What is a personality disorder?
A personality disorder is a mental health condition that involves long-lasting, all-encompassing, disruptive patterns of thinking, behavior, mood and relating to others. These patterns cause a person significant distress and/or impair their ability to function.
There are 10 types of personality disorders, each with different characteristics and symptoms.
Personality is vital to defining who we are as individuals. It involves a unique blend of traits — including attitudes, thoughts and behaviors — as well as how we express these traits in our interactions with others and with the world around us.
Personality disorders may cause distorted perceptions of reality, abnormal behaviors and distress across various aspects of life, including work, relationships and social functioning. Additionally, people with a personality disorder may not recognize their troubling behaviors or the negative effect they have on others.
What are the types of personality disorders?
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the standard reference publication for recognized mental illnesses, organizes the 10 types of personality disorders into three main clusters (categories). Each cluster has different symptoms in common.
Cluster A personality disorders
Cluster A personality disorders involve unusual and eccentric thinking or behaviors. These include:
- Paranoid personality disorder: The main feature of this condition is paranoia, which is a relentless mistrust and suspicion of others without adequate reason for suspicion. People with paranoid personality disorder often believe others are trying to demean, harm or threaten them.
- Schizoid personality disorder: This condition is marked by a consistent pattern of detachment from and general disinterest in interpersonal relationships. People with schizoid personality disorder have a limited range of emotions when interacting with others.
- Schizotypal personality disorder: People with this condition display a consistent pattern of intense discomfort with and limited need for close relationships. Relationships may be hindered by their distorted views of reality, superstitions and unusual behaviors.
Cluster B personality disorders
Cluster B personality disorders involve dramatic and erratic behaviors. People with these types of conditions display intense, unstable emotions and impulsive behaviors. Cluster B personality disorders include:
- Antisocial personality disorder (ASPD): People with ASPD show a lack of respect toward others and don’t follow socially accepted norms or rules. People with ASPD may break the law or cause physical or emotional harm to others around them. They may refuse to take responsibility for their behaviors and/or display disregard for the negative consequences of their actions.
- Borderline personality disorder (BPD): This condition is marked by difficulty with emotional regulation, resulting in low self-esteem, mood swings, impulsive behaviors and subsequent relationship difficulties.
- Histrionic personality disorder: This condition is marked by intense, unstable emotions and a distorted self-image. For people with histrionic personality disorder, their self-esteem depends on the approval of others and doesn’t come from a true feeling of self-worth. They have an overwhelming desire to be noticed by others, and may display dramatic and/or inappropriate behaviors to get attention.
- Narcissistic personality disorder: This condition involves a consistent pattern of perceived superiority and grandiosity, an excessive need for praise and admiration and a lack of empathy for others. These thoughts and behaviors often stem from low self-esteem and a lack of self-confidence.
Cluster C personality disorders
Cluster C personality disorders involve severe anxiety and fear. They include:
- Avoidant personality disorder: People with this condition have chronic feelings of inadequacy and are highly sensitive to being negatively judged by others. Though they would like to interact with others, they tend to avoid social interaction due to the intense fear of being rejected.
- Dependent personality disorder: This condition is marked by a constant and excessive need to be cared for by someone else. It also involves submissiveness, a need for constant reassurance and the inability to make decisions. People with dependent personality disorder often become very close to another person and spend great effort trying to please that person. They tend to display passive and clinging behavior and have a fear of separation.
- Obsessive-compulsive personality disorder (OCPD): This condition is marked by a consistent and extreme need for orderliness, perfectionism and control (with no room for flexibility) that ultimately slows or interferes with completing a task. It can also interfere with relationships.
This is a separate condition from obsessive-compulsive disorder (OCD), which is classified as an anxiety disorder. While people with OCD usually are aware that OCD is causing their behavior and accept they need to change, people with OCPD usually have little, if any, self-awareness of their behaviors.
People might have mixed symptoms of more than one personality disorder.
Who do personality disorders affect?
Anyone can have a personality disorder. But different types of personality disorders affect people differently.
Most personality disorders begin in the teen years when your personality further develops and matures. As a result, almost all people diagnosed with personality disorders are above the age of 18. One exception to this is antisocial personality disorder — approximately 80% of people with this disorder will have started to show symptoms by the age of 11.
Antisocial personality disorders are more likely to affect people assigned male at birth. Borderline, histrionic and dependent personality disorders are more likely to affect people assigned female at birth.
How common are personality disorders?
Approximately 9% of adults in the U.S. have some type of personality disorder, and about 6% of the global population has a personality disorder.
