Personality disorders are characterized by the predominance or deficiency of certain personality traits that cause disturbances in a person's daily functioning at home or at work. The personality traits associated with these disorders are present in all individuals to varying extents since childhood but they tend to be firmly established only by adulthood.
The personality disorders are classified into different types, depending on the type of trait that is more dominant in the individual.
There are three broad clusters or groups of personality disorders, within which there are several specific personality disorders. Personality disorders in each cluster have similar characteristics and symptoms along with certain specific personality traits.
Cluster A: Disorders characterized by odd or eccentric behavior
Cluster B: Disorders characterized by dramatic, erratic or emotional behavior
Cluster C: Disorders characterized by anxious and fearful behavior
For a person to be diagnosed with any of these disorders there has to be an observable pattern of behavior that causes distress at a personal, interpersonal or occupational level.
Note: All of us have the traits that are described in the individual classifications. Some of the behavioral symptoms suggested in the classifications may be present in you, or those around you. Remember that the trait becomes a personality disorder only when:
a) The traits are present to an extreme, and influences the person’s view of themselves, others and their environment. The person exhibits these traits across a sustained period of time, and they are clearly evident in different situations.
b) The traits cause significant distress to the individual and to those around him or her
These descriptions are meant to be guidelines for identifying a problem, but by no means indicate or confirm the presence of a disorder. The diagnosis must be done by a mental health professional.
The disorders in this cluster are dominated by distorted patterns of thinking and behavior that others may not be able to understand. The person tends to be highly suspicious of others, prefers being by themselves, and shows indifference towards others, profoundly impacting their relationships and the way they function in daily life.
A person with paranoid personality disorder finds it very difficult to trust others. Unlike others, they do not keep this mistrust to themselves – they show it through their actions and behavior. The person has a general mistrust of people including their family, close friends and relatives. They are constantly afraid that these people may cheat or harm them or take advantage of them. This makes them emotionally detached from their loved ones. They may not be willing to confide anything, even with their spouse. They may hold a grudge against a person for a minor mistake even long after the incident. They are unable to cooperate and work with other people. They may also voice out their suspicions, and tell others that they know about their motives.
A person with paranoid personality disorder may be unwilling to share his computer with other people (including his friends or family) due to the fear that someone may hack into his data – even when it may cost him his job or a relationship.
Persons with schizoid personality disorders tend to be cold and aloof. They are happy to be alone. They do not like social interaction, or participate in activities that others enjoy. They do not seem to be happy when they are praised, or disturbed when they are criticized, and may not want to be involved in matters that can affect them, or their family and friends. Others may see them as cold and unresponsive, and this makes it difficult for family and friends to have a meaningful interaction with them.
A person with this disorder may feel lost if they are compelled to spend time in a social situation; they don’t know what to do or say. They may also avoid situations in which they may be forced to interact with others.
Schizotypal Personality Disorder is a combination of some of the traits exhibited by those with schizoid and paranoid personality disorder. The person is generally distrustful of others, and keeps himself away from establishing close relationships. In addition to these symptoms, the person may also have some behavior that seem eccentric to those around them. The person may also exhibit repeated patterns of strange behavior: checking things repeatedly, making sure everything is symmetrical, or having to count the number of grains on their plate.
The repetitive behavior of persons with schizotypal personality disorder can sometimes be confused as symptoms of obsessive compulsive personality disorder. A person with obsessive compulsive personality disorder is aware that their behavior is silly, bizarre or irrational, but is unable to alter it. A person with schizotypal personality disorder, on the other hand, is not aware that his or her behavior is irrational or abnormal.
A person with this disorder is also likely to have ‘magical thinking’ – that is, making a cause-effect inference from two events that are not connected in any way. They may have a huge interest in superstitions or the paranormal. The person also has trouble real events, and those that they have imagined.
The disorders in this cluster are marked by a behavior that is seen as dramatic or overly emotional. They believe that their needs are more important than that of others, and they often pursue them at the cost of those around them. Another commonality among these disorders is that the individual is unable to see beyond the immediate outcome of their actions, and consequently has problems with impulse control, and managing emotions.
The one trait that identifies a person with antisocial personality disorder is the callous disregard for the concerns of others and the consequences of their actions, as long as it meets their own needs. The person is unable to see the future impact of his actions on others or self, even if they are counterproductive. The person also has a strong sense of entitlement and a feeling of being superior and more deserving than others.
A person with antisocial personality disorder displays destructive behavior – being emotionally and physically violent; breaking the rules; disregard for others property (eg., breaking things that belong to others). These individuals may have had persistent behavioral difficulties as children, often expressed through bullying, intimidation and physical violence towards more vulnerable groups, such as weaker children and small animals. They often see nothing wrong with their behavior, or the harm they cause to themselves or others. They may be able to justify their behavior to convince others that the violence was necessary. They can be very aggressive and manipulative as well – lying or using others to get things done; pretending to regret their actions just to gain acceptance, and slipping back into antisocial behavior once their objectives are met.
People with antisocial personality disorder tend to be reckless. They may take risks and also have substance abuse problems. They may refuse to take responsibility for their actions, or consider others’ circumstances or point of view.
