What is a Personality Disorder?

The character of a person is shown through his or her personality ― by the way he or she thinks, feels, and behaves.  Most personality disorders begin as problems in personal development and character during adolescence that can lead to an impaired sense of self and others, and a failure to adapt to one’s environment.

Personality DisorderThe Diagnostic and Statistical Manual of Mental Health Disorders DSM-5, published by the American Psychiatric Association, defines a personality disorder as an enduring pattern of inner experience and behavior that deviates markedly from the expectation of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.

Diagnosis is made when when a mental health professional determines there is a pervasive pattern of experience and behavior that significantly disrupts a person’s daily life and relationships, and is abnormal with respect to any two of the following: thinking, mood, personal relations, and the control of impulses.

Ten personality disorders are listed in the DSM-5 and are grouped into three clusters based on similarities within each cluster. These descriptions should be taken as a guide rather than a label. as they are not based on any scientific test or objective criteria.

Cluster A (“odd, eccentric”)

Paranoid Personality Disorder:  Marked distruct of others, including the irrational belief that others are exploiting, harming, or trying to deceive him or her; lack of trust; belief of others’ betrayal; belief in hidden meanings; unforgiving and grudge-holding.

Schizoid Personality Disorder:  Very limited range of emotion, both in expressing and experiencing feelings; cold, flat, non-reactive affect; indifferent to social relationships; solitary lifestyle.

Schizotypal Personality Disorder:  Peculiarities of thinking, odd beliefs, and eccentricities of appearance, behavior, interpersonal style, and thought (e.g., belief in psychic phenomena and having magical powers).

Cluster B (“dramatic, emotional, erratic”)

Antisocial Personality Disorder:  Lack of regard for the moral or legal standards in the local culture; lack of empathy; marked inability to get along with others or abide by societal rules. Sometimes called psychopaths or sociopaths. Known as conduct disorder for persons under age 18.

Borderline Personality Disorder:  Lack of one’s own identity; unstable self-image; rapid changes in mood; intense unstable interpersonal relationships; marked impulsivity.

Histrionic Personality Disorder:  Exaggerated and often inappropriate displays of emotional reactions in everyday behavior that approaches theatricality; sudden and rapidly shifting emotional expressions.

Narcissistic Personality Disorder:  Behavior, or a fantasy, of gradiosity; lack of empathy; a need to be admired by others; inability to see the viewpoints of others; hypersensitivity to the opinions of others.

Cluster C (“anxious, fearful”)

Avoidant Personality Disorder:  Marked social inhibition, avoiding interaction with others; feelings of inadequacy (“not good enough” thinking); extremely sensitive to criticism; fearful of being rejected.

Dependent Personality Disorder:  Extreme need of other people to a point where the person is unable to make any decisions or take an independent stand on his or her own; fear of separation and abandonment; submissive behavior; lack of self-confidence.

Obsessive-Compulsive Personality Disorder:  Characterized by perfectionism and inflexibility. Preoccupation with order, rules, and uncontrollable patterns of thought and action; “control freak.”

According to Dr. Sam Vaknin, self-proclaimed narcissist and author of Malignant Self Love – Narcissism Revisted, individuals with personality disorders have many things in common:

Self-centeredness that manifests itself through a me-first, self-preoccupied attitude

Lack of individual accountability that results in a victim-mentality and blaming others, society, and the universe for his or her problems

Lack of perspective-taking

Manipulative or exploitative behavior

Unhappiness and depression

Distorted or superficial understanding of self and others’ perceptions, being unable to see his or her objectionable, unacceptable, disagreeable, or self-destructive behaviors or the issues that may have contributed to the personality disorder

Socially maladaptive, changing the rules of the game, introducing new variables, or otherwise influencing the external world to conform to his or her own needs

Very likely to have co-occurring mental disorders, including anxiety disorders (e.g., panic attacks, PTSD), mood disorders (e.g., bipolar disorder), impulse control disorders (e.g., ADHD), and substance abuse

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