Personality is the synthesis of behaviours, cognitions and emotions that makes each person unique. Despite this uniqueness, both “healthy” personality and personality disorder have defined patterns. Although our personalities allow others to predict and anticipate our responses to situations, a person with a “healthy” personality demonstrates a range of coping responses and styles when placed in a stressful situation. A disordered personality does not have this kind of adaptability and flexibility. The lack of adaptability and the limited repertoire of coping responses can result in distress for the person and for those around him or her.
Currently, there are 10 personality disorders recognized in psychiatry. Borderline personality disorder and antisocial personality disorder are the most frequently diagnosed personality disorders.
The 10 personality disorders are grouped into three clusters according to shared characteristics. Each personality disorder has its own signs and symptoms, but there are similarities within each of the three clusters:
Cluster A: paranoid, schizoid and schizotypal personality disorders. These are characterized by feeling paranoid, distrustful and suspicious.
Cluster B: impulsive personality disorders, such as borderline, narcissistic, histrionic and antisocial personality disorders. These are characterized by having difficulty controlling emotions, fears, desires and anger.
Cluster C: anxious personality disorders, such as obsessive-compulsive, dependent and avoidant personality disorders. These are characterized by experiencing compulsions and anxiety.
People with personality disorders are at increased risk for self-harming behaviours and suicide. They may also have more difficulty getting along with others than do people without personality disorders.
The causes of personality disorders are not known, but research has begun to explore such potential factors as genetics, childhood trauma, verbal abuse, high reactivity/oversensitivity and peer influences.
Personality disorders are considered to be among the most difficult mental health disorders to treat. However, some therapies have proven to be quite effective. For example, dialectical behaviour therapy (DBT) is the most researched psychotherapy for borderline personality disorder. This form of cognitive behavioural therapy (CBT) traces the person’s emotional upheaval to a combination of temperament and an invalidating environment. DBT emphasizes validating and accepting the person’s experience while focusing on change.
Researchers are hopeful that treatments for BPD will lead to advances in treating the other nine personality disorders. There is no evidence yet that CBT is an effective therapy for personality disorders other than BPD.
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