Personality disorders

DEFINITION

A personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and to people. This causes significant problems and limitations in relationships, social encounters, work and school.

In some cases, you may not realize that you have a personality disorder because your way of thinking and behaving seems natural to you. And you may blame others for the challenges you face.

Personality disorders usually begin in the teenage years or early adulthood. There are many types of personality disorders. Some types may become less obvious throughout middle age.

CAUSES

Personality is the combination of thoughts, emotions and behaviors that makes you unique. It’s the way you view, understand and relate to the outside world, as well as how you see yourself. Personality forms during childhood, shaped through an interaction of two factors:

• Your genes. Certain personality traits may be passed on to you by your parents through inherited genes. These traits are sometimes called your temperament.
• Your environment. This involves the surroundings you grew up in, events that occurred, and relationships with family members and others.

Personality disorders are thought to be caused by a combination of these genetic and environmental influences. Your genes may make you vulnerable to developing a personality disorder, and a life situation may trigger the actual development.

SYMPTOMS

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

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. It’s not necessary to exhibit all the signs and symptoms listed for a disorder to be diagnosed.

Paranoid personality disorder

Pervasive distrust and suspicion of others and their motives

Unjustified belief that others are trying to harm or deceive you

Unjustified suspicion of the loyalty or trustworthiness of others

Hesitant to confide in others due to unreasonable fear that others will use the information against you

Perception of innocent remarks or nonthreatening situations as personal insults or attacks

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

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 response to others

“Magical thinking” — believing you can influence people and events with your thoughts

Belief that certain casual incidents or events have hidden messages meant specifically 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. It’s not necessary to exhibit all the signs and symptoms listed for a disorder to be diagnosed.

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

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

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

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. It’s not necessary to exhibit all the signs and symptoms listed for a disorder to be diagnosed.

Avoidant personality disorder

Too sensitive to criticism or rejection

Feeling inadequate, inferior or unattractive

Avoidance of work activities that require interpersonal contact

Social inhibition, timidity and isolation, especially 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 feels 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 own due to 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

Obsessive-compulsive personality disorder isn’t the same as obsessive-compulsive disorder, a type of anxiety disorder.

When to see a doctor

If you have any signs or symptoms of a personality disorder, see your doctor, mental health provider or other health care professional. Untreated, personality disorders can cause significant problems in your life that may get worse without treatment