Personality Disorders

Overview

This section will initially consist of a summary of the DSM-IV-TR’s[1] information on Personality Disorders, over time it will expanded with additional resources.

The DSM-IV-TR defines a personality disorder as “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture,[2] is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.”[3]

It is worth noting that personality disorders are not exclusive – they can be co-occurring – and they are not restricted to only occurring with disorders within there cluster (aka. someone could have a personality disorder from Cluster A and Cluster C).[4]

Important Disclaimer

I am not a physician, psychiatrist, or mental health professional. I am providing a lay person’s understanding, compilation, and amplification of readily available materials on these disorders. I present this information in hopes that individuals who see something of these disorders in themselves or a loved one will seek out appropriate medical assistance. One should not self-diagnose nor diagnose others. There are innumerable variations on mental illness that a professional will be better able to consider – thus why the DSM-IV-TR clocks in at 943 pages!

The Personality Disorders

  • Cluster A[5]
    • Paranoid Personality Disorder
    • Schizoid Personality Disorder
    • Schizotypal Personality Disorder
  • Cluster B[6]
  • Cluster C[7]
    • Avoidant Personality Disorder
    • Dependent Personality Disorder
    • Obsessive-Compulsive Personality Disorder

The DSM-IV-TR also includes “Personality Disorder Not Otherwise Specified”[8]  which is a catch-all category for dysfunctional patterns of behaviors which indicate a personality disorder but lack the traits necessary for diagnosing with any one specific disorder.

Diagnostic Criteria

These are criteria used to determine if an individual has a personality disorder, if one meets the criteria for a personality disorder in general, then a mental health professional would attempt to diagnose the specific type of personality disorder.

  1. “An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture. This pattern is manifested in two…of the following areas:
    1. cognition (i.e., ways of perceiving and interpreting self, other people and events)
    2. affectivity (i.e., the range, intensity, lability, and appropriateness of emotional response)
    3. interpersonal functioning
    4. impulse control
  2. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.
  3. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  4. The pattern is stable and of long duration, and its onset can be traced back at least to adolescence or early adulthood.”[9]

Other Important Notes

  • In general, children and adolescents should not be diagnosed with personality disorders, as their character has not entirely solidified, it is possible that they may (and even likely that they will) change during the process of maturation.[10]
  • Some believe that personality disorders are untreatable, and while this has been true of some in the past, this is no longer current belief. Even the DSM-IV-TR which was printed in 2000 notes that “Some types of Personality Disorder…tend to become less evident or remit with age…”[11] Drs. Jeffrey E. Young and Janet S. Klosko have done some extensive work in the treatment of personality disorders, which has been affirmed by Dr. Aaron Beck.[12]

 

  1. [1]For all references where the work is not given and a page number is specified, the reference is to the DSM-IV-TR. Other resources will have fuller annotations.
  2. [2]This is extremely important, while we may object to a culture’s norms, the presence of a disorder is present if the individual is acting in a way out of sync with their culture resulting in disruption and dysfunction. See pg. 687 “Specific Culture, Age, and Gender Features.”
  3. [3]Page 685.
  4. [4]Page 686.
  5. [5]“Individuals with these disorders often appear odd or eccentric.” – pg. 685.
  6. [6]“Individuals with these disorders often appear dramatic, emotional, or erratic.” – pg. 685.
  7. [7]“Individuals with these disorders often appear anxious or fearful.” – pg. 686.
  8. [8]Sometimes abbreviated as Personality Disorder NOS.
  9. [9]Technically, there are two additional criteria, but these are common-sense: “The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder” and “…is not due to the direct physiological effects of a substance…or a general medication condition…” – pg. 689.
  10. [10]See pg. 687 for more information.
  11. [11]Page 688.
  12. [12]The founder of cognitive therapy, one of the most effective psychological treatments currently available.

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