Personality Disorders

Personality disorders are separated into three categories

  • Cluster A: Odd or eccentric behavior

    • paranoid, schizoid, and schizotypal personality disorders

  • Cluster B: dramatic, emotional, or erratic behavior

    • antisocial, borderline, narcissistic, and histrionic personality disorders

  • Cluster C: anxious or fearful behavior

    • avoidant, dependent, and obsessive compulsive personality disorders


1 and 10 adults in the United States have a personality disorder


Paranoid Personality Disorder

  • characterized by deep suspicion or mistrust of others even when there's no reason to be suspicious

  • often avoid relationships

  • assume other people are out to harm or trick them

  • sensitive to criticism and can be argumentative

  • they don't recognize they have a problem and believe they are right i what they are thinking


Schizoid Personality Disorder

  • avoids social activities and interactions with others

  • not interested in social relationships

  • limited range of emotional expression

  • don't show emotion and are focused on themselves

  • don't realize their behavior is unusual

  • does not cause hallucinations or delusions


Schizotypal Personality Disorder

  • socially isolated

  • lack close friendships

  • excessive social anxiety

  • suspicious and paranoid thoughts

  • belief in special powers and magical thinking

  • dress in peculiar ways

  • 30 to 50% also meet criteria for major depressive disorder

  • treatment is medical and psychological treatment

    • antipsychotic medication

  • greater risk of developing if they have a relative who has schizophrenia or another psychotic disorder


Antisocial Personality Disorder

  • sometimes described as psychopaths or sociopaths

  • persistently disregard and violate others’ rights

  • most linked to adult criminal behavior

  • often displayed some pattern of misbehavior before the age of 15

  • lying and cheating are usual for them

  • lack remorse for the harm they inflict and take little responsibility for their actions

  • not all are criminals

  • they use charm to manipulate others and they are arrogant and impulsive

  • they have poor or abusive relationships

  • unlikely to maintain employment

  • higher rates of alcoholism and other substance related disorders


Borderline Personality Disorder

  • intense fear of abandonment by friends and family

  • unstable, intense relationships

  • impulsive behaviors that can have dangerous outcomes

  • self-harming behavior

  • paranoid thoughts and severe cases of stress

  • extreme mood swings

  • feelings of emptiness

  • black or white thinking

  • prone to bouts of anger

  • most frequently diagnosed personality disorder in inpatient and outpatient settings

  • most commonly diagnosed in early adulthood

  • Psychotherapy and CBT are effective along with healthy coping skills and having a positive bond with a therapist along with medications like antidepressants, antipsychotics, or mood stabilizing drugs


Histrionic Personality Disorder

  • extremely emotional and continually seek to be the center of attention

  • often the life of the party

  • they love approval and praise

  • often described as vain, self-centered, and demanding

  • some make suicide attempts to manipulate others

  • perceive a relationship as being more intimate than it is because of their need for romantic fantasy

  • their lives are full of drama

  • uncomfortable in situations where they are not the center of attention 

  • Psychodynamic therapy and group therapy

  • drug therapy is less successful


Narcissistic Personality Disorder

  • generally grandiose, need much admiration, and feel no empathy for others

  • need constant attention and admiration from those around them

  • exaggerate their achievements and talents and often appear arrogant

  • look down on people they don't think are important

  • expect special favors

  • become angry when they don't get special attention

  • exaggerated sense of self-importance

  • take advantage of people to get what they want

  • inability to recognize the needs and feelings of others

  • none of the major treatment approaches have had much success

 

Avoidant Personality Disorder

  • very uncomfortable and inhibited in social situations, overwhelmed by feelings of inadequacy, and extremely sensitive to negative evaluation

  • believe that they are inferior and often have few friends

  • want relationships but have difficulty initiating contact

  • fear of humiliation and low self-confidence 

  • Fear close social relationships

  • Involve themselves with others when they feel certain of acceptance

  • afraid to speak up for fear of saying the wrong thing

  • cannot be diagnosed in childhood

  • Treat the disorder like social phobia and anxiety


Dependent Personality Disorder

  • persistent, excessive need to be taken care of

  • clingy and obedient, fearing separation from their loved ones

  • rely on others so much that they cannot make the smallest decision for themselves

  • fear of rejection and someone leaving them

  • avoid disagreements

  • low self-esteem, self-doubt, self-criticism

  • at risk for depression and anxiety and may be especially prone to suicidal thoughts

  • Treatment to help patients accept responsibility for themselves

  • couples and group therapy are helpful and recommended

  • psychodynamic, behavioral, and cognitive therapy all have some effectiveness


Obsessive Compulsive Personality Disorder

  • preoccupied with order, perfection, and control and they lose all flexibility, openness, and efficiency

  • spend a considerable amount of time on detail and organization

  • set unreasonably high standards for themselves and others, they often fear making a mistake, and struggle with making decisions

  • may have trouble expressing affection

  • Competitiveness, time conscientious, impatience, workaholism, rigid, stubborn, perfectionistic

  • do not  generally have obsessions and compulsions