There exists 3 different subtypes categorised by “Clusters A, B and C.
Cluster A personality disorders;
Having a cluster A personality disorder means that you find it difficult to relate to other people. You might be viewed by others as odd or eccentric.
- Paranoid Personality Disorder
- Schizoid Personality Disorder
- Schizotypal Personality Disorder
Cluster B personality disorders;
Cluster B personality disorders are grouped based on those who find it difficult to control their emotions. You might be viewed as unpredictable by others.
- Antisocial Personality Disorder
- Histrionic Personality Disorder
- Narcissistic Personality Disorder
- Borderline Personality Disorder
Cluster C personality disorders;
Cluster C personality disorders can make you avoid or cling to people, depending on the specific disorder.
- Avoidant Personality Disorder
- Dependent Personality Disorder
- Obsessive- Compulsive Personality Disorder
These are the 10 personality disorders.
You can only be diagnosed with a personality disorder by a trained professional, a psychiatrist or psychologist. Your GP cannot diagnose you.
To be diagnosed with a personality disorder you have to meet certain criteria including behavioural traits and history.
As a general rule you need to be over the age of 18 to be diagnosed but more recently you can be diagnosed slightly earlier as of showing signs or a personality disorder.
So what do they all mean?
Paranoid personality disorder (PPD) is a mental health condition marked by a pattern of distrust and suspicion of others without adequate reason to be suspicious. People with PPD are always on guard, believing that others are constantly trying to demean, harm or threaten them.
Schizoid personality disorder (SPD) is a chronic and pervasive condition characterized by social isolation and feelings of indifference toward other people. 1 Those that live with this disorder are often described as distant or withdrawn and tend to avoid social situations that involve interaction with other people.
Schizotypal personality disorder (STPD) is a mental health condition marked by a consistent pattern of intense discomfort with close relationships and social interactions. People with STPD have distorted views of reality, superstitions and unusual behaviours. Their relationships are usually hindered by their symptoms.
Histrionic personality disorder is commonly described as dramatic, excitable, erratic, or volatile. Specifically, people with histrionic personality disorder are typically characterized as flirtatious, seductive, charming, manipulative, impulsive, and lively.
Narcissistic personality disorder is a mental condition in which people have an inflated sense of their own importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others.
Borderline personality disorder (BPD) also known as Emotionally unstable Personality Disorder (EUPD)is a condition that affects how you think, feel and interact with other people.
Symptoms of borderline personality include being emotionally unstable, having upsetting thoughts and acting without thinking.
The main treatment for borderline personality disorder is a type of talking therapy called psychotherapy.
The cause of borderline personality disorder is unclear. It’s been linked to traumatic events during childhood, such as neglect or abuse.
Antisocial personality disorder (ASPD) is a condition characterized by a lack of empathy and regard for other people. People who have antisocial personality disorder have little or no regard for right or wrong. They antagonize and often act insensitively or in an unfeeling manner. Individuals with this disorder may lie, engage in aggressive or violent behaviour, and participate in criminal activity.
Avoidant personality disorder (AVPD) is an enduring pattern of behaviour related to social inhibition, feelings of inadequacy, and sensitivity to rejection that causes problems in work situations and relationships.
Dependent personality disorder (DPD) is a type of anxious personality disorder. People with DPD often feel helpless, submissive or incapable of taking care of themselves. They may have trouble making simple decisions. But, with help, someone with a dependent personality can learn self-confidence and self-reliance.
Obsessive-compulsive personality disorder is characterized by a pervasive preoccupation with orderliness, perfectionism, and control (with no room for flexibility) that ultimately slows or interferes with completing a task.
These are the ten different types of personality disorder but they can overlap in symptoms making things more complicated. It is often the case to receive a dual diagnosis but will almost always be from the same cluster type.
Want to know more about personality disorders? Read on….
To be diagnosed with a personality disorder you have to meet certain criteria as defined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders)
(DSM-5 contains the most up-to-date criteria for diagnosing mental disorders, along with extensive descriptive text, providing a common language for clinicians to communicate about their patients).
Usually done by a psychiatrist they will evaluate you symptoms and history to make a diagnosis.
What are the criteria for personality disorder diagnosis?
