What Is Personality Disorder Not Otherwise Specified?

An Old Diagnosis from DSM-IV

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Personality disorder not otherwise specified (PD-NOS), also referred to as personality disorder NOS, was a diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV-TR). This diagnostic category was reserved for a clinically significant problem in personality functioning that did not fit into any of the other existing personality disorder categories.

Changes in Personality Disorder NOS in DSM-5

In the new Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), personality disorder not otherwise specified has been replaced by personality disorder—trait specified (PD-TS).

This diagnosis is given when you have the characteristics of a personality disorder, but you don't fully meet the criteria for any specific one. You may even have a variety of symptoms of several different personality disorders.

Types and Features of Personality Disorders

Personality disorders are characterized by thinking and feeling about yourself and others in a way that causes significant impairment to your everyday functioning and relationships. There are ten personality disorders listed in DSM-5. They include:

  • Borderline personality disorder 

This disorder is characterized by turbulent relationships with others, paranoid thinking, a deep-rooted and extreme fear of abandonment, emotional instability, impulsive behaviors and an unstable sense of self. 

  • Paranoid personality disorder

People with paranoid personality disorder may be socially isolated, hostile, have a constant worry that others have ulterior motives, expect people to use them for their own means and have trouble working and getting along with others.

  • Avoidant personality disorder

If you have avoidant personality disorder, you may be very shy, easily hurt, see yourself as not as good as everyone else, avoid situations or jobs that force you to be in contact with others, not open up in romantic relationships and blow situations out of proportion.

  • Schizoid personality disorder

    This disorder may be related to schizophrenia, but is not as severe. People with this disorder may be emotionally unavailable, distant, appear aloof and tend to isolate themselves from others. They have no desire for close relationships, even with family members.

    • Obsessive-compulsive personality disorder

    Not to be mistaken for obsessive-compulsive disorder (OCD), which is an anxiety disorder, obsessive-compulsive personality disorder (OCPD) does have many of the same features as OCD. One of the main differences between the two is that in OCD, people have thoughts they don't want and in OCPD, people believe their thoughts are correct. This disorder features a rigid adherence to rules and/or lists, perfectionism, an inability to be flexible, generous or show affection and being obsessed with work.

    • Antisocial personality disorder

    Antisocial personality disorder involves behavior that is often criminal. People with this disorder tend to manipulate, not care about others' safety, lie, steal, fight, be angry, have no remorse for their actions, violate others' rights, be charming, engage in substance abuse, break the law and use other people for their own benefit.

    • Histrionic personality disorder

    If you have histrionic personality disorder, you are likely able to function well in life. This disorder involves needing to be the center of attention and engaging in intense emotional drama to do so. Other symptoms are having a hard time dealing with criticism, blaming others for failure, an extreme worry about what others think, impulsive behavior, being overly concerned about your looks and always needing approval and/or reassurance. 

    • Narcissistic personality disorder

    In narcissistic personality disorder, people have an inflated sense of themselves and their importance, are unable to empathize with others and focus almost entirely on themselves and what they want and need.

    • Schizotypal personality disorder

    Unlike people with schizophrenia, if you have schizotypal personality disorder (SPD), you are in touch with reality and usually don't experience hallucinations or delusions. Symptoms of SPD include having strange beliefs and/or fears, being uncomfortable in social situations, not having close friends, having an unusual appearance or behavior and being unable to express your feelings appropriately.

    • Dependent personality disorder

    This disorder is characterized by being too dependent on others for your physical and/or emotional needs. Symptoms include not wanting to be alone, not being able to make independent decisions, being unable to express disagreement, becoming passive in interpersonal relationships, excessive caring about what others think, worry about being abandoned and an inability to deal with criticism or disapproval.

    Sources:

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed, text revision. Washington, DC, Author, 2000.

    Oldham, J. M. "The alternative DSM-5 model for personality disorders." World Psychiatry14(2), 2015.

    "Personality Disorders Fact Sheet." American Psychiatric Association (2013).

    Medical Encyclopedia. MedLine Plus, U.S. National Library of Medicine (2014).

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