Personality Disorders

What are personality disorders?

A personality disorder is a long-lasting pattern of thinking, feeling and behaving that differs significantly from what is expected in a person’s culture, is inflexible, and leads to distress or problems in relationships, work or other areas of life. These patterns usually become noticeable in adolescence or early adulthood.

Types

Clinicians describe several personality disorders, often grouped into three clusters:

• Cluster A (odd or eccentric patterns), such as paranoid and schizoid personality disorders.
• Cluster B (dramatic, emotional or erratic patterns), such as borderline, narcissistic and antisocial personality disorders.
• Cluster C (anxious or fearful patterns), such as avoidant, dependent and obsessive-compulsive personality disorders. (Obsessive-compulsive personality disorder is different from OCD.)

Borderline personality disorder

BPD is characterized by intense and unstable emotions, a fragile sense of self, fear of abandonment, impulsive behavior and difficulties in relationships. Self-harm and suicidal thoughts can occur, so access to support is important.

These symptoms can occur with personality disorders, but only a qualified professional can provide a diagnosis.

Causes

Personality disorders likely result from a combination of genetic factors and life experiences, particularly childhood adversity or trauma.

Treatment

Psychotherapy is the main treatment. For BPD, approaches with good evidence include dialectical behavior therapy (DBT), mentalization-based treatment, schema therapy and transference-focused psychotherapy. Medications are not a primary treatment for personality disorders but may be used for co-occurring symptoms such as depression or anxiety.