Each of us has our own unique way of viewing the world, interpreting experiences, and responding emotionally and behaviorally. These individual differences form the essence of our personality, shaping who we are as individuals.

As adults, most of us have developed a personality that aligns with societal expectations, reflecting a unique combination of thoughts, emotions, and actions that shape our interactions and worldview (Hooley et al., 2017). While it’s common to recognize distinctive qualities in people during our daily encounters—whether it’s a tendency towards shyness, a flair for drama, or a disposition towards suspicion—these traits contribute to the rich diversity of human behavior and personality.

However, for some individuals, this intricate tapestry becomes entangled, leading to challenges in relationships, personal distress, and difficulties in everyday life. Even though they may not show clear signs of specific disorders, they have rigid and unhelpful traits that make it hard for them to fit in and function well in society. (Barlow & Durand, 2015). 

In such cases, we may identify these individuals as having a personality disorder, characterized by chronic interpersonal challenges, struggles with self-identity, and difficulty functioning adequately in social settings (Livesley & Jang, 2000).

People with personality disorders face many difficulties in connecting with others and handling daily life. Their internal thoughts and external actions often don’t match what society expects, causing significant struggles in social, educational, and family settings. Unlike temporary mental health issues, personality disorders persist from childhood into adulthood, shaping how individuals see the world and impacting their relationships, social interactions, and work-life (Widiger, 2012).

Join us in this blog as we untangle the complexities of personality disorders!

What are personality disorders?

A personality disorder is characterized by a consistent pattern of emotions, thoughts, and actions that lead to lasting emotional distress for the individual and/or those around them, often resulting in challenges with work and relationships (American Psychiatric Association, 2013).

While those with personality disorders may not necessarily feel distress themselves, their actions can profoundly affect others, as seen in cases such as antisocial personality disorder, where individuals may exhibit a blatant disregard for others’ rights without remorse (Hare, Neumann, & Widiger, 2012).

Personality disorders don’t typically pop up due to recent stress overload. Instead, they gradually form rigid and distorted ways of thinking and behaving, causing ongoing problems in how we see and relate to the world. While they’re not just a reaction to recent stress, tough events early in life can play a role in shaping these patterns (Barlow & Durand, 2015). 

The category of personality disorders is pretty broad, covering a wide range of behavioral issues that differ greatly in their form and severity. In less severe cases, individuals may get by alright but are often perceived by those around them as troublesome, eccentric, or hard to understand. They might have trouble making close connections or find it tough to get along with others, even with the people they’re closest to.

Personality disorders were once believed to originate in childhood and persist into adulthood. However, more recent studies suggest that personality disorders can improve over time, although different personality disorders may replace them. This means that someone might receive a diagnosis of one personality disorder at one point, but years later, they might no longer meet the criteria for that disorder and instead show characteristics of a different one. 

Our understanding of the developmental course of personality disorders is limited, and there are research gaps that need to be addressed. One reason for this lack of research is that many individuals don’t seek treatment until the later stages of their disorder, after years of distress. This makes it challenging to study the early stages of personality disorders. (Cloninger & Svakic, 2009; Torgersen, 2012; Pulay et al., 2009; Stinson et al., 2008; Barlow & Durand, 2015). 

Also Read: Psychotic Spectrum Disorders

Image depicting a young man in a Halloween costume resembling a corpse hand. This illustration relates to types of personality disorders.

Clusters of Personality Disorders

The DSM-5 groups personality disorders into three clusters based on their similarities. These clusters are: Cluster A, which includes paranoid, schizoid, and schizotypal disorders and is known as the odd or eccentric cluster; Cluster B, consisting of antisocial, borderline, histrionic, and narcissistic disorders, termed the dramatic, emotional, or erratic cluster; and Cluster C, encompassing avoidant, dependent, and obsessive-compulsive disorders, named the anxious or fearful cluster. This classification helps to organize the different types of personality disorders until more scientific evidence is available to potentially rearrange them (American Psychiatric Association, 2013). 

Cluster A – Odd or eccentric cluster

1. Paranoid Personality Disorder

It’s natural to be a little cautious when dealing with others, but being overly suspicious can get in the way of making connections and getting through daily life. People with paranoid personality disorder are overly mistrustful and suspicious of others, even when there’s no reason for it. They always think others are trying to harm or deceive them, so they find it hard to open up and trust anyone.

They see innocent events as personal attacks, like a friend forgetting to return a phone call or a passing stranger on the street giving them a quick glance. This constant mistrust can make it tough for them to form meaningful relationships (Bernstein & Useda, 2007). 

2. Schizoid Personality Disorder

We know our fair share of people who prefer to be alone rather than socialize with others. They may prefer to stay in on a Friday night, rather than go out and socialize in crowded places. However, for those grappling with schizoid personality disorder, this preference for solitude is amplified many times over (Hopwood & Thomas, 2012). 

