Personality Disorders

What are personality disorders?

For persons without a personality disorder, personality traits are patterns of thinking, reacting, and behaving that remain relatively consistent and stable over time. Persons with a personality disorder display more rigid and maladaptive thinking and reacting behaviors that often disrupt their personal, professional, and social lives.

What are the most common types of personality disorders?

Generally, personality disorders are divided into three subtypes (or clusters), and include the following:

Examples of odd/eccentric (Cluster A) personality disorders

• Paranoid personality disorder. Persons with this disorder are often cold, distant, and unable to form close, interpersonal relationships. Often overly, yet unjustifiably, suspicious of their surroundings, persons with paranoid personality disorder generally cannot see their role in conflict situations and often project their feelings of paranoia as anger onto others.

• Schizoid personality disorder. Persons with this disorder are often cold, distant, introverted, and have an intense fear of intimacy and closeness. Persons with schizoid personality disorder are often so absorbed in their own thinking and daydreaming that they exclude themselves from attachment to persons and reality.

• Schizotypal personality disorder. Similar to schizoid personality disorder, persons with this disorder are often cold, distant, introverted, and have an intense fear of intimacy and closeness. Yet, with schizotypal personality disorder, persons also exhibit disordered thinking, perception, and ineffective communication skills. Many symptoms of schizotypal personality disorder resemble schizophrenia, but are less intense and intrusive.

Examples of dramatic/erratic (Cluster B) personality disorders

• Borderline personality disorder. Persons with this disorder present instability in their perceptions of themselves, and have difficulty maintaining stable relationships. Moods may also be inconsistent, but never neutral - their sense of reality is always seen in "black and white." Persons with borderline personality disorder often feel as though they lacked a certain level of nurturing while growing up and, as a result, incessantly seek a higher level of caretaking from others as adults. This may be achieved through manipulation of others, leaving them often feeling empty, angry, and abandoned, which may lead to desperate and impulsive behavior.

• Antisocial personality disorder. Persons with this disorder characteristically disregard the feelings, property, authority, and respect of others, for their own personal gain. This may include violent or aggressive acts involving or targeting other individuals, without a sense of remorse or guilt for any of their destructive actions.

• Narcissistic personality disorder. Persons with this disorder present severely overly-inflated feelings of self-worth, grandiosity, and superiority over others. Persons with narcissistic personality disorder often exploit others who fail to admire them, and are overly sensitive to criticism, judgment, and defeat.

• Histrionic personality disorder. Persons with this disorder are overly conscious of their appearance, are constantly seeking attention, and often behave dramatically in situations that do not warrant this type of reaction. The emotional expressions of persons with histrionic personality disorder are often judged as superficial and exaggerated.

Examples of anxious/inhibited (Cluster C) personality disorders

• Dependent personality disorder. Persons with this disorder rely heavily on others for validation and fulfillment of basic needs. Often unable to properly care for themselves, persons with dependent personality disorder lack self confidence and security, and are deficient in making decisions.

• Avoidant personality disorder. Persons with this disorder are hypersensitive to rejection and thus, avoid situations with any potential for conflict. This reaction is fear-driven, however, persons with avoidant personality disorder become disturbed by their own social isolation, withdrawal, and inability to form close, interpersonal relationships.

• Obsessive-compulsive personality disorder. Persons with this disorder are inflexible to change and bothered by a disrupted routine due to their obsession for order, thus, they experience anxiety and have trouble completing tasks and making decisions. Persons with obsessive-compulsive personality disorder often become uncomfortable in situations that are beyond their control and have difficulty maintaining positive, healthy interpersonal relationships as a result.

Treatment for personality disorders

Specific treatment for each personality disorder will be determined by your physician based on:

• Your age, overall health, and medical history

• Type and severity of symptoms

• Extent of the disease

• Your tolerance for specific medications, procedures, or therapies

• Expectations for the course of the disease

• Your opinion or preference

Personality disorders are often difficult to treat and may require long-term attention to change the inappropriate behavior and thought patterns. Treatment may include:

• Medication (although medication may be abused and has limited effectiveness)

• Psychological treatment (including family involvement)