2022/03/18 · 1 citation
Psychology · Arts and Humanities · #Personality Disorders and Psychopathology #Mental Health and Psychiatry #Psychotherapy Techniques and Applications
paper · doi:10.1176/appi.books.9780890425787.x18_personality_disorders
openalex publication_date 2022/03/18 · openalex created_date 2025/10/10 · openalex updated_date 2025/11/06
This chapter begins with a general definition of personality disorder that applies to each of the 10 specific personality disorders. A personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the norms and expectations 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. With any ongoing review process, especially one of this complexity, different viewpoints emerge, and an effort was made to accommodate them. Thus, personality disorders are included in both Sections II and III. The material in Section II represents an update of text associated with the same criteria found in DSM-5 (which were carried over from DSM-IV-TR), whereas Section III includes the proposed model for personality disorder diagnosis and conceptualization developed by the DSM-5 Personality and Personality Disorders Work Group. As this field evolves, it is hoped that both versions will serve clinical practice and research initiatives, respectively. The following personality disorders are included in this chapter. Paranoid personality disorder is a pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent. Schizoid personality disorder is a pattern of detachment from social relationships and a restricted range of emotional expression. Schizotypal personality disorder is a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior. Antisocial personality disorder is a pattern of disregard for, and violation of, the rights of others, criminality, impulsivity, and a failure to learn from experience. Borderline personality disorder is a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity. Histrionic personality disorder is a pattern of excessive emotionality and attention seeking. Narcissistic personality disorder is a pattern of grandiosity, need for admiration, and lack of empathy. Avoidant personality disorder is a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Dependent personality disorder is a pattern of submissive and clinging behavior related to an excessive need to be taken care of. Obsessive-compulsive personality disorder is a pattern of preoccupation with orderliness, perfectionism, and control. Personality change due to another medical condition is a persistent personality disturbance that is judged to be the direct pathophysiological consequence of another medical condition (e.g., frontal lobe lesion). Other specified personality disorder is a category provided for two situations: 1) the individual’s personality pattern meets the general criteria for a personality disorder, and traits of several different personality disorders are present, but the criteria for any specific personality disorder are not met; or 2) the individual’s personality pattern meets the general criteria for a personality disorder, but the individual is considered to have a personality disorder that is not included in the DSM-5 classification (e.g., passive-aggressive personality disorder). Unspecified personality disorder is for presentations in which symptoms characteristic of a personality disorder are present but there is insufficient information to make a more specific diagnosis. The personality disorders are grouped into three clusters based on descriptive similarities. Cluster A includes paranoid, schizoid, and schizotypal personality disorders. Individuals with these disorders often appear odd or eccentric. Cluster B includes antisocial, borderline, histrionic, and narcissistic personality disorders. Individuals with these disorders often appear dramatic, emotional, or erratic. Cluster C includes avoidant, dependent, and obsessive-compulsive personality disorders. Individuals with these disorders often appear anxious or fearful. It should be noted that this clustering system, although useful in some research and educational situations, has serious limitations and has not been consistently validated. For instance, two or more disorders from different clusters, or traits from several of them, can often co-occur and vary in intensity and pervasiveness. A review of epidemiological studies from several countries found a median prevalence of 3.6% for disorders in Cluster A, 4.5% for Cluster B, 2.8% for Cluster C, and 10.5% for any personality disorder Huang et al. 2009; Morgan and Zimmerman 2018 . Prevalence appears to vary across countries and by ethnicity, raising questions about true cross-cultural variation and about the impact of diverse definitions and diagnostic instruments on prevalence assessments McGilloway et al. 2010; Tyrer et al. 2010 .