Borderline personality disorder (BPD) is a disorder that affects the way a person manages their emotions, and reacts to situations. The person may not have a fixed idea of their identity, and go through a constant struggle of trying to ‘fit in’. Their personality traits appear to change depending on which group of people they are with; this makes them seem needy and attention-seeking. People with BPD are highly emotionally sensitive to events happening around them; this causes them a great deal of distress as they struggle to cope with everyday life.
The word ‘narcissist’ is used to describe a person who is obsessed with himself, admires his own looks, qualities and traits, and takes excessive pride in them.
A person with narcissistic personality disorder has extreme obsession with themselves. They are preoccupied with fantasies of his or her own beauty, importance and greatness. The person may believe that they are entitled to some special treatment, power, riches and success. The person may be so lost in fantasies of power and success, that they neglect to actually work towards making it happen. They may often use the limitations of others to demonstrate their own superior status, and are willing to undermine others to achieve their superiority.
People with NPD are seen by others as haughty, snobbish or arrogant. While they seem distant and haughty, they are actually very sensitive to criticism. The patient may be impulsive, and constantly crave attention from others. They may also take advantage of others in order to achieve the goals they think they deserve.
The sense of feeling special, along with having a self-centered attitude makes it difficult for a person with this disorder to have fulfilling relationships with others.
The term megalomania (which means an obsession with greatness) is sometimes used with reference to this disorder.
As the name suggests, Histrionic Personality Disorder is characterized by intense displays of emotion and attention-seeking behavior. A person with this disorder always wants to be the center of attention in any gathering. They may be willing to go any lengths to get this attention, including the threat of committing suicide. They tend to display all emotions, happy or sad, in an exaggerated fashion. They constantly seek others’ attention and approval; this may reflect in their dressing style, their behavior (dramatic display of emotion, flattering, or flirting to get attention) and tendency to take impulsive decisions without evaluating the risks (trying to kill themselves).
In their relationships, they imagine a greater level of intimacy than actually exists – someone may see them as just an acquaintance, but they treat the other like a very dear friend. The exaggeration in their emotions makes their behavior look superficial or fake. They are seen as fickle and easily influenced by others. They have short attention spans and may not be able to stick with a single project for a long time. They crave excitement and attention, and are uncomfortable when they are not the center of attention.
The disorders in this cluster are characterized by anxiety, compulsive and obsessive-compulsive behavior, and isolation. The major feature of this cluster is the high level of anxiety people have about their own self that stems from doubts of their own abilities, making it difficult for them to function.
A person with avoidant personality disorder is extremely concerned about what others may think about him or her. They are extremely fearful that others will judge them negatively, identify their flaws, or think of them as useless or unworthy. This puts them in a state of anxiety, unable to relax when in the midst of people.
People with avoidant personality disorder have a low sense of self-esteem. They are plagued by beliefs that they are not intelligent enough, not good enough, not rich enough or not worthy enough. They are fearful of interacting with people who they see as superior or better than them (which may not be true). They are desperate for interaction and connection, and at the same time afraid of criticism and rejection. They try to avoid situations involving social interaction due to the fear of being judged. They are extremely sensitive to criticism – they may see any criticism of their actions as rejection of them. Others see them as shy, stiff and emotionally distant.
A person with dependent personality disorder is dependent on those around them. They think they are not capable of taking decisions on their own, and are afraid of taking responsibilities for their own care, or their work. They are prepared to be submissive and obedient in order to get support, to the extent of doing things they don’t really want to do. They feel helpless when they have to do anything on their own. They constantly need to have someone to ‘take care’ of them. Others may see them as needy and clingy. For the person with the disorder, losing a relationship is such a great fear that they make themselves prey to abuse or ill-treatment. The person is also likely to develop anxiety disorders or depression.
A person with obsessive compulsive personality disorder is rigid in their ideas of how things should be done. They want everything to be done to perfection and are willing to go any lengths to achieve this. They are rigid in their approach: a task cannot just be done; it has to meet their exact standards, and anything below the standard they expect may fill them with extreme anxiety. They are willing to forego fun, rest or even neglect their physical wellbeing to make sure that something is done just the way they like it. This makes them unwilling to delegate tasks and take on more than they can manage. They are also likely to be obsessive workers, neglecting their personal lives for perfection in professional tasks.
A person obsessive compulsive personality disorder may have a strong affinity for rules and regulations. They try to control how things are done by laying down rules, making lists and creating schedules that have to be strictly followed. They may be seen by others as miserly because they like to control how they spend their money, and are fearful of losing it. The person may understand that his or her behavior as being irrational or unreasonable, but is unable to alter such behavior.
Difference between OCD and OCPD
Obsessive compulsive personality disorder is sometimes confused with obsessive compulsive disorder due to the similarity of symptoms and behavior.
A person with obsessive compulsive disorder repeats the same behavior over and over again to avoid the distress caused by the compulsions. A person with OCPD, on the other hand, has no compulsions of this sort. They show certain behaviors because of the fear of losing control, or being perceived as imperfect. They may get panic attacks when faced with a situation where they cannot control the outcome. In both cases, the behavior is caused by anxiety. While the anxiety in a person with OCD is caused by the compulsion to perform certain tasks, a person with OCPD experiences anxiety due to their personality traits. (In most cases, the trait of doing things to perfection or rigid thinking about how things should be done causes anxiety).
A person with OCD recognizes that their behavior is irrational or eccentric. A person with OCPD does not know that their behavior is abnormal.