ANGIRA GUPTA

CLINICAL PSYCHOLOGY
Psychopathology - 3
Personality disorder is an enduring pattern of inner experience and behavior that deviates
markedly from the norms and expectations of the individual’s culture, is pervasive and
inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to
distress or impairment.
The following personality disorders are included:
● Paranoid personality disorder is a pattern of distrust and suspiciousness such that
others’ motives are interpreted as malevolent.
● Schizoid personality disorder is a pattern of detachment from social relationships and
a restricted range of emotional expression.
● Schizotypal personality disorder is a pattern of acute discomfort in close
relationships, cognitive or perceptual distortions, and eccentricities of behavior.
● Antisocial personality disorder is a pattern of disregard for, and violation of, the
rights of others, criminality, impulsivity, and a failure to learn from experience.
● Borderline personality disorder is a pattern of instability in interpersonal
relationships, self image, and affects, and marked impulsivity.
● Histrionic personality disorder is a pattern of excessive emotionality and attention
seeking.
● Narcissistic personality disorder is a pattern of grandiosity, need for admiration, and
lack of empathy.
● Avoidant personality disorder is a pattern of social inhibition, feelings of inadequacy,
and hypersensitivity to negative evaluation.
● Dependent personality disorder is a pattern of submissive and clinging behavior
related to an excessive need to be taken care of.
● Obsessive-compulsive personality disorder is a pattern of preoccupation with
orderliness, perfectionism, and control.
Clusters:
The personality disorders are grouped into three clusters based on descriptive similarities.
- Cluster A includes paranoid, schizoid, and schizotypal personality disorders.
Individuals with these disorders often appear odd or eccentric.
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- Cluster B includes antisocial, borderline, histrionic, and narcissistic personality
disorders. Individuals with these disorders often appear dramatic, emotional, or
erratic.
- Cluster C includes avoidant, dependent, and obsessive-compulsive personality
disorders. Individuals with these disorders often appear anxious or fearful. It should
be noted that this clustering system, although useful in some research and educational
situations, has serious limitations and has not been consistently validated.
Diagnostic Criteria (FOR DETAILED CRITERIA PLEASE REFER TO
DSM 5)
Paranoid Personality Disorder: A pervasive distrust and suspiciousness of others such that
their motives are interpreted as malevolent, beginning by early adulthood and present in a
variety of contexts.
Schizoid Personality Disorder: A pervasive pattern of detachment from social relationships
and a restricted range of expression of emotions in interpersonal settings, beginning by early
adulthood and present in a variety of contexts.
Schizotypal Personality Disorder: A pervasive pattern of social and interpersonal deficits
marked by acute discomfort with, and reduced capacity for, close relationships as well as by
cognitive or perceptual distortions and eccentricities of behavior, beginning by early
adulthood and present in a variety of contexts.
Antisocial Personality Disorder: A pervasive pattern of disregard for and violation of the
rights of others, occurring since age 15 years.
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.
Histrionic Personality Disorder: A pervasive pattern of excessive emotionality and
attention seeking, beginning by early adulthood and present in a variety of contexts.
Narcissistic Personality Disorder: A pervasive pattern of grandiosity (in fantasy or
behavior), need for admiration, and lack of empathy, beginning by early adulthood and
present in a variety of contexts.
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Avoidant Personality Disorder: A pervasive pattern of social inhibition, feelings of
inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and
present in a variety of contexts.
Dependent Personality Disorder: A pervasive and excessive need to be taken care of that
leads to submissive and clinging behavior and fears of separation, beginning by early
adulthood and present in a variety of contexts.
Obsessive-Compulsive Personality Disorder: A pervasive pattern of preoccupation with
orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility,
openness, and efficiency, beginning by early adulthood and present in a variety of contexts.
What causes personality disorders?
Research suggests that genetics, abuse and other factors contribute to the development of
obsessive-compulsive, narcissistic or other personality disorders.
In the past, some believed that people with personality disorders were just lazy or even evil.
But new research has begun to explore such potential causes as genetics, parenting and peer
influences:

● Genetics: Researchers are beginning to identify some possible genetic factors behind
personality disorders. One team, for instance, has identified a malfunctioning gene
that may be a factor in obsessive-compulsive disorder.Other researchers are exploring
genetic links to aggression, anxiety and fear — traits that can play a role in
personality disorders.
● Childhood trauma: Findings from one of the largest studies of personality disorders,
the Collaborative Longitudinal Personality Disorders Study, offer clues about the role
of childhood experiences. One study found a link between the number and type of
childhood traumas and the development of personality disorders. People with
borderline personality disorder, for example, had especially high rates of childhood
sexual trauma.
● Verbal abuse: Even verbal abuse can have an impact. In a study of 793 mothers and
children, researchers asked mothers if they had screamed at their children, told them
they didn’t love them or threatened to send them away. Children who had experienced
such verbal abuse were three times as likely as other children to have borderline,
narcissistic, obsessive-compulsive or paranoid personality disorders in adulthood.
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● High reactivity: Sensitivity to light, noise, texture and other stimuli may also play a
role. Overly sensitive children, who have what researchers call “high reactivity,” are
more likely to develop shy, timid or anxious personalities. However, high reactivity’s
role is still far from clear-cut. Twenty percent of infants are highly reactive, but less
than 10 percent go on to develop social phobias.

Treatment
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. The treatment team may include your primary doctor or other
primary care provider as well as a:

➔ Psychiatrist
➔ Psychologist or therapist
➔ Psychiatric nurse

Psychotherapy: Psychotherapy, also called talk therapy, is the main way to treat personality
disorders. During psychotherapy with a mental health professional, you can learn about your
condition and talk about your moods, feelings, thoughts and behaviors. 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 behaviors
that interfere with your functioning and relationships. Family therapy provides support and
education to families dealing with a family member who has a personality disorder.

Medications: 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.
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➔ 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 behavior, so they're avoided
in certain types of personality disorders.

Hospital and residential treatment programs: 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.