American Medical Association Family Medical Guide - American Medical Association [463]
Avoidant personality disorder
A person with avoidant personality disorder has a lifelong fear of rejection, is preoccupied with feelings of inadequacy, and harbors fears of criticism. He or she longs to have a social life but avoids social gatherings, intimate relationships, and new activities because they may prove embarrassing. This type of personality disorder is thought to be related to social anxiety disorder (see page 721).
Dependent personality disorder
The distinguishing feature of dependent personality disorder is a strong need to be taken care of. This need creates submissive and clinging behavior in relationships. People with this personality disorder always depend on other people to make decisions and assume responsibility.
Obsessive-compulsive personality disorder
Not to be confused with obsessive-compulsive disorder (see page 720), obsessive-compulsive personality disorder produces a preoccupation with orderliness, perfectionism, and control over both thoughts and other people. People with this disorder are inflexible and often inefficient because they adhere excessively to rules, schedules, lists, and trivial details.
Diagnosis
When diagnosing a personality disorder, a psychiatrist or other mental health professional interviews the person and his or her family to find out what kind of behavior the person displays and the nature of his or her relationships with other people. The doctor must take care not to mistake the person’s cultural habits, ethnic customs, or religious beliefs for a personality disorder. For example, people from countries in which food and other necessities are scarce may exhibit disregard for others by cutting in front of people who are waiting in line. This behavior does not mean that they have an antisocial personality disorder, which requires evidence that the person also had a conduct disorder (aggressive behavior that disregards the rights of others) before the age of 15 years. When diagnosing a personality disorder, the doctor also carefully rules out the presence of another mental disorder or evidence of substance abuse or a medical condition, such as a severe head injury, when making a diagnosis.
Treatment
Psychiatrists treat personality disorders with psychotherapy and, at times, with a combination of medication and psychotherapy, depending on the disorder. Each of the three clusters calls for a specific type of medication. Cluster A personality disorders (paranoid, schizoid, and schizotypal) may respond to antipsychotic medication (see page 713). People with Cluster B disorders (antisocial, borderline, histrionic, and narcissistic), which typically cause mood instability, usually benefit from drugs called mood stabilizers (see page 713), which are also prescribed for bipolar disorder. No medication works very effectively for antisocial personality disorder, however. Doctors treat cluster C personality disorders (avoidant, dependent, and obsessive-compulsive) with antianxiety medications (see page 713) or antidepressants (see page 712). Cognitive-behavioral therapy also helps people with personality disorders change their ineffective thought and behavior patterns to enable them to improve their relationships.
Eating Disorders
Few people are genetically programmed to be thin, but this image is the ideal in our society. The unrealistic desire to be slim has made many people, especially women, feel uncomfortable, awkward, or ashamed of their body shape. People who have a negative body image are more likely to be depressed, have low self-esteem, and struggle with weight loss. At any given time, 45 percent of American women and 25 percent of American men are on a diet. For some people, simple dieting crosses the line into an eating disorder. People at increased risk for an eating disorder often engage in sports (such as gymnastics or figure skating) or have careers (such as modeling or acting) that