People with this disorder tend to keep to themselves and don’t show much emotion in social situations. They may come across as distant, uninterested, and even cold towards others. The term “schizoid” was coined a while back by Bleuler (1924) to describe folks who tend to withdraw from the world around them. They’re not big on expressing their feelings and often pursue their interests vaguely or abstractly.

People with schizoid personality disorder don’t seem to crave or appreciate close connections with others, including romantic or sexual relationships. Because of this, they often come across as distant and uninterested, and they don’t seem to be influenced by praise or criticism.

3. Schizotypal Personality Disorder

People with schizotypal personality disorder are often socially isolated, much like those with schizoid personality disorder. However, they also tend to act in ways that might seem strange to others and are prone to suspicion and holding unusual beliefs. 

Some experts view schizotypal personality disorder as being on a spectrum with schizophrenia but without some of the more severe symptoms like hallucinations and delusions.

People diagnosed with schizotypal personality disorder may experience symptoms similar to those of psychosis, such as believing that everything relates to them personally. They also struggle with social interactions, and some may have difficulties with thinking or experience paranoia (Kwapil & Barrantes-Vidal, 2012).

Cluster B – Dramatic, emotional, or erratic cluster

1. Antisocial personality disorder

We commonly hear people say that they are “antisocial,” intending to convey a message that they aren’t fond of interacting with others – but it’s crucial to understand that this term means something entirely different…

People with antisocial personality disorder have a history of disregarding societal rules and engaging in unacceptable behaviors like stealing from loved ones. Additionally, they exhibit traits of irresponsibility, impulsiveness, and deceitfulness. Completely devoid of conscience and empathy, they selfishly pursue their desires, violating social norms without feeling any remorse (De Brito & Hodgins, 2009; Hare, 1993, p. xi).

2. Borderline Personality Disorder

Borderline personality disorder (BPD) is a mental health condition characterized by fluctuations in emotions, behaviors, and relationships. Those with BPD often experience intense and erratic emotions, struggle to control their feelings, and grapple with their sense of self and identity. They may engage in impulsive actions, have turbulent relationships, and fear abandonment intensely. These people may often feel empty and are at great risk of dying by their own hands. 

Additionally, individuals with BPD may encounter periods of dissociation, feeling disconnected from reality. While BPD can greatly impact daily life and relationships, with appropriate treatment and support, individuals can learn to manage their symptoms and enhance their overall well-being.

(Barlow & Durand, 2015). 

3. Histrionic Personality Disorder:

Histrionic personality disorder (HPD) is a mental health condition known for excessive attention-seeking behavior and intense emotions. Individuals with HPD often come across as overly dramatic, almost as if they’re performing. This is why the term “histrionic,” meaning theatrical, is used to describe them. 

They constantly seek attention, using dramatic or theatrical tactics to capture it, and are easily influenced by others. Due to their need for constant validation, they struggle to maintain stable relationships and may show shallow or rapidly changing emotions. 

People with HPD have a strong desire to be the center of attention, often relying on their physical appearance or seductive behavior to achieve this. Their behavior can be exemplified by actions like hugging someone they’ve just met or crying uncontrollably during a sad movie (Blashfield, Reynolds, & Stennett, 2012). 

4. Narcissistic Personality Disorder

We all know people who possess an inflated sense of self, exaggerate their abilities, and believe they are superior to others, deserving of special treatment. In narcissistic personality disorder, this tendency is magnified.

Psychoanalysts, including Freud, coined the term “narcissistic” to describe individuals who exhibit an exaggerated sense of self-importance and are fixated on seeking attention.

Individuals with narcissistic personality disorder possess an excessive sense of self-importance and are so focused on themselves that they lack empathy and compassion for others often taking advantage of them for personal gain.

(Ronningstam, 2012; Barlow & Durand, 2015). 

Seeking the best of everything, they may insist on the finest accommodations during travel, the most prestigious seats at events, etc. When faced with individuals who outshine them, they often exhibit envy and arrogance. Additionally, their failure to meet their own high standards often leads to feelings of depression. (Barlow & Durand, 2015). 

Also Read: Mental Wellness in the Workplace

Illustration depicting clusters of personality disorders concept, featuring various characteristics and traits.

Cluster C – Anxious or Fearful cluster

1. Avoidant Personality Disorder

Individuals with avoidant personality disorder desire contact with others, yet their discomfort in social situations causes them significant anxiety. They experience acute self-consciousness and harsh self-criticism, which often leads to depression. Despite their longing for social connections, their fear of rejection and deeply ingrained low self-esteem prevent them from forming meaningful friendships, forcing them to depend on a small, trusted circle of individuals with whom they feel safe and accepted (Barlow & Durand, 2015; Hooley, et al., 2017; Sanislow, et al., 2012). 

2. Dependent Personality Disorder

We’re all familiar with the concept of relying on someone else, but for individuals with dependent personality disorder, this reliance extends far beyond ordinary needs. They lean on others for both minor and major decisions, driven by an intense fear of abandonment. 

