Personality Disorders
What Is Meant By Personality Disorders?
A personality disorder is a mental health condition that involves long-lasting, all-encompassing, disruptive patterns of thinking, behavior, mood, and relating to others. These patterns cause a person significant distress and/or impair their ability to function.
This generates substantial challenges and constraints in relationships, social activities, employment, and school.
What are the symptoms of personality disorders?
Identity and a sense of self
People with a personality disorder generally lack a clear or stable image of themselves, and how they see themselves often changes depending on the situation or the people they’re with. Their self-esteem may be unrealistically high or low.
Relationships
People with a personality disorder struggle to form close, stable relationships with others due to their problematic beliefs and behaviors. They may lack empathy or respect for others, be emotionally detached or be overly needy of attention and care.
Another distinguishing sign of personality disorders is that most people who have one often have little to no insight or self-awareness of how their thoughts and behaviors are problematic.
Causes Of Personality Disorders
Personality disorders are among the least understood mental health conditions. Scientists are still trying to figure out the cause of them.
So far, they believe the following factors may contribute to the development of personality disorders:
Genetics
Scientists have identified a malfunctioning gene that may be a factor in obsessive-compulsive personality disorder. Researchers are also exploring genetic links to aggression, anxiety, and fear, which are traits that can play a role in personality disorders.
Brain changes
Researchers have identified subtle brain differences in people with certain personality disorders. For example, findings in studies on paranoid personality disorder point to altered amygdala functioning. The amygdala is the part of your brain that’s involved with processing fearful and threatening stimuli. In a study on schizotypal personality disorder, researchers found a volumetric decrease in the frontal lobe of the brain.
Childhood trauma
One study revealed a link between childhood traumas and the development of personality disorders. People with borderline personality disorder, for example, had especially high rates of childhood sexual trauma. People with borderline and antisocial personality disorders have issues with intimacy and trust, both of which may be related to childhood abuse and trauma.
Verbal abuse
In one study, people who experienced verbal abuse as children were three times as likely to have borderline, narcissistic, obsessive-compulsive, or paranoid personality disorders in adulthood.
Cultural factors
Cultural factors may also play a role in the development of personality disorders, as demonstrated by the varying rates of personality disorders between different countries. For example, there are remarkably low cases of antisocial personality disorders in Taiwan, China, and Japan, along with significantly higher rates of cluster C personality disorders.
What Are the Factors That Lead to the Risks and Complications of Eating Disorders?
Since people with personality disorders often don’t seek proper medical attention, the overall prognosis for personality disorders is poor.
Untreated personality disorders may result in:
- Poor relationships.
- Occupational difficulties.
- Impaired social functioning.
Studies show that personality disorders are associated with elevated rates of:
- Unemployment.
- Divorce.
- Domestic abuse.
- Substance use.
- Homelessness.
- Crime (especially antisocial personality disorder).
In addition, people with personality disorders are more likely to visit the emergency room (ER), experience traumatic accidents, and have early deaths by suicide.
Although the outlook is dire, studies show that collaborative care management can greatly improve outcomes for people with personality disorders if they stay committed to treatment.
If you know someone who has or may have a personality disorder, try to persuade them to seek treatment. It’s also important to educate yourself about the nature of the specific personality disorder so you can better understand what to expect.
Can personality disorders be prevented?
At this time, there’s no known way to prevent personality disorders, but many of the related problems might be lessened with treatment. Seeking help as soon as symptoms appear can help decrease the disruption to the person’s life, family, and friendships.
Types of personality disorders
Cluster A personality disorders
Cluster A personality disorders are characterized by odd, eccentric thinking or behavior. They include paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder.
Paranoid personality disorder
- Pervasive distrust and suspicion of others and their motives
- An unjustified belief that others are trying to harm or deceive you
- Unjustified suspicion of the loyalty or trustworthiness of others
- Hesitancy to confide in others due to unreasonable fear that others will use the information against you
- Perception of innocent remarks or non-threatening situations as personal insults or attacks
- The angry or hostile reaction to perceived slights or insults
- Tendency to hold grudges
- Unjustified, recurrent suspicion that spouse or sexual partner is unfaithful
Schizoid personality disorder
- Lack of interest in social or personal relationships, preferring to be alone
- Limited range of emotional expression
- Inability to take pleasure in most activities
- Inability to pick up normal social cues
- The appearance of being cold or indifferent to others
- Little or no interest in having sex with another person
Schizotypal personality disorder
- Peculiar dress, thinking, beliefs, speech, or behavior
- Odd perceptual experiences, such as hearing a voice whisper your name
- Flat emotions or inappropriate emotional responses
- Social anxiety and a lack of or discomfort with close relationships
- Indifferent, inappropriate, or suspicious responses to others
- “Magical thinking” — believing you can influence people and events with your thoughts
- The belief that certain casual incidents or events have hidden messages meant only for you
Cluster B personality disorders
Cluster B personality disorders are characterized by dramatic, overly emotional, or unpredictable thinking or behavior. They include antisocial personality disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder.
