Personality Disorders: An Overview

A personality disorder is defined as a deeply ingrained and maladaptive pattern of behavior of a specified kind. Typically, they manifest by the time one reaches adolescence and can cause long-term difficulties in personal relationships or in functioning in society. Today we tend to use this term very flippantly in our everyday language, but this post will attempt to explore the different types of diagnosable personality disorders, what they look like, and how they are treated.

The concept of a personality disorder has evolved greatly over the centuries. In ancient Greece, the study of personalities was rooted in what they called “characters,” most of which could be considered what we call personality disorders today. Tyrtamus (371-287 bc) divided the people of Athens into 30 different personality types, including ‘arrogance,’ ‘irony’ and ‘boastfulness.’ The teachings of Tyrtamus would go on to inform much of the subsequent studies such as those of Thomas Overbury (1581-1613) in England and Jean de la Bruyère (1645-1696) in France.

Personality disorders as we know them today were first introduced by Philippe Pinel’s in 1801. He observed patients with symptoms such as outbursts of rage and violence and termed it manie, or mania, and patients with symptoms of psychosis (such as delusions and hallucinations) and termed it délires, or deliriums.

Over 200 years later, psychologist Kurt Schneider (1887-1967) wrote Die Psychopathischen Persönlichkeiten (Psychopathic Personalities), a volume that still defines how we classify personality disorders today. According to Schneider:

A personality disorder can be diagnosed if there are significant impairments in self and interpersonal functioning together with one or more pathological personality traits. In addition, these features must be (1) relatively stable across time and consistent across situations, (2) not better understood as normative for the individual’s developmental stage or socio-cultural environment, and (3) not solely due to the direct effects of a substance or general medical condition.

The Diagnostic and Statistical Manual of Mental Disorders 5th Revision, DSM-5, is what is used as the standard for classifying personality disorders in the modern era. DSM-5 consists of 10 official personality disorders (PD) split up into three different clusters, named A, B and C.  Cluster A is characterized by behavior that is odd, bizarre or eccentric, and includes Paranoid PD, Schizoid PD, Schizotypal PD. Cluster B is characterized by behavior that is erratic or dramatic and includes Antisocial PD, Borderline PD, Histrionic PD and Narcissistic PD. Finally, Cluster C is anxious and fearful behavior as seen in Avoidant PD, Dependent PD and Obsessive-compulsive PD.

Though these clusters act as an effective way to categorize certain broad behaviors common to these disorders, psychologists are careful to assign them in any sort of concrete way. The clusters are based more on historic observations of tendencies rather than concrete and consistent characterizations. It’s very common for people with personality disorders to never seek mental healthcare. If they do, it’s often in times of crisis, such as when they begin inflicting harm on themselves or others.

It is estimated that about 10% of the population has one or more of these ten personality disorders. Diagnosing personality disorders in patients is very important to mental health professional however, because they can often pre-indicate other mental health disorders. Also, because they can lead to significant stress and impairment within a patient, they often need to be treated in their own right. However, it can often be difficult to diagnose a personality disorder because judging the severity of a certain personality trait, and determining if it actually qualifies as a “disorder,” can be very subjective.

Once a personality disorder is diagnosed, treatment is determined by the severity of the case, type of personality disorder and life situation.  If it is a mild disorder, you may only need occasional monitoring from your primary care doctor. If the disorder is more severe, a combination of psychotherapy and medication will most likely be prescribed. However, personality disorders cannot really be treated, just managed and monitored, since they are ingrained in an individual.

Another dimension of personality disorders, and one that can often make pressure on those suffering from them worse, is the stigma perpetuated by the media. Even though mental health advocates actively fight stigma associated with mental illness, Borderline Personality Disorder (BPD) in particular remains one of the field’s most misunderstood, misdiagnosed and stigmatized conditions. In an effort to bring awareness to this stigma, the National Education Alliance for Borderline Personality Disorder (NEA-BPD) will be celebrating persons in recovery from Borderline Personality Disorder throughout the month of October through their #BeyondBPDStigma social media campaign.

References

Burton, Neel. “The 10 Personality Disorders.” Psychology Today, Sussex Publishers, 29 May 2012, www.psychologytoday.com/blog/hide-and-seek/201205/the-10-personality-disorders.

“Personality Disorders.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 23 Sept. 2016, www.mayoclinic.org/diseases-conditions/personality-disorders/diagnosis-treatment/treatment/txc-20247667.

“Stigma Campaign! Month of October.” Borderline Personality Disorder, www.borderlinepersonalitydisorder.com/stigma-campaign-month-of-october-spread-the-word/.

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