Personality disorder: What are the different types? (original) (raw)

A personality disorder is a consistent pattern of thoughts and behaviors that differ from societal norms and expectations. These may interfere with a person’s daily life, task aptitude, and relationships.

These experiences can lead to distress and social isolation and increase the risk of depression and other mental health issues.

The DSM-5 groups personality disorders into three broad clusters that it refers to as A, B, and C.

Cluster A personality disorders

Paranoid personality disorder

A person with paranoid personality disorder finds it hard to trust others. They might think that people are lying to or manipulating them, even when there is no evidence of this happening. A person may experience:

• mistrust and suspicion
• hypervigilance
• fear
• anxiety about someone taking advantage of them
• anger over perceived abuse
• concern about hidden meanings or motives

Schizoid personality disorder

A person with schizoid personality disorder often feels uncomfortable when they have to relate to others. Others may see the person as aloof, detached, cold, or as a “loner.” The person may tend to:

• avoid close social contact with others
• have difficulty forming personal relationships
• seek out employment that involves limited personal or social interaction
• react to situations in ways that others consider inappropriate
• appear withdrawn and isolated

Schizotypal personality disorder

People with schizotypal personality disorder may have few close relationships outside their own family. This is because they have difficulty understanding how relationships develop and also how their behavior affects others. They may also find it hard to understand or trust others.

• ideas of reference, for example, when a minor event happens, the person believes it has special significance for them
• odd beliefs or magical thinking that influences their behavior, such as superstitious thinking, beliefs in telepathy, or bizarre fantasies or preoccupations
• unusual perceptual experiences, including bodily illusions
• odd thinking and speech, for example, metaphorical thinking and over-elaboration

Cluster B personality disorders

Antisocial personality disorder

A person with antisocial personality disorder (ASPD) acts without regard to right or wrong or without thinking about the consequences of their actions on others. This can result in:

• irresponsible and delinquent behavior
• novelty-seeking behavior
• violent behavior
• a risk of criminal activity

Borderline personality disorder

A person with borderline personality disorder has trouble controlling their emotions. They may experience:

• mood swings
• shifts in behavior and self-image
• impulsive behavior
• periods of intense anxiety, anger, depression, boredom

Histrionic personality disorder

A person with histrionic personality disorder feels a need for others to notice them and reassure them that they are significant. This can affect the way the person thinks and acts. The person may feel a strong need to be loved, and they may also feel as if they are not strong enough to cope with everyday life alone.

It may lead to behavior that appears:

• self-centered
• provocative and flirtatious
• inappropriate
• excessively emotional or dramatic
• emotionally shallow
• insincere, as likes and dislikes shift to suit those around the person
• risky, as the person constantly seeks novelty and excitement

Narcissistic personality disorder

This disorder features a sense of self-importance and power, but it can also involve feelings of low self-esteem and weakness. A person with this condition may show the following personality traits:

• have an inflated sense of their own importance, attractiveness, success, and power
• crave admiration and attention
• lack regard for others’ feelings
• overstate their talents or achievements
• expect to have the best of everything

Cluster C personality disorders

Anxiety and fear underlie the behaviors that occur with cluster C personality disorders. These disorders probably result from a combination of genetic and environmental factors.

Avoidant personality disorder

A person with avoidant personality disorder avoids social situations and close interpersonal relationships, mainly due to a fear of rejection and feeling that they are not good enough. They may:

• feel inadequate
• have low self-esteem
• find it hard to trust people

Dependent personality disorder

A person with a dependent personality disorder typically lacks confidence in themselves and their abilities. It is difficult for them to undertake projects independently or to make decisions without help. They may find it hard to take responsibility. A person with this condition may have the following characteristics:

• has an excessive need to be taken care of by others
• has a deep fear of separation and abandonment
• goes to great lengths to avoid disagreement and conflict

Obsessive-compulsive personality disorder

A person with OCPD may:

• appear inflexible
• feel an overwhelming need to be in control
• find that concerns about rules and efficiency make it hard to relax
• hoard items

It is not clear what causes personality disorders, and the root may often be complex and can be multifactorial. A person may develop a personality disorder as a result of inherited genetics and environmental influences such as trauma and relationships.

Personality disorders often share features, and it can be hard to distinguish between them.

A licensed mental health professional, such as a psychologist or psychiatrist, will assess a person’s repeating behaviors and medical and personal history in line with DSM-5 criteria to diagnose specific personality disorders.

Following a diagnosis, treatment can help people with different personality disorders. Following diagnosis, a licensed mental health professional may recommend medication, therapy, or a combination of both for treatment.

One common type of therapy is cognitive behavioral therapy (CBT). This can help a person to see their behavior in a new way and to learn alternative ways of reacting to situations. In time, this can make it easier for the person to function in everyday life and to maintain healthy relationships with others.

There are several therapy approaches to treating personality disorders, and the approach will vary based on the diagnosis. Common types of therapy include:

• cognitive behavioral therapy (CBT)
• dialectical behavioral therapy (DBT)
• psychodynamic therapy

Some personality disorders respond better than others to psychotherapy, and long-term treatment is often necessary.

There are many types of personality disorders, each with its own symptoms and diagnostic criteria. The causes and treatments of these conditions will vary between people and can be complex.

Appropriate diagnosis is essential to construct an effective treatment or management plan.