Personality Disorder
What is “Personality?”
According to the National Mental Health Association (NMHA), personality refers to a distinctive set of traits, behavior styles, and patterns that make up one’s character or individuality. How we perceive the world, our attitudes, thoughts, and feelings are all part of our personality. People with healthy personalities are able to cope with normal stresses and have no trouble forming relationships with family, friends, and co-workers.
What is a Personality Disorder?
The NMHA further states that those who struggle with a personality disorder have great difficulty dealing with other people. They tend to be inflexible, rigid, and unable to respond to the changes and demands of life. Although they feel that their behavior patterns are “normal” or “right,” people with personality disorders tend to have narrow views of the world and find it difficult to participate in social activities.
Linda Lebelle (Director of Focus Adolescent Services) states personality disorders are not illnesses in a strict sense, as they do not disrupt emotional, intellectual, or perceptual functioning. However, those with personality disorders suffer a life that is not positive, proactive, or fulfilling. Not surprisingly, personality disorders are also associated with failures to reach potential.
The DSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, defines a personality disorder as an enduring pattern of inner experience and behavior that deviates markedly from the expectation 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.
A personality disorder must fulfill several criteria. A deeply ingrained, inflexible pattern of relating, perceiving, and thinking serious enough to cause distress or impaired functioning is a personality disorder. Personality disorders are usually recognizable by adolescence or earlier, continue throughout adulthood, and become less obvious throughout middle age.
Some experts believe that events occurring in early childhood exert a powerful influence upon behavior later in life. Others indicate that people are genetically predisposed to personality disorders. In some cases, however, environmental facts may cause a person who is already genetically vulnerable to develop a personality disorder.
Currently, there are 10 distinct personality disorders identified in the DSM-IV:
1. Antisocial Personality Disorder: People with antisocial personality disorder characteristically act out their conflicts and ignore normal rules of social behavior. These individuals are impulsive, irresponsible, and callous. Typically, the antisocial person has a history of legal difficulties, belligerent and irresponsible behavior, aggressive and even violent relationships. They show no respect for other people and feel no remorse about the effects of their behavior on others. They are at high risk for substance abuse, especially alcoholism, since it helps them to relieve tension, irritability and boredom.
2. Avoidant Personality Disorder: Avoidant personalities are often hypersensitive to rejection and are unwilling to become involved with others unless they are sure of being liked. Excessive social discomfort, timidity, fear of criticism, avoidance of social or work activities that involve interpersonal contact are characteristic of the avoidant personality. People with avoidant personality disorder may have no close relationships outside of their family circle, although they would like to, and are upset at their inability to relate well to others.
3. Borderline Personality Disorder: People with borderline personality disorder are unstable in several areas, including interpersonal relationships, behavior, mood, and self-image. Abrupt and extreme mood changes, stormy interpersonal relationships, an unstable and fluctuating self-image, unpredictable and self-destructive actions are common. These individuals generally have great difficulty with their own sense of identity. They often experience the world in extremes, viewing others as either “all good” or “all bad.” A person with borderline personality may form an intense personal attachment with someone only to quickly dissolve it over a perceived slight. Fears of abandonment may lead to an excessive dependency on others. Self-mutilation or suicidal behavior is characteristic.
4. Dependent Personality Disorder: People with dependent personality disorder may exhibit a pattern of dependent and submissive behavior, relying on others to make decisions for them. They require excessive reassurance and advice, and are easily hurt by criticism or disapproval. They feel uncomfortable and helpless if they are alone, and can be devastated when a close relationship ends. They have a strong fear of rejection. Typically lacking in self-confidence, the dependent person rarely initiates projects or does things independently.
5. Histrionic Personality Disorder: People with Histrionic Personality Disorder exhibit exaggerated, dramatic, and rapidly shifting displays of emotional reactions. They are easily influenced by others or by circumstances, continually seek excitement, appreciation by others, and activities in which they can be the center of attention. Inappropriate seductiveness in appearance or behavior is common, and they are often overly concerned with physical attractiveness. Associated features may include self-indulgence, continuous longing for appreciation, feelings that are easily hurt, and persistent manipulative behavior to achieve own needs.
6. Narcissistic Personality Disorder: People with narcissistic personality have an exaggerated sense of self-importance, fantasies of success, and seek constant attention. The narcissistic personality is oversensitive to failure and often complains of multiple physical symptoms. Prone to fluctuations between admiration seeking and insecurity, interpersonal relationships tend to be conflict ridden.
7. Obsessive-Compulsive Personality Disorder: Compulsive personalities are conscientious and have high levels of aspiration, but they also strive for perfection. Never satisfied with their achievements, people with compulsive personality disorder take on more and more responsibilities. They are reliable, dependable, orderly, and methodical, but their inflexibility often makes them incapable of adapting to changed circumstances. People with compulsive personality are highly cautious, weigh all aspects of a problem, and pay attention to every detail, making it difficult for them to make decisions and complete tasks. When their feelings are not under strict control, events are unpredictable, or they must rely on others, compulsive personalities often feel a sense of isolation and helplessness.
8. Paranoid Personality Disorder: People with paranoid personality disorder are untrusting, unforgiving, and prone to angry or aggressive outbursts because they perceive others as unfaithful, disloyal, condescending or deceitful. They may also feel jealous, guarded, secretive, and may appear to be excessively serious.
9. Schizoid Personality Disorder: Schizoid personalities are introverted, withdrawn, solitary, and distant. They are often focused on their own thoughts and feelings and are fearful of closeness and intimacy with others. Often described as more like daydreamers than practical action takers, they have few, if any relationships and have great difficulty making emotional connections with others.
10. Schizotypal Personality Disorder: A pattern of peculiarities such as odd or eccentric manners of speaking or dressing and strange, outlandish or paranoid beliefs and thoughts are common. People with schizotypal personality disorder have difficulties forming relationships and experience extreme anxiety in social situations. They may react inappropriately or not react at all during a conversation or they may talk to themselves. They also display signs of “magical thinking” by saying they can see into the future or read other people’s minds.
Further Reading
Kreisman, Jerold; Straus, Hal (1991) I Hate You; Don’t Leave Me; Understanding the Borderline Personality
Miller, Alice (1990) Drama of the Gifted Child
Moskovitz, Richard (1996) Lost in the Mirror: An Inside Look at Borderline Personality Disorder
Becker, Dana (1997) Through the Looking Glass: Women and Borderline Personality Disorder
Oldham, John; Morris, Lois; (1995) The New Personality Self-Portrait: Why You Think, Work, Love, and Act the Way You Do
Robinson (2005) Field Guide to Personality Disorders
Golomb, Elan (1995) Trapped in the Mirror
Stout, Martha (2005) The Sociopath Next Door: The Ruthless Versus the Rest of Us
Horowitz, Mardi (1991) Hysterical Personality Style and the Histrionic Personality Disorder
Shapiro, David (1999) Neurotic Styles