Personality Disorders

 

Learn more about the symptoms of various personality disorders.  The most common treatments for these disorders are psychotherapy and off-label (not FDA approved) use of antidepressants or mood stabilizers.  


Cluster A Personality Disorders

Paranoid Personality Disorder

  • A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning in early adulthood and present with at least four of the following:
    • Suspects that others are exploiting, harming or deceiving him or her.
    • Is preoccupied with doubts about the loyalty or trustworthiness of friends or acquaintances.
    • Is reluctant to confide in others because of fear that the information will be used against him or her.
    • Reads hidden meanings into benign remarks or events.
    • Persistently bears grudges.
    • Perceives attacks on his or her character or reputation that are not perceived by others and is quick to react angrily or to counterattack.
    • Has recurrent suspicions about the faithfulness of a significant other or sexual partner.
  • These symptoms cannot be attributed to any substance, medication, or other medical or mental condition.

Schizoid Personality Disorder

  • A pervasive pattern of detachment fro social relationships and a restricted range of expression of emotions, beginning in early adulthood, as indicated by the presence of at least four of the following:
    • Does not desire or enjoy close relationships, including family.
    • Almost always chooses solitary activities.
    • Has little or no interest in having sexual experiences with another person.
    • Take pleasure in few activities.
    • Lacks close friends.
    • Appears indifferent to the praise or criticism of others.
    • Show emotional coldness or less emotional responses.
  • These symptoms cannot be attributed to any substance, medication, or other medical or mental condition.

Schizotypal Personality Disorder

  • A pervasive pattern of social and interpersonal deficits marked by discomfort with close relationships as well as by cognitive or perceptual disorder distortions and eccentricities of behavior, beginning in early adulthood, as indicated by the presence of at least five of the following:
    • Ideas of reference (when an individual believes innocuous events or coincidences are about him or her).
    • Odd beliefs or magical thinking (the irrational belief that one events happens as a result of another) that influences behavior and is inconsistent with social norms.
    • Unusual perceptual experiences, including bodily illusions.
    • Odd thinking and speech.
    • Paranoid ideation or suspiciousness.
    • Inappropriate or constricted emotions.
    • Behavior or appearance that is eccentric, odd or peculiar.
    • Lack of close friends or confidants.
    • Excessive social anxiety associated with paranoid fears.
  • These symptoms cannot be attributed to any substance, medication, or other medical or mental condition.

Cluster B Personality Disorders

 Antisocial Personality Disorder 

  • A pervasive pattern or disregard for and violation of the rights of others, occurring since age 15, as indicated by at least three of the following:
    •  Failure to conform to social norms with respect to the law, as evidenced by repeatedly performing acts that are grounds for arrest.
    • Deceitfulness, as evidenced by repeated lying, use of aliases or conning others.
    • Failure to plan ahead or impulsivity.
    • Irritability and aggressiveness, as evidenced by repeated physical fights.
    • Reckless disregard for the safety of self or others.
    • Consistent irresponsibility, as evidenced by repeated issues with work behavior or honoring financial obligations.
    • Lack of remorse or rationalizing having mistreated, hurt, or stolen from another.
  • The individual is at least 18 years old.
  • There is evidence of conduct disorder before age 15 years.
  • These symptoms cannot be attributed to any substance, medication, or other medical or mental condition.

Borderline Personality Disorder 

  • A pervasive pattern or instability of interpersonal relationships, self image, and emotions, and marked impulsivity, beginning in early adulthood, as indicated by at least five of the following:
    • Frantic efforts to avoid real or imagined abandonment.
    • A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization (attributing exaggerated positive qualities to self or others) and devaluation (attributing exaggerated negative qualities to self or others).
    • Identity disturbance (unstable sense of self or self-image).
    • Impulsivity in at least two areas of life that are potentially self-damaging, such as sexual activity, spending habits, substance abuse, reckless driving or binge eating.
    • Self-mutilating behavior or recurrent suicidal behavior, gestures, or threats.
    • Emotional instability due to extreme reactivity of mood.
    • Chronic feelings of emptiness.
    • Inappropriate, intense anger or difficulty controlling anger.
    • Transient, stress-related paranoid thoughts or severe dissociative symptoms.

