Table 2 Aspects of personality functioning that contribute to severity determination in Personality Disorder

Degree and pervasiveness of disturbances in functioning of aspects of the self:

● Stability and coherence of one’s sense of identity (e.g., extent to which identity or sense of self is variable and inconsistent or overly rigid and fixed).

● Ability to maintain an overall positive and stable sense of self-worth.

● Accuracy of one’s view of one’s characteristics, strengths, limitations.

● Capacity for self-direction (ability to plan, choose, and implement appropriate goals).

Degree and pervasiveness of interpersonal dysfunction across various contexts and relationships (e.g., romantic relationships, school/work, parent-child, family, friendships, peer contexts):

● Interest in engaging in relationships with others.

● Ability to understand and appreciate others’ perspectives.

● Ability to develop and maintain close and mutually satisfying relationships.

● Ability to manage conflict in relationships.

Pervasiveness, severity, and chronicity of emotional, cognitive, and behavioral manifestations of the personality dysfunction:

Emotional manifestations

     ○ Range and appropriateness of emotional experience and expression.

     ○ Tendency to be emotionally over- or underreactive.

     ○ Ability to recognize and acknowledge unwanted emotions (e.g., anger, sadness).

Cognitive manifestations

     ○ Accuracy of situational and interpersonal appraisals, especially under stress.

     ○ Ability to make appropriate decisions in situations of uncertainty.

     ○ Appropriate stability and flexibility of belief systems.

Behavioural manifestations

     ○ Flexibility in controlling impulses and modulating behaviour based on the situation and consideration of the consequences.

     ○ Appropriateness of behavioural responses to intense emotions and stressful circumstances (e.g., propensity to self-harm or violence).

The extent to which the dysfunctions in the above areas are associated with distress or impairment in personal, family, social, educational, occupational or other important areas of functioning.