“She has a great personality”, “He’s got such a sunny disposition all the time”, “Her temperament is very abrasive.” These are all phrases we hear when people talk about someone’s personality. But what is personality and what are personality disorders (PDs)?
Personality is defined as traits that emerge from environmental and biological factors that result in a set of behaviors, cognitions, and emotional patterns. Someone with a personality disorder exhibits consistent and ongoing behaviors and patterns that differ from what society considers to be normal.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), there are 10 different types of personality disorders which are grouped into three different clusters; Cluster A, Cluster B, and Cluster C.
TYPES OF PERSONALITY DISORDERS
The concept of personality disorders dates back to around the early 1800s and continues to evolve. In 1923, psychiatrist Kurt Schneider’s landmark volume, “Psychopathic Personalities” formed the basic foundation for today’s definitions of personality disorders for the DSM-5.
According to the National Institute of Mental Health (NIMH), 9.1% of the United States’ adult population has a personality disorder. In addition, research shows that about half of all psychiatric patients have some type of personality disorder.
The DSM-5 says that a personality disorder can be diagnosed when there are significant impairments in self and interpersonal functioning coupled with one or more pathological personality traits. What’s more, these must be a) stable and consistent over time, b) not considered the ‘norm’ for developmental stages or socio-cultural environments, and c) not from a substance or medical problem.
As mentioned, the DSM-5 names 10 types of personality disorders grouped into three clusters. These clusters are:
Cluster A (Odd, Bizarre, Eccentric)
- Paranoid personality disorder
- Schizoid personality disorder
- Schizotypal personality disorder
Cluster B (Dramatic, Erratic)
- Antisocial personality disorder
- Borderline personality disorder
- Histrionic personality disorder
- Narcissist personality disorder
Cluster C (Anxious, Fearful)
- Avoidant personality disorder
- Dependent personality disorder
- Obsessive-compulsive personality disorder
It’s important to note that while there are these three clusters and 10 types, there is usually a blur of characteristics between two or more types within the same cluster. For example, a paranoid personality often blurs with either a schizoid or schizotypal personality.
Let’s briefly explores a few traits of each of these 10 personality disorders:
CLUSTER A (ODD, BIZARRE, ECCENTRIC)
This personality disorder is characterized by a pervasive distrust of others including family, friends, and partners. Individuals with paranoid personality disorder believe that others, even loved ones, are trying to harm them in some way.
People with schizoid personality disorder are distant, aloof, and withdrawn into themselves. He or she is not usually interested much in or has too much trouble maintaining social, intimate, or sexual relationships.
This type of personality disorder, previously called ‘latent schizophrenia’, is characterized by odd and unusual behavior, speech, and appearance. Schizotypal personality disorder most often progresses to schizophrenia.
CLUSTER B (ERRATIC, DRAMATIC)
This personality disorder that is more common in men than women is characterized by not caring about others or being callous towards their feelings. Individuals with an antisocial personality disorder often disregard societal rules and laws. This is also referred to as being a ‘sociopath’ or ‘psychopath.’ An antisocial personality disorder affects 7.4 million Americans or more than 3.5% of the population.
With this type of personality disorder, individuals tend to lack a sense of self which makes them feel empty and fearful of abandonment. More women than men are diagnosed with borderline personality disorder and are marked by intense and unstable relationships, emotional instability, impulsivity, and angry outbursts often accompanied by violence. It’s estimated that 1.4% of the adult U.S. population experiences borderline personality disorder.
A histrionic personality disorder is based on a poor sense of self or lack of self-esteem. This makes the individual seek this sense of worth from others and often are superficial, and behave in overly charming or seductive ways.
The narcissist personality disorder is characterized by the individual feel an enormous sense of self-importance, entitlement, and the need to be revered by others. Individuals with narcissistic personality disorder lack empathy and regularly lie and use people to achieve their goals. Approximately 0.5% of the United States population, or one in 200 people, has a narcissistic personality disorder.
