Personality disorder (A guide)

In this brief guide, the personality disorder will be discussed in detail along with its symptoms, diagnostic criteria, types, causes and treatment options for personality disorders.

A person with a personality disorder thinks, feels, and behaves differently.

There are several different types of personality disorders clustered into different categories on the basis of their characteristics.

A personality disorder is a persistent pattern of behaving and feeling, which is altered.

Initially in DSM IV, personality disorder used to be diagnosed on Axis-II, but in DSM 5 (2013), the axial system has been changed and now single diagnosis with co-occurring symptoms use to be given.

Symptoms of Personality Disorder

There are a number of different personality disorders, such as the cluster A is categorized as suspicious, delusional, not interested in social interactions or not having social skills to maintain the social relationships, as well as inability to consider the consequences of their actions and lead towards illegal, and risky behaviour.

Similarly, Cluster B is categorized on the basis of dramatic symptoms.

The person experiencing cluster B personality condition will report feelings of emptiness, self-harm incidents or multiple failed suicide attempts, overly impressionistic, having a fragile self-esteem, and excessively praising oneself in situations.

Whereas, Cluster C, is categorized on the basis of anxious symptoms.

They are sometimes overly clingy to another person, are overly concerned with order, or tries to avoid social situations because of fear of criticism.

Diagnostic Criteria of Personality Disorder

The Diagnostic and Statistical Manual of Mental Disorder 5 (2013), has given the criteria for the personality disorder diagnosis, the overview of that criteria are given below:

A.     It is the enduring pattern and persistent pattern of behaviour which is not according to the particular culture the person is living.

This disturbing pattern is manifested in either, cognition, affectivity, interpersonal relationships or spontaneity.

B.     This pattern of behaviour is constant over time and prevail in a number of personal or social situations.

C.      The condition is affecting other areas of a person’s functioning such as work, academics, personal life etc.

D.     The pattern of behaviour became more consistent and spans over the course of years, as well as it appeared in teenage or young adulthood.

E.      The condition is not the symptom of any other mental disorder

F.      The condition and symptoms are not because of the impact of drug or substance and medical condition.

Types of Personality Disorder

The personality disorders are clustered into three:

Cluster A: Odd, Eccentric

In this cluster there are three disorders named:

1.      Paranoid Personality Disorder

2.      Schizoid Personality Disorder

3.      Schizotypal Personality Disorder

Cluster B: Dramatic, or Unpredictable

1.      Antisocial Personality Disorder

2.      Borderline Personality Disorder

3.      Histrionic Personality Disorder

4.      Narcissistic Personality Disorder

Cluster C: Anxious, or Fearful

1.      Avoidant Personality Disorder

2.      Dependent Personality Disorder

3.      Obsessive Personality Disorder

Now we will go into detail of all the nine disorders in each cluster:

Cluster A

1.     Paranoid Personality Disorder:

In the paranoid personality disorder, it will be difficult for the person to put trust into others, they are always suspicious, and thinks that others are taking advantage of them.

They keep an eye on the actions of others and keenly monitor the signs of mistrust and cheating.

They are quick in reading the danger signs and reacts immediately which are hard for others to notice.

2.     Schizoid Personality Disorder

In the schizoid personality disorder, person losses interest in forming and maintaining relationships with other people, including their own family.

They consider relationships as intervening and prefer freedom.

They want to be immersed in their own thoughts and unable to enjoy life.

They are not interested in romantic relationships and feels emotionally aloof of others feelings and emotions.

3.     Schizotypal Personality Disorder

In schizotypal personality disorder, the person experiencing the symptoms will go through a hard time in developing relationships, they are unable to form close relationships.

It is difficult for them to express themselves.

They behave in an odd manner which makes others fearful of themselves, they also feel anxiousness about others who are not able to understand them.

They consider themselves to have extraordinary sense and claim to understand what anyone else is thinking.

Cluster B

1.     Antisocial Personality Disorder

A person with an antisocial personality disorder will be reckless, dangerous and unable to think about the consequences of their actions.

They are dangerous, aggressive and gets easily bored. They have no feeling of guilt or remorse.

They consider whatever they value is an opportunity and they have to avail it, no matter if they are hurting the feelings of others.

For the diagnosis of antisocial disorder, the age must be 18 years or older, as before the age of 18 years these symptoms are diagnosed as conduct disorder if happening before 15 years of age.

2.     Borderline Personality Disorder

They are dramatic and think as other people are leaving them, they have an extreme feeling of emptiness, having intense emotions that last for a few days and then vanish.

They have weak self-esteem, as well as it is difficult for them to maintain stable relationships, they are driven by impulses and exercise self-harm or attempt suicide mostly for the purpose to seek attention.

They feel lonely at times and experience extreme anger.

Sometimes they also report experiencing the psychotic features.

3.     Histrionic Personality Disorder

People with histrionic personality disorder are overly impressionistic, attention-seeking by their exaggerated dramatized body language, accent, or appearance.

They are selfish and consider themselves before anyone else.

They require a lot of admiration and approval from others.

They try to keep everyone entertained and try to remain in the centre.

4.     Narcissistic Personality Disorder

They consider themselves to be superior to others.

