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Personality Disorders

A personality disorder is a lasting pattern of behavior that is maladaptive and culturally abnormal. The behavior must seem inflexible and cause problems across a wide range of situations.

According to the DSM-IV, personality disorders are divided into three clusters: Cluster A:odd behavior, Cluster B: dramatic/emotional behavior, and Cluster C: eccentric behavior. Cluster A is composed of Paranoid Personality Disorder, Schizoid Personality Disorder, and Schizotypal Personality Disorder. Cluster B contains Histrionic Personality Disorder, Antisocial Personality Disorder, Borderline Personality Disorder, and Narcissistic Personality Disorder. Cluster C includes Avoidant Personality Disorder, Dependent Personality Disorder, and Obsessive-Compulsive Personality Disorder.

Cluster A Personality Disorders

Paranoid Personality Disorder, Schizotypal Personality Disorder, and Schizoid Personality Disorder are organized into Cluster A because of their shared, bizarre behavioral traits, such as an inability to connect socially with others because of paranoia, impaired interpersonal understanding, and lack of desire.
Paranoid Personality Disorder

Paranoid Personality Disorder

Paranoid Personality Disorder is charactized as having difficulty trusting others, being highly suspicious, has difficulty accepting criticism, often explains neutral behavior in terms of conspiracy or hostile intent, has trouble forgiving others and feels excessive self-importance. Theodore Millon’s subtypes of PPD also include narcissistic or sadistic tendencies and some with compulsive, negativistic, or avoidant features. Therapy for people with PPD is usually client-based and humanistic in approach. Family/ group therapy should be avoided because the client with PPD may become suspicious of others. Cognitive-Behavioral Therapy may be ineffective because of their irrational delusions.

Schizotypal Personality Disorder

Schizotypal Personality Disorder is characterized as socially maladaptive behavior that causes interpersonal and relationship impairment. Symptoms include bizarre convictions such as superstition and telepathy, strange perceptions, unusual thought and speech patterns, lack of close friends because of high social anxiety based on paranoia and not low self-esteem. Theodore Millon’s subtypes also had dependent, schizoid and melancholic features or avoidant and negativistic features.

Treatment for Schizotypal Personality Disorders includes a variety of effective approaches. Medications for anxiety or mood disorders may be helpful. Psychotherapy can be useful in helping the person with SPD to learn to trust others. Behavioral therapy can be used to help the client understand distortions he/she may have about social interaction.

Schizoid Personality Disorder

Schizoid Personality Disorder is characterized as an enduring pattern of behavior in which the are detached from social relationships and display a limited variety of emotions in interpersonal situations. People with this disorder do not wish to have close relationships with others, including friends or family members, prefers to be alone, has minimal or no desire to have intimate experiences with others (even physical intimacy), does not appear to react to praise or criticism, seems cold, distant or flat. In Millon’s subtypes of Schizoid Personality Disorder, people with SPD exude other symptoms as well, such as avoidant, melancholic, compulsive, or schizotypal features.

Treatment for Schizoid Personality Disorder is usually short-term focused psychotherapy. Group therapy can be helpful if trust becomes less of an issue. Client should be focusing on truing to get out of his/ her head and into reality. If trusting authority is a problem self-help and support groups can be used as treatments.

Cluster B Personality Disorders

There are four personality disorders in Cluster B: Antisocial Personality Disorder, Histrionic Personality Disorder, Borderline Personality Disorder, and Narcissistic Personality Disorder. They share common dramatic or erratic behavioral traits, such as inappropriate emotional responses ranging from excessive to absent.

Antisocial Personality Disorder

Antisocial Personality Disorder is when someone has an enduring pattern of behavior that ignores or breaches other’s rights. A common term for people with APD is “psychopath”. People with APD typically disregard the law and can be violent. Due to their lack of empathy, they rarely feel remorse and have difficulty fulfilling responsibilities they have for other people. They tend to be aggressive and not care about other’s safety or their own. People with APD usually exhibit a pattern of deception in their relationships with others by repeatedly lying or manipulating others for enjoyment. According to, roughly one percent of women and three percent of men have this disorder.

It is difficult to treat people with Antisocial Personality Disorder because they often do not want or think that they need help. Some suggested treatments for APD are psychotherapy, anger management, hospitalization and medication. While there is no medication designed specifically to treat APD, anti-anxiety and mood-stabilizing drugs can be effective.

While the cause for Antisocial Personality Disorder is still undetermined, early intervention in the lives of children who live in abusive or neglectful environments and exhibit early signs of misbehavior can be beneficial.

There are five subtypes of Antisocial Personality Disorder. These include: Nomadic, Malevolent, Covetous, Risk-taking, and Reputation-defending. Nomadic APD has schizoid and avoidant tendencies, so people with this subtype often feel neglected and are outcasts. People with Malevolent APD have sadistic and paranoid tendencies, so they behave vengefully, brutally, and without remorse. Covetous APD is a slight variation of basic APD but feels more deprived. People with Risk-taking APD have histrionic features so they are highly impulsive and hazardous. Reputation-defending APD has narcissistic tendencies, so people with this subtype need to be viewed as perfect and indestructible.

Cluster C Personality Disorders

Cluster C Personality Disorders are grouped together because they have maladaptive ways of dealing with abnormally high anxiety. These disorders include: Avoidant Personality Disorder, Dependent Personality Disorder, and Obsessive-Compulsive Personality Disorder.

Avoidant Personality Disorder

Avoidant Personality Disorder is a disorder in which a person demonstrates social anxiety over a long period of time. People with this disorder often feel inferior, causing them to be extremely anxious when interacting with other people. They have an abnormal level of fear of others reacting negatively to them. Their lack of confidence leads to very limited social circles and/or isolation.

Dependent Personality Disorder

Dependent Personality Disorder is diagnosed when someone displays characteristics of being overly needy and reliant on other people. People with this disorder find solitude nearly unbearable and are always reaching out to others for support. They are often submissive to other people for fear of losing their support. Paradoxically, people with DPD can often isolate themselves because of their strong need to be around other people.

Obsessive-Compulsive Personality Disorder

Obsessive-Compulsive Personality Disorder is characterized as someone who is fixated on rules, structure, and control. People with disorder are often extremely diligent, but not always efficient due to their inability to differentiate between important and unimportant details. They also are very inflexible, especially when trying to accomplish tasks with others. People with this disorder have limited social interaction because they often put work or projects before spending time with others or leisure activities.

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