Mental Health

Personality Disorders

9 Mins read

When someone talks about your personality, they are talking about how you think, act and behave. Genetic and environmental factors can affect your personality more than some people may believe.

Patterns of feeling, thinking, interacting and behaving that deviates from cultural expectations can cause significant distress and problems functioning in society characterize a personality disorder.

The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, otherwise known as the DSM-5, categorizes the ten personality disorders into three different clusters based on their characteristics. 

Cluster A Personality Disorders

Cluster A personality disorders include schizotypal personality disorder, schizoid personality disorder, and paranoid personality disorder. These Cluster A personality disorders all share similar symptoms such as odd and eccentric behaviour. However, these personality disorders are not in this cluster just due to their similar symptoms but also because they also have similar genetic and environmental risk factors.

Schizoid Personality Disorder

People with schizoid personality disorder have a lifelong pattern of social isolation and indifference toward others. Those with a schizoid personality disorder do not have cognitive or perceptual disturbances like people with schizophrenia.

There is no known cause of schizoid personality disorder. Still, many believe that one thing that significantly contributes to it is heritability. Which is the amount of observable variation in a population attributable to individual genetic differences. Schizoid personality disorder usually develops in late childhood or adolescence.

To get a diagnosis for schizoid personality disorder, you need more than four of the following symptoms:

  • No enjoyment of or desire for close relationships
  • Strongly prefers solitary activities.
  • Small to no interest in sexual activity with others
  • Enjoy a few to no activities.
  • Having very few or no close relationships, except for possibly first-degree relatives like parents or sibling
  • Apparent apathy to praise or criticism
  • Emotional coldness or detachment

Schizotypal Personality Disorder

People with schizotypal personality disorder often prefer to avoid others and find being in relationships uncomfortable. They, in some cases, have odd behaviour, mannerisms, or an odd or limited range of emotions. 

A schizotypal personality disorder is related to schizoid personality disorder and schizophrenia. Some people believe that people with these disorders share similar genetic vulnerabilities. 

Schizotypal personality disorder is in the middle of the spectrum of these related disorders, while schizophrenia is on the more severe end and schizoid personality disorder is on the milder end.

Still, it is unclear why some people develop more severe forms of the disorder.

To diagnose someone with schizotypal personality disorder, they need to have more than five of the following symptoms:

  • Ideas of reference. This is when someone believes that their thoughts, actions, or presence caused something to occur.
  • Uncommon beliefs or magical thinking such as believing in clairvoyance, telepathy, or a sixth sense
  •  perceptual experiences like hearing a voice whispering their name
  • Odd thoughts or speech, such as speech that is excessively elaborate, vague, metaphorical or stereotyped
  • Paranoid thoughts
  • Incongruous effect (e.g. the patient will have happy thoughts and look happy when talking about a sad event) or limited effect.
  •  Eccentric or peculiar behaviour and appearance
  • Lack of close relationships, except for first-degree relatives
  • Social anxiety that does not improve even as they get more familiar. Not fueled by negative judgments about themselves but by paranoid fears.

Paranoid Personality Disorder

Characteristics of paranoid personality disorder include being paranoid, suspicious of others without good reason to be suspicious, and relentlessly mistrusting.

While there is no known cause of paranoid personality disorder some believe that biological and psychological factors can affect the chance of developing it. Some people also think that paranoid personality disorder has a genetic link schizophrenia and delusional disorder. This belief is because people with Paranoid Personality Disorder commonly have close relatives with those disorders. Having childhood trauma is another factor that people think contributes to someone having a paranoid personality disorder

To diagnose a person with Paranoid Personality Disorder, they have to have more than four of the following symptoms:

  • Unwarranted suspicion that others are exploiting, deceiving or injuring them
  • Obsession with unjustified doubts about the reliability of others
  • Hesitancy to confide in others for fear that they will use the information against them
  • Being overly sensitive or Misinterpreting benign remarks or events as having hidden some hostile meaning
  • Holding grudges against others for injuries, insults or slights
  • Often assuming that their character or reputation is under attack, and quick to react angrily or counterattack
  • Recurrent, unwarranted suspicions of spousal infidelity

Cluster B Personality Disorders

Cluster B personality disorders are characterized by emotional regulation and impulse control problems. People with personality disorders in Cluster B can be described as emotional, dramatic and erratic. They are also often involved in interpersonal conflicts.

Antisocial Personality Disorder

Antisocial personality disorder can make people with it have a long-term pattern of exploiting, manipulating or violating the rights of others without feeling any guilt. 