Borderline personality disorder (BPD) and antisocial personality disorder are the most frequently diagnosed personality disorders.
Symptoms and Causes
What causes personality disorders?
Personality disorders are among the least understood mental health conditions. Scientists are still trying to figure out the cause of them.
So far, they believe the following factors may contribute to the development of personality disorders:
- Genetics: Scientists have identified a malfunctioning gene that may be a factor in obsessive-compulsive personality disorder. Researchers are also exploring genetic links to aggression, anxiety and fear, which are traits that can play a role in personality disorders.
- Brain changes: Researchers have identified subtle brain differences in people with certain personality disorders. For example, findings in studies on paranoid personality disorder point to altered amygdala functioning. The amygdala is the part of your brain that’s involved with processing fearful and threatening stimuli. In a study on schizotypal personality disorder, researchers found a volumetric decrease in the frontal lobe of their brain.
- Childhood trauma: One study revealed a link between childhood traumas and the development of personality disorders. People with borderline personality disorder, for example, had especially high rates of childhood sexual trauma. People with borderline and antisocial personality disorders have issues with intimacy and trust, both of which may be related to childhood abuse and trauma.
- Verbal abuse: In one study, people who experienced verbal abuse as children were three times as likely to have borderline, narcissistic, obsessive-compulsive or paranoid personality disorders in adulthood.
- Cultural factors: Cultural factors may also play a role in the development of personality disorders, as demonstrated by the varying rates of personality disorders between different countries. For example, there are remarkably low cases of antisocial personality disorders in Taiwan, China and Japan, along with significantly higher rates of cluster C personality disorders.
What are the symptoms of personality disorders?
Each of the 10 types of personality disorders has its own specific signs and symptoms.
But, in general, personality disorders involve problems with:
- Identity and a sense of self: People with a personality disorder generally lack a clear or stable image of themselves, and how they see themselves often changes depending on the situation or the people they’re with. Their self-esteem may be unrealistically high or low.
- Relationships: People with a personality disorder struggle to form close, stable relationships with others due to their problematic beliefs and behaviors. They may lack empathy or respect for others, be emotionally detached or be overly needy of attention and care.
Another distinguishing sign of personality disorders is that most people who have one often have little to no insight or self-awareness of how their thoughts and behaviors are problematic.
How do you know if someone has a personality disorder?
You can’t know for sure if someone has a personality disorder unless they receive a professional, medical diagnosis.
It’s important to understand the difference between personality types and personality disorders. A person who is shy or likes to spend time alone doesn’t necessarily have an avoidant or schizoid personality disorder.
The difference between personality style and a personality disorder can often be determined by assessing how the person’s personality affects different parts of their life, including:
- Awareness of reality.
- Behavior and impulse control.
Some general signs of people with a personality disorder include:
- Their behavior is inconsistent, frustrating and confusing to loved ones and other people they interact with.
- They may have issues understanding realistic and acceptable ways to treat others and behave around them.
- They may be unaware of how their behaviors cause problems for themselves and/or others.
- If they’re a parent, their parenting style may be detached, overemotional, abusive or irresponsible. This can sometimes lead to physical, emotional or mental issues in their children.
Diagnosis and Tests
How are personality disorders diagnosed?
Personality disorders can be difficult to diagnose since most people with a personality disorder don’t think there’s a problem with their behavior or way of thinking.
Because of this, people with a personality disorder typically don’t seek help or a diagnosis for their condition. Instead, their loved ones or a social agency may refer them to a mental health professional because their behavior causes difficulty for others.
When they do seek help, it’s often due to conditions such as anxiety, depression or substance use, or because of the problems created by their personality disorder, such as divorce or unemployment, not the disorder itself.
Healthcare providers base the diagnosis of a specific personality disorder on criteria provided in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.
When a mental health professional, like a psychologist or psychiatrist, suspects someone might have a personality disorder, they often ask broad, general questions that won’t create a defensive response or hostile environment. They ask questions that will shed light on:
- Past history.
- Previous work history.
- Reality testing.
- Impulse control.
Because a person suspected of having a personality disorder may lack insight into their behaviors, mental health professionals often work with the person’s family, friends and/or parole officers to collect more insight about their behaviors and history.
Personality disorders are generally underdiagnosed because providers sometimes focus on the symptoms of anxiety or depression, which are much more common in the general population than personality disorders. These symptoms may overshadow the features of any underlying personality disorder.
Management and Treatment
How are personality disorders treated?
