Understanding Personality Discorders

Elizabeth Jackson

What is a personality disorder?

Each of us have different ways of experiencing emotions, forming thoughts, and communicating them. Often, this distinctiveness is seen as a personal trait or a unique aspect that distinguishes us. It is our individuality that adds intrigue and diversity to our interactions with others. Our personality is shaped by our experiences, environmental factors, and genetic traits. Generally, our personality remains consistent over time.

A personality disorder is characterized by deviations from cultural norms in thinking, feeling, and behaving, leading to distress or impaired functioning. These patterns typically emerge in late adolescence or early adulthood and persist over time, often requiring treatment for lasting improvement (Drescher, 2022).

Over time, the comprehension of personality disorders has progressed to encompass ten distinct conditions. Although each personality disorder exhibits unique symptoms and traits, experts categorize them into three clusters: A, B, and C, based on shared fundamental characteristics among the disorders within each cluster (Gbhp, 2019).

Three Clusters of Personality Disorders

Cluster A: eccentric/odd

Individuals with these disorders display behaviors that are perceived as unusual or erratic by others, often leading to social challenges. The disorders categorized in Cluster A include:

Schizotypal Personality Disorder: Individuals with this disorder frequently experience auditory hallucinations, interpret commonplace events as significant messages directed at them, and entertain beliefs that their thoughts possess extraordinary influence over people and circumstances. They may also feel uneasy in intimate relationships (Gbhp, 2019).

Paranoid Personality Disorder: Those afflicted with this disorder struggle to trust others, even without any rational suspicion. They may harbor grudges for extended periods, withhold personal information, and interpret innocuous remarks as intentional insults.

Schizoid Personality Disorder: This disorder manifests as a preference for solitude, causing those effected to appear distant and unapproachable. Individuals with schizoid personality disorder struggle to understand social cues, enjoy typical activities, or openly express emotions.

Cluster B: erratic/dramatic

Individuals diagnosed with Cluster B personality disorders often exhibit behaviors that are unpredictable and responses that are excessively dramatic to everyday occurrences. Their actions are characterized by impulsivity and unpredictability. The four distinct types of personality disorders within Cluster B include:

Borderline Personality Disorder: Characterized by fragile self-esteem and fear of abandonment by loved ones. This fear often results in unstable relationships, not only with romantic partners but also with others. When faced with perceived slights or relationship challenges, individuals with this cluster b discorder may react impulsively, exhibiting behaviors such as threats of self-harm, outbursts of anger, and feelings of paranoia. Additionally, they may engage in risky behaviors due to their impulsivity (Gbhp, 2019).

Antisocial Personality Disorder: A persistent pattern of thinking that revolves around social irresponsibility, often accompanied by exploitative, delinquent, and criminal behaviors without feeling remorse. Common symptoms include disregard for others’ rights, such as breaking the law, difficulty in keeping a steady job, engaging in deception and manipulation for personal benefit, and struggling to maintain stable relationships (Fisher & Hany, 2024).

Histrionic Personality Disorder: Characterized by attention-seeking behavior and exaggerated emotions, often emerging in late adolescence or early adulthood. Individuals with this disorder seek validation and may feel undervalued when not in the spotlight (French et al., 2024).

Narcissistic Personality Disorder: Involving a consistent pattern marked by grandiose beliefs, fantasies of immense power or significance, and a strong desire for admiration or special treatment. Those with NPD often face considerable psychological distress due to difficulties in interpersonal relationships and impaired functioning (Kacel et al., 2017).

Cluster C: fearful/anxious

There is a common clinical presumption that cluster C personality disorders are generally less severe compared to cluster B. However, only a limited number of studies have directly compared patients diagnosed with cluster B disorders to those diagnosed with cluster C disorders.

Avoidant Personality Disorder: This condition causes an intense fear of rejection or criticism to those effected, leading them to actively avoid social interactions. These individuals often perceive themselves as unattractive and unworthy of affection, further reinforcing their avoidance behaviors.

Dependent Personality Disorder: Those affected by this disorder have a severe fear of self-reliance and decision-making. Consequently, they rely heavily on others to meet their needs, make choices, and constantly seek approval. Individuals with this disorder are vulnerable to remaining in abusive relationships and harbor a profound dread of confrontation.

Obsessive-Compulsive Personality Disorder: Individuals with this disorder exhibit an extreme preoccupation with perfectionism, fixating on rules, cleanliness, and orderliness. They fear dire consequences if tasks are left incomplete or standards aren’t met, which often results in rigid behaviors that impact relationships and restrict their ability to live a fulfilling life (Gbhp, 2019).

What Causes a Personality Disorder?

Studies indicate that genetics, along with experiences of abuse and various other factors, play significant roles in the emergence of personality disorders. However, further research should take place.

Historically, there existed a misconception that individuals with personality disorders were merely lazy or inherently evil. However, contemporary research has shifted focus towards investigating potential factors such as genetic predispositions, parenting styles, and peer influences as contributors to the development of these disorders.