Antisocial personality disorder
- Disregard for others’ needs or feelings
- Persistent lying, stealing, using aliases, conning others
- Recurring problems with the law
- Repeated violation of the rights of others
- Aggressive, often violent behavior
- Disregard for the safety of self or others
- Impulsive behavior
- Consistently irresponsible
- Lack of remorse for behavior
Borderline personality disorder
- Impulsive and risky behavior, such as having unsafe sex, gambling or binge eating
- Unstable or fragile self-image
- Unstable and intense relationships
- Up and down moods, often as a reaction to interpersonal stress
- Suicidal behavior or threats of self-injury
- Intense fear of being alone or abandoned
- Ongoing feelings of emptiness
- Frequent, intense displays of anger
- Stress-related paranoia that comes and goes
Histrionic personality disorder
- Constantly seeking attention
- Excessively emotional, dramatic, or sexually provocative to gain attention
- Speaks dramatically with strong opinions, but few facts or details to back them up
- Easily influenced by others
- Shallow, rapidly changing emotions
- Excessive concern with physical appearance
- Thinks relationships with others are closer than they really are
Narcissistic personality disorder
- The belief that you’re special and more important than others
- Fantasies about power, success, and attractiveness
- Failure to recognize others’ needs and feelings
- Exaggeration of achievements or talents
- The expectation of constant praise and admiration
- Arrogance
- Unreasonable expectations of favors and advantages, often taking advantage of others
- Envy of others or belief that others envy you
Narcissistic personality disorder
Cluster C personality disorders
Cluster C personality disorders are characterized by anxious, fearful thinking or behavior. They include avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder.
Avoidant personality disorder
- Too sensitive to criticism or rejection
- Feeling inadequate, inferior, or unattractive
- Avoidance of work activities that require interpersonal contact
- Socially inhibited, timid, and isolated, avoiding new activities or meeting strangers
- Extreme shyness in social situations and personal relationships
- Fear of disapproval, embarrassment, or ridicule
Dependent personality disorder
- Excessive dependence on others and feeling the need to be taken care of
- Submissive or clingy behavior toward others
- Fear of having to provide self-care or fend for yourself if left alone
- Lack of self-confidence, requiring excessive advice and reassurance from others to make even small decisions
- Difficulty starting or doing projects on your own due to a lack of self-confidence
- Difficulty disagreeing with others, fearing disapproval
- Tolerance of poor or abusive treatment, even when other options are available
- Urgent need to start a new relationship when a close one has ended
Obsessive-compulsive personality disorder
- Preoccupation with details, orderliness, and rules
- Extreme perfectionism, resulting in dysfunction and distress when perfection is not achieved, such as feeling unable to finish a project because you don’t meet your own strict standards
- Desire to be in control of people, tasks, and situations, and inability to delegate tasks
- Neglect of friends and enjoyable activities because of excessive commitment to work or a project
- Inability to discard broken or worthless objects
- Rigid and stubborn
- Inflexible about morality, ethics, or values
- Tight, miserly control over budgeting and spending money
An obsessive-compulsive personality disorder is not the same as obsessive-compulsive disorder, a type of anxiety disorder.
How are personality disorders diagnosed?
Personality disorders can be difficult to diagnose since most people with a personality disorder don’t think there’s a problem with their behavior or way of thinking.
Because of this, people with a personality disorder typically don’t seek help or a diagnosis for their condition.
When they do seek help, it’s often due to conditions such as anxiety, depression, or substance use, or because of the problems created by their personality disorder, such as divorce or unemployment, not the disorder itself.
When a mental health professional, like a psychologist or psychiatrist, suspects someone might have a personality disorder, they often ask broad, general questions that won’t create a defensive response or hostile environment. They ask questions that will shed light on:
- Past history.
- Relationships
- Previous work history.
- Reality testing.
- Impulse control.
Personality disorders are generally underdiagnosed because providers sometimes focus on the symptoms of anxiety or depression, which are much more common in the general population than personality disorders. These symptoms may overshadow the features of any underlying personality disorder.
How are personality disorders treated?
If a person with a personality disorder seeks treatment, modern medicine is still lacking in available treatment options — there are no medications currently approved to treat any personality disorder.
But there are medications that can help with symptoms of anxiety and depression, which are common in people with a personality disorder.
But psychotherapy (talk therapy) can help manage personality disorders.
Psychotherapy
Psychotherapy is a term for a variety of treatment techniques that aim to help you identify and change troubling emotions, thoughts, and behaviors. Working with a mental health professional, like a psychologist or psychiatrist, can provide support, education, and guidance to you and your family.
The main goals of psychotherapy for treating personality disorders include:
- Reducing immediate distress, such as anxiety and depression.
- Helping the person understand that their problems are internal and not caused by other people or situations.
- Decreasing unhealthy and socially undesirable behavior.
- Modifying the personality traits that are causing difficulties.
There are several different types of psychotherapy, and each personality disorder requires different types.
For example, studies show that dialectical behavior therapy (DBT) is effective for treating those with borderline personality disorder, and people with a histrionic personality disorder often benefit from cognitive-behavioral therapy (CBT).
FAQs
1
Which doctor should I consult for personality disorders?
A Psychiatrist can be consulted for treating personality disorders.
2
Is personality disorder easily noticed?
For a personality disorder to be diagnosed, the behavioral pattern should cause significant distress or impairment in personal, social, and occupational situations. Most individuals though lead normal lives and only seek psychotherapeutic treatment/intervention during times of increased stress or social demands.
3
What is the prevalence of different types of personality disorders?
Prevalence of individual personality disorder varies from 2% to 3% for common forms like schizotypal, antisocial, borderline, and histrionic, whereas 0.5–1% for the least common, like narcissistic and avoidant personalities.
4
What is the risk factor for developing personality disorder?
Though the exact cause of personality disorder is not known. There are certain factors that seem to raise the risk, including:
- Family history of personality disorders or other mental illnesses
- Low education level and lower socio-economic status
- Verbal, physical, or sexual abuse during childhood
- Unstable or neglect or chaotic family life during childhood
- Variations in brain chemistry and structure
- Having been diagnosed with childhood conduct disorder
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