Even when their own opinions differ, they may comply to others’ viewpoints to avoid rejection. This disorder often stems from a deep-seated desire for supportive and nurturing relationships, which manifests in traits like submissiveness, timidity, and passivity. Similar to individuals with avoidant personality disorder, those with dependent personality disorder experience feelings of inadequacy and are highly sensitive to criticism. However, their response significantly differs—they cling to relationships rather than avoid them, seeking constant reassurance and validation from others (Bornstein, 2012; Barlow & Durand, 2015).

3. Obsessive Personality Disorder

Obsessive personality disorder (OCPD) may sound similar to obsessive-compulsive disorder (OCD), but they have distinct differences. While OCPD involves a fixation on perfectionism and control, OCD is characterized by distressing obsessions and compulsions.

People with obsessive-compulsive personality disorder are fixated on perfection and doing things “right.” While their dedication may seem admirable, their focus on details often gets in the way of completing tasks efficiently. Their rigidity also makes it hard for them to build and keep relationships. It’s important to know that this disorder is only loosely related to obsessive-compulsive disorder, which is classified as an anxiety disorder (Samuels & Costa, 2012; Barlow & Durand, 2015)

In a nutshell, personality disorders represent a complex array fo mental health conditions characterized by patterns in which an individual’s thoughts, feelings, and behaviors deviate from societal norms. Personality disorders can significantly disrupt someone’s life, impacting their relationships, work, and day-to-day activities. Seeking treatment or help from psychologist in India is essential because it offers strategies to manage symptoms, improve relationships, and enhance overall well-being, ultimately paving the way for a happier and more fulfilling life journey!

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5©). American Psychiatric Pub, Washington, DC (2013). 

Barlow, D. H., Durand, V. M. (2015). Abnormal Psychology, An Integrative Approach (Seventh Edition). 

Bernstein, D. P., & Useda, J. (2007). Paranoid personality disorder. In W. O’Donohue, K. Fowler, & S. Lilienfeld (Eds.), Personality disorders: Toward the DSM-V (pp. 41–62). Thousand Oaks, CA: Sage.

Bleuler, E. (1924). Textbook of psychiatry (A. A. Brill, Trans.). New York, NY: Macmillan.

Cloninger, C. R., & Svakic, D. M. (2009). Personality disorders. In B. J. Sadock, V. A. Sadock, & P. Ruiz (Eds.), Kaplan & Sadock’s comprehensive textbook of psychiatry (9th ed., Vol. II, pp. 2197–2240). Philadelphia, PA: Lippincott Williams & Wilkins.

De Brito, S. A., & Hodgins, S. (2009). Antisocial personality disorder. In M. McMurran & R. C. Howard (Eds.), Personality, personality disorder and violence: An evidence-based approach (pp. 133–154). New York, NY: Wiley.

Hare, R. D. (1993). Without conscience: The disturbing world of the psychopaths among us. New York, NY: Pocket Books.

Hooley, J.M., Butcher, J, N., Nock, M., & Mineka, S. (2017). Abnormal Psychology, 17th Edition.

Hopwood, C. J., & Thomas, K. M. (2012). Paranoid and schizoid personality disorders. In T. A. Widiger (Ed.), The Oxford handbook of personality disorders (pp. 582–602). New York: Oxford University Press.

Kwapil, T. R., & Barrantes-Vidal, N. (2012). Schizotypal personality disorder: An integrative review. In T. A. Widiger (Ed.), The Oxford handbook of personality disorders (pp. 437–477). New York, NY: Oxford University Press.

Pulay, A. J., Stinson, F. S., Dawson, D. A., Goldstein, R. B., Chou, S. P., Huang, B., & Ruan, W. J. (2009). “Prevalence, correlates, disability, and comorbidity of DSM-IV schizotypal personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions.” Primary Care Companion Journal of Clinical Psychiatry, 11(2), 53.

Ronningstam, E. (2012). Narcissistic personality disorder: The diagnostic process. In T. A. Widiger (Ed.), The Oxford handbook of personality disorders (pp. 527–548). New York, NY: Oxford University Press.

Samuels, J., & Costa, P. T. (2012). Obsessive-compulsive personality disorder. In T. A. Widiger (Ed.), The Oxford handbook of personality disorders (pp. 566–581). New York, NY: Oxford University Press.

Sanislow, C. A., da Cruz, K. L., Gianoli, M. O., & Reagan, E. M. (2012). Avoidant personality disorder, traits, and type. In T. A. Widiger (Ed.), The Oxford handbook of personality disorders (pp. 549–565). New York, NY: Oxford University Press.

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Stinson, F. S., Dawson, D. A., Goldstein, R. B., Chou, S. P., Huang, B., Smith, S. M., & Pickering, R. P. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 69(7), 1033.

Torgersen, S. (2012). Epidemiology. In T. A. Widiger (Ed.), The Oxford handbook of personality disorders (pp. 186–205). New York, NY: Oxford University Press.

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