Personality disorders are long-standing and deeply rooted beliefs about one’s self, with characteristics that may include a lack of insight or self-awareness, inflexibility, and limited ability to utilize coping skills to help with positive change.
Those with personality disorders tend to either blame others for their problems or, on the other hand, blame themselves too much and struggle with interpersonal relationships. Because those with personality disorders have a limited capacity for self-reflection and deeply ingrained beliefs — internally and externally – many don’t see a need or a desire for change and therefore are hard to treat.
According to the National Institute for Health, approximately 23 million Americans have a personality disorder. A large majority of those with a personality disorder have a history of trauma, emotional abuse, or neglect and tend to come from families with impaired functioning, as well as poor or harmful communication styles.
Personality Disorders By Clusters
Cluster A is considered the odd and eccentric cluster with characteristics that include social awkwardness or withdrawal or avoidance of social settings. These personality disorders include:
- Paranoid Personality Disorder
- Schizoid Personality Disorder
- Schizotypal Personality Disorder
Cluster B personality disorders include traits that can be characterized as dramatic, overly emotional, or erratic. These include:
- Borderline Personality Disorder
- Narcissistic Personality Disorder
- Histrionic Personality Disorder
- Antisocial Personality Disorder
Cluster C personality disorders include traits of being anxious and fearful and include the following:
- Avoidant Personality Disorder
- Dependent Personality Disorder
- Obsessive-compulsive Personality Disorder (this is not the same as obsessive-compulsive disorder, which is a type of anxiety disorder)
Differences in the Type of Personality Disorders
There are several subtypes of personality disorders. Below is a brief overview of each:
Paranoid Personality Disorder – a person has the belief that others dislike them or are out to get them and utilize defense mechanisms to protect themselves by treating others badly. As a result, they tend to be guarded, as well as critical, suspicious, defensive, and jealous of others, and therefore have trouble maintaining relationships
Schizoid Personality Disorder – a pattern of detachment from social situations and tend to like solitary activities and avoid intimate or social relationships. This person can seem aloof or indifferent and have difficulty showing emotions.
Schizotypal Personality Disorder – features of this disorder include paranoia and superstition and people tend to be guarded or hypersensitive. People with schizotypal disorder tend to be described as odd or eccentric and have very few interpersonal relationships except with close family.
Borderline Personality Disorder – characterized by a pervasive pattern of emotional and relationship instability, with a lack of a positive view of self. People with borderline personality disorder often see the world in extremes — either good or bad — and therefore struggle with intimacy and interpersonal relationships, as those who are close to people with borderline personality struggle with their extreme mood changes and irrationality. This disorder is also characterized by impulsive behaviors and inappropriate anger.
Narcissistic Personality Disorder – includes personality traits of grandiosity, superiority, or egocentricity and tends to lack empathy. While people with narcissistic personality disorder present as confident and superior, underneath they have a pervasive feeling of inferiority and vulnerability that must be defended against. This disorder is characterized by strong reactions to criticism, disregarding others’ feelings, a sense of entitlement, and the belief that they are right.
Histrionic Personality Disorder – people with this disorder seek attention and need constant reassurance and praise. They tend to place high importance on physical attractiveness and are seen as self-centered, as well as dramatic. Additionally, people with histrionic personality disorder tend to be jealous and manipulative and can experience extreme mood changes based on how people react to them.
Antisocial Personality Disorder – this is the only disorder that must be diagnosed after the age of 18. People who struggle with antisocial personality disorder react negatively to social norms or roles, typically through impulsiveness or aggression. People with this disorder are prone to manipulation, lying, and theft, as well as violence toward people and animals, and may feel no remorse or guilt for their actions. They have a strong need for admiration and attention and react negatively when they feel rejected.
Avoidant Personality Disorder – tend to view themselves as inferior or unattractive and lack poor social skills, because of fear of rejection or embarrassment. Unlike schizoid personality disorder, in which they prefer solitary activities and interests, those with avoidant personality disorder have a strong desire for intimacy and companionship but their fear of connection prevents them from establishing these relationships
Dependent Personality Disorder – is characterized by a fear of being alone and a belief they are not capable of making decisions and lack self-confidence for self-sufficiency. People with dependent personality disorder are submissive and rely on others to make decisions for them. They require reassurance and acknowledgment and have a fear of rejection.
Obsessive-Compulsive Personality Disorder – a pervasive pattern of preoccupation with rules, order, and perfection and the need to control others. People with obsessive-compulsive personality disorder have difficulty delegating things because of a need for perfectionism and fear that it won’t be done correctly. These people tend to be self-critical and have difficulty expressing emotions because of fear of vulnerability.
Causes of Personality Disorders
While there is no definitive cause for the development of personality disorders, that are several factors that may play a role. Those include:
Genetics – those with personality disorders may carry a specific genetic makeup, predisposing them to the development of a personality disorder.
Environmental – Research has shown that several environmental factors play a large role in the development of personality disorders, including:
Sexual abuse and childhood trauma – high levels of sexual abuse have been reported in people with personality disorders. Additionally, those with personality disorders have a high reported rate of childhood neglect or physical/emotional and or verbal abuse.
Family chaos and impairment – those whose family life was chaotic, unsupportive, and dysfunctional have a higher rate of personality disorders.
Signs and Symptoms
While each specific personality disorder includes specific criteria for accurate diagnosis, the following generic overview of personality disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM), a reference manual used by healthcare professionals as the authoritative guide to the diagnosis of mental disorders – provides a topline overview of signs and symptoms of personality disorders:
Personality disorders are characterized by an enduring pattern of inner experience and behavior that is markedly different from the expectations of one’s culture. This pattern of thinking or experience is exhibited through:
- Distorted thinking or cognition in the way they perceive themselves, other people, or events.
- Difficulty in emotional functioning
- Struggles with interpersonal relationships
Impulse control issues
This pattern of thinking or behaviors is inflexible and rigid across a broad range of personal and social experiences.
These personality traits cause significant distress or impairment in social, work, and relationship functioning.
The pattern of thinking and behavior is stable and long-lasting and can be traced to early adulthood or adolescents.
Treatment for Personality Disorder
The establishment of a sound therapeutic alliance focused on empathy, compassion, and respect is the strongest predictor of success in treating personality disorders.
At Clarity Clinic our experienced clinicians guide clients toward the proper treatments, including pharmacological and nonpharmacological interventions.
At Clarity Clinic, we have highly trained therapists who specialize in the treatment of personality disorders and provide treatment in a safe and nurturing environment to foster the therapeutic alliance. Our therapists work with a variety of treatment modalities to improve the symptoms of those with personality disorders, including Dialectical Behavior Therapy (DBT), a type of cognitive behavior therapy shown to be effective in the treatment of personality disorders, particularly borderline personality disorder.
Additionally, because friends and family members of those who struggle with personality disorders can also be affected by their extreme mood swings and impaired functioning, Clarity Clinic’s marriage and family therapists can work with couples and families to help support them and work through negative emotions connected to the personality disorder.
While there is no medication designed for personality disorders, a high percentage of those with personality disorders have co-occurring disorders that can be helped through pharmacological treatment.
For more information on personality disorders, below are several additional resources to help learn more:
What are Personality Disorders?