Main Vampire the Masquerade Sourcebook (Revised Edition)

The trauma, guilt or inner conflict that causes this derangement forces the individual to focus nearly all ofher attention and energy onto a single repetitive behavior or action. Obsession relates to an individual's desire to control her environment keeping clean, keeping an area quiet and peaceful, or keeping undesirable individuals from an area, for example. A compulsion is an action or set of actions that an individual is driven to perform to soothe her anxieties: for example, placing objects in an exact order, or feeding from a mortal in a precise, ritualistic fashion that is never allowed to vary .
Vampires with an obsessive or compulsive derangement must determine a set of specific actions or behaviors, as described above, and follow them to the exclusion of all else. The effects of obsessive/compulsive behavior can be negated for the course of one scene by spending a temporary Willpower point. The difficulty of any attempt to coerce or Dominate a vampire into ceasing her behavior is raised by one. If a vampire is forcibly prevented from adhering to her derangement, she automatically frenzies.
Another Imput for Obsessive/Complusive: A neat freak who wears gloves so that he doesn't get dirty, the strange man who rearranges all the books in the store to match his home collection. Charlie Chaplin's mother suffered from this illness. Crumbling bread and hiding food in her purse so that they would never take her children away again, even after Charlie bought her a grand house in California. The film Chaplin shows the pain this caused him, as well as the more unsettling aspects of this illness.

Multiple Personalities
The trauma that spawns this derangement fractures the victim's personality into one or more additional personas, allowing the victim to deny her trauma or any actions the trauma causes by placing the blame on "someone else." Each personality is created to respond to certain emotional stimuli - an abused person might develop a tough-as-nails survivor personality, create a "protector," or even become a murderer in order to deny the abuse she is suffering. In most cases none of the personalities is aware of the others, and they come and go through the victim's mind in response to specific situations or conditions.
When a vampire suffers this derangement, the Storyteller and the player must agree upon how many and what kind of personalities develop, and the situations that trigger their domi nance in the victim. Each personality should be relevant to the trauma that causes it. Not only is each personality distinct, but in the case of Kindred, the different personalities might believe themselves to be from different clans and sires.
Kindred with multiple personalities can manifest different Abilities and even Virtues for each of their personalities, but it is the Storyteller's responsibility to determine the specific details.
Another Imput for Multiple Personalities: This is possibly one of the most maligned and misunderstood derangements out there. Yes, the sufferer does adopt different personas due to stress and trauma. No, they don't talk to each other, and they aren't aware of each other. Each thinks it is the only persona in the body. Sibyl was possibly the most intense case in recent history, with upwards of thirty documented personalities, you really never knew who you were talking to. In some cases, as in Trudi Chase, who wrote "When Rabbit Howls" the victim of MPD is fully aware of each of the personalities.

Conflicting, unresolveable sets of feelings and impulses can cause a victim to develop schizophrenia, which manifests as a withdrawal from reality, violent changes in behavior, and hallucinations. This is the classical sort of derangement, causing victims to talk to walls, imagine themselves to be the King of Siam, or receive instructions from their pets telling them to murder people.
Roleplaying this derangement requires careful thought, because the player must determine a general set of behaviors relevant to the trauma that caused the derangement. The hallucinations, bizarre behavior and unseen voices stem from a terrible inner conflict that the individual cannot resolve. The player needs to establish a firm idea of what that conflict is and then rationalize what kind of behavior this conflict will cause.
Kindred with this derangement are unpredictable and dangerous. In situations that trigger a vampire's inner conflict, the difficulties of all rolls to resist frenzy increase by three, and the vampire loses three dice from all Willpower rolls.
Another Input for Schizophrenia: Schizophrenia is not Multiple Personalities. However, if your dog tells you that he's Satan and that you should kill people, you're a good candidate. Schizophrenia manifests itself in delusions related to the trauma that spawned it. Robin William's character in The Fisher King is a prime example of this derangement. A teacher with a fascination for the Holy Grail, he watched his wife get gunned down in a restaurant, and was so traumatized that he began seeing fae and a Red Knight, pushing him and his other knights to reclaim the Holy Grail from a castle outside of Central Park.