Behaviours characteristic of antisocial personality disorder can be due to a conduct disorder or a phase in adolescence. So, typically you can only get a diagnosis if reach the age of 18 and still behave the same way and show symptoms that you have an antisocial personality disorder.

 Some believe that factors such as genetics, environment, childhood trauma, etc., can affect one’s chance of developing an antisocial personality disorder. 

There are some early warning signs such as antisocial personality disorder, setting fires and committing animal cruelty during childhood.

 People can only get a diagnosis for an antisocial personality disorder if they have three or more of the symptoms below:

  • Being unable or failing to conform to social norms such as lawful behaviour.
  • Failing to plan ahead or acting impulsively 
  • Being Irritable and aggressive
  • Recklessly disregarding the safety of self or others.
  • Being deceitful (repeatedly lying, using aliases, or conning others for personal gain or pleasure)
  • Lack of guilt after having hurt, mistreated or stolen from another person.
  •  Acting irresponsibly consistently

Borderline Personality Disorder

Borderline personality disorder can be characterized by an ongoing pattern of instability in self-image, varying moods, impulsive behaviours, and issues with relationships. Some believe that it does not have a single cause, but multiple risk factors that can increase the chances someone will develop it.

These risk factors include childhood trauma such as abuse or abandonment and genetics. People with close family members with borderline personality disorder are more likely to develop it.

To diagnose someone with Borderline personality disorder, they need to have five or more of the following symptoms or signs:

  • Desperately trying to avoid abandonment (real or imagined) through their efforts.
  • Having a pattern of unstable and intense relationships that alternate between idealizing and devaluing the other person
  • Noticeably unstable sense of self or self-image
  • Potentially self-damaging Impulsive actions in at least two areas (e.g., unsafe sex, binge-eating, reckless driving)
  • Recurrent suicidal behaviour, gestures, threats, or self-mutilating behaviour
  • Rapid mood changes that will usually last a few hours, but could rarely last more than a few days.
  • Persistently feel empty
  • Problems controlling anger
  • Severe dissociative symptoms triggered by stress or temporary paranoid thoughts

Histrionic Personality Disorder

People with a histrionic personality disorder often act theatrically and emotionally, which draws the attention of others to themselves. Unlike many other personality disorders, people with this disorder may be high functioning and successful at work and in relationships. 

The causes of histrionic personality disorder are unknown. Still, some believe that genetics and events in early childhood may be responsible. While it is diagnosed more often in women than in men, some doctors believe that is because there are men that may have the disorder but do not get diagnosed. Histrionic personality disorder typically begins in the late teens or early 20s.

To diagnose a person with histrionic personality disorder, they must have five or more of the following symptoms:

  • Feeling uncomfortable in situations where they are not the centre of attention.
  • People often view them as inappropriate, sexually seductive or provocative when interacting with others.
  • Has shallow expression of emotions that can quickly shift
  • Uses their physical appearance to draw attention to self, consistently
  • Has a manner of speech that is lacking in detail
  • Exaggerated expressions
  • They are easy to sway or influence
  • Considers relationships that are not very intimate as more intimate than they are

Narcissistic Personality Disorder

People with a narcissistic personality disorder often have an inflated sense of self-importance, an extreme obsession with themselves, and a lack of empathy for others. They also often have physical and mental health comorbidities, such as substance abuse and mood and anxiety disorders.

Like many personality disorders, the exact cause of narcissistic personality disorder is unknown. But some believe that early life events and experiences play a role in developing this disorder.

A person with a narcissistic personality disorder can only get a diagnosis if the person shows five or more of the following symptoms:

  • Has a grandiose sense of self-importance
  • Obsessed with their fantasies of success, influence, power, intelligence, beauty, or ideal love
  • Has a sense of entitlement 
  • Believes that they are uniquely special and should only associate with special or high-status people ‘like’ them. 
  • Has a need for excessive admiration
  • Exploits others with no remorse to achieve their own goals
  • Lacks empathy and is unwilling to identify with or recognize the feelings and needs of other people
  • Envies others and believes that others will also envy them
  • Displays an arrogant and haughty attitude

Cluster C Personality Disorders

Cluster C personality disorders are characterized by intense fear and anxiety. This extreme fear and anxiety are so severe they can affect your ability to function in everyday life. Cluster C personality disorders are the most common of the three clusters.