Personality disorders are some of the most difficult disorders to treat in psychiatry. This is mainly because people with personality disorders don’t think their behavior is problematic, so they don’t often seek treatment.
And even if a person with a personality disorder seeks treatment, modern medicine is still lacking in available treatment options — there are no medications currently approved to treat any personality disorder. But there are medications that can help with symptoms of anxiety and depression, which are common in people with a personality disorder.
But psychotherapy (talk therapy) can help manage personality disorders. Psychotherapy is a term for a variety of treatment techniques that aim to help you identify and change troubling emotions, thoughts and behaviors. Working with a mental health professional, like a psychologist or psychiatrist, can provide support, education and guidance to you and your family.
The main goals of psychotherapy for treating personality disorders include:
- Reducing immediate distress, such as anxiety and depression.
- Helping the person understand that their problems are internal and not caused by other people or situations.
- Decreasing unhealthy and socially undesirable behavior.
- Modifying the personality traits that are causing difficulties.
There are several different types of psychotherapy, and each personality disorder requires different types.
For example, studies show that dialectical behavior therapy (DBT) is effective for treating those with borderline personality disorder, and people with histrionic personality disorder often benefit from cognitive-behavioral therapy (CBT).
Can personality disorders be prevented?
At this time, there’s no known way to prevent personality disorders, but many of the related problems might be lessened with treatment. Seeking help as soon as symptoms appear can help decrease the disruption to the person’s life, family and friendships.
Outlook / Prognosis
What is the prognosis (outlook) for personality disorders?
Since people with personality disorders often don’t seek proper medical attention, the overall prognosis for personality disorders is poor.
Untreated personality disorders may result in:
- Poor relationships.
- Occupational difficulties.
- Impaired social functioning.
Studies show that personality disorders are associated with elevated rates of:
- Domestic abuse.
- Substance use.
- Crime (especially antisocial personality disorder).
In addition, people with personality disorders are more likely to visit the emergency room (ER), experience traumatic accidents and have early deaths by suicide.
Although the outlook is dire, studies show that collaborative care management can greatly improve outcomes for people with personality disorders if they stay committed to treatment.
If you know someone who has or may have a personality disorder, try to persuade them to seek treatment. It’s also important to educate yourself about the nature of the specific personality disorder so you can better understand what to expect.
A note from Cleveland Clinic
It’s important to remember that personality disorders are mental health conditions. As with all mental health conditions, seeking help as soon as symptoms appear can help decrease the disruptions to your life. Mental health professionals can offer treatment plans that can help you manage your thoughts and behaviors.
The family members of people with personality disorders often experience stress, depression, grief and isolation. It’s important to take care of your mental health and seek help if you’re experiencing these symptoms.
They include antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder.What are the 10 types of personality disorders? ›
- Paranoid personality disorder. ...
- Schizoid personality disorder. ...
- Schizotypal personality disorder. ...
- Antisocial personality disorder. ...
- Borderline personality disorder. ...
- Histrionic personality disorder. ...
- Narcissistic personality disorder. ...
- Avoidant personality disorder.
DSM-5 lists ten specific personality disorders: paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent and obsessive–compulsive personality disorder.What are the 20 types of mental disorders? ›
- Anxiety disorders.
- Behavioural and emotional disorders in children.
- Bipolar affective disorder.
- Dissociation and dissociative disorders.
- Eating disorders.
- Obsessive compulsive disorder.
- Anxiety Disorders. ...
- Depression. ...
- Bipolar Disorder. ...
- Post-Traumatic Stress Disorder (PTSD) ...
- Schizophrenia. ...
- Eating Disorders. ...
- Disruptive behaviour and dissocial disorders. ...
- Neurodevelopmental disorders.
The odd/eccentric cluster includes people with paranoid, schizoid, and schizotypal personalities. These are the most severe types of personality disorders.What is the hardest mental illness to live with? ›
Individuals with Borderline Personality Disorder (BPDs) become overwhelmed and incapacitated by the intensity of their emotions, whether it is joy and elation or depression, anxiety, and rage. They are unable to manage these intense emotions.What is the hardest personality disorder? ›
But antisocial personality disorder is one of the most difficult types of personality disorders to treat. A person with antisocial personality disorder may also be reluctant to seek treatment and may only start therapy when ordered to do so by a court.What personality type do narcissists hate? ›
Type As can also be dangerous to narcissists
Although they can be targeted, type A people can also become a narcissist's worst nightmare. One of the most important defenses against dark personalities is having strong boundaries yourself, and type A people are usually aware they have the right to build them.
