Another complication is the influence of emotional states and mental illnesses. Anyone may seem utterly transformed by chronic depression or alcoholism. Professionals who did not take sufficient notice of this once spoke of the alcoholic personality. The difficulty of distinguishing personality traits from states of mind and the demands of social roles is so serious that a few researchers have even denied the existence of individual patterns that persist in every mood and social context.
In the first two editions of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-I and DSM-II), personality disorders were relegated to a secondary place along with a mixture of other conditions; symptom disorders had priority. The third edition (DSM-III), published in 1980, gave equal prominence to personality disorders for the first time. The diagnostic scheme was strongly criticized from the start and has already been revised once, in the new edition published in 1987 (DSM-III-R). It will certainly be revised further, but the main outlines drawn a decade ago remain. DSM-III-R still dominates the field and provides at least a starting point for many mental health professionals in their consideration of personality problems.
2. Schizoid: socially isolated, with restricted emotional expression.
3. Schizotypal: disconcerting peculiarities of thought, appearance, and behaviour; emotionally detached and isolated.
B. Dramatic, emotional, or erratic< 4. Antisocial: manipulative, exploitative, pervasively dishonest and disloyal; lacks guilt, habitually breaks social rules, often has a criminal record.
5. Borderline: intolerant of solitude, intense and unstable moods and personal relationships, suicide attempts, chronic boredom or anger, drug and alcohol abuse.
6. Histrionic: seductive, demands constant reassurance and immediate gratification; rapidly changing, shallow emotional expression.
7. Narcissistic: self-absorbed, fantasies of perfection, preoccupied with envy, demands adulation, expects special treatment.
C. Anxious or fearful< 8. Avoidant: reticent, easily hurt or embarrassed, few close friends, afraid to abandon routines.
9. Dependent: allows others to make decisions, needs constant advice and reassurance, fears abandonment.
10. Obsessive-compulsive: stiff, perfectionistic, overconscientious, indecisive, preoccupied with details, unable to express affection.
11. Passive-aggressive: resents demands and suggestions, procrastinates, sulks, avoids obligations by 'forgetting' or deliberate inefficiency.
Added in 1987 (DSM-III-R)< 12. Sadistic: takes pleasure in cruelty, fascinated by violence, controls others by intimidation and humiliation.
13. Self-defeating: feels exploited and mistreated; creates situations bound to cause disappointment and rejection; excessive unsolicited self-sacrifice, rejects help and opportunities for pleasure.