Personality Disorders

Personality Disorders

DSM-5 diagnosis

Disorder ICD-10-CM Code Specifiers Severity Z-codes
Substance Use Disorder F14.21
  • Taking cocaine in large amounts
  • Needing more cocaine to perform
  • Withdrawal symptoms such as troubles in sleeping, depression, and anxiousness (Saunders, 2017)



Severe in sustained remission Z65- Problems related to psychosocial circumstances
Narcissist Personality Disorder  
  • Unaware of her moral convictions
  • Low personal standards
  • Sensitive to criticisms
  • Impaired abilities to recognize other people’s feelings
  • Superficial relationships
  • Condescending towards others (Sleep et al., 2019)
Moderate Z72 Problems related to lifestyle


Explanation of the Diagnosis

From the DSM-5 diagnosis, it is evident that precious is suffering from substance use disorder since she has a history of drug abuse and is experiencing related symptoms. First, Precious has been abusing drugs since she was 14. She began with marijuana, followed by heroin, and later cocaine. She has been experimenting on different drugs and was incarcerated due to drug-related charges. Precious has been experiencing symptoms related to substance use disorder such as continuing to use cocaine despite understanding that it can lead to health problems, using cocaine in large amounts, building up tolerance, and withdrawal symptoms such as insomnia, anxiousness, and depression (Saunders, 2017).

Precious may also exhibit narcissist personality disorder. First, she feels unimportant compared to her siblings and is increasingly frustrated due to the added responsibility of taking care of her mother. She is condescending towards her siblings, father, and other family members and her standards are too low. Precious lacks empathy towards others which is demonstrated when she gives her roommate herps without minding how it will affect him (Sleep et al., 2019). Most of her relationships are superficial and she is self-centered.

Close differentials and why they were eliminated.

A close differential to Precious’ case is borderline personality behavior. Some of the symptoms of borderline personality behavior evident in precious include the tendency to view others as bad, ongoing feelings of emptiness, being bitter and sarcastic, suicidal feelings, and unstable relationships. This disorder was eliminated since most symptoms in the diagnostic criteria are not exhibited by precious. For instance, she does not lose her temper easily, does not have physical fights or intense anger, fear of abandonment, self-harm, and unclear self-image (Sleep et al., 2019). She is instead coherent, casually groomed, and goal-oriented.

How power and privilege may influence who is labeled with a personality disorder

Power and privilege can significantly influence people who are labeled with personality disorders. People with high influence and power get adequate protection and more access to mental health services compared to those who are underprivileged. They have the advantage of disability income and stays of unlimited durations in hospitals. Nonetheless, they have a host of rehabilitation programs and social work programs of their care. Apart from protection against the disadvantageous contract, those in power and with privilege have special legal benefits as excuses for their criminal actions (Saunders, 2017). The underprivileged on the other hand mostly have mental health issues that go unnoticed due to lack of money, do not have access to mental health, and sometimes are incarcerated despite their mental health issues.

How trauma affects the case

Precious experienced a traumatic event after her mother was involved in an accident. This trauma led to her increased risk of using drugs such as marijuana and heroin (Sleep et al., 2019). As a way of self-medication and to dampen the moods linked to the accident, among other problems Precious resolved to abuse marijuana and heroin.










Saunders, J. B. (2017). Substance use and addictive disorders in DSM-5 and ICD 10 and the draft ICD 11. Current opinion in psychiatry30(4), 227-237. DOI:

Sleep, C. E., Lynam, D. R., Widiger, T. A., Crowe, M. L., & Miller, J. D. (2019). An evaluation of DSM–5 Section III personality disorder Criterion A (impairment) in accounting for psychopathology. Psychological Assessment31(10), 1181.


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