Paranoid Personality Disorder;
An individual with PPD is very suspicious of other people, which may interfere with their daily life and activities. They mistrust the motives of others and believe that others want to harm them.
Additional hallmarks of this condition include:
- being reluctant to confide in others
- bearing grudges
- finding demeaning or threatening subtext in even the most innocent of comments or events
- quickly feeling anger and hostility toward others
The DSM-5 diagnostic criteria state that people must display at least four of the following symptoms in order to be diagnosed with SPD: Always chooses solitary activities. Emotional detachment and lack of emotional expression4 Experiences little pleasure from activities.
For a diagnosis of Narcissistic personality disorder, patients must have;
A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by 5 (or more) of the following:
* Is uncomfortable in situations in which he or she is not the centre of attention
* Interaction with others is often characterized by inappropriate sexually seductive or provocative behaviour
* Displays rapidly shifting and shallow expression of emotions
* Consistently uses physical appearance to draw attention to self
* Has a style of speech that is excessively impressionistic and lacking in detail
* Shows self-dramatization, theatricality, and exaggerated expression of emotion
* Is suggestible (i.e. – easily influenced by others or circumstances)
* Considers relationships to be more intimate than they actually are
Antisocial Personality Disorder criteria
The DSM-5’s criteria for ASPD require that the individual have conduct problems evident by the age of 15. Persistent antisocial behaviours, as well as a lack of regard for others in childhood and adolescence, are known as conduct disorder and are the precursor of ASPD.
Borderline Personality Disorder criteria
Diagnostic criteria of borderline personality disorder*
A pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by 5 (or more) of the following:
- Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behaviour
- A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
- Identity disturbance: markedly and persistently unstable self-image or sense of self.
- Impulsivity in at least 2 areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behaviour.
- Recurrent suicidal behaviour, gestures or threats, or self-mutilating behaviour.
- Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days).
- Chronic feelings of emptiness.
- Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
- Transient, stress-related paranoid ideation or severe dissociative symptoms.
Avoidant Personality Disorder criteria
The person must exhibit at least four to meet the diagnostic threshold. The criteria are:
- Avoids occupational activities involving significant interpersonal contact, due to fears of criticism, disapproval, or rejection
- Is unwilling to get involved with people unless certain of acceptance
- Shows restraint within intimate relationships due to fears of shame or ridicule
- Preoccupied with fears of receiving criticism or rejection in social situations
- Inhibited in new interpersonal situations due to feelings of inadequacy
- Considers self as inferior to others, socially inept, or personally unappealing
- Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing
Dependant Personality Disorder criteria
- Troubled making daily decisions unless he gets a lot of advice and encouragement from others.
- The intense need for others to take responsibility for major aspects of one’s life.
- Trouble expressing discord with people due to fear of losing appreciation or approval. (Note: Does not include true fears of retribution.)
- Trouble creating projects or initiating something by himself (due to a lack of self-esteem in making judgments and capabilities instead of a lack of determination or energy).
- Exerting too much effort in obtaining nurturance and appreciation from other people to the extent of volunteering to do displeasing things
- Feeling helpless or uncomfortable when he is by himself because of too much fear of being unable to take care of themselves
- An urgent need for new relationships to feel cared for and supported when a relationship ends. Unrealistic preoccupation with a fear of being alone and obliged to care for themselves
Obsessive-compulsive personality disorder criteria
- perfectionism to the point that it impairs the ability to finish tasks
- stiff, formal, or rigid mannerisms
- being extremely frugal with money
- an overwhelming need to be punctual
- extreme attention to detail
- excessive devotion to work at the expense of family or social relationships
- hoarding worn or useless items
- an inability to share or delegate work because of a fear it won’t be done right
- a fixation with lists
- a rigid adherence to rules and regulations
- an overwhelming need for order
- a sense of righteousness about the way things should be done
- a rigid adherence to moral and ethical codes
OCPD is diagnosed when symptoms impair your ability to function and interact with others.
How is personality disorder treated?
The treatment that’s best for you depends on your particular personality disorder, its severity and your life situation. Often, a team approach is needed to make sure all of your psychiatric, medical and social needs are met. Because personality disorders are long-standing, treatment may require months or years.
