What Are the Three Types of Personality Disorders?

Personality disorders are mental and behavioral problems that are so severe they impair the person’s functioning in work and relationships. There are three main groups, each with different specific disorders as subtypes.

A personality disorder is a type of mental disorder that describes personality traits so inflexible and maladaptive they impair one’s thoughts, feelings, and behaviors. Thoughts, displays of emotion, impulsiveness, and interpersonal behavior must deviate significantly from the expectations of an individual's culture in order to be diagnosed with a personality disorder.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) groups the 10 personality disorders into three clusters based upon descriptive similarities:

• Cluster A characteristics: Individuals may appear odd and eccentric
  • Paranoid personality disorder
  • Schizoid personality disorder
  • Schizotypal personality disorder
• Cluster B characteristics: Individuals often appear dramatic, emotional, or erratic
  • Antisocial personality disorder
  • Borderline personality disorder
  • Histrionic personality disorder
  • Narcissistic personality disorder
• Cluster C characteristics: Individuals often appear anxious or fearful
  • Avoidant personality disorder
  • Dependent personality disorder
  • Obsessive-compulsive personality disorder (this is not the same as obsessive-compulsive disorder, or OCD)

Personality disorders develop over time. Symptoms of a personality disorder can range from mild to severe and may include:

• Frequent mood swings
• Angry outbursts
• Social anxiety and difficulty making friends
• Need to be the center of attention
• Feeling of being taken advantage of
• Impulsivity/difficulty delaying gratification
• Not feeling there is anything wrong with one’s behavior 
• Blaming the world for one’s behaviors and feelings

Specific symptoms of individual personality disorders include:

• Paranoid: Distrust and suspiciousness of others and interpreting motives as vindictive or unkind, assumption people will harm or deceive them, will not confide in others or become close to them
• Schizoid: Detachment from social relationships, restricted range of expression of emotions with others, does not seek close relationships, chooses to be alone, does not appear to care about praise or criticism from others
• Schizotypal: Social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions, eccentric behavior, odd beliefs, peculiar behavior or speech, excessive social anxiety
• Antisocial: Disregarding and violating the rights of others, not conforming to social norms, lying and deception, stealing, impulsivity, defaulting on debts, neglecting children 
• Borderline: Instability in interpersonal relationships, poor self-image, intense emotions, and poor impulse control, suicide attempts, inappropriate intense anger, feelings of emptiness
• Histrionic: rapidly shifting or exaggerated emotions, attention seeking, discomfort when not the center of attention
• Narcissistic: Grandiosity (in fantasy or behavior), need for admiration, lack of empathy, sense of entitlement, takes advantage of others 
• Avoidant: Social inhibition, extreme shyness, feelings of inadequacy, hypersensitivity to criticism, unwillingness to become involved with others unless they are certain they will be liked, preoccupation with being rejected, seeing themselves as not good enough 
• Dependent: Feelings of inadequacy, inability to make own decisions, submissiveness, clingy behavior, need to be taken care of, avoidance of confrontation for fear of losing source of support, difficulty making daily decisions without reassurance 
• Obsessive-compulsive: Preoccupation with perfectionism, mental and control, and orderliness, at the expense of flexibility, openness, and efficiency; excessive focus on details, works excessively without allowing time for leisure or friends, inflexibility in morality and values

Personality disorders may be caused by:

• Genetics
  • Family history of mental illness
• Environment
  • Childhood trauma
  • Verbal abuse in childhood
• High reactivity (being overly sensitive) 

Personality disorders are diagnosed by mental health professionals and are generally not diagnosed until a person is over age 18, because personalities are still developing. 

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines specific criteria patients must meet in order to be diagnosed, including:

1. An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas:
   1. Cognition (i.e., ways of perceiving and interpreting self, other people, and events)
   2. Affectivity (i.e., the range, intensity, lability, and appropriateness of emotional response) 
   3. Interpersonal functioning
   4. Impulse control 
2. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.
3. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.
4. The pattern is stable and of long duration, and its onset can be traced back at least to adolescence or early adulthood.
5. The enduring pattern is not better explained as a manifestation or consequence of another mental disorder.
6. The enduring pattern is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., head trauma).

The DSM-5 also includes diagnostic criteria for each of the individual personality disorders.

Treatment for personality disorders includes: 

• Individual psychotherapy: a first-line treatment 
• Support groups
• Medication: generally used as an adjunct treatment to psychotherapy 
• Patient self-education
• Substance use disorder treatment as needed
• Hospitalization as needed

Complications of personality disorders include:

• Difficulty in interpersonal relationships
• Problems at work or school
• Social isolation
• Alcohol and drug abuse
• Suicide attempts