Histrionic Personality Disorder

  • A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and indicated by at least five of the following:
    • Is uncomfortable in situations in which he or she is not the center of attention.
    • Displays rapidly shifting and shallow expressions of emotions.
    • Inappropriate sexually seductive or provocative behavior while interacting with others.
    • Uses physical appearance to draw attention to self.
    • Has a style of speech that is based on subjective feelings and lacking details.
    • Shows exaggerated emotions, theatricality and self-dramatization.
    • Is easily influenced by others or circumstances.
    • Considers relationships to be more intimate than they actually are.

Narcissistic Personality Disorder

  • A pervasive pattern of grandiosity, need for admiration, and lack of empathy, beginning by early adulthood, as indicated by at least 5 of the following:
    • Has a grandiose sense of self-importance.
    • Is preoccupied with fantasies of unlimited power, success, beauty, brilliance, or ideal love.
    • Believes that he or she is special and unique and can only be understood by, or associate with, other special or high status people or institutions.
    • Requires excessive respect and approval.
    • Has a sense of entitlement.
    • Takes advantage of others to achieve his or her own ends.
    • Lacks empathy.
    • Often feels envious of others or believes that others are envious of him or her.
    • Shows arrogant behaviors or attitudes.

Cluster C Personality Disorders

Avoidant Personality Disorder 

  • A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning in early adulthood, as indicated by at least four of the following:
    • Avoids work activities that involve significant social interactions because of fears of disapproval, criticism, or rejection.
    • Is unwilling to get involved with people unless certain or being liked.
    • Shows restraint within intimate relationships because of fear or being ridiculed or shamed.
    • Is worried about being criticized or rejected in social situations.
    • Is inhibited in new social situations because of feelings of inadequacy.
    • Views self as inferior to others, socially inept, or personally unappealing.
    • Is reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.

Dependent Personality Disorder 

  • A pervasive and excessive need to be take care of that leads to submissive and clingingbehavior and fears of separations, beginning in early adulthood, as indicated by at least five of the following:
    • Has difficulty making everyday decisions without advice and reassurance from others.
    • Needs others to assume responsibility for major areas of his or her life.
    • Has difficulty expressive disagreement with others because of fears of loss of approval or support.
    • Has difficulty starting projects or doing things on his or her own because of a lack of self-confidence.
    • Goes to great lengths to obtain support and nurturance from others, often to the point of volunteering to do things that are unpleasant.
    • Feels uncomfortable or helpless when alone because of fears of being unable to care for himself or herself.
    • Seeks another relationship as a source of support or care when a close relationship ends.
    • Is unrealistically worried about being left to take care of himself or herself.

Obsessive-Compulsive Personality Disorder 

  • A pervasive pattern or preoccupation with perfectionism, orderliness, and mental and interpersonal control, at the expense of flexibility, openness and efficiency, beginning in early adulthood, as indicated by at least four of the following:
    • Is preoccupied with rules, details, lists, order, organization, or schedules to the degree that the major point of the activity is lost.
    • Shows perfectionism that interferes with completing tasks.
    • Is excessively devoted to work and productivity to the extent that it interferes with leisure activities and friendships.
    • Is overconscientious, inflexible and scrupulous about matters of morality, ethics or values.
    • Is unable to throw out worn-out or worthless objects even when they have no sentimental value.
    • Is reluctant to delegate tasks or to work with others unless they agree to exactly his or her way of doing things.
    • Has a stingy spending style; money is viewed as something to be saved for future problems.
    • Is rigid and stubborn.
 

The above criteria are adapted from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).