Personality Disorders (Smarty PANCE)

What are personality disorders?

Personality disorders in general are pervasive, enduring patterns of thinking, perceiving, reacting, and relating that cause significant distress or functional impairment

How many types of personality disorders are there?

DSM-5 identifies 10 types of personality disorders grouped into 3 clusters (A, B, and C), based on similar characteristics

What are the personality disorders in cluster A?

Cluster A is characterized by appearing odd or eccentric. It includes the following personality disorders with their distinguishing features:

● Paranoid: Mistrust and suspicion

● Schizoid: Disinterest in others

● Schizotypal: Eccentric ideas and behavior

What are the personality disorders in cluster B?

Cluster B is characterized by appearing dramatic, emotional, or erratic. It includes the following personality disorders with their distinguishing features:

● Antisocial: Social irresponsibility, disregard for others, deceitfulness, and manipulation of others for personal gain

● Borderline: Inner emptiness, unstable relationships, and emotional dysregulation

● Histrionic: Attention seeking and excessive emotionality

● Narcissistic: Self-grandiosity, need for admiration, and lack of empathy

What are the personality disorders in cluster C?

Cluster C is characterized by appearing anxious or fearful. It includes the following personality disorders with their distinguishing features:

● Avoidant: Avoidance of interpersonal contact due to rejection sensitivity

● Dependent: Submissiveness and a need to be taken care of

● Obsessive-compulsive: Perfectionism, rigidity, and obstinacy

Characterized by persistent feelings of suspiciousness and mistrust of other people

Paranoid Personality Disorder (Cluster A)

Disinterest in others - Patients tend to have emotional aloofness, indifferent to praise or criticism, without bizarre or idiosyncratic thinking

Schizoid Personality Disorder (Cluster A)

A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships. Presents with eccentric behavior, magical thoughts, odd beliefs, and perceptual distortion

Schizotypal Personality Disorder (Cluster A)

Schizoid vs. Schizotypal Personality Disorder

The main difference between schizotypal and schizoid personality disorder is that schizoid does not have any paranoid ideation or suspiciousness. This means that people with a schizoid diagnosis will not be overly worried about other people's motivations or worried that people are out to get them.

Sociopath - a lack of remorse and no concern for others. A disregard for and violation of the rights of others with a lack of remorse which commonly results in criminality

Antisocial Personality Disorder (Cluster B)

Attention seeker, overly emotional. Needs to be the center of attention. Very dramatic. Dresses for attention. Very shallow. Seductive and flirtatious.

Histrionic Personality Disorder (Cluster B)

Presents with emotional instability, unstable relationships, poor self-image, and self-harming behavior. Relationships are either all good ("my boyfriend is a perfect angel") or all bad ("my boyfriend is evil and I hate him")

Borderline Personality Disorder (Cluster B)

Need for admiration, grandiose thoughts, concerned about what others think yet lack empathy

Narcissistic Personality Disorder (Cluster B)

Avoidance of interpersonal contact due to rejection sensitivity. Suffers from feelings of inadequacy and hypersensitivity to negative evaluation beginning by early adulthood and present in a variety of contexts.

Avoidant Personality Disorder (Cluster C)

Submissive and clingy with an excessive need to be taken care of resulting from a low self-esteem

Dependent Personality Disorder (Cluster C)

Patients tend to be preoccupied with order, perfectionism, and control

Obsessive-compulsive personality disorder (Cluster C)

Obsessive-compulsive disorder vs. obsessive-compulsive personality disorder?

Obsessive-compulsive personality disorder is ego-syntonic - the patient is not aware of their behavior causing issues vs. OCD which is ego-dystonic - behavior inconsistent with one's own beliefs and attitudes