They consider as they are special and more deserving than the others.

They have a fragile self-esteem, as well as depend on others to acknowledge their importance and value.

They are selfish and think about themselves, tries to take benefit from others, and feels sad about the achievements of others.

Cluster C

1.     Avoidant Personality Disorder

In this condition, the person tries to escape social situations and avoid activities where others are involved.

They avoid work, social activities, ad sensitive to criticism. They remain in the fear of being pointed out and shamed.

They feel embarrassed about the slightest events, as well as they try to avoid making relationships and friendships, they feel lonely and dissatisfied with life.

2.     Dependent Personality Disorder

In the dependent personality disorder, a person is overly clingy to any attachment figure.

They feel compelled and requires someone to be attached to.

They feel as weak and unable to do anything if deserted.

They have low self-esteem, as well as believe that others are good at things then they are, they are submissive and passive.

3.     Obsessive-Compulsive Personality Disorder

They set unrealistic goals, demand order and control.

They consider their plan of action as perfect and things are required to follow that order, they are reluctant to spend money, and are worried for others if they will make the mistakes.

Obsessive-compulsive disorder is different from an obsessive-compulsive personality disorder, which can be found here.

Causes of Personality Disorder

There are a number of causes of personality disorder, but there is no one clear cause of personality disorder.

The factors contribute to personality disorders are biological, psychological, physical and socio-cultural.

The biological causes include the genes, heredity, family history, functioning of neurotransmitters and chemical substances.

The psychological causes of personality disorders are childhood trauma, stress, adverse family environment, low self-esteem, child neglect and parental rejection.

Physical causes include brain dysfunction and psychiatric pathology.

The sociocultural causes include divorce, being deserted, deprivation of relationships, assault, abuse death and separation.

Treatment of Personality Disorder

There are different forms of treatment for personality disorders.

1.      Psychotherapy

2.      Medication

Psychotherapy:

It is one form of treatment, in this a mental health professional especially a psychologist deal with the client experiencing the personality disorder symptoms.

This is also called ‘talk-therapy’, this usually takes up to three months and sometimes more.

There are different therapies which can be used for personality disorder.

Dialectic Behaviour Therapy

This is the evidence-based therapy for personality disorders, especially for the treatment of the borderline disorder.

In this treatment approach, the skills to manage one’s emotions, as well as mindfulness is discussed in detail.

Arts Therapy

This type of therapy is useful to uncover the unconscious pattern and understand the person’s emotions, and feelings in a non-threatening environment.

It includes the use of dance, art, drama and music.

Cognitive Behaviour Therapy

In CBT, the clinician looks for the discrepancy in the thoughts, emotions and behaviour of the person along with the automatic thought patterns.

Schema Therapy

It is a long term talking therapy, which is based on the model of CBT, and goes further deep into the core beliefs and schemas of the person, which influence their thoughts, behaviours and actions.

Medication

There are no specific drugs made for personality disorders, but the combination of drugs for the symptoms of depression, anxiety, and psychosis are used for particular symptoms.

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Frequently Asked Questions for Personality Disorders

What are the 3 types of personality disorders?

The personality disorders are clustered into three different clusters.

Cluster A, B, and C, on the basis of the main characteristic symptoms.

One group is odd or eccentric, second is dramatic, and third is an anxious and fearful cluster.

What are the signs of a personality disorder?

The signs of personality disorders are relationship disturbances, a weak self-image, incidents of self-harm, mood swings, impulsive, risky behaviour and uncontrollable anger.

What causes a personality disorder?

There are a number of causes of personality disorder, they can be biological, physical, psychological and sociocultural.

Is a personality disorder a mental illness?

Yes, it is a mental illness, and its criteria are given in the Diagnostic and Statistical Manual of Mental Disorder 5, published by the American Psychiatric Association.

What is the most common personality disorder?

The most common personality disorder is an obsessive-compulsive personality disorder, and the second common is a narcissistic personality disorder.

What triggers a person with a borderline personality disorder?

The most common borderline trigger is interpersonal relationships, interpersonal distress.

Please make sure to let us know what you think about the article as well as your comments and suggestions regarding the condition, below in the comments section.

What we recommend for personality disorders

Professional counselling

  • If you are suffering from a personality disorder then ongoing professional counselling may be your ideal first point of call. Counselling will utilize theories such as Cognitive behavioural therapy which will help you live a more fulfilling life.

References

Mind.org.uk

NHS

RC PSYCH

 Recommended Readings

The Borderline Personality Disorder Survival Guide: Everything You Need to Know About Living with BPD

Get Me Out of Here: My Recovery from Borderline Personality Disorder

Loving Someone with Borderline Personality Disorder: How to Keep Out-of-Control Emotions from Destroying Your Relationship

Personality Disorders & Mental Illnesses: The Truth About Psychopaths, Sociopaths, and Narcissists (Personality Disorders, Mental Illnesses, Psychopaths, Sociopaths, Narcissists)

Mental Health: Personalities: Personality Disorders, Mental Disorders & Psychotic Disorders (Bipolar, Mood Disorders, Mental Illness, Mental Disorders, Narcissist, Histrionic, Borderline Personality)

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