Genetics

Among the most common personality disorders, borderline personality disorder, genetic predisposition plays a significant role, as evidenced by twin studies indicating over 50% heritability, surpassing even that of major depression. Studies conducted in 2000 and 2008 consistently revealed a higher concordance rate for borderline personality disorder among monozygotic twins compared to dizygotic twins (Chapman, 2023).

Abuse/Trauma

A longitudinal study examined the impact of childhood verbal abuse on the development of personality disorders (PDs) in adolescence and early adulthood using data from a community-based sample of 793 mothers and their offspring. Results showed that individuals who experienced maternal verbal abuse during childhood were over three times more likely to develop borderline, narcissistic, obsessive-compulsive, and paranoid PDs later in life. These findings remained significant even after controlling for various factors such as offspring temperament, other forms of childhood abuse and neglect, parental education, and co-occurring psychiatric disorders (Johnson et al., 2002). Another study found that sexual abuse correlated with symptoms of paranoid, schizoid, borderline, and avoidant personality disorders (PD), while physical abuse was linked to antisocial PD. Emotional abuse showed associations with paranoid, schizotypal, borderline, and cluster C PD, whereas emotional neglect was associated with histrionic and borderline PD (Lobbestael et al., 2010).

Craig’s Story

Craig reflects his journey with OCD, which began in childhood with intrusive thoughts and compulsive behaviors. Despite efforts to manage it independently, the disorder intensified in adulthood, impacting his relationships and daily life. Recognizing the need for professional help, Craig sought treatment, with his wife’s unwavering support.

Therapy and medication enabled Craig to confront his OCD and adopt a slower lifestyle, albeit with initial resistance. Supported by loved ones, he found solace in therapy at Rogers Behavioral Health, where exposure therapy proved transformative. Emerging after 47 days with newfound freedom, Craig now embraces life with spontaneity and joy, grateful for the support of his family and the contentment of the present.

How can I help someone with a personality disorder?

Although there are medical and behavioral treatments that have been found to be successful such as cognitive behavioral therapy and prescriptions, it is important to know how we can individually support those with personality disorders.

Educate yourself: Take some time to learn more about the disorder your loved one is suffering from. By doing this, you have a better undertsanding of where they’re coming from, which will help you nevigate situations with them properly.

Be patient: Personality disorders can be challenging to manage, and recovery takes time. Be patient with your loved one and offer them understanding as they navigate their challenges.

Active listening: This involves fully engaging with your loved one’s words, without interruption or judgment. It means creating a safe space for them to express themselves freely. By being present, attentive, and validating, you can strengthen your connection with your loved one and provide meaningful support.

Set boundaries: Clarifying the boundaries and expectations within your relationship can be beneficial in managing challenging emotions and situations. Establishing mutual agreement on communication norms, assistance limitations, and respectful interaction guidelines can provide clarity and foster understanding between both parties (Mind, 2020).

References

Chapman, J. (2023, June 2). Borderline personality disorder. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK430883/
Drescher, J. (2022). What are personality disorders?. Psychiatry.org – What are Personality Disorders? https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders
Fisher , K. A., & Hany, M. (2024). Antisocial personality disorder. National Center for Biotechnology Information. https://pubmed.ncbi.nlm.nih.gov/31536279/
French, J. H., Torric, T. J., & Shrestha, S. (2024, January 31). Histrionic personality disorder. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK542325/
Gbhp. (2019, August). Three clusters of personality disorders: Georgia therapy. Georgia Behavioral Health Professionals. https://www.mygbhp.com/blog/three-clusters-personality-disorders/
Johnson, J. G., Cohen, P., Smailes, E. M., & Skodol, A. E. (2002, May 25). Childhood verbal abuse and risk for personality disorders during adolescence and early adulthood. Comprehensive Psychiatry. https://www.sciencedirect.com/science/article/pii/S0010440X01668895
Kacel, E. L., Ennis, N., & Pereira, D. B. (2017). Narcissistic personality disorder in Clinical Health Psychology Practice: Case studies of comorbid psychological distress and life-limiting illness. Behavioral medicine (Washington, D.C.). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819598/
Lobbestael, J., Arntz, A., & Bernstein, D. P. (2010). Disentangling the Relationship Between Different Types of Childhood Maltreatment and Personality Disorders. Guilford Press Periodicals. https://guilfordjournals.com/doi/10.1521/pedi.2010.24.4.412
Mind. (2020). Helping someone with a personality disorder. https://www.mind.org.uk/information-support/types-of-mental-health-problems/personality-disorders/for-friends-family/ https://www.youtube.com/watch?v=s0lsQGudcuo

Photos

Cover photo: AI Photo Generator

https://www.istockphoto.com/illustrations/emotional-abuse-child

https://www.reddit.com/r/coolguides/comments/yv7xoy/personality_disorders/

https://www.youtube.com/watch?v=s0lsQGudcuo