How to Diagnose Personality Disorders

As promised, this month we are starting a series on various mental health disorders. There is a wide range of mental health conditions that affect your thinking, mood and behaviour, and we plan to cover all the main disorders. This will give you insight into yourself and also into others as we explore the human mind, what can go wrong sometimes, and how anyone can be helped to manage and recover their mental health. Minding your mind is important and we encourage you to reach out and talk to somebody if you are having concerns about yourself or a loved one.

People dealing with personality disorders are often lonely and feel disconnected from others. These types of disorders are the most challenging to treat, as they are considered intractable and imbedded deeply within the construct of the person’s development.

Personality disorders are treatable. Success depends on accessing the right treatment and committing to it.

According to the Diagnostic and Statistical Manual, Fifth Edition (published in 2013), there are ten distinctive personality disorder types, which are divided into three clusters, type A, B and C.

There is also an “other personality disorders” category which accounts for personality changes due to medical conditions and unspecified personality disorders that may not fit into a particular category.

According to the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions, 15% of adults in the United States have a minimum of one personality disorder.

How is Personality Disorder Diagnosed

As with any condition, personality disorders are diagnosed by licensed professionals in the field of mental health.

These disorders are often suspected as a root cause when people present with patterns of deviation from their cultural norms in the following ways:

  • Cognition (ways of thinking or perceiving others, oneself and events)
  • Affect (intense or seemingly inappropriate responses)
  • Interpersonal function (challenges with relationships with others)
  • Impulse control (difficulty managing sudden urges to act without thinking it through)

Mental health professionals use the DSM 5 as a guide for diagnosing personality disorders. The manual offers criteria for each specific type of personality disorder, and there are benchmarks for each condition (i.e., one must experience a certain number of symptoms to be diagnosed).

Before diagnosing personality disorder, clinicians rule out other mental health conditions that may better account for the symptoms being presented.

Cluster A Personality Disorders

Cluster A type account for 5.7% of those diagnosed with personality disorder. People with this particular type are often described as eccentric or displaying odd behaviours. The Cluster A group includes Paranoid, Schizoid and Schizotypal personality disorders.

Paranoid Personality Disorder.

Ongoing distrust and suspicion of others and their motives. Paranoid personality disorder can cause people to bear grudges and distrust without merit. This can damage interpersonal relationships and limit true connections with others.

Schizoid Personality Disorder.

Detachment from relationships with others and restricted emotional affect. Schizoid personality disorder often results in withdrawal from others and minimal interactions with friends, outside of first-degree relatives, due to the discomfort of social interactions.

Schizotypal Personality Disorder.

Interpersonal deficits and severe discomfort with close relationships, punctuated by eccentric or odd behaviours. It is often difficult for people with schizotypal personality disorder to relate with others and it causes great discomfort.

Unusual behaviours impact the reactions of others, which makes this condition self-perpetuating.

Cluster B Personality Disorders

People with cluster B personality disorders are least common and constitute approximately 1.5% of the population. Those with this form of personality disorder are described as erratic and emotional and are more dramatic than most.

Antisocial Personality Disorder.

Patterns of disregard for others’ rights that manifests in violation of societal norms and values. Antisocial personality disorder results in behaviours that include aggression toward people and animals, property destruction, theft and deceitfulness or violation of rules or laws.

People with antisocial personality are often difficult to trust and this results in few close relationships or relationships in which others are exploited.

Borderline Personality Disorder.

Unstable relationships with others, low self-esteem and desperate fears of being abandoned, which result in risky or dramatic behaviours. The behaviours associated with borderline personality disorder often push others away, which reinforces the self-esteem and instability challenges.

Histrionic Personality Disorder.

Excessively attention seeking and emotional behaviours in which the person feels compelled to be the centre of attention. People with histrionic personality disorder often experience shallow connections with others.

Narcissistic Personality Disorder.

Pattern of personal grandiosity (internally or behaviourally) with an excessive need for admiration from others.

People with narcissistic personality disorder lack empathy for others and believe they are superior to most. This disorder impacts relationships negatively as admiration is expected and rarely reciprocated.

Cluster C Personality Disorders

The cluster C personality type accounts for the greatest number of personality disorder types at 6.0% and is characterized by fear and anxiety.

Avoidant Personality Disorder.

Feelings of inadequacy, hypersensitivity and social inhibition. People with avoidant personality disorder often struggle with fears of rejection and this results in increasing social isolation, avoidance and loneliness.

Dependent Personality Disorder.

Excessive fears of separation and need for care-taking by others. Reliance on others for direction and advice beyond what would normally be expected.

Those dealing with dependent personality disorder may find themselves staying in unhealthy relationships due to a fear of being alone.

Obsessive-Compulsive Personality Disorder.

Preoccupation with control, perfection and orderliness which interferes with ability to be flexible and open. Obsessive-compulsive personality disorder can impact productivity and quality of life, due to the belief that one must perform perfectly in order to function.

People managing personality disorders can live satisfying lives when treatment is sought and one is consistent with their dedication to wellness. It is important to engage in self-care and talk openly with mental health providers about thoughts and feelings in order to get the most out of treatment.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.

[This blog post originally appeared on Teyhou’s website ~ some content may have been modified for the UK context.]

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