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Diagnostic Criteria for Antisocial Personality Disorder (Psychopathy/Sociopathy)

This is the official diagnostic criteria which psychiatrists, psychologists, and therapists use to diagnose antisocial personality disorder.  This criteria comes from the Diagnostic and Statistical Manual of Mental Disorders, version 5.  

The person must meet the overall criteria for a Personality Disorder and the criteria listed below to be diagnosed with antisocial personality disorder.  Please note:  the words "psychopathy" and "sociopathy" are words used by the public to describe this disorder.  But there is only one diagnosis:  antisocial personality disorder and this is the criteria for diagnosing the disorder.  

The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose antisocial personality disorder, the following criteria must be met:

• A. Significant impairments in personality functioning manifest by:
  • 1. Impairments in self functioning (a or b):
    • a. Identity: Ego-centrism; self-esteem derived from personal gain, power, or pleasure.
    • b. Self-direction: Goal-setting based on personal gratification; absence of prosocial internal standards associated with failure to conform to lawful or culturally normative ethical behavior
      
      AND
      
      
  • 2. Impairments in interpersonal functioning (a or b):
    • a. Empathy: Lack of concern for feelings, needs, or suffering of others; lack of remorse after hurting or mistreating another.
    • b. Intimacy: Incapacity for mutually intimate relationships, as exploitation is a primary means of relating to others, including by deceit and coercion; use of dominance or intimidation to control others.
• B. Pathological personality traits in the following domains:
  • 1. Antagonism, characterized by:
    • a. Manipulativeness: Frequent use of subterfuge to influence or control others; use of seduction, charm, glibness, or ingratiation to achieve one's ends.
    • b. Deceitfulness: Dishonesty and fraudulence; misrepresentation of self; embellishment or fabrication when relating events.
    • c. Callousness: Lack of concern for feelings or problems of others; lack of guilt or remorse about the negative or harmful effects of one's actions on others; aggression; sadism.
    • d. Hostility: Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults; mean, nasty, or vengeful behavior.
  • 2. Disinhibition, characterized by:
    • a. Irresponsibility: Disregard for – and failure to honor – financial and other obligations or commitments; lack of respect for – and lack of follow through on – agreements and promises.
    • b. Impulsivity: Acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of outcomes; difficulty establishing and following plans.
    • c. Risk taking: Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard for consequences; boredom proneness and thoughtless initiation of activities to counter boredom; lack of concern for one's limitations and denial of the reality of personal danger
• C. The impairments in personality functioning and the individual's personality trait expression are relatively stable across time and consistent across situations.
• D. The impairments in personality functioning and the individual's personality trait expression are not better understood as normative for the individual's developmental stage or socio-cultural environment.
• E. The impairments in personality functioning and the individual's personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).
• F. The individual is at least age 18 years.

Diagnostic Criteria for Narcissistic Personality Disorder

This is the official diagnostic criteria which psychiatrists, psychologists, and therapists use to diagnose narcissistic personality disorder.  This criteria comes from the Diagnostic and Statistical Manual of Mental Disorders, version 5.  The person must meet the overall criteria for a Personality Disorder and the criteria listed below to be diagnosed with narcissistic personality disorder. 

The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose narcissistic personality disorder, the following criteria must be met:

• A. Significant impairments in personality functioning manifest by:
  • 1. Impairments in self functioning (a or b):
    • a. Identity: Excessive reference to others for self-definition and self-esteem regulation; exaggerated self-appraisal may be inflated or deflated, or vacillate between extremes; emotional regulation mirrors fluctuations in self-esteem.
    • b. Self-direction: Goal-setting is based on gaining approval from others; personal standards are unreasonably high in order to see oneself as exceptional, or too low based on a sense of entitlement; often unaware of own motivations.
      
      AND
      
      
  • 2. Impairments in interpersonal functioning (a or b):
    • a. Empathy: Impaired ability to recognize or identify with the feelings and needs of others; excessively attuned to reactions of others, but only if perceived as relevant to self; over- or underestimate of own effect on others.
    • b. Intimacy: Relationships largely superficial and exist to serve self-esteem regulation; mutuality constrained by little genuine interest in others‟ experiences and predominance of a need for personal gain
• B. Pathological personality traits in the following domain:
  • 1. Antagonism, characterized by:
    • a. Grandiosity: Feelings of entitlement, either overt or covert; self-centeredness; firmly holding to the belief that one is better than others; condescending toward others.
    • b. Attention seeking: Excessive attempts to attract and be the focus of the attention of others; admiration seeking.
• C. The impairments in personality functioning and the individual's personality trait expression are relatively stable across time and consistent across situations.
• D. The impairments in personality functioning and the individual's personality trait expression are not better understood as normative for the individual's developmental stage or socio-cultural environment.
• E. The impairments in personality functioning and the individual's personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).