The victim of paranoia believes that her misery and insecurity stem from external persecution and hostility. Paranoids obsess about their persecution complexes, often creating vast and intricate conspiracy theories to explain who is tormenting them and why. Anyone or anything perceived to be "one of them" is often subjected to violence.
Kindred who suffer from paranoia have difficulty with social interaction; the difficulties of all dice rolls involving interaction are increased by one. They are distrustful and suspicious of everyone, even their own blood bound progeny. The slightest hint of suspicious behavior is enough to provoke a frenzy roll, with the difficulty relative to the degree of the behavior. This paranoia may even extend to complex and rigorous feeding practices, to keep "them" from contaminating the vampire's food supply.
Another Input for Paranoia: Just because you're paranoid... Fox Mulder from the X-Files, or his friends the Lone Gunmen, are a good example of the kind of conspiracy theorists that suffer from this derangement. Everything is done to cause you harm, specifically, everyone is out to get you, even though you try your best to be nice to them. The Government, or the Illuminati, or maybe just the neighbors, all plan against you, plotting in their back rooms to destroy you slowly.

Individuals with this derangement are obsessed with accumulating power and wealth, salving their insecurities by becoming the most potent individuals in their environment. Such individuals are invariably arrogant and supremely sure of their abilities, convinced of their own inherent superiority . The means of achieving their status can take many forms, from devious conspiracies to outright brutality. Any individual of equalor higher status than the victim is perceived to be "competition." Kindred with this derangement constantly struggle to rise to the height of power and influence, by whatever means necessary. In a megalomaniac's view, there are only two classes of people: those who are weaker, and those who do not deserve the power they have and must be made weaker. This belief extends to everyone around the vampire, including members of her own coterie. This derangement lends an extra die to all of the victim's Willpower rolls, due to her towering sense ofsuperiority.
If a megalomaniacal vampire is presented with the chance to diablerize a more potent Kindred, she will be sorely tempted.
A Willpower roll (difficulty 10) is needed for the vampire to avoid taking "what is rightfully hers."

Individuals with bulimia assuage their guilt and insecurity by indulging in activities that comfort them - in this case, consuming food. A bulimic will eat tremendous amounts of food when subjected to stress, then empty her stomach through drastic measures so she can eat still more.
In the case of vampires with this derangement, the need to feed is a means of relieving the fear and anxiety endemic to the World of Darkness. A bulimic vampire may feed four or more times a night - gorging herself, burning the blood in pointless (or not so pointless) activity, then starting the cycle again.
A vampire with bulimia gets hungry much more quickly than other vampires do. When feeding, a bulimic vampire must make a Conscience roll (difficulty 7). Ifshefails the roll, she feeds untilher blood pool is full, whether the vampire needs the extra blood or not. A vampire who is forcibly kept from feeding risks frenzy ( make a frenzy roll, difficulty 6) . The difficulty increases by one for every 15 minutes that she is prevented from drinking.

A person in the grip of hysteria is unable to control her emotions, suffering severe mood swings and violent fits when subjected to stress or anxiety.
Hysterical Kindred must make frenzy checks whenever subjected to stress or pressure. The difficulties of these rolls are normally 6, increasing to 8 if the stress is sudden or especially severe. Additionally, any action that results in a botch causes the vampire to frenzy automatically.

Manic-depressives suffer from severe mood swings, sometimes resulting from severe trauma or anxiety. Victims may be upbeat and confident one moment, then uncontrollably lethargic and pessimistic the next.
Kindred with this derangement are constantly on a hair trigger, never knowing when the next mood swing will strike.
Whenever the vampire fails a task, the Storyteller has the option of secretly making a Willpower roll (difficulty 8) for the character. If the character fails the roll, she lapses into depression.
Additionally, the vampire will go into depression whenever one of her rolls is botched, or if her blood pool ever drops below 2.
The Storyteller should roll a die to determine how many scenes the character remains depressed, keeping the number a secret.
Vampires in a depressive state have their Willpower ratings halved (minimum 1). In addition, the vampire may not access her blood pool to raise Attributes. Upon emerging from the depressive state, the character is energetic, relentlessly upbeat and active ( obsessively so) for a number of scenes proportionate to the time spent in depression. When a vampire is in this manic state, the difficulty of all rolls to resist frenzy is raised by one.

