Key features: detachment from social relationships, restricted range of emotions in interpersonal settings. NOT bothered by isolation (this is the key to distinguish from avoidant PD, who IS bothered). No psychosis. No desire for relationships. No magical thinking (distinguishes from schizotypal). Flat, indifferent, content alone.

Schizotypal: odd, magical thinking, ideas of reference, unusual perceptual experiences. WANTS relationships but is too odd for them to work. Schizoid: no desire for relationships at all. If the patient has perceptual distortions or magical thinking AND wants connection but fails, that is schizotypal, not schizoid. The desire for connection is the key split.

Key features: odd or magical thinking, ideas of reference (neutral events seem to have personal meaning), unusual perceptual experiences, odd speech (vague, circumstantial, metaphorical), suspiciousness. WANTS relationships but cannot sustain them due to eccentricity. Closely related to schizophrenia spectrum (first-degree relatives of schizophrenic patients have higher rates). Not psychotic. No treatment required, low-dose antipsychotics if severe.

Key features: pervasive distrust and suspiciousness. Reads malicious intent into neutral actions. Holds grudges. Suspicious of partner (pathological jealousy without evidence). NOT psychotic (no frank delusions or hallucinations). Differs from delusional disorder: the paranoid PD patient has a pattern of suspicion, not a fixed, specific delusion. Very ego-syntonic: the patient thinks everyone ELSE is the problem.

Key features: unstable identity, unstable relationships (splitting: all-good or all-bad), frantic efforts to avoid real or imagined abandonment, impulsivity (sex, substance, spending, self-harm), affective instability, chronic emptiness. Self-harm and suicidality are common. Treatment: dialectical behavior therapy (DBT). Board loves to test: SPLITTING and ABANDONMENT FEAR as core BPD features.

Key features: grandiosity (in fantasy or behavior), need for admiration, lack of empathy, sense of entitlement, exploits relationships. Key board trap: narcissistic patients are FRAGILE underneath the grandiosity. Criticism triggers narcissistic injury, leading to rage or shame. Distinguish from antisocial PD: narcissists want admiration; antisocials want power and feel no remorse.

Key features: pervasive disregard for and violation of the rights of others since age 15. Criteria require the patient to be 18 or older AND have a history of conduct disorder before age 15. Deceitful (repeated lying, conning), impulsive, reckless, aggressive, no remorse. Diagnosis cannot be made if the behaviors occur only during schizophrenia or bipolar mania. Most heritable personality disorder.

Key features: excessive emotionality and attention-seeking. Feels uncomfortable when not the center of attention, uses physical appearance to draw attention, rapidly shifting and shallow emotions, theatrical, considers relationships more intimate than they are. Board trap: histrionic vs. BPD: histrionic patients seek attention and are dramatic but lack the abandonment fear, splitting, and self-harm of BPD.

Key features: social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation. WANTS relationships but avoids them for fear of rejection or embarrassment. This is the critical board trap: avoidant PD vs. schizoid PD. Schizoid does NOT want relationships and is not bothered. Avoidant desperately WANTS connection but is too fearful to pursue it. Treat: CBT, SSRIs for anxiety component.

Key features: submissive and clinging behavior related to an excessive need to be taken care of. Cannot make decisions without excessive reassurance, fears separation, urgently seeks a new relationship when one ends, difficulty expressing disagreement. Treat: psychotherapy (CBT, insight-oriented). Avoid long-term benzodiazepines (fosters dependence). Distinguish from BPD: dependent PD is not impulsive and does not have splitting or identity disturbance.

Key features: preoccupation with orderliness, perfectionism, and mental and interpersonal control. Rigid adherence to rules, excessive devotion to work at the expense of relationships, inability to delegate (must do it themselves to be sure it's done right), hoarding objects of no value, miserly with money. BOARD TRAP: OCPD vs. OCD. OCD is ego-DYStonic (the patient is bothered by the obsessions). OCPD is ego-SYNtonic (the patient thinks their standards are correct and others are the problem).