Personality Disorders
Personality disorders are longstanding and enduring traits of an individual which negatively effects different aspects of people’s lives, i.e. their thoughts, emotions, interpersonal functioning or impulse control.
Personality disorder co-exists with 50-60% of other primary disorders, such as the affective and anxiety groups. There are many factors which contribute to the development of personality disorders. Treatment for the personality disorders can take much longer than for other mental disorders.
The personality disorders are divided into three clusters:
Cluster A
This is the eccentric group, consisting of the paranoid, schizoid and schizotypal individual. They are not necessarily related to Schizophrenia.
Paranoid Personality Disorder
They are generally distrustful and hold unjustified beliefs that others are disloyal, harmful and deceptive. They are over sensitive to remarks and may respond in a hostile way and hold grudges. Their world view is that of a longstanding and unwarranted mistrust of others.
Schizoid Personality Disorder
They have little interest in personal relationships and may seem emotionally detached, and usually choose solitary activities. This is no longer seen as a disorder in new diagnostic systems.
Schizotypal Personality Disorder
This group comes across as peculiar; they may experience odd and magical perceptions and thoughts and are rather suspicious. They often feel socially anxious and experience interpersonal deficits.
Cluster B
These people are dramatic, emotional and unpredictable. They include the anti-social, borderline, histrionic and narcissistic personalities.
Anti-social Personality Disorder
This disorder was previously known as psychopathic and sociopathic disorders. They disregard and violate the rights of others from the age of 15 years. This individual does not consider the feelings of others and does not experience remorse. He/she is not concerned about safety and can present with impulsive, irresponsible and aggressive behaviour. They have a history of non-conformance and manipulation of people for personal gain.
Borderline Personality Disorder
Borderline in this case does not mean bordering psychosis, but rather refers to a group that does not belong to other diagnostic categories. Instability is a prominent feature in this condition; unstable feelings, self-image problems and unstable relationships will be present. They fluctuate between rejecting and needing the people in their life. They may test the loyalty of these people in harmful ways. Feelings are most often intense and are accompanied by anger outbursts and self-damaging acts such as self-injury. Impulsivity and paranoia are also part of this profile. Gradual improvements and a reduction of symptoms have been seen due to treatment, which is a long term process. This group responds well to DBT, a hybrid of CBT.
Histrionic Personality Disorder
This person will be dramatic and attention seeking. They are concerned with physical appearance and present with shallow emotion and interpersonal interaction. This is a seperate category from Dissociative, Conversion and Somatization disorders which in history have a 'hysteria' basis.
Narcissistic Personality Disorder
The term is based on Greek mythology. They hold the idea that they are or desire to be more special than they are and therefore expect special treatment (entitlement). They project an air of arrogance and do not notice or respond to the needs of others. They imagine that they possess power that others do not have and that others find them particularly attractive. Often however, this is in compensation of underlying inferiority feelings. Treatment is rarely sought as insight is limited.
Cluster C
This is the anxious and fearful group, consisting of the avoidant, dependent and obsessive compulsive group.
Avoidant Personality Disorder
This is the extremely shy person who feels inadequate and fears rejection. They therefore avoid situations in which risk of feeling embarrassed would be involved. They also tend to avoid relationships although there is a longing to be in one. It is more severe and a more constant state than social anxiety.
Dependent Personality Disorder
They lack self-confidence and would remain submissive and clingy in relationships, even when being mistreated. They find it difficult to live alone or to do things themselves. There is a lack of self-confidence rather than a lack of motivation or energy. They need others to take care of them.
Obsessive-compulsive Personality Disorder
Their behaviour is characterized by rigidity and inflexibility, they need to control others and situations. They are preoccupied by lists, rules, and order and are overconscientious and inflexible. They are often perfectionistic and may work excessively at the expense of personal relationships. (OCD refers to uncontrollable thoughts and compulsive rituals in very specific circumstances.)
Reading4:
BPD demystified (Friedel)
Helping teens who cut (Hollander)
Never good enough: how to use perfectionism to your advantage (Basco et al)
Overcoming BPD: a family guide (Porr)
Stop walking on eggshells (Mason & Kreger)
Mindfulness for borderline personality disorder (Aguiree & Galen)