Victims suffering from fugue experience "blackouts" and loss of memory. When subjected to stress, the individual begins a specific, rigid set ofbehaviors to remove the stressful symptoms.
This differs from multiple personalities, as the individual in the grip of a fugue has no separate personality, but is on a form of "autopilot" similar to sleepwalking.
Kindred suffering from this derangement require a Willpower roll when subjected to extreme stress or pressure (difficulty 8). If the roll fails, the player must roleplay her character's trancelike state; otherwise, control of the character passes to the Storyteller for a number of scenes equal to the roll of a die. During this period, the Storyteller may have the character act as she sees fit to remove the source of the stress. At the end of the fugue, the character "regains consciousness" with no memory of her actions.

Sanguinary Animism
This derangement is unique to the Kindred, a response to vampires' deep-seated guilt regarding the act of feeding on the blood of mortals. Kindred with this derangement believe that they do not merely consume victims' blood, but their souls as well, which are then made apart of the vampire's consciousness.
In the hours after feeding, the vampire hears the voice of her victim inside her head and feels a tirade of "memories" from the victim's mind - all created by the vampire's subconscious. In extreme cases, this sense of possession can drive a Kindred to carry out actions on behalf of her victims. Obviously, diablerie would be unwise for an animist to perform....
Whenever a vampire with this derangement feeds on a mortal, a Willpower roll is needed ( difficulty 6, or 9 if she drains the mortal to the point of death). If the roll succeeds, she is tormented by the "memories" of the person whose soul she has partially consumed, but is still able to function normally. If the roll fails, then the images in her mind are so strong that it is akin to having a second personality inside her, an angry andreproachful personality that seeks to cause harm to the vampire and her associates. The player must roleplay this state; otherwise, control of the character passes to the Storyteller, who runs the character as if the mind ofher victim is in control. During the moments just before dawn, control automatically reverts to the vampire.

Malkavian Clanbook Revised Derangements

The vampire with this affliction is a virtual emotional amputee. As a derangement, desensitization inhibits the vampire's ability to feel any sort of strong emotion whatsoever, whether joy, sadness, anger or love. The afflicted just can't make the appropriate neural connections ( well, for want of a better term).
The power of Dominate or the blood bond can still hold a vampire so afflicted in check, but even though such supernatural compulsion governs the vampire's actions, it has less of an effect on her psyche. Even when blood bound, the vampire goes through the motions of love and devotion like a distracted actor half-heartedly playing a part. She will still throw herself in front of a car to save her "loved one," but she will do so without so much as a word, a tear or a smile. When she frenzies, she does so in a chillingly silent paroxysm of violence; when struck with the Rotschreck, she scuttles away like a cockroach instinctively fleeing the light.
Vampires with this derangement find it difficult to truly believe in their own ideals, and so make all Humanity, Path, Conscience or Conviction rolls at + 2 difficulty. They also suffer a one-die penalty to any Social dice pools that require some show of emotion or warmth, and cannot purchase the Performance Ability at all.

Disassociative Blood-Spending
One of the less obvious derangments, this affliction inhibits a vampire's conscious control over his own vitae. Vampires with this derangement have a tendency to unconsciously spend blood points to raise their Attributes at unusual and inappropriate times - increasing their strength in the middle of a round of drinks, upping their reaction speed while trying to compose a letter, and so on. These vampires have even been known to spend blood points during the day while they sleep, waking up even hungrier than usual and never knowing why.
If a character has this derangement, once per session the Storyteller can rule that the vampire has just spent a blood Point to raise a given Attribute, or that the vampire wakes up an extra blood point low. The Storyteller is even within her rights to tell the player that his character's missing a blood point, without elaborating exactly when and where he spent the blood, or what for. After all, the vampire wouldn't know where it went. Players are also welcome to roleplay this derangement, of course (and it can be fun to start randomly spending blood in the middle of a tense scene, just to worry the oilier players), but the Storyteller has final control over making this derangement a drawback railier than a simple quirk.

