Personality Disorders

Personality Disorders are mental health presentations that share several unique qualities. They contain symptoms that are more or less enduring and play a major role in most, if not all, aspects of the person’s life. While many disorders vacillate in terms of symptom presence and intensity, personality disorders typically remain relatively constant and require more intense treatment approaches. Most people have a combination of different personality styles and this also applies to the definition of personality disorders. It is difficult to pinpoint the threshold when a style becomes a disorder and the defining criterion is again the degree of interference with social, occupational and other areas of life. The diagnosis of personality disorders is usually postponed or avoided as it is often not necessarily helpful to attach a label to a ‘personal style’. Diagnosis will only be made when it is helpful for intervention purposes.

To be able to provide a diagnosis of  a disorder in this category, a Psychologist will look for the following criteria:

  • Symptoms have been present for an extended period of time, are inflexible and pervasive, and are not a result of alcohol or drugs or another psychiatric disorder. The history of symptoms can be traced back to adolescence or at least early adulthood.
  • The symptoms have caused and continue to cause significant distress or negative consequences in different aspects of the person’s life.

Symptoms are seen in at least two of the following areas:

  • Thoughts (ways of looking at the world, thinking about self or others, and interacting)
  • Emotions (appropriateness, intensity, and range of emotional functioning)
  • Interpersonal Functioning (relationships and interpersonal skills)
  • Impulse Control

Paranoid Personality Disorder

Paranoid Personality Disorder is a condition characterized by excessive distrust and suspiciousness of others. This disorder is only diagnosed when these behaviours become persistent and very disabling or distressing.

Schizoid Personality Disorder

Schizoid Personality Disorder is a condition characterized by excessive detachment from social relationships and a restricted range of expression of emotions in interpersonal settings.

Schizotypal Personality Disorder

Schizotypal Personality Disorder is a serious condition in which a person usually has few to no intimate relationships. These people tend to turn inward rather than interact with others, and experience extreme anxiety in social situations. They may also exhibit odd behaviours, and respond inappropriately to social cues.

Antisocial Personality Disorder

Antisocial Personality Disorder is a presentation in which your ways of thinking, perceiving situations and relating to others is dysfunctional. People diagnosed with Antisocial Personality Disorder hav ebeen described as typically having no regard for right and wrong. They may often violate the law and the rights of others, landing themselves in frequent trouble or conflict. Antisocial Personality Disorder has been known as Sociopathic Personality Disorder or Psychopathy.

Borderline Personality Disorder

The major symptoms of this disorder revolve around unstable relationships, poor or negative sense of self, inconsistent moods, and significant impulsivity. The individual vacillates between extremes of mood states and behaviours (i.e. externalizing versus internalizing actions – hence ‘on the border’ of different mental health states). There is an intense fear of abandonment that interferes with many aspects if the individual’s life. This fear often acts as a self-fulfilling prophecy as they cling to others, are very needy, feel helpless, and become overly involved and immediately attached. When the fear of abandonment becomes overwhelming, they will often push others out of their life as if trying to avoid rejection. The cycle most often continues as the individual will then try everything to get people back in his or her life and once again becomes clingy, needy, and helpless. It is important to note that an individual may have borderline traits, but does not meet criteria for Borderline Personality Disorder. (This is true for most of the other diagnoses as well).

The fact that people often do leave someone who exhibits this behaviour only proves to support their distorted belief that they are insignificant, worthless, and unloved. At this point in the cycle, the individual may exhibit self-harming behaviours such as suicide attempts, mock suicidal attempts, cutting or other self-mutilating behaviours. There is often intense and sudden anger involved, directed both at self and others, as well as difficulty controlling destructive behaviours.

Histrionic Personality Disorder

Histrionic Personality Disorder is a condition characterized by excessive emotionality and attention-seeking. This disorder is only diagnosed when these behaviours become persistent and very disabling or distressing. Individuals with this disorder may have difficulty achieving emotional intimacy in romantic relationships. Without being aware of it, they often act out a role (e.g., “victim” or “princess”). They crave novelty, stimulation, and excitement and have a tendency to become bored with their usual routine. Individuals with this diagnosis are at increased risk for suicidal gestures and threats to get attention and coerce better care giving.”

Narcissistic Personality Disorder

The symptoms of Narcissistic Personality Disorder revolve around a pattern of grandiosity, need for admiration, and sense of entitlement. Often individuals feel overly important and will exaggerate achievements and will accept, and often demand, praise and admiration. They may be overwhelmed with fantasies involving unlimited success, power, love, or beauty and feel that they can only be understood by others who are, like them, superior in some aspect of life. There is a sense of entitlement, of being more deserving than others based solely on their superiority. These symptoms, however, are a result of an underlying sense of inferiority and are often seen as overcompensation. Because of this, they are often envious and even angry of others who have more, receive more respect or attention, or otherwise steal away the spotlight.

Avoidant Personality Disorder

Anxious (Avoidant) Personality Disorder is a condition characterized by extreme shyness, feelings of inadequacy, and sensitivity to rejection. These individuals feel inferior to others. This disorder is only diagnosed when these behaviours become persistent and very disabling or distressing. This diagnosis should be used with great caution in children and adolescents for whom shy and avoidant behaviour may be appropriate (e.g., new immigrants). Loss and rejection may be so painful that the individual with this disorder will choose loneliness rather than risk trying to connect with others. The individual with this disorder has few close friends, but often is very dependent on them. Individuals with this disorder are described by others as being “shy”, “timid,” “lonely,” and “isolated”. Their occupational functioning may also suffer because they avoid the social situations that are important for job advancement.

Dependent Personality Disorder

Dependent Personality Disorder is a condition characterized by an over-reliance on others that leads to submissive and clinging behaviour and fears of separation. The dependent and submissive behaviours arise from feeling unable to cope without the help of others. This disorder is only diagnosed when these behaviours become persistent and very disabling or distressing. This diagnosis should be used with great caution, if at all, in adolescents, for whom dependent behaviour may be developmentally appropriate. Complications of this disorder are increased risk of: depression; alcohol or drug abuse; physical, emotional, or sexual abuse. Occupational functioning is impaired if independent initiative is required. The individual avoids positions of responsibility and becomes anxious when faced with decisions. Social relations tend to be limited to those few people on whom the individual is dependent.

Obsessive Compulsive Personality Disorder

Obsessive-Compulsive Personality Disorder is a condition characterized by a chronic preoccupation with rules, orderliness, and control. This disorder is only diagnosed when these behaviours become persistent and disabling. The individual with this disorder often becomes upset when control is lost. The individual then either emotionally withdraws from these situations, or becomes very angry. The individual usually expresses affection in a highly controlled or stilted fashion and may be very uncomfortable in the presence of others who are emotionally expressive. The person often has difficulty expressing tender feelings, and rarely pays compliments. The individual’s chronic preoccupation with rules, orderliness, and control seems to prevent many of the complications (e.g., drug abuse, reckless sex, financial irresponsibility) that are common to some other personality disorders. Occupationally, the individual tends to be a high achiever with an excessive devotion to work. However, inflexibility, perfectionism, preoccupation with detail, and inability to delegate work may seriously interfere with the individual’s ability to complete a given task. The individual experiences occupational difficulties when confronted with new situations that demand flexibility and compromise.