During psychotherapy with a mental health professional, you can learn about your condition and talk about your moods, feelings, thoughts and behaviours. You can learn to cope with stress and manage your disorder.
Psychotherapy may be provided in individual sessions, group therapy, or sessions that include family or even friends. There are several types of psychotherapy — your mental health professional can determine which one is best for you.
You may also receive social skills training. During this training you can use the insight and knowledge you gain to learn healthy ways to manage your symptoms and reduce behaviours that interfere with your functioning and relationships.
There are no medications specifically approved by the Food and Drug Administration (FDA) to treat personality disorders. However, several types of psychiatric medications may help with various personality disorder symptoms.
- Antidepressants. Antidepressants may be useful if you have a depressed mood, anger, impulsivity, irritability or hopelessness, which may be associated with personality disorders.
- Mood stabilizers. As their name suggests, mood stabilizers can help even out mood swings or reduce irritability, impulsivity and aggression.
- Antipsychotic medications. Also called neuroleptics, these may be helpful if your symptoms include losing touch with reality (psychosis) or in some cases if you have anxiety or anger problems.
- Anti-anxiety medications. These may help if you have anxiety, agitation or insomnia. But in some cases, they can increase impulsive behaviour, so they’re avoided in certain types of personality disorders.
In some cases, a personality disorder may be so severe that you need to be admitted to a hospital for psychiatric care. This is generally recommended only when you can’t care for yourself properly or when you’re in immediate danger of harming yourself or someone else.
After you become stable in the hospital, your doctor may recommend a day hospital program, residential program or outpatient treatment.
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy (CBT) is a common type of talk therapy (psychotherapy). You work with a mental health counsellor (psychotherapist or therapist) in a structured way, attending a limited number of sessions. CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way.
CBT can be a very helpful tool either alone or in combination with other therapies in treating mental health disorders, such as depression, post-traumatic stress disorder (PTSD) or an eating disorder. But not everyone who benefits from CBT has a mental health condition. CBT can be an effective tool to help anyone learn how to better manage stressful life situations.
Dialectical Behaviour Therapy (DBT)
Dialectical behaviour therapy (DBT) is a type of talk therapy (psychotherapy). It’s based on cognitive behavioural therapy (CBT), but it’s specially adapted for people who experience emotions very intensely.
Cognitive behavioural therapy (CBT) is a type of talk therapy that helps people understand how thoughts affect emotions and behaviours.
“Dialectical” means combining opposite ideas. DBT focuses on helping people accept the reality of their lives and their behaviours, as well as helping them learn to change their lives, including their unhelpful behaviours.
Dialectical behaviour therapy was developed in the 1970s by Marsha Linehan, an American psychologist.
Dialectical behaviour therapy (DBT) is especially effective for people who have difficulty managing and regulating their emotions.
DBT has proven to be effective for treating and managing a wide range of mental health conditions, including:
- Borderline personality disorder (BPD).
- Suicidal behaviour.
- Post-traumatic stress disorder (PTSD).
- Substance use disorder.
- Eating disorders specifically binge eating disorder and bulimia.
Personality disorders and medical comorbidity
In general those with personality disorders do not feel as fit as others do. Also, those with personality disorders in addition to other psychiatric disorders, such as depression and antisocial personality disorder, are likely to have more health problems than those without personality disorders. People with active borderline personality disorder have been shown to have more medical problems than those with remitted borderline personality disorder. Personality disorders can complicate the course of chronic medical illnesses. Finally, the use of psychotropic medications is not unusual in personality disorders and in itself can be associated with medical illnesses.
Around one in 20 people in the UK has a personality disorder.
Individuals with personality disorders have higher morbidity and mortality than the general population an this may be due to maladaptive health behaviours such as smoking.
Individual differences in underlying personality dimensions of behavioural under control, affective dysregulation, psychoticism and antagonism are thought to explain the high comorbidity between PDs and smoking and nicotine dependence.
In particular, borderline personality disorder (BPD) is comorbid with alcohol use, cigarette use and nicotine dependence.
It is important for professionals to recognise this and encourage smoking cessation or switch to a safer alternative such as e-cigarettes.
E-cigarettes / disposable vapes offer a good alternative to get the nicotine they crave without shortening their lives any further.