A person with this derangement closely associates pain with pleasure. In vampires, who no longer enjoy sex in its own right, masochism tends to be linked to the pleasure received by drinking blood or receiving the Kiss. Masochism is usually linked to deep feelings of shame, and masochistic vampires have a tendency to be repulsed by the actual process of feeding from mortals. They are only fulfilled when they're suffering, presumably as some sort of penance for the pleasure they feel when feeding.
Vampires with this derangement begin to have difficulty operating when they become wounded. Once a masochistic vampire drops below the Bruised health level, he must make a Willpower roll, difficulty 6; failure indicates that he takes no action next turn, instead delighting in the sensation of pain.
Furthermore, the masochist must make a Self-Control roll, difficulty 8, in order to use blood points to heal himself, no matter how terrible his injuries.

Memory Lapses
This derangement isn't like amnesia in the classic sense. It's not that a portion of the vampire's memories has been permanently blocked off - it's that the vampire tends to lose random portions of her memory at inopportune times. The memories fade in and out, and can return as quickly as within a few minutes, or they might not come back for decades.
At least once per scene, the vampire suffering from memory lapses will forget something relevant for a time. This might be as simple as forgetting where she left her keys (which can be a real problem when you're locked out of your haven and the eastern sky's getting brighter), or as complicated as forgetting an entire Ability - and even the knowledge that she once had that skill.
("Why are you looking at me like that? I've never touched a keyboard before in my life.")
Since this derangement requires particular attention from the Storyteller, players should double-check that it's okay to take this for a character. Yes, the player can ad-lib minor memory lapses as they come along, but sooner or later the lapse has to get more serious. It can be hard to determine just when forgetting how to use a gun will be dramatically appropriate, and when it'll make the other players organize an impromptu lynch mob.
Storyteller discretion is particularly advised.

Power-Object Fixation
The vampire afflicted with this derangement has invested much of her self-confidence in an external object, to the point where she believes she cannot function properly without its presence. Such a derangement is often linked to some past trauma in which the object in question played a major role although not always in the obvious way. For instance, a victim might fixate on his dead fiancee's engagement ring if holding his fiancee's hand was his only source of comfort during hard years, but another individual might focus on the belt her father beat her with as her source of strength.
Victims of this fixation lose two dice from all their dice pools if somehow separated from their object of focus. It is hard to hide this fixation from careful observers; in times of stress, the vampire must make a Willpower roll to avoid cradling the object to her torso, rubbing it obsessively or otherwise physically comforting herself with its presence.
This derangement sometimes spawns other related derangements over time. The fixated person may, for instance, develop multiple personalities related to the object - the aforementioned abuse victim might develop a bullying personality much like her abusive failier's, and so on.

When confronted with stressful situations, a character with this derangement has a tendency to mentally revert back to a childlike state. Regressives are notable for poor senses of cause and effect, flawed interpretations of morality, and a general tendency to avoid confrontation. They do not, however, usually believe themselves to be actual children who've lost their parents - more typically, regressive vampires continue to think of themselves as the same people they always are. Ofcourse, they're notably much more self-centered, fearful of the unknown, and reliant on strong "parent" figures, but this is a nuance that the vampire in question tends to miss.
Vampires with this derangement are at a permanent + 2 difficulty on all Self-Control and Instinct rolls; children have very little sense of discipline for the sake of discipline, and aren't sufficiently self-aware to master their own Beasts. The regressive is no different.
[Storytellers beware: This derangement, improperly used, leads to Malkavians who are cute railier than creepy; you know the type. The ones with teddy bears and bunny slippers. When properly used, a regressive should be a terrifying supernaturally powerful creature with no real sense of right or wrong - so feel free to crack down on players who tend to play this derangement more for laughs than for horror value.]

