A Brief Overview of the Three Personality Disorder Clusters
The 2004 National Epidemiologic Survey on Alcohol and Related Conditions states that 14.79 percent (30.8 million) of the U.S. population has at least one personality disorder (Grant et al., 2004). Personality disorders originate from distorted patterns in personality and behavior, which result in maladaptive perception, cognition, and social relationships (Butcher, et. al., 2004). Typically personality disorders develop in either the teenage years or early adulthood and are often not apparent to the effected individual ("Personality Disorders, n.d.).
The DSM-V lists ten different personality disorders that are grouped by similarity into three different clusters, labeled A, B, and C, respectively. People can be diagnosed with one or more personality disorders. In fact, the majority of patients with one personality disorder also meet the criteria for one or more others (Skodol, 2019).
Cluster A includes three related personality disorders: paranoid, schizoid, and schizotypal. Two common factors of each of these disorders are an inability to maintain normal social relationships and eccentric thinking and or behavior ("Personality Disorders," n.d.). Though cluster A disorders all involve impaired social relationships, the cause varies with each disorder. Paranoid personalities are highly distrustful and suspicious of other individuals and their motives, highly sensitive, quick to anger, and slow to forgive. Schizoid personalities do not have a wide range of emotional expression, are typically emotionally non-reactive, and lack the ability to adequately express themselves to others ("What Are," n.d.).
Unlike the other two disorders in this cluster, schizoid personalities do not seem to desire to have social relationships. Like the schizoid personality, schizotypal personalities have a lack of ability to form social relationships, but in addition, they also experience distorted thinking and perceptions and are likely to experience temporary psychotic episodes. One other feature of this disorder is the common belief of the individual that he or she possesses special abilities, which may manifest in the performance of magical rituals or superstitious beliefs (Butcher, et al., 2004).
Cluster B includes four related personality disorders: histrionic, narcissistic, antisocial, and borderline. In addition to having impaired social relationships, the personalities in this cluster tend to be self-centered and impulsive, although this varies in borderline personality disorder due to emotional instability. This self-centeredness takes the form of attention-seeking and grandiosity in histrionic and narcissistic personalities, but in antisocial and borderline personalities it takes the form of manipulation and a lack of respect for others. This lack of respect for others (and their property) is most vivid in antisocial personalities, whereas in borderline personality, it manifests as self-destructive behavior that is often used to manipulate others. It is very difficult for these personalities to experience empathy towards others, which only heightens their appearance of self-preoccupation. Unlike the other personalities in this cluster, antisocial and borderline personalities tend to be violent and destructive – the former towards others and the later towards his or her self (Butcher, et al., 2004).
Cluster C includes three related personality disorders: avoidant, dependent, and obsessive-compulsive. These three personalities each experience anxiety and hindered personal relationships. In the case of the avoidant personality, the individual experiences loneliness and desires social relationships (unlike the schizoid personality), but has trouble developing these relationships due to hypersensitivity and fear of rejection. The dependent personality has social relationships, but due to a fear of loosing them, dependent personalities often end up in abusive relationships that they are afraid of ending. Obsessive-compulsive personalities are neither generous with themselves or others, and are often preoccupied with their work, which takes its toll on personal relationships. A common factor between avoidant and dependent personalities is that they both fear rejection by others. Although such fear is also common with borderline personalities, reaction to rejection is different in that the borderline personality often reacts with anger whereas the dependent personality reacts with submissiveness – and avoidant personalities do everything they can to avoid such rejection, which usually results in not forming any close relationships (Butcher, et al., 2004).
If you think that you may have a mental health issue, please talk to your primary care medical provider. If you have thoughts of harming yourself or another, please call one of the help lines below:
National Suicide Prevention Lifeline: 1‑800‑273‑TALK (8255)
SAMHSA Treatment Referral Helpline: 1‑877‑SAMHSA7 (1‑877‑726‑4727)
Any emergency: 911
In addition to having the potential to cause problems with relationships, work, and school, personality disorders can also lead to social isolation and substance abuse ("Personality Disorders, n.d.). Diagnosis requires psychiatric evaluation and or testing. Treatment often involves a health care team composed of psychiatrists, psychologists, social workers, and or medical doctors and can comprise various types of psychotherapy. Although there are no medications specifically for treating personality disorders, medications may be used to treat various symptoms.
American Psychiatric Association. (n.d.) What are personality disorders? https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders
Butcher