Personality Disorders

Cluster A

The personality disorders in cluster A consist of paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. The behavior of people with a cluster-A personality disorder is described as odd or eccentric. Because the symptoms of cluster-A personality disorders resemble symptoms of schizophrenia, researchers believe these disorders may be genetically related to schizophrenia.

Paranoid personality disorder (PPD) is characterized by a: 

• pervasive distrust of others
• chronic suspicion about others’ motives
•  and paranoid thinking

This often causes others to avoid individuals with PPD, which reinforces their mistrust. The suspicion is chronic and creates a difficulty in establishing and maintaining interpersonal relationships. PPD is more prevalent in males than females.

Schizoid personality disorder (SPD) is characterized by a: 

•  pervasive and long-lasting lack of desire to interact with others. The term “schizoid” was initially chosen to refer to the preliminary or latent symptoms of schizophrenia, specifically an absence of expressivity and a tendency to focus inward.
• A person with this disorder displays little or no interest in social or intimate relationships, prefers being alone or engaging in solitary activities, and has difficulty expressing emotions and appropriate reactions.
• Because of this, people with SPD typically do not establish relationships with others, although they may have relationships that do not require or otherwise involve emotional intimacy. They often feel as though they cannot experience pleasure and may experience a strong sense of observing life rather than participating in it. They are perceived by others as being aloof, indifferent, humorless, and/or apathetic.

Schizotypal personality disorder (STPD) is characterized by

• significant difficulties in forming and maintaining relationships, combined with peculiar patterns of belief, behavior, and interpretation of events.
• People with this disorder exhibit excessive social anxiety and have difficulty understanding interpersonal relationships and responding to social cues. They may be unable to accurately interpret other people's behaviors and motivations, which can lead them to develop a distrust of others.
• They also experience "ideas of reference"—that is, the tendency to interpret unrelated or innocuous events as having strong personal significance—and may express superstitious beliefs or engage in fantasy-based thinking. Although their thought processes might be unusual, their beliefs are not considered to be of delusional proportions.

Cluster B

The personality disorders of cluster B are borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, and histrionic personality disorder. The cluster-B personality disorders are described as dramatic, erratic, and emotional. The behavior of people with such disorders creates significant impairment in establishing and maintaining interpersonal relationships.

Borderline personality disorder (BPD) is the most prevalent personality disorder. It is diagnosed twice as often among women as men and is characterized by: 

• a long-standing and inflexible pattern of emotional instability and unstable personal relationships.
• Individuals with BPD have an intense fear of abandonment and tend to form intense and unstable relationships with others. They tend to fluctuate between having positive and negative feelings about significant people in their lives. This behavior is referred to as "splitting" and may contribute to the emotional instability displayed by people with the disorder.
• People with BPD often engage in self-destructive behavior, such as self-mutilation, suicidal acts, or drug abuse. Those with BPD report chronic feelings of emptiness.

Antisocial personality disorder (ASPD) is exemplified by an enduring pattern of behavior that disregards and violates the rights of others. The term “antisocial” refers to behaviors that are antisociety. ASPD is preceded by conduct disorder in the adolescent stages of development. People with ASPD often appear initially to be: 

•  charming and intelligent, yet they are also manipulative and grandiose.
• They lack a moral code that would disallow unacceptable or hurtful behaviors.
• An individual with ASPD is likely to engage in criminal acts, manipulative behavior, and the exploitation of others.

Freud coined the term “narcissistic personality disorder” (NPD) in reference to the Greek myth of Narcissus, who fell in love with his own reflection in a pool of water. The essential feature of NPD is: 

• an exaggerated sense of self-importance. This disorder is characterized by a need to be the center of attention and a preoccupation with fantasies of one’s success or power.
• A person with NPD has difficulty understanding the feelings of others and constantly demands attention. These grandiose behaviors typically mask feelings of insecurity.

Symptoms of histrionic personality disorder (HPD) include: 

• excessive emotionality and attention-seeking behavior.
• A person with HPD is overly dramatic and emotional and is inappropriately seductive to gain the attention of others. HPD is more commonly diagnosed among females than males.

Cluster C

The disorders in cluster C are avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder. The behavior of people with a cluster C personality disorder is described as anxious or fearful.

People with avoidant personality disorder (AvPD) display a pervasive pattern of social discomfort and a fear of being disliked by others. Because of these feelings, a person with this disorder: 

•  avoids social interactions with others. People with AvPD are extremely shy and have great difficulty establishing interpersonal relationships. They want to be liked by others, but their social discomfort and insecurities prevent them from engaging in interpersonal relationships.

Dependent personality disorder (DPD) is characterized by: 

• a chronic pattern of dependent and needy behavior, with an intense fear of being alone.
• People with this disorder attempt to please other people to avoid potential abandonment. They may say certain things just to be liked by others.
• They have difficulty making their own decisions and are submissive with others. Individuals with DPD have difficulty separating from others.

Obsessive-compulsive personality disorder (OCPD) is characterized by an inflexible and enduring need for control and order. People who suffer from OCPD are so preoccupied with order and organization that they may lose sight of the main objective of an activity. People with this disorder are: 

• usually excessively work-oriented and have little patience for leisure time.
• They are intolerant of indecisiveness or emotionality in others and favor intellect over affect.
• People with this disorder are perceived as difficult to get along with and unwilling to be a team player.

OCPD is different from obsessive-compulsive disorder (OCD), which is categorized as an anxiety disorder and involves obsessive thoughts and compulsive behaviors.