American Medical Association Family Medical Guide - American Medical Association [462]
Personality Disorders
A personality disorder is a long-lasting pattern of maladaptive behavior that adversely affects a person’s ability to interact with others. The disorder usually first appears in adolescence or early adulthood. The person’s behavior is noticeably different from expected behavior. Psychiatrists classify personality disorders into three different clusters. Cluster A personality disorders (paranoid, schizoid, and schizotypal) are characterized by odd or eccentric behavior. Cluster B personality disorders (antisocial, borderline, histrionic, and narcissistic) are marked by dramatic and highly emotional behavior. Cluster C personality disorders (avoidant, dependent, and obsessive-compulsive) are typified by anxious, fearful behaviors.
Personality disorders affect up to 3 percent of the general population. A personality disorder can affect both men and women, but some, such as antisocial personality disorder and paranoid personality disorder, are more prevalent in men.
Symptoms
The symptoms of a personality disorder depend on the type. It is possible to have a personality disorder that displays traits of more than one type. The disorders described here are the most common medically recognized personality disorders.
Paranoid personality disorder
People with paranoid personality disorder are so distrustful and suspicious of other people’s motives that, without any evidence, they may assume that others intend to harm, exploit, or deceive them. They bear grudges, do not forgive perceived injustices, and react with anger when they think they are being attacked.
Schizoid personality disorder
People with schizoid personality disorder are not interested in forming close relationships and seem cold and indifferent. They prefer to be alone and do not express much emotion, including anger. This type of personality disorder is thought to be a limited form of schizophrenia (see page 728) and sometimes eventually becomes schizophrenia.
Schizotypal personality disorder
People with a schizotypal personality disorder are uncomfortable in close relationships, seem eccentric, and are preoccupied with superstitions or the paranormal. They may believe they have special powers, such as clairvoyance, or that they have magical control over others. This type of personality disorder is also thought to be a limited form of schizophrenia (see page 728).
Antisocial personality disorder
The essential feature of antisocial personality disorder is callous disregard for other people’s rights or suffering. A person with this disorder may be contemptuous, deceitful, and manipulative and often break the law by destroying property, stealing, or conning other people.
Borderline personality disorder
People with borderline personality disorder have a lifelong history of mood instability and fear real or imagined abandonment. They try to counteract it by impulsively entering and ending relationships, engaging in spending sprees, having promiscuous sex, driving recklessly, or abusing drugs or alcohol.
They lead tempestuous lives and may engage in self-mutilation or attempt suicide. Borderline personality disorder may be related to bipolar disorder (see page 715).
Histrionic personality disorder
Attention-seeking and shallow, exaggerated emotionality characterize histrionic personality disorder. Affected people demand to be the center of attention, are sexually seductive, and are easily influenced by others.
Narcissistic personality disorder
People with narcissistic personality disorder have an exaggerated sense of self-importance. They assume they are superior to others and feel slighted when their superiority is not recognized. They require excessive admiration, have