What constitutes a personality disorder?
“A personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the 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”.
The diagnosis of personality disorders should be avoided while the patient is in a crisis; avoid throwing around pejorative labels for difficult patients.
A personality disorder as “an enduring pattern of inner experience and behavior that deviates markedly from the 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.”
What are the major types, shared characteristics, and clusters of personality disorders?
Paranoid, schizoid, and schizotypal personality disorders share odd or eccentric characteristics and are grouped together in cluster A.
Borderline, histrionic, narcissistic, and antisocial personality disorders share dramatic, emotional, or erratic features and make up cluster B.
Dependent, avoidant, and obsessive–compulsive personality disorders share anxious or fearful features and are grouped together in cluster C.
Are there types of personality disorders?
The DSM-5 recognizes 10 distinct personality disorders, which are arranged into clusters. Cluster A personalities are the “odd” types, including paranoid (suspicious), schizoid (detached), and schizotypal (eccentric). Cluster B personality disorders are considered “dramatic” types and include antisocial (disregard for others), narcissistic (self-important), borderline (emotionally unstable), and histrionic (attention-seeking). Cluster C personality disorders are “anxious” types and include dependent (submissive and clingy), avoidant (feels inadequate), and obsessive-compulsive (perfectionistic). The DSM also recognizes personality change due to a medical condition or unspecified/other specified personality disorder to include patients with significant personality dysfunction that do not meet specific criteria for other diagnoses. Due to considerable shortcomings with interrater reliability, and with patients often meeting criteria for more than one personality disorder, the DSM-5 introduces a second system that defines personality dysfunction based on traits rather than categorical diagnoses.
How are personality disorders treated?
Psychotherapies, including DBT (mainly used for borderline personality disorder), CBT, and psychodynamic therapy, as well as group therapy are the mainstay of treatment of personality disorders.
Pharmacotherapy, if used, is typically symptom focused.
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