A personality disorder is a psychiatric illness in which the patient‘s thoughts, emotions and behaviors are distorted in unhealthy ways. Patients with personality disorders tend to be inflexible and may appear irrational, at least at times, to those around them. Over a long time period, their behavior leads to serious difficulties in school, in the workplace and in relationships. For those with personality disorders, life is troubling and often stormy. For them, everyday stresses often represent overwhelming, or even, insurmountable problems. Believed to begin in childhood, personality disorders may have genetic, as well as environmental underpinnings and are often difficult to treat.
Personality disorders have been divided into three groups, according to their thought and behavior patterns. In some cases, a patient may be diagnosed with one personality disorder but may also have some symptoms of another. Patients need not exhibit all of the symptoms to be diagnosed with a particular personality disorder.
Cluster A Personality Disorders
Cluster A personality disorders are characterized by odd or eccentric thinking or behavior. They differ according to the types of thoughts patients experience and the types of behavior they engage in.
Paranoid Personality Disorder
Patients with paranoid personality disorder are distrustful, suspicious, secretive and often hostile. They attribute malicious motives to those around them, interpret oversights as insults, and hold grudges over imagined slights. It is common for patients with this disorder to suspect disloyalty in friends, co-workers and sexual partners.
Schizoid Personality Disorder
Patients with schizoid personality disorder present as flat emotionally, appearing indifferent or cold. They show little excitement about activities normally considered pleasurable, such as sex, and usually prefer to be alone.
Schizotypal Personality Disorder
Patients with schizotypal personality disorder are considered odd by those who come into contact with them. Their peculiarities of speech, dress and behavior set them apart. Such patients frequently believe that their thoughts have magical powers or that they are being contacted through hidden messages. They may experience auditory hallucinations and have difficulty with social situations or close relationships.
Cluster B Personality Disorders
Patients with cluster B personality disorders are overly emotional and melodramatic. Their thinking and behavior are unpredictable and often disconcerting to those around them.
Antisocial Personality Disorder
Patients with antisocial personality disorder, previously known as sociopaths, are impulsive and irresponsible. They repeatedly lie, steal or misrepresent themselves, frequently veering into criminal behavior. They are unconcerned with the feelings of others and may become aggressive or violent. They may seem to have no conscience, expressing no remorse for their bad behavior.
Borderline Personality Disorder
Patients with borderline personality disorder engage in impulsive, risk-taking behavior, including gambling or unsafe sexual activity. Their relationships are intense and unstable and their lives are filled with drama. These patients are extremely moody, often fluctuating between euphoria and feelings of emptiness or abandonment. Those with borderline personality disorder may have violent outbursts of anger and may threaten or attempt suicide.
Histrionic Personality Disorder
Patients with histrionic personality disorder constantly need to be the center of attention. In order to achieve this, they behave in a theatrical manner, dressing flamboyantly and often being sexually provocative. They tend to exaggerate the details of their life to make them more interesting or dramatic and to believe their relationships are more involved or intimate than they actually are. These patients express themselves with hyperbole and express strong, controversial opinions in order to draw attention to themselves.
Narcissistic Personality Disorder
Patients with narcissistic personality disorder have never passed through the childhood phase of narcissism and continue to believe that they are more important, special and deserving than others. They are not tuned in to the needs or emotions of those around them and tend to be arrogant. Such patients exaggerate their talents and achievements, expecting constant adulation. They may believe that others envy them, but may also experience intense jealousy of those who garner more attention than they do.
Cluster C Personality Disorders
Cluster C personality disorders are characterized by anxious or fearful thinking and behavior. Patients with cluster C disorders tend to withdraw, depend excessively on others, or try to control their surroundings with overly organized routines.
Avoidant Personality Disorder
Patients with avoidant personality disorder are excessively shy, fearful of social contact, particularly with people they don‘t already know. Such patients have low self-esteem and experience even slight criticism as disapproval or rejection. They avoid situations necessitating interpersonal contact, including meetings, parties and social gatherings.
Dependent Personality Disorder
Patients with dependent personality disorder feel incapable of caring for themselves and constantly lean on others for emotional support. Lacking the self-confidence to make even small decisions, they require constant advice and reassurance, becoming irritating to those around them. These patients cling to others, submissive and overly agreeable in an attempt to curry favor and prevent abandonment. They have great difficulty being alone, seeking a replacement as soon as a relationship has ended.
Obsessive-compulsive Personality Disorder
Obsessive-compulsive personality disorder is not the same as obsessive-compulsive disorder. Where individuals with obsessive-compulsive disorder perform rituals to keep emotional demons at bay, patients with obsessive-compulsive personality disorder take pleasure in inflexible habits and details, believing them to be necessary and rational. Far from being troubled by their behavior, such patients are proud of their ability to organize and take control. They are perfectionistic and unable to delegate.
Characteristics of patients with obsessive-compulsive personality disorder may include rigidity in regard to beliefs and opinions and preoccupation with rules, lists, schedules and details. Individuals with this disorder are obsessed with keeping order and control of finances, work projects, household tasks, and even vacations or romantic encounters.