According to the American Psychiatric Association, a personality disorder is a way of thinking, feeling, and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time. There are 10 specific types of personality disorders.
Personality disorders affect at least two of these areas:
Personality disorders occur in 10 to 20 percent of the general population, and they can last for decades. A personality disorder is also a predisposing factor for other psychiatric disorders, such as substance abuse, suicide, affective disorders, impulse-control disorders, eating disorders, and anxiety disorders. Individuals with personality disorders are far more likely to refuse psychiatric help and to deny their problems than persons with other mental health conditions. That’s because they are not concerned about their maladaptive behavior.
Personality disorders are generally divided into three subtypes (or clusters) and include the following:
Cluster A – Odd/Eccentric
Cluster B – Dramatic/Erratic
Cluster C – Anxious/Inhibited
There is evidence that genetics plays a role in personality disorders and associated mental health problems. For example, an antisocial personality disorder is associated with alcohol abuse. Depression is common in the family background of individuals with a borderline personality disorder. People with an avoidant personality disorder often have high anxiety levels.
A diagnosis of “general personality disorder” is given to an individual with an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the person’s culture. The disorder is demonstrated in two or more of the following areas:
The longstanding pattern can be traced back at least to adolescence or early adulthood. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. The pattern leads to significant distress or impairment in social, occupational, or other important areas of functioning. The disorder is not related to another mental disorder and is not attributable to the physiological effects of a substance (e.g., a drug of abuse or medication) or another medical condition (e.g., head trauma).
“Paranoid personality disorder” is a pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent. The disorder begins by early adulthood with four or more of the following:
The pattern does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, or another psychotic disorder. The disorder is not attributable to the physiological effects of another medical condition.
“Schizoid personality disorder” is a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings. The disorder begins by early adulthood and is demonstrated by four or more of the following:
The symptoms do not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder. The disorder is not attributable to the physiological effects of another medical condition.
“Schizoid personality disorder” is a pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior. The disorder begins by early adulthood and is indicated by five or more of the following:
The symptoms do not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder.
“Antisocial personality disorder” is a pervasive pattern of disregard for and violation of the rights of others, occurring since the age of 15, as indicated by three or more of the following:
A diagnosis of an antisocial personality disorder requires that the individual is at least 18 years of age and has no evidence of a conduct disorder before the age of 15. The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder.
“Borderline personality disorder” is a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity. The disorder begins by early adulthood and is indicated by five or more of the following:
“Histrionic personality disorder” is a pervasive pattern of excessive emotionality and attention-seeking, beginning by early adulthood. It is indicated by five or more of the following:
“Narcissistic personality disorder” is a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy. The disorder begins by early adulthood and is indicated by five or more of the following:
“Avoidant personality disorder” is a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood. The patterns is indicated by four or more of the following:
“Dependent personality disorder” is a pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation. The disorder begins by early adulthood and is indicated by five or more of the following:
“Obsessive-compulsive personality disorder” is a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness and efficiency. The disorder begins by early adulthood and is indicated by four or more of the following:
Yes. In fact, there is a diagnosis for “personality change due to another medical condition.” This diagnosis is based on a persistent personality disturbance that represents a change from the individual’s previous characteristic personality. There must be evidence from the history, physical examination, or laboratory findings that the disturbance is the direct consequence of another medical condition. The change in personality is not better explained by another mental disorder, and it does not occur exclusively during the course of a delirium. The diagnosis also requires that the disturbance causes significant distress or impairment in social, occupational, or other important areas of functioning.
Yes, a person can receive a diagnosis for a personality disorder that falls into the category of “other specified personality disorder” or “unspecified personality disorder.” Either one of these categories applies when an individual has symptoms characteristic of a personality disorder that cause significant distress or impairment in daily life but the symptoms do not meet the full criteria for any specific personality disorder diagnosis. The “other specified” personality disorder diagnosis may be given when there are mixed personality features from different categories. The “unspecified” diagnosis may be given when there is insufficient information to make a more specific diagnosis.
Specific treatment for each personality disorder is based on each individual’s age, overall health, and medical history. Personality disorders are often challenging to treat. They may need long-term attention to change the inappropriate behavior and thought patterns. Treatment will often involve psychotherapy (talk therapy) and include family involvement. Medication is often useful in dealing with anxiety, depression, mood swings, rage, hostility, and brief psychotic episodes.