Self-Annihilation Impulse
This derangement is more common among older vampires, although there's nothing stopping a neonate from acquiring the affliction. The afflicted vampire feels a deep sense of revulsion for his flesh, and is literally terrified of the thoughtof "living" forever, or of continuing to exist inside a cold, dead shell. This revulsion is entirely unconscious, however; on a conscious level, the vampire is wholly unaware of his "death wish," although he may demonstrate a morbid streak.
Whenever the character is confronted with more-or-less direct evidence of his immortality - such as visiting the churchyard where his mortal daughter is buried, or watching a ghoul die - he must make an immediate Willpower roll, or begin to undertake some sort of potentially deadly behavior. This behavior might be as direct as storming into Elysium and giving the prince a piece of his mind, or it might be more subtle, such as breaching the Masquerade by talking to a reporter.
In any event, the pursuit of self-destruction is not a conscious decision, and it's not open for debate. The character will doggedly go about his "chosen" task until it's completed, resisting any attempts to talk him out of it. He may even consciously believe that the actions he's undertaking are perfectly safe. The compulsive behavior lasts only for a scene or so; however, depending on the nature of the threats he's called down on himself, the consequences can last quite a bit longer.

This derangement has little to do with logic and more with sensory interpretation. The afflicted vampire's sensory input is somewhat "scrambled"; although he's still capable of receiving sensory information, the information each sense provides is processed in terms of a different sense. In short, the synesthetic "hears" colors, "smells" textures, "tastes" sounds and the like, and is hard-pressed to tlink of such stimuli in any other fashion.
Although the synesthetic is presumably accustomed to the unusual sensory input, his real problem lies in communicating what he senses to others. A character so afflicted has difficulty expressing concepts as simple as "cut the red wire" - he's much more likely to say "cut the sandpaperywire" or something similar - and even has similar difficulties comprehending speech from others. Since the associations vary from individual to individual, there's not even any guarantee that another synesthetic would be able to understand the vampire.
Apart from the aforementioned difficulties in daily communication, the synesthetic receives + 2 difficulty to any Expression and Performance rolls that don't involve creating purely surreal art, poetry or the like. The synesthetic may spend a Willpower point to correlate her sensory input in a "normal" fashion for a turn - or rather, at least to be able to communicate "normally" in terms of colors, textures, smells, tastes, temperature or sound. The character would still hear a ringing noise and think of it as a spicy smell, for instance - he's just able to focus enough to associate that spicy smell he hears with what other people call "ringing."

Other Possible Derangments (at Storyteller Discretion)

Hypnopompic Hallucinations (Waking Dreams)
During times of great stress, the malkavian must roll willpower with a standard difficulty. If he fails the roll, he experiences a waking dream, causing hallucinations of startling and surreal imagery. Exactly what the malkavian sees and how long the hallucinations last is up to the storyteller, but it will usually be related to the cause of stress.
For example: Rupert is lost in the streets of Atlanta while trying to escape from a particularly persistent vampire hunter. Turning down yet another street, the storyteller advises Rupert's player to make a willpower roll. The roll fails, and Rupert is assaulted on all sides by living street signs, as the road twists into knots beneath his feet. Throwing his hands over his head, he pushes past startled pedestrians and runs for the safety of a nearby building. Only after calming down and getting his bearings does the area outside look normal again.

Body Image Dysmorphia - Similar to what mortals would have that results in drastic measures to change their appearance. Many with this disorder also suffer from bulimia and anorexia. This disorder is characterized by an overwhelming belief that there is something physically wrong with the person, whether it be they're too fat, too thin, their nose is too pointy, their lips are too big...or any and many combinations of these things. A person that suffers from this disorcer will often take extreme measures, often medically to correct perceived wrongs in their physical form.

Temporal Dysphoria - This derangement causes the victim to be confused about the order of events. Things that are planned for tomorrow may be thought of as things that already happened. Needless to say, this derangement makes it very difficult to schedule and even be present at events. It also manifests itself as a permanent state of deja-vu, where events that are occurring in the present, often register as memories, and can be very confusing to those around the victim of this derangement.

Hypochondria - The victim of this derangement feels that there is something critically wrong with her. Though vampires do not get sick normally, she will constantly complain about physical symptoms of an imaginary illness. The illness, and the syptoms are very real to the vampire.