Dependent Personality Disorder

People with dependent personality disorder feel helpless, submissive, and incapable of taking care of themselves. Thus, they usually depend on others too much for both their physical and emotional needs. They can also have trouble making simple decisions for themselves, which can lead to them not being able to function properly in society.

While the causes of dependent personality disorder are unknown. It is known that the disorder typically begins in childhood. Some Experts have also found that dependent personality disorder is more likely in people if they have:

  • Been in an abusive relationship
  • Childhood trauma
  • Family history of having the disorder
  • Certain religious, cultural or family behaviours or practices that emphasize reliance on authority.

A person can only be diagnosed with a dependent personality disorder if they have five or more of the following symptoms:

  • Difficulty making daily decisions alone
  • They require others to be responsible for important aspects of their life.
  • Obsessed with fears of being left to take care of themselves
  • Difficulty expressing disagreement for fear they might lose support or approval
  • When a close relationship ends, they feel a need to establish a new one to gain care and support quickly,
  • They will go to great efforts to obtain support from others.
  • Difficulty starting projects by themselves due to being unconfident in their abilities and judgment 
  • When they are alone, they feel helpless or uncomfortable due to fearing they cannot take care of themselves.

Obsessive-Compulsive Personality Disorder

Obsessive-compulsive personality disorder (OCPD) is characterized by the obsession those who have it have with orderliness, control, rules and perfectionism. People with this disorder have a very rigid mindset and are unable to compromise or change their views. This rigid mindset could jeopardize their social relationships as a result. People with OCPD commonly have very straightforward black-or-white right-or-wrong thinking with no acceptance of grey areas, anything left to chance or maybes. 

Obsessive-compulsive personality disorder has been observed to appear often in families, so it is assumed that genetics could be a possible cause for OCPD. Some people also believe that a person’s childhood experiences and environment could also play a role in this disorder. For example, if a person was raised in a strict family with harsh discipline, it could increase the chances of them developing OCPD.

To diagnose a person with Obsessive-compulsive personality disorder, they must have four or more of the following symptoms:

  • Obsession with details, rules, schedules, organization, and lists
  • Being too conscientious, meticulous, and inflexible regarding ethical and moral issues and values
  • Trying to do something perfectly to the point that it starts to interfere with completing the task.
  • Being so engrossed and devoted to work and productivity, not due to financial necessity, they neglect leisure and social activities.
  • Being stubborn and rigid in thinking
  • Hoarding objects, even if they have no sentimental value or a worthless
  • Being reluctant to work or delegate with others unless they agree to work exactly as they want.
  • Being frugal in spending money because they see money as something to be saved for future disasters

Avoidant Personality Disorder

Those with avoidant personality disorder are extremely limited socially because of an intense fear of rejection and feelings of inadequacy. You can notice symptoms of avoidant personality disorder in childhood, and it may cause discomfort in adolescence, but It is not typically diagnosed in people younger than 18 years old.

The cause of avoidant personality disorder is unknown but some people believe it to be a combination of factors related to genetics and the environment you grew up in. Some think that this disorder may be passed down through genes, but it has not been proven. Those with an avoidant personality disorder often carry on the shyness usual in young children through adolescence to adulthood. 

To get a diagnosis for an avoidant personality disorder a person must have four or more of the following symptoms:

  • Avoids job and job-related activities that involve contact with other people due to the fear of criticism or rejection.
  • Does not want to involve themselves with people unless they are confident that the people will like them
  • Views themselves as socially unappealing, inept or inferior to others
  • They hesitate and avoid taking risks or participating in new activities due to their fear of embarrassment
  • Restrains themselves from getting ‘too close’ in close relationships because they fear humiliation
  • Obsessed with criticism or rejection in social situations.
  • Restrains themselves in new social situations because of their feeling of inadequate

Other DSM-5 Personality Disorders

There are three personality patterns that do not match or meet the DSM-5 diagnostic criteria for the ten recognized personality disorders. The first of these personality patterns is when your personality changes due to another medical condition. The next is where the personality pattern matches personality disorders from multiple clusters simultaneously. Some call this Mixed personality disorder. But in DSM-5 they refer to it as ‘Other specified personality disorder’. The last is called Unspecified personality disorder or personality disorder not otherwise specified (NOS). This diagnosis happens when there is not enough information to diagnose it, or the patient does not match any of the criteria in DSM-5.

Support

If you believe you match any personality disorder symptoms above and are undiagnosed, then contact your GP. They can help you seek the support and help you need. Usually by helping you to seek a diagnosis from a Mental health professional, so you can get treatment if you need it.

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