Judgments about personality functioning must involve a consideration of the person’s ethnic, cultural, and social background (APA, 2000). Members of minority groups, immigrants, political refugees, and people from different ethnic backgrounds may display guarded or defensive behavior as a result of language barriers or previous nega-tive experiences; this should not be confused with para-noid personality disorder. People with religious or spiritual beliefs, such as clairvoyance, speaking in tongues, or evil spirits as a cause of disease, could be misinterpreted as having schizotypal personality disorder.
There is also a difference in how some cultural groups view avoidance or dependent behavior, particularly for women. An emphasis on deference, passivity, and polite-ness should not be confused with a dependent personality disorder. Cultures that value work and productivity may produce citizens with a strong emphasis in these areas; this should not be confused with obsessive–compulsive personality disorder.
Certain personality disorders—for example, antisocial and schizoid personality disorders—are diagnosed more often in men. Borderline and histrionic personality disorders are diagnosed more often in women. Social stereotypes about typical gender roles and behaviors can influence diagnostic decisions if clinicians are unaware of such biases.