CLUSTER C (ANXIOUS, FEARFUL)
Those with this personality disorder feel like they aren’t able to measure up with others. This leaves them in almost constant fear of embarrassment, rejection, or criticism. An avoidant personality disorder is commonly connected with anxiety disorders.
Individuals with dependent personality disorder fear abandonment and is dependent on others for their care. They struggle to make decisions—both big and small ones—and are often naive and childlike.
Also referred to as ananakastic personality disorder, obsessive-compulsive personality disorder manifests as strict adherence to rules, order, schedules, and lists. This type of individual is very doubting and cautious.
As mentioned, often there are shared traits from personality disorders within the same cluster. In addition, many times personality disorders are also found with other mental health issues. This comorbidity often is found with anxiety disorders, depressive disorders, mood disorders, and substance abuse.
It’s also important to note that many times the presence of a personality disorder impacts how another mental health issue may present. This is another reason why the proper diagnosis of a personality disorder is critical particularly when there are other mental health issues occurring.
WHAT CAUSES PERSONALITY DISORDERS?
Personality disorders are the most common type of severe mental health disorder. As mentioned, they are often accompanied by other mental health issues. Data shows that about 10 to 13% of the world’s population has a personality disorder of some kind.
PD are some of the least understood, researched, and diagnosed mental health disorders. Therefore the cause or causes are not clear cut to define. However, most professionals and researchers believe that a combination of heredity and environment cause personality disorders to manifest.
To date, no research has shown that a PD is something a person is born with, rather, a person can be born with a predisposition to developing a PD. This development may occur when there is interference with the development of a healthy personality.
For example, a personality disorder may develop as a way of coping with a difficult situation such as neglect or abuse in childhood. This then may turn, over time, into a personality disorder. Personality disorders do not occur suddenly but develop over time. Almost all PD diagnoses occur in individuals over the age of 18 years old.
Symptoms of a Personality Disorder
As mentioned, personality disorders are believed to be underdiagnosed. Symptoms of a PD vary from one type of PD to another. And there are personality traits that can sometimes be found in a PD. Once a medical cause is ruled out, a mental health professional will look at the behaviors of the individual. They will specifically look at how they relate to the following areas of that person’s life:
- Work or school
- Sense of self or self-identity
- Interpersonal relationships
- Impulse control
- Perception of reality
If the initial evaluation is performed by a medical doctor such as a primary care doctor, it should be followed by an assessment by a psychologist or psychiatrist for an official diagnosis.
Are Personality Disorders Treatable?
Unfortunately, many PD go undiagnosed and untreated. Often, people with personality disorders don’t seek treatment on their own but are ‘forced’ by getting themselves into some type of trouble, such as with the law.
While there is no magic ‘cure’ for a PD, there are ways to help manage it. The one approach found to be most beneficial is psychotherapy. Psychotherapies such as dialectical behavior therapy (DBT) and cognitive-behavioral therapy (CBT) have been found to be helpful in evaluating faulty thinking and behavioral patterns and replacing them with healthier ones.
For many with personality disorders, they are pervasive and it’s hard to break the associated behaviors. It has also been noted that many with PD do not follow the recommended treatment course which makes it hard to assess how well treatments work.
In some cases, medications may be recommended to help deal with disabling symptoms such as anxiety, depression, or psychotic episodes. However, these are in the most severe cases.
As with any mental health disorder, a proper assessment is the first step in getting relief. An assessment that looks at any other mental health issues that may accompany the personality disorder is essential for effective treatment. Whether it’s substance abuse, depression, or a mood disorder, treating all conditions at once is imperative to success and recovery.
If you or someone you love is living with a mental health issue reach out for help today. Futures Recovery Healthcare treats both substance abuse and some mental health conditions such as depression, anxiety, and mood disorders. Reach out today for more information on any of our programs. Call us at 866-804-2098.