 

 

 

 

Diagnostic Criteria for Personality Disorders

This is the official diagnostic criteria which psychiatrists, psychologists, and therapists use to diagnose  all personality disorders.  This criteria comes from the Diagnostic and Statistical Manual of Mental Disorders, version 5.  The person must meet the overall criteria for a Personality Disorder then  meet the diagnostic criteria for the specific personality disorder, e.g. antisocial, narcissistic, or borderline.  

The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose a personality disorder, the following criteria must be met:

• A. Significant impairments in self (identity or self-direction) and interpersonal (empathy or intimacy) functioning.
• B. One or more pathological personality trait domains or trait facets.
• C. The impairments in personality functioning and the individual's personality trait expression are relatively stable across time and consistent across situations.
• D. The impairments in personality functioning and the individual's personality trait expression are not better understood as normative for the individual's developmental stage or socio-cultural environment.
• E. The impairments in personality functioning and the individual's personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).

Diagnostic Criteria for Borderline Personality Disorder

This is the official diagnostic criteria which psychiatrists, psychologists, and therapists use to diagnose borderline personality disorder.  This criteria comes from the Diagnostic and Statistical Manual of Mental Disorders, version 5.  The person must meet the overall criteria for a Personality Disorder and the criteria listed below to be diagnosed with borderline personality disorder. 

The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose borderline personality disorder, the following criteria must be met:

• A. Significant impairments in personality functioning manifest by:
  • 1. Impairments in self functioning (a or b):
    • a. Identity: Markedly impoverished, poorly developed, or unstable self-image, often associated with excessive self-criticism; chronic feelings of emptiness; dissociative states under stress.
    • b. Self-direction: Instability in goals, aspirations, values, or career plans.
      
      AND
      
      
  • 2. Impairments in interpersonal functioning (a or b):
    • a. Empathy: Compromised ability to recognize the feelings and needs of others associated with interpersonal hypersensitivity (i.e., prone to feel slighted or insulted); perceptions of others selectively biased toward negative attributes or vulnerabilities.
    • b. Intimacy: Intense, unstable, and conflicted close relationships, marked by mistrust, neediness, and anxious preoccupation with real or imagined abandonment; close relationships often viewed in extremes of idealization and devaluation and alternating between over involvement and withdrawal.
• B. Pathological personality traits in the following domains:
  • 1. Negative Affectivity, characterized by:
    • a. Emotional liability: Unstable emotional experiences and frequent mood changes; emotions that are easily aroused, intense, and/or out of proportion to events and circumstances.
    • b. Anxiousness: Intense feelings of nervousness, tenseness, or panic, often in reaction to interpersonal stresses; worry about the negative effects of past unpleasant experiences and future negative possibilities; feeling fearful, apprehensive, or threatened by uncertainty; fears of falling apart or losing control.
    • c. Separation insecurity: Fears of rejection by – and/or separation from – significant others, associated with fears of excessive dependency and complete loss of autonomy. 
    • d. Depressivity: Frequent feelings of being down, miserable, and/or hopeless; difficulty recovering from such moods; pessimism about the future; pervasive shame; feeling of inferior self-worth; thoughts of suicide and suicidal behavior.
  • 2. Disinhibition, characterized by:
    • a. Impulsivity: Acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of outcomes; difficulty establishing or following plans; a sense of urgency and self-harming behavior under emotional distress.
    • b. Risk taking: Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard to consequences; lack of concern for one's limitations and denial of the reality of personal danger.
  • 3. Antagonism, characterized by:
    • a. Hostility: Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults.
• C. The impairments in personality functioning and the individual's personality trait expression are relatively stable across time and consistent across situations.
• D. The impairments in personality functioning and the individual's personality trait expression are not better understood as normative for the individual's developmental stage or socio-cultural environment.
• E. The impairments in personality functioning and the individual's personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).