A personality disorder may disrupt your personal, professional, and social life. There are three general types of personality disorders: Cluster A, characterized by odd or eccentric behavior. Cluster B, characterized by dramatic or erratic behavior Cluster C, characterized by anxious or inhibited behavior.
Also proposed for DSM-5 was the retention of six personality disorder types (ie, borderline, antisocial, schizotypal, narcissistic, obsessive-compulsive, and avoidant) that would have been diagnosed in large part by a list of maladaptive personality traits,4 consistent with the FFM prototype matching approach developed ...How many personality disorders are there? ›
There are 10 specific types of personality disorders in the DSM-5-TR. Personality disorders are long-term patterns of behavior and inner experiences that differ significantly from what is expected.Which personality disorders is no longer in DSM-5? ›
To address the problem of excessive comorbidity, the DSM-5 Personality and Personality Disorders Work Group recommended reducing the number of specific personality disorder diagnoses from 10 to 5 by eliminating paranoid, schizoid, histrionic, narcissistic, and dependent personality disorders.What are the Big 5 personality traits DSM? ›
The Big Five dimensions are commonly labeled Extraversion, Neuroticism, Agreeableness, Conscientiousness, and Openness/Intellect. The Personality Inventory for the DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2012) was not intentionally developed to be congruent with the Big Five.What is the #1 most diagnosed mental disorder? ›
Impacting an estimated 300 million people, depression is the most-common mental disorder and generally affects women more often than men.What are the 10 most disabling mental illnesses? ›
Mood disorders (major depressive disorder, mania, and dysthymic disorder), anxiety disorders (post-traumatic stress disorder, panic disorder, agoraphobia, social phobia, specific phobia, obsessive-compulsive disorder, and generalized anxiety disorder), alcohol use disorder, illicit drug use disorder, intermittent ...What are the top 5 worst mental disorders? ›
The top 10 mental health issues and illnesses include anxiety disorders, bipolar affective disorders, depression, dissociative disorders, eating disorders, paranoia, PTSD, psychosis, schizophrenia and OCD.What are the darkest personality disorders? ›
Psychologists have identified three traits that make up the sinister-sounding "Dark Triad": narcissism, Machiavellianism and psychopathy.What personality disorder is hard to treat? ›
People with borderline personality disorder can be challenging to treat. While they often seek help, they also tend to drop out of therapy.What personality disorder is the difficult to treat? ›
Why Borderline Personality Disorder is Considered the Most “Difficult” to Treat. Borderline personality disorder (BPD) is defined by the National Institute of Health (NIH) as a serious mental disorder marked by a pattern of ongoing instability in moods, behavior, self-image, and functioning.
Bipolar disorder may worsen with age or over time if the condition is left untreated. As time goes on, a person may experience episodes that are more severe and more frequent than when symptoms first appeared.What is the most misdiagnosed mental illness? ›
Bipolar is one of the most frequently misdiagnosed mental health issues. Somewhere between 1.4 and 6.4 percent of people worldwide are affected by bipolar disorder. However, it's hard to say which number is more accurate due to the frequency of wrongful diagnosis.What is the most mentally painful mental illness? ›
Borderline personality disorder is one of the most painful mental illnesses since individuals struggling with this disorder are constantly trying to cope with volatile and overwhelming emotions.What is the angriest personality disorder? ›
MD. Commonly referred to as borderline rage, an inability to control intense bouts of anger and extreme, often unwarranted anger is a feature of borderline personality disorder (BPD).What is the most feared personality type? ›
Our study, published in Personality and Individual Differences, identified a group of individuals with dark traits who report above average empathic capacities – we call them "dark empaths". Since this study, the dark empath has earned a reputation as the most dangerous personality profile.What personality type is the most complex? ›
In short: INFJs are decisive, efficient, and organized while still being emotional, warm, and empathetic. They are also Introverted yet acutely sensitive to others' feelings and needs. These apparently contradictory characteristics make INFJs the most complex personality type.Who do narcissists fear the most? ›
Although narcissists act superior, entitled and boastful, underneath their larger-than-life facade lies their greatest fear: That they are ordinary. For narcissists, attention is like oxygen. Narcissists believe only special people get attention.What words can destroy a narcissist? ›
- 'I know the truth about you' or 'I see right through you' ...
- 'I don't remember that' ...
- 'I'm busy and don't have time for you right now' ...
- 'You are a failure' or 'I am so disappointed in you' ...
- 'It's your fault' ...
- 'I Don't Believe You' ...
8 Triggers of a Narcissist's Rage
They feel that they've been criticized, even if the critique is constructive or said kindly. They're not the center of attention. They're caught breaking rules or not respecting boundaries. They're held accountable for their actions.
