Personality disorders
Personality disorders are characterized by inflexible, maladaptive patterns of thoughts, emotions, behaviors, and interpersonal functioning that are stable over time and across situations, but which deviate from the expectations of the individual’s culture, causing extensive long-term interference in social and occupational functioning.
Diagnosis
In diagnosis personality disorders, clinicians need to be careful about culture because one's culture may be different from the clinician's, and their behavior may be considered normal in their culture. If so, then that behavior is more likely not a predictor of a personality disorder.
DSM diagnostic criteria for personality disorder
- Criterion A: An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture. This pattern is manifested in two or more of the following areas:
- (1) cognition (perception, interpretation)
- (2) affectivity (range, intensity, lability, appropriateness)
- (3) interpersonal functioning
- (4) impulse control
- Criterion B: The enduring pattern is inflexible and pervasive across a broad range of personal and social situations
- Criterion C: The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning
- Criterion D: The pattern is stable and of long duration, and its onset can be traced to adolescence or at least young adulthood
- Criterion E: The pattern is not better accounted for by another mental disorder
- Criterion F: The enduring pattern is not due to direct effects of a substance or a general medical condition
Personality disorder list
Personality disorders are classified under one of three clusters.
Cluster A: Odd, eccentric behavior:
In Cluster A personality disorders, schizophrenia needs to be ruled out first.
All Cluster A personality disorders are more prevalent in males.
People with a Cluster A personality disorder are characterized by isolation; they are disinterested in relationships.
- Paranoid personality disorder
- Prevalence among general population: <1%
- Characteristics: Suspicious, mistrustful, hypersensitive, aloof
- Schizoid personality disorder
- Prevalence among general population: <1%
- Characteristics: Cold, flat, detached, emotionally indifferent, hermit-like
- Schizotypal personality disorder
- Prevalence among general population: 2%
- Characteristics: Like mild schizophrenia; bizarre beliefs, distortions
Cluster B: Dramatic, erratic emotional behavior:
- Antisocial personality disorder (ASPD) (psychopathic)
- Prevalence among general population: 2%
- More common among males
- Characteristics: Law breaking, lack of guilt/remorse, superficially charming
- Borderline personality disorder (BPD)
- Prevalence among general population: 2%
- Prevalence in hospitals: 20%
- More common among females
- Characteristics: Intense fluctuations in mood, self-image, relationships; emptiness; unstable and intense
- Histrionic personality disorder
- Prevalence among general population: 1-3%
- Even gender distribution
- Characteristics: Dramatic, attention-seeking, shallow, egocentric
- Narcissistic personality disorder
- Prevalence among general population: <1%
- More common among males
- Characteristics: Self-important, exploitative, lack empathy
Cluster C: Anxious, fearful behavior
- Avoidant personality disorder
- Prevalence among general population: <1%
- Even gender distribution
- Characteristics: Fear rejection, humiliation; low self-esteem; fantasy; crave emotional closeness but distance themselves
- Dependent personality disorder
- Prevalence among general population: 2-3%
- Unknown gender distribution
- Characteristics: Low self-esteem, high help-seeking/reliance on others, indecisive and needy
- Obsessive-compulsive personality disorder
- Prevalence among general population: 1-2%
- More common among males
- Characteristics: Perfectionistic, rigid, rules & order, “anal”; may be hostile