Personality disorder

"A personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations 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". (American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.)

Types of personality disorders

Narcissistic rage is an outburst of intense anger or silence that can happen to someone with narcissistic personality disorder.

• Paranoid personality disorder is a pattern of distrust and suspiciousness such that others' motives are interpreted as malevolent.

• Schizoid personality disorder is a pattern of detachment from social relationships and a restricted range of emotional expression.

• Schizotypal personality disorder is a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior.

• Antisocial personality disorder is a pattern of disregard for, and violation of, the rights of others.

• Borderline personality disorder is a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity.

• Histrionic personality disorder is a pattern of excessive emotionality and attention seeking.

• Narcissistic personality disorder is a pattern of grandiosity, need for admiration, and lack of empathy.

• Avoidant personality disorder is a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.

• Dependent personality disorder is a pattern of submissive and clinging behavior related to an excessive need to be taken care of.

• Obsessive-compulsive personality disorder is a pattern of preoccupation with orderliness, perfectionism, and control." [ibid.]

Individuals with more than one personality disorder

According to the American Psychiatry Association: "Technically, according to DSM-5*, a person can receive more than one personality disorder diagnosis. People who are diagnosed with a personality disorder most often qualify for more than one diagnosis. A person with a severe personality disorder might meet the criteria for four, five or even more disorders! In practice, clinicians usually recognize that meeting more criteria for personality disorders means more severe disorder."

Anthony D. Smith LMHC indicates:

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It's no secret that some personality disorders (PDO) have significant similarities. The Narcissistic and Antisocial share a lack of empathy and tendency for rage; Borderlines and Dependents have profound fears of abandonment and clingy behavior; the Schizoid and Avoidant are socially anxious and unassertive. Despite the glaring similarities, careful differential diagnosis can yield one "pure" personality disorder. However, it's most common that patients exhibit a mixed presentation (APA, 2013) such as Antisocial with some Paranoid PDO characteristics, or in fact meet full criteria for two or more PDOs (e.g., Grant et al., 2005; Millon, 2011; Skewes et al., 2015). Readers familiar with PDOs may notice that the above examples are both intra-cluster and inter-cluster (see below regarding personality disorder organization). Indeed, the PDO cluster boundaries are permeable. Grant (2005) noted that this is common, with both inter- and intra-cluster PDO combinations being "... pervasive in the general U.S. population." Personality Disorder Organization Generally, personality disorders are categorized under three different umbrellas, or themes, and the collection of disorders under each umbrella is called a cluster. They are arranged in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as follows: Cluster A are PDOs with a semi-psychotic theme. These include the Paranoid, Schizotypal, and Schizoid. Cluster B are PDOs with a common theme of dramatic behavior/entitlement/moodiness/poor impulse control. This includes the Antisocial, Borderline, Histrionic, and Narcissistic. Cluster C are PDOs with an anxious-depressed common theme. Here we find the Avoidant, Dependent, and Obsessive-Compulsive/Perfectionistic.

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See also

• Atheism, alcoholism and personality disorders