An Introduction to Personality Disorders

Note to students: The following notes and short quiz will offer a rounded knowledge of personality disorders. The descriptions are designed to be approachable and memorable, and it is recommended that these notes are reviewed in conjunction with your own notes and with definitions from the DSM-5. The DSM-5 will provide an exhaustive list of symptoms for each personality disorder, which might need to be memorized for exams.

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What is a Personality Disorder?

Personality Disorders (PD's) differ from other mental disorders in that they are primarily a disorder of identity formation. While the cause of each individual PD is unclear, research suggests that PD’s arise as a result of poor circumstances during major developmental phases or as a coping mechanism in response to trauma.

There are ten personality disorders in total, which are sorted into three separate categories known as ‘clusters’. These clusters are made up of disorders that share similar qualities. They are colloquially referred to as the ‘mad, bad, and sad’ clusters.

Cluster A/Mad: The first cluster of PD’s consists of Paranoid, Schizoid, and Schizotypal personality. People who present with one of these disorders will appear odd or eccentric in their thinking and behaviour.

1. Paranoid: People with Paranoid PD experience an innate distrust and suspicion of other people. They are reluctant to open up due to the fear that personal information will be used against them, and they tend to hold grudges.
2. Schizoid: People with Schizoid PD have little interest in social relationships and sex. Their ability to experience pleasure is limited, and they have a lower range of emotional expression, making them appear cold.
3. Schizotypal: Schizotypal PD is characterised by odd perceptual experiences, low affect (dull emotion), excessive suspicion of others, delusions, magical thinking, and social anxiety. It is the personality disorder that is most similar to Schizophrenia.

Cluster B/Bad: Cluster B consists of Antisocial, Borderline, Histrionic, and Narcissistic Personality Disorder. People with these disorders can be exploitative, and will present as dramatic, emotional, and unpredictable.

1. Antisocial: Approximately eighty percent of convicted criminals meet the diagnostic criteria for APD. Those with APD are impulsive and lack remorse for their violent behaviour. They have a disregard for the needs of others.
2. Borderline: Perhaps the most well 'known' PD, Borderline is typified by impulsive and risky behaviour, a fragile self-image, unstable relationships, mood swings, suicidal behaviour or threats, fear of being alone, feelings of emptiness, and stress-related paranoia.
3. Histrionic: People with Histrionic personality disorder like to be the centre of attention. They require excessive admiration and will act in dramatic or manipulative ways to get it.
4. Narcissistic: Someone with Narcissistic Personality Disorder will come across as grandiose and self-obsessed. They view other people as objects to exploit for their own personal satisfaction.

Cluster C/Sad: People with Cluster C Personality Disorders share anxious and fearful traits. The disorders include Avoidant, Dependant, and Obsessive Compulsive Personality Disorder.

Treatment

Because personality disorders are thought to be related to one's upbringing as opposed to a biological disposition, there are no medications that are specifically targeted towards treating personality disorders. Generally, personality disorders are managed through therapy. Due to PD's lodging themselves into the psyche at an integral age of development, they are difficult to treat and, thus, require long-term management.

A number of medications may be offered to those who suffer from personality disorders to help treat extraneous symptoms, including antidepressants, mood-stabilisers, antipsychotic medication, and anti-anxiety medication.

Common Questions

What is the difference between Schizotypal PD, Schizoid PD and Schizophrenia?

Schizophrenia is a mental disorder, meaning it does not arise as a result of poor developmental circumstances or as a result of trauma in the same way that a Personality Disorder does; it is related to brain chemistry.

However, Schizotypal and Schizoid PD's share similar traits that can be seen in those with Schizophrenia. Schizotypal represents the 'positive' characteristics of Schizophrenia (positive meaning something has been added; i.e. hallucinations or delusions) while Schizoid PD represents the 'negative' traits of schizophrenia (meaning something has been removed, such as emotional range).

Is Psychopathy a Personality Disorder?

Technically no. The personality disorder that is most similar to Psychopathy is Antisocial Personality Disorder. Once again, the differentiation is related to brain structure. Psychopathy is a disorder defined by abnormal brain structure and genetics, whereas Personality Disorders are linked to the persons environment (not their biology).

It is more accurate to say that Antisocial Personality Disorder is similar to Sociopathy.

What is the difference between Borderline Personality Disorder and Bipolar?

While the presentation might be similar, people with Bipolar experience longer durations of emotional and mental fluctuations. For example, someone with Bipolar might experience depression for a month, before experiencing an extreme high.

Borderline PD is typified by rapid mood-swings, meaning someone with BDP might experience depression followed by an extreme high within the hour.

Is there a difference between Obsessive Compulsive Personality Disorder and OCD

Yes. As is the case with Schizophrenia, Psychopathy, and Bipolar, OCD is a mental disorder that is related to brain structure. People with OCD experience excessive anxiety and fear responses that lead to repetitive behaviours and intrusive thoughts. Obsessive Compulsive Personality Disorder is better defined as strict rules that dictate someone's behaviour. People with OCD don't necessarily function based on rules, but as a result of their fear response.

Is Multiple Personality Disorder a 'Personality Disorder'?

No. Multiple Personality Disorder is actually known by Psychologists as 'Dissociative Identity Disorder' and while it is thought to arise as a result of trauma, it is not the same as a PD. People with Dissociative Identity Disorder experience memory loss when their alternative personality arises.

Can you have more than one Personality Disorder?

Yes. Overlap between PD's is common. PD's are also often related to other mental disorders that arise as a result of the dysfunctional personality. So, comorbid depression, anxiety, or substance abuse is be common.

Practice Quiz

1. How many personality disorders are there in total?
2. Which PD is the most likely to be found in prison?
3. Which PD is characterised by a fragile self-image and mood swings?
4. Which PD is characterised by anxious and fearful traits?
5. Is Psychopathy a personality disorder?

Answers

1. Ten
2. Antisocial Personality Disorder
3. Borderline Personality Disorder
4. Cluster C
5. No. It is similar to Antisocial Personality Disorder, but it is not a PD itself.

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