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Understanding Personality Disorders: Types, Traits, and Treatment

Delve into the world of personality disorders, including Cluster A's eccentric traits, Cluster B's dramatic behaviors, and Cluster C's anxious characteristics. Learn about the dimensional models of personality and treatment options to improve quality of life.

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Understanding Personality Disorders: Types, Traits, and Treatment

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  1. Personality Disorders Rebecca Sposato, MS, RN

  2. Overview of Personality Disorders • Personality: an enduring pattern of inner experiences, emotional responses, attitudes and behaviors in an individual • Takes years to change • Personality Disorders occupy Axis-II in the DSM-IV • conduct follows an inflexible, pervasive pattern that significantly deviates from cultural expectations and leads to distress and impairment • Emerge during adolescence or young adulthood

  3. Dimensional Models of Personality • Personality is seen as place of intersection of 5 major traits: openness, conscientiousness, extraversion, agreeableness, neuroticism • For persons with disorders the intersection is not in the middle • The DSM-IV has 3 categories of personality disorders, based on their location on grid

  4. Cluster A: Eccentric • Paranoid: hold others in distrust, interpret the actions of peoples or entities as malevolent without evidence. • Conspiracy theories, accuse others of plotting and hold grudges for minor infractions • vigilant for expected personal attacks • Poor social relationships and interactions • 1% of general population, 20% of inpt. Psych pop.

  5. Cluster A: Eccentric • Schizoid: Social detachment and bland emotional range • Strongly introverted and indifferent to other’s opinions, approvals or criticisms • Few to none quality relationships/interactions • Drifting life goals, passive to change or adverse events • Considered too uncommon in clinical settings for statistical comparisons

  6. Cluster A: Eccentric • Schizotypal: Distorted interpretation of things, events and actions by others • Magical, paranormal and superstitious explanations • Anxious social interactions and reduced capacity for social relationships, ‘feel like an outsider’ • 50% qualify for depression disorder • 3% of general population

  7. Cluster B - Dramatic • Antisocial Personality: Inconsiderate, disregard or violation of the rights, wishes and feelings of others • Often engage in high risk and illegal behaviors • Resort to lying, intimidation, extortion and aggression in achievement of goals • Emotional chameleons in usury relationships with a warped sense of victim and villain • General population: 1-3% of general population (more male than female) >25% of prison population

  8. Cluster B: Dramatic • Borderline: unstable self-image, relationships, emotional affect, values and interests • Highly charged emotions, attention seeking • Labile Interpersonal patterns: • Mentally splitting person into ‘good’ and ‘bad’ versions • Range clingy to pushing away • Risky, Reckless and impulsive actions • Suicide threats /attempts (10% complete suicide), self-mutilating and damaging • 2% of general population, 20% of inpt psych

  9. Cluster B: Dramatic • Narcissistic: View self as superior and special, seek attention and approval with consistent devalue and lack empathy for others • Cover for low self-esteem and will react strongly when criticized, very sensitive to disproval • Usury and unilateral relationships • Overestimate their accomplishments, and underestimate the accomplishments of others

  10. Cluster B: Dramatic • Histrionic: excessive emotional expression and attention seeking behaviors • Gage self-esteem by external measures of attention and impressing others • Engage in embelishing, provocative and seductive behaviors when routine interventions do not yield enough attention

  11. Cluster C: Anxious • Avoidant: social inhibition, feeling inadequate and hypersensitive to negative evaluation and rejection • Assume others are primarily critical and disapproving • Do not take risks, try new things or expand comfort zone • Although they desire affection and friendship the end result is self-isolating, limited social circle • 1% of general population

  12. Cluster C: Anxious • Dependent: excessive need to be taken care of leading to submissive and clingy behaviors • Cannot tolerate independence • Will no take the initiative because they lack self confidence they can do an adequate job • Seek advice and reassurance for minor or inconsequential decisions • Will comply with wishes of others even when contrasting their own

  13. Cluster C: Anxious • Obsessive Compulsive Personality: preoccupation with orderliness, perfection and control at the expense of time, flexibility and efficiency • Repeat tasks and work in pursuit of inconsequential details • Limit and delay or try to control leisure time and recreational pursuits • Reluctant to delegate tasks or tolerate preferences of others

  14. Treatment • Identify and change behaviors limiting quality of life • Traditional management of depression, hostility, anxiety, addiction and self harming behaviors • Psychoanalysis, CBT, REBT, DBT, milieu, coping skills

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