Personality disorders are defined as continuous patterns of behavior and internal experiences that are highly deviant from most societal and cultural expectations or norms. Such behaviors are inflexible and pervasive. They start in late childhood or early adulthood, continue over time, and provide a source of distress and even impairment.
DSM-V, the main diagnostic manual used by mental health professionals, organizes personality disorders into three clusters (A, B and C) that represent an umbrella for the 10 recognized disorders.
How long have personality disorders been diagnosed?
The concept of a personality disorder is fairly recent and only dates back to about 1801. A French psychiatrist named Philippe Pinel detailed a condition he called mania without symptoms of delirium, such as delusions or hallucinations. The mania would be characterized by violent outbursts and sudden fits of rage.
In 1896, a German psychiatrist named Emil Kraepelin further created an umbrella of what he called a psychopathic personality, beneath which he detailed seven types of antisocial behavior. His young colleague Kurt Schneider would go on to help broaden the idea, and his book "Psychopathic Personalities" is still used as the basis for today's classification.
What are the symptoms of personality disorders?
The four core features indicating a personality disorder are as follows:
- Distorted thought patterns
- Disturbing emotional responses
- Impulse control that is over or under regulated
- Interpersonal problems
These four features are found in every personality disorder, but they combine in a variety of ways to form each of the 10 unique disorders. In order to be diagnosed, a patient must display significant and long-standing problems in at least two of the four areas. Besides that, each disorder also presents a list of specific characteristics associated with it.
There are three personality disorder clusters known as A, B, and C. The A cluster is described as odd, eccentric, and bizarre. The B cluster is dramatic, overly emotional, and erratic. The C cluster is anxious, fearful, and nervous.
More than one personality disorder can be present in a single patient. Sometimes the disorders in one cluster may occur in the same person. In order to be diagnosed with any of the disorders, the patient must show significant symptoms that are distressing or causing impairment.
How are personality disorders categorized?
- Cluster A includes paranoid, schizoid, and schizotypal disorders. The most common symptoms of these disorders are social ineptness and withdrawal. The most dominant of the four core features is distorted thought patterns.
Those with paranoid personality disorder are intensely distrustful and think that everyone is "out to get them" in some way. They often hold grudges and display intense jealousy.
Schizoid types tend to be socially withdrawn and detached. It is often typified by an inability to reproduce normal human emotions. Schizotypal patients differ slightly in that they display eccentric behavior and odd beliefs, like the ability to read minds.
- Cluster B includes borderline, narcissistic, antisocial and histrionic personality disorders. These disorders are characterized by problems with impulse control and regulating emotions.
Those with antisocial disorders often display hostile and aggressive behavior that appears in childhood. The histrionic disorder is somewhat the opposite, with sufferers displaying dramatic and uncontrollable emotions.
Those with narcissistic personality disorders are extremely insecure and entitled. They might believe they deserve special treatment and that they are uniquely talented. Borderline cases tend to view the world in over-simplified, polarized terms and have unstable moods and intense emotions.
- Cluster C includes avoidant, dependent and obsessive compulsive disorders. These disorders are dominated by high levels of anxiety and fearfulness.
Avoidant personality disorders usually have a pattern of avoiding social interaction due to the fear of being rejected, criticized, or ridiculed. Dependent disorders are the opposite, with patients having a strong need to be taken care of. Obsessive compulsive disorders are characterized by a strong obsession with lists, rules, and details. Sufferers compulsively create rigid structures of perfectionism for themselves.