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Personality Disorders

Personality can be defined as an individual's typical set of attitudes, their styles of behaving, reacting and interacting with others, and their ways of experiencing the world. One's personality develops during childhood and adolescence, and thereafter becomes a relatively stable feature that persists throughout adulthood.

Some people have personality traits that make it difficult for them to relate well to other people, and they may have ways of behaving and experiencing the world that lead them to run into major difficulties and distress continually in their lives. In these cases, we talk of Personality Disorders.

American statistics indicate that up to 15% of all people in the general population can be diagnosed with a Personality Disorder [ref], and that these conditions tend to be associated with very significant levels of disability [ref].

Symptoms and Definition of Personality Disorders

According to the DSM-IV-TR, a Personality Disorder is defined as a problematic or maladaptive pattern of behaving and of experiencing the world that starts in adolescence or early adulthood and thereafter remains stable and enduring. This pattern is inflexible, pervasive across a broad range of personal and social situations, and is out of keeping with the norms and expectations of the individual's culture. It will involve significant problems in at least 2 of the following areas:

  • The individual's ways of perceiving and interpreting events, other people, and oneself
  • The range, intensity, variability and appropriateness of the person's emotional responses
  • The person's ways of handling interpersonal relationships
  • The person's ability to control their impulses

By definition, a Personality Disorder causes significant distress or impairs a person's ability to function in their life roles. Furthermore, the symptoms should not be better explained by a different psychiatric disorder, a general medical condition (eg. head trauma), or the effects of a particular drug or substance.

Types of Personality Disorders

The DSM-IV-TR describes 10 types of Personality Disorders that can be grouped into three clusters, as described below. However, there is an ongoing debate about whether these categories are the best way to describe and classify the Personality Disorders [ref, ref]. It is estimated that a significant proportion of the people who have Personality Disorders according to the definition described above will not fit the descriptions of any of these 10 particular types, and will thus be diagnosed as having a Personality Disorder NOS (Not-Otherwise-Specified) [ref]. Also, many individuals with Personality Disorders can have the features of more than one of these types.

Cluster A Personality Disorders

The Cluster A Personality Disorders are ones where the person's character is considered odd or eccentric.

Paranoid Personality Disorder: characterized by highly exaggerated suspicions and mistrust of others.

Schizoid Personality Disorder: having little interest in social relationships and leading a solitary, reclusive life.

Schizotypal Personality Disorder: characterized by odd and eccentric thoughts and behaviors.

Cluster B Personality Disorders

These Personality Disorders include styles of thinking and behaving that are highly dramatic, erratic, and emotional.

Antisocial Personality Disorder: involves a pattern of disregarding and violating the rights of others, often associated with violence and criminal behavior.

Borderline Personality Disorder: characterized by very unstable moods, relationships, self-image, and self-destructive behaviors.

Histrionic Personality Disorder: involves excessive attention-seeking behavior, inappropriate seductiveness, and melodramatic emotional expressions.

Narcissistic Personality Disorder: a pattern of putting on airs and needing to feel powerful and admired while having little concern or empathy for others.

Cluster C Personality Disorders

The Cluster C Personality Disorders include character types that are highly anxious, fearful and insecure.

Avoidant Personality Disorder: involves a tendency to avoid interpersonal relationships or social situations unless the person is certain of being liked, for these individuals tend to feel inadequate, self-conscious, and fear being judged by others.

Dependent Personality Disorder: is characterized by an excessive need to be taken care of that is associated with submissive and clinging behavior and fears of separation.

Obsessive-Compulsive Personality Disorder: not to be confused with Obsessive-Compulsive Disorder, it is characterized by rigid conformity to rules, to moral codes and to excessive orderliness.

Other possible forms of Personality Disorders

There are some other types of Personality Disorders that have been discussed or proposed and felt to be have clinical relevance, though they are not formally recognized by the DSM-IV-TR:

Passive-Aggressive Personality Disorder: also known as Negativistic Personality Disorder, this is characterized by excessive feelings of bitterness, resentment, and of being misunderstood and unappreciated, which leads to a pattern of scorning authority and of passive resistance or defiance in one's social and interpersonal roles.

Depressive Personality Disorder: describes people who seem always gloomy, unhappy and dejected, very down on themselves and with low self-esteem.

Sadistic Personality Disorder: is a pervasive pattern of cruel, demeaning and aggressive behavior.

Self-Defeating Personality Disorder: also known as Masochistic Personality Disorder or Codependent Personality, this is characterized by a tendency to undermine one's own pleasures and goals and to feel comfortable with oneself only when one is sacrificing important things or taking on the role of a martyr.