Personality Disorders

Personality disorders are a group of psychiatric conditions in which a person’s long-term (chronic) behaviors, emotions, and thoughts are very different from their culture’s expectations and cause serious problems with relationships and work

Personality Disorders are mental illnesses that share several unique qualities. They contain symptoms that are enduring and play a major role in most, if not all, aspects of the person’s life. While many disorders vacillate in terms of symptom presence and intensity, personality disorders typically remain relatively constant.

Mental health professionals categorize these disorders into the following types : 

Antisocial personality disorder : Antisocial personality disorder is a mental health condition in which a person has a long-term pattern of manipulating, exploiting, or violating the rights of others. This behavior is often criminal.

Avoidant personality disorder : Avoidant personality disorder is a mental health condition in which a person has a lifelong pattern of feeling very shy, inadequate, and sensitive to rejection.

Borderline personality disorder : Borderline personality disorder is a condition in which people have long-term patterns of unstable or turbulent emotions, such as feelings about themselves and others. These inner experiences often cause them to take impulsive actions and have chaotic relationships.

Dependent personality disorder : Dependent personality disorder is a long-term (chronic) condition in which people depend too much on others to meet their emotional and physical needs.

Histrionic personality disorder :Histrionic personality disorder is a condition in which people act in a very emotional and dramatic way that draws attention to themselves.

Narcissistic personality disorder : Narcissistic personality disorder is a condition in which people have an inflated sense of self-importance and an extreme preoccupation with themselves.

Obsessive-compulsive personality disorder : Obsessive-compulsive personality disorder (OCPD) is a condition in which a person is preoccupied with rules, orderliness, and control.

Paranoid personality disorder : Paranoid personality disorder is a psychiatric condition in which a person has a long-term distrust and suspicion of others, but does not have a full-blown psychotic disorder such as schizophrenia.

Schizoid personality disorder : Schizoid personality disorder is a psychiatric condition in which a person has a lifelong pattern of indifference to others and social isolation.

Schizotypal personality disorder : Schizotypal personality disorder is a mental health condition in which a person has trouble with relationships and disturbances in thought patterns, appearance, and behavior.

There are numerous possible causes of mental disorders, and they may vary depending on the disorder and the individual and their circumstances. There may be genetic dispositions as well as particular life experiences, which may or may not include particular incidents of trauma or abuse.

The causes of antisocial personality disorder are unknown. Genetic factors and child abuse are believed to contribute to the development of this condition. People with an antisocial or alcoholic parent are at increased risk. Far more men than women are affected. The condition is common in people who are in prison.

Personality disorders are lifelong patterns of behavior that cause problems with work and relationships. About 1% of the population has avoidant personality disorder. Both males and females have the condition equally. The cause is unknown.

The causes of borderline personality disorder (BPD) are unknown. Genetic, family, and social factors are thought to play roles. Risk factors for BPD include Abandonment in childhood or adolescence, Disrupted family life, Poor communication in the family, Sexual abuse. This personality disorder tends to occur more often in women and among hospitalized psychiatric patients.

Dependent personality disorder usually begins in childhood. The causes of this disorder are unknown. It is one of the most common personality disorders, and is equally common in men and women.

Histrionic personality disorder usually begins in early adulthood. The cause of this disorder is unknown. Both genes and early childhood events are thought to contribute. It occurs more often in women than in men, although it may be diagnosed more often in women because attention-seeking and sexual forwardness are less socially acceptable for women.

The causes of Narcissistic personality disorder are unknown. An overly sensitive personality and parenting problems may affect the development of this disorder.

Obsessive-compulsive personality disorder tends to occur in families, so genes may be involved. A person’s childhood and environment may also play roles. This condition can affect both men and women, but it most often occurs in men.

The causes of paranoid personality disorder are unknown. The disorder appears to be more common in families with psychotic disorders such as schizophrenia and delusional disorder, which suggests genes may be involved. However, environmental factors may play a role, as well. The condition appears to be more common in men.

The causes of schizoid personality disorder are unknown. This disorder may be related to schizophrenia and it shares many of the same risk factors. However, schizoid personality disorder is not as disabling as schizophrenia. It does not cause hallucinations, delusions, or the complete disconnection from reality that occurs in untreated (or treatment-resistant) schizophrenia.

Schizotypal personality disorder should not be confused with schizophrenia. People with schizotypal personality disorder can have odd beliefs and behaviors, but they are not disconnected from reality and usually do not hallucinate. The exact cause is unknown. Genes are thought to be involved, because this condition is more common in relatives of schizophrenics.

Symptoms vary widely depending on the type of personality disorder. In general, personality disorders involve feelings, thoughts, and behaviors that do not adapt to a wide range of settings. These patterns usually begin in adolescence and may lead to problems in social and work situations. The severity of these conditions ranges from mild to severe.

General symptoms of a personality disorder include : 

  • Frequent mood swings
  • Stormy relationships
  • Social isolation
  • Angry outbursts
  • Suspicion and mistrust of others
  • Difficulty making friends
  • A need for instant gratification
  • Poor impulse control
  • Alcohol or substance abuse

Specific types of personality disorders : 

The specific types of personality disorders are grouped into three clusters based on similar characteristics and symptoms. Many people with one diagnosed personality disorder also have signs and symptoms of at least one additional personality disorder.

In clinical practice, individuals are generally diagnosed by an interview with a psychiatrist based on a mental status examination, which may take into account observations by relatives and others. One tool of diagnosing personality disorders, is a process involving interviews with scoring systems. The patient is asked to answer questions in a questionnaire, and depending on their answers, the trained interviewer tries to code what their responses were. This process is fairly time consuming.

To be diagnosed with personality disorders, a psychologist will look for the following criteria:

Symptoms have been present for an extended period of time, are inflexible and pervasive, and are not a result of alcohol or drugs or another psychiatric disorder. The history of symptoms can be traced back to adolescence or at least early adulthood.

The symptoms have caused and continue to cause significant distress or negative consequences in different aspects of the person’s life.

Symptoms are seen in at least two of the following areas:

Thoughts (ways of looking at the world, thinking about self or others, and interacting)
Emotions (appropriateness, intensity, and range of emotional functioning)
Interpersonal Functioning (relationships and interpersonal skills)
Impulse Control

At first, people with personality disorders usually do not seek treatment on their own. They tend to seek help once their behavior has caused severe problems in their relationships or work, or when they are diagnosed with another psychiatric problem, such as a mood or substance abuse disorder.

Although personality disorders take time to treat, there is increasing evidence that certain forms of psychotherapy help many people. In some cases, medications can be a useful addition to therapy.

There are several different forms (modalities) of treatment used for personality disorders : 

•   Individual psychotherapy has been a mainstay of treatment.
•   Family therapy, including couples therapy.
•   Group therapy for personality dysfunction is probably the second most used.
•   Psychological-education may be used as an addition.
•   Self-help groups may provide resources for personality disorders.
•   Psychiatric medications for treating symptoms of personality dysfunction or co-occurring conditions.