Personality
Disorders
Amy Burgess MS, OTR/L
General Description
• Personality is the combination of thoughts, emotions, behaviors
• Impacts the way people view, understand, and relate to the outside
world, as well as how they see themselves.
• Personality Disorder
● Characteristics and patterns of inner experience and behavior deviate
markedly from culturally accepted norms in areas of cognition, impulse
control and interpersonal relating.
● Behavior inflexible and maladaptive across a broad range of personal and
social situations
● Must have evidence of onset late childhood or adolescence
Types and clusters:
Specific types are grouped into three clusters based on similar
characteristic and symptoms
Cluster A
Individuals often present as odd or eccentric
Paranoid, schizoid and schizotypal personality disorders
Cluster B
Often present as dramatic, emotional and erratic
Antisocial, borderline, histrionic and narcissistic personality disorders
Cluster C
Often perceived as anxious and fearful
Avoidant, dependent, obsessive-compulsive and not otherwise specified
personality disorders
Cluster A
• Paranoid personality disorder
● Longstanding suspicion and distrust of others
● Refuse responsibility for own feelings and assign responsibility to others
● Emotional detachment, can be hostile, irritable and angry
• Schizoid personality disorder
● Lifelong pattern of social withdrawal and isolation
● Uncomfortable with interaction, introverted
● Constricted affect and as eccentric
• Schizotypal personality disorder
● Seen as odd or peculiar in thinking or behavior
● Peculiar ideas, magical thinking, ideas of reference, illusions and derealization are seen
Cluster B personality disorders
• Antisocial personality disorder
● Continual antisocial or criminal
activity
● Inability to conform to social norms
● Disregard for safety and feelings
others
● Lack of remorse
• Borderline personality disorder
● Extraordinarily unstable affect, mood,
behavior, relationships and self image
● Fear of abandonment leads to frantic
efforts to avoid it
● Recurrent self destructive or self
mutilating behavior threatened or
carried out
● Majority have history of trauma/abuse
• Histrionic personality disorder
● Colorful, dramatic, extroverted
behavior
● Excitable and very emotional people
● Inability to maintain deep long lasting
attachments with flamboyant
presentation
• Narcissistic personality disorder
● Increased feeling of self importance
and grandiosity, special in some way
● Failing to recognize other people's
emotions and feelings
Cluster C personality disorders
• Avoidant personality disorder
● Extreme sensitivity to criticism or
rejection
● Can lead to social isolation
● Desire for social relatedness but
consider self unworthy or inept
● Need unusually strong, and repeated
guarantees of unconditional acceptance
● Inferiority complex
• Dependent personality disorder
● Subordinate own needs to those of
others
● Need others to assume responsibility
for major areas of their life
● Dsicomfort when alone and lack self
confidence
• Obsessive-compulsive personality
disorder
● Characterized by:
● Emotional constriction
● Orderliness
● Perseverance
● Stubborness
● Indecisiveness
● Pervasive pattern of perfectionism and
inflexibility.
• Not otherwise specified
● Passive-aggressive
● Depressive
● Sadomasochistic
● Sadistic
Causes, Prevalence and Prognosis
• Thought to be caused by a combination of genetic vulnerability and
environmental influences.
• Onset is late childhood early adolescence
• Prevalence ranges from rare to 9.1% depending on type
• Prognosis varies but often remains unchanged
● Increased risk for depressive disorders
● Some evidence that avoidant, borderline and antisocial personality
disorder symptoms may decrease with age
Increase risk of developing
disorder:
• Family history of personality disorders or other mental illness
• Low socioeconomic status
• Verbal, physical or sexual abuse during childhood
• Neglect during childhood
• An unstable or chaotic family life during childhood
• Being diagnosed with childhood conduct disorder
• Loss of parents through death or traumatic divorce during childhood
Complications and Problems
• Depression
• Child abuse
• Anxiety
• Alcohol or substance abuse
• Eating disorders
• Aggression or violence
• Suicidal behavior
• Incarceration
• Self-injury
• Relationship difficulties
• Reckless behavior
• Social isolation
• Risky sexual behavior
• School and work problems