3. Empathy: Preoccupation with, and sensitivity to, criticism or rejection, associated with distorted inference of others' perspectives as negative.
4. Intimacy: Reluctance to get involved with people unless being certain of being liked; diminished mutuality within intimate relationships because of fear of being shamed or ridiculed.
B. Three or more of the following four pathological personality traits. one of which must be (1) Anxiousness: 1. Anxiousness (an aspect of Negative Attectivlty): Intense feelings of nervous- ness, tenseness, or panic. often in reaction to social situations; worry about the negative effects of past unpleasant experiences and future negative possibilities; feeling tearful, apprehensive, or threatened by uncertainty; tears of embarrass- ment.
2. Withdrawal (an aspect of Detachment): Reticence in social situations; avoidance of social contacts and activity; lack of initiation of social contact.
3. Anhedonia (an aspect of Detachment): Lack of enjoyment from, engagement in, or energy for life's experiences; deficits in the capacity to feel pleasure or take in- terest in things.
4. Intimacy avoidance (an aspect of Detachment): Avoidance of close or romantic relationships, interpersonal attachments, and intimate sexual relationships.
Specifiers. Considerable heterogeneity in the form of additional personality traits is found among individuals diagnosed with avoidant personality disorder. Trait and level of personality functioning specifiers can be used to record additional personality features that may be present in avoidant personality disorder. For example, other Negative Affec- tivity traits (e.g., depressivity, separation insecurity, submissiveness, suspiciousness, hos- tility) are not diagnostic criteria for avoidant personality disorder (see Criterion B) but can be specified when appropriate. Furthermore, although moderate or greater impairment in personality functioning is required for the diagnosis of avoidant personality disorder (Cri- terion A), the level of personality functioning also can be specified.
Typical features of borderline personality disorder are instability of self-image, personal goals, interpersonal relationships, and affects, accompanied by impulsivity, risk taking, and/ or hostility. Characteristic difficulties are apparent in identity, self—direction, empa- thy, and / or intimacy, as described below, along with specific maladaptive traits in the do- main of Negative Affectivity, and also Antagonism and / or Disinhibition.
A. Moderate or greater impairment in personality functioning, manifested by characteristic difficulties in two or more of the following tour areas: 1. Identity: Markedly impoverished, poorly developed, or unstable seIf-image, often associated with excessive self—criticism; chronic feelings of emptiness; dissociative states under stress.
2. SeIt-direction: Instability in goals, aspirations, values, or career plans.
3. Empathy: Compromised ability to recognize the feelings and needs of others asso- ciated with interpersonal hypersensitivity (i.e., prone to feel slighted or insulted); per- ceptions of others selectively biased toward negative attributes or vulnerabilities.
4. 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 alternat- ing between overinvolvement and withdrawal.
B. Four or more of the following seven pathological personality traits, at least one of which must be (5) Impulsivity, (6) Risk taking, or (7) Hostility: 1. Emotional lability (an aspect of Negative Affectivity): Unstable emotional expe- riences and frequent mood changes; emotions that are easily aroused, intense, and/or out of proportion to events and circumstances.