Personality Disorder (PDs)

Characteristic

• Individual with PDs show:

- chronic
- lifelong
- rigid
- unsuitable patterns of relating with others
 that cause social & occupational problems
 Con’t (2)

• Person with PDs

- generally are not aware that they are the
cause of their own problems
- do not have frank psychotic symptoms
- do not seek psychiatric help
Classification

The DSM-IV-TR into (DSM-5):

Cluster A: Cluster B: Cluster C:

- Paranoid - Histrionic - Avoidant
- Schizoid - Narcissistic - Obsessive-
- Schizotypal - Borderline Compulsive
- Antisocial - Dependent
 ICD -10
• Paranoid
• Schizoid
• Dissocial
• Emotional unstable: impulsive
borderline
• Histrionic
• Anankastic
• Anxious (avoidant)
• Dependent
 Cluster A
Hallmark: Avoids social relationships, is
“peculiar” but not psychotic
Genetic or familial association: Psychotic illnesses

Paranoid: distrustful, suspicious, litigious,

attributes responsibility for own
problems to others
Schizoid: long-standing pattern of voluntary
social withdrawal
Schizotypal: peculiar appearance,
magical thinking,
odd thought patterns & behaviour
Cluster B
Hallmark: Dramatic, emotional, inconsistent
Genetic of familial association:
mood disorders & substance abuse

Histrionic: Theatrical, extroverted, emotional,

sexually provocative, “life of the party”,
In men, “Don Juan” dress & behaviour
Cannot maintain intimate relationships

Narcissistic: Pompous, with a sense of special

entitlement
Lacks empathy for others
 Con’t…. Cluster B

Antisocial: Refuses to conform to social norms &

shows no concern for others
Associated with conduct disorder in
childhood & criminal behavior in
adulthood (“psychopaths” or
“sociopaths”)
Borderline: Erratic, impulsive, unstable behavior &
mood
Feeling bored, alone & “empty”
Suicide attempts for relatively trivial
reasons
Self-mutilation
Mini-psychotic episodes
Cluster C
Hallmark : Fearful, anxious
Genetic or familial association: anxiety disorders

Avoidant: Sensitive to rejection, socially

withdrawn
Feelings of inferiority
Obsessive-compulsive:
Perfectionistic, orderly, inflexible
Indecisive
Dependent: Allows other people to make
decisions & assume responsibilty
for them
Poor self-confidence
 Con’t….cluster C

Passive-aggressive:
Procrastina & is inefficient
Shows outward compliance, but feels
inward defiance

Note:
- Emotionally unstable
Tendency to act impulsively without consideration of the
consequences, together with affective instability.
Easily precipitated when impulsive acts are criticized or
thwarted by others.
 Treatment

• For those who seek help, individual & group

psychotherapy may be useful
• Pharmacotherapy can also be used to treat symptoms
such as depression & anxiety that may be associated
with the PDs.