Personality Disorders Symptoms

  • Symptoms

    Symptoms of personality disorder depend on the specific disorder present Table 01.

    Table 1.  Classification of Personality Disorders

    Personality disorder Features
    Odd-eccentric cluster
    Paranoid personality disorder Defensive, suspicious, distrustful, secretive, oversensitive
    Schizoid personality disorder Shy, introverted, detached, solitary, avoids interactions with others
    Schizotypal personality disorder Cognitive and perceptual distortions, tangential and circumstantial thinking, odd beliefs, suspicious, paranoid ideation, uncomfortable with social interaction
    Dramatic cluster
    Histrionic personality disorder Manipulative, seductive, provocative, excessively emotional, displays attention-seeking behavior
    Narcissistic personality disorder Self-centered, exaggerated sense of self-importance, demands attention
    Borderline personality disorder The most impaired of the dramatic cluster; affectively labile, impulsive, manipulative, sensitive to rejection, lacks self-control, may self-mutilate or attempt suicide, has highly unstable and intensive relationships
    Antisocial personality disorder Lacks empathy and remorse, disregards social norms including the law, is unable to control impulses and behavior, fails to learn from experience
    Anxious-fearful cluster
    Avoidant personality disorder Shy, lacks self-esteem, fears criticism and rejection, displays prominent social anxiety
    Dependent personality disorder Passive, defers to others, lacks confidence and self-esteem, avoids responsibility
    Obsessive-compulsive personality disorder Perfectionist, workaholic, unable to relax and enjoy spontaneous pleasures, excessively inhibited emotionally, preoccupied with issues of control over affect, thought, and action

    Paranoid personality disorder is characterized by suspiciousness and a distrust of others. A paranoid person often finds signs of insult, threat, or injury in others' most benign statements and acts. Paranoids are often secretive and mistrustful, and think that people are talking about them, staring, or laughing at them. They can respond to these feelings with anger or even aggression.

    People with schizoid personality disorder show little emotion, and appear to be detached from interpersonal relationships. People with schizoid disorder are often the “loners” of society, occupying solitary jobs and generally avoiding interactions whenever possible. Despite the similar name, these people do not have the thought disorders (hallucinations, delusions, etc.) seen in schizophrenia.

    Characteristics of schizotypal personality disorder include discomfort in social relations and tendency toward idiosyncratic thinking. Unlike other disorders in the odd-eccentric cluster, however, this disorder can manifest with thought disorders similar to those of schizophrenia. However, those with schizotypal disorders do not become schizophrenic over time.

    Histrionic personality disorder is characterized by an excessively emotional and attention-seeking style of interacting with others. People with histrionic personality disorder try to command attention though manipulation, seduction, and provocation. Their relationships tend to be mostly self-serving and shallow.

    People with narcissistic personality disorder have an extreme need for attention coupled with an overblown sense of entitlement. Narcissistic individuals have an inflated sense of importance and little appreciation for the thoughts and needs of others.

    Borderline personality disorder is the most severe of the dramatic cluster of personality disorders. People with borderline personality disorder have a well-established pattern of instability in personal relationships (which are often stormy and intense), self-image, and emotional tone. They are also very impulsive and self-damaging in their actions. They quickly shift their view of the world, themselves, and others from one extreme to another, and are seldom neutral.

    People with antisocial personality disorder have no regard for the rights and feelings of others. Antisocial personality disorder is often associated with criminality. People with antisocial personality disorder tolerate frustration poorly, which can cause them to become hostile or violent. They also exhibit a complete lack of remorse for the problems they cause others.

    People with avoidant personality disorder are often described as “painfully shy”. A person with avoidant personality disorder feels inadequate, and has a deep fear of rejection or ridicule that causes them to avoid relationships. Unlike the schizoid, the avoidant patient very much desires a close relationship, but is afraid of disapproval. Anxiety in social situations is common, and can lead to social phobia.

    Those with a dependent personality disorder have fears of rejection and abandonment. Dependent individuals also have an unrealistic fear of being unable to care for themselves, and will submit themselves to others who will take care of them. If this relationship is threatened, the dependent shows signs of severe anxiety. Dependent individuals avoid responsibility and are “born followers”.

    People with obsessive-compulsive personality disorder are reliable, dependable, and orderly, but often cannot successfully adapt to change. Obsessive-compulsive disorder patients tend be overly cautious, and analyze all aspects of a problem. This excessive caution can lead to “paralysis by analysis” in decision-making.

  • Risk Factors

    Many personality disorders run in families; however, whether this occurs as a result of genetics or learned behavior is still a subject of debate.

    Gender plays a role in one's likelihood of having a particular personality disorder. Certain personality disorders (such as antisocial personality disorder) are more frequent in males, whereas others (such as borderline, histrionic, and dependent personality disorders) are seen more often in women.

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