compulsive Preoccupation with orderliness, perfectionism, and control, Personality Disorder at the expense of Clexibility and openness.