Narcissistic personality disorder (NPD) is associated with an assortment of characteristics that undermine interpersonal functioning. A lack of empathy is often cited as the primary distinguishing feature of NPD.
Type B personalities can be generally summarised as; easy going, relaxed and highly-flexible. Generally taking a much more carefree approach and wider philosophical view of themselves, work/life balance and other traits which make them less stressed and more widely appreciated when compared to Type A personalities.What can be confused with narcissism? ›
Based on overlapping symptoms, Borderline Personality Disorder (BPD) and Narcissistic Personality Disorder (NPD) are often mistaken for one another.What hurts a borderline? ›
Separations, disagreements, and rejections—real or perceived—are the most common triggers for symptoms. A person with BPD is highly sensitive to abandonment and being alone, which brings about intense feelings of anger, fear, suicidal thoughts and self-harm, and very impulsive decisions.How intelligent are people with borderline personality disorder? ›
Research indicates that BPD is linked to above-average intelligence (IQ > 130) and exceptional artistic talent (Carver, 1997). Because your partner with BPD may be exceptionally bright, they digest information and discover answers to problems more quickly than the average person.What is a cluster C personality disorder? ›
Cluster C personality disorders include avoidant, dependent, and obsessive-compulsive personalities. Personality disorders are mental health conditions that involve a series of personality traits and patterns of thought and behavior that may lead to a great deal of distress and friction in interpersonal relationships.What is the most common personality disorders? ›
- Obsessive-compulsive personality disorder.
- Paranoid personality disorder.
- Schizoid personality disorder.
- Schizotypal personality disorder.
Some people with schizophrenia appear to talk to themselves as they respond to the voices. People with schizophrenia believe that the hallucinations are real.What is the personality of a narcissist? ›
Narcissistic personality disorder is a mental health condition in which people have an unreasonably high sense of their own importance. They need and seek too much attention and want people to admire them. People with this disorder may lack the ability to understand or care about the feelings of others.Can you have a mix of personality disorders? ›
Technically, according to DSM-5*, a person can receive more than one personality disorder diagnosis. People who are diagnosed with a personality disorder most often qualify for more than one diagnosis. A person with a severe personality disorder might meet the criteria for four, five or even more disorders!What is the least studied personality disorder? ›
NPD is one of the least studied personality disorders. It appears to be prevalent, highly comorbid with other psychiatric disorders, and associated with significant psychosocial disability. NPD is difficult to treat, and can complicate the treatment of co-occurring disorders.
A pattern of turbulent and unstable relationships with friends and family. Feeling constantly bored and/or empty. Impulsive choices and behaviors that may result in risky behavior, such as gambling, shopping sprees, or engaging in unprotected sex with multiple partners.What is a Machiavellian person? ›
“Machiavellians are sly, deceptive, distrusting, and manipulative. They are characterized by cynical and misanthropic beliefs, callousness, a striving for … money, power, and status, and the use of cunning influence tactics.What is dependency disorder? ›
Dependent personality disorder (DPD) is a type of anxious personality disorder. People with DPD often feel helpless, submissive or incapable of taking care of themselves. They may have trouble making simple decisions. But, with help, someone with a dependent personality can learn self-confidence and self-reliance.What is the OCEAN theory of personality? ›
“OCEAN” is an acronym used to represent the Big Five personality traits, which include openness, conscientiousness, extroversion, agreeableness and neuroticism. Each trait represents a spectrum, and an individual can fall anywhere on the spectrum.What is the hardest personality disorder to treat? ›
But antisocial personality disorder is one of the most difficult types of personality disorders to treat. A person with antisocial personality disorder may also be reluctant to seek treatment and may only start therapy when ordered to do so by a court.What is the most well known personality disorder? ›
BPD is currently the most commonly diagnosed personality disorder. You can read more about it on our pages on borderline personality disorder (BPD).What is the most misunderstood mental disorder? ›
- Schizophrenia. Myth: Schizophrenia is when a person has multiple personalities. ...
- Bipolar Disorder. Myth: Bipolar disorder is just mood swings, which everybody has. ...
- Obsessive-Compulsive Disorder (OCD) ...
- Dissociative Identity Disorder (DID) ...
- Borderline Personality Disorder (BPD)
Obsessive-Compulsive Personality Disorder: Compulsive personalities are conscientious and have high levels of aspiration, but they also strive for perfection. Never satisfied with their achievements, people with compulsive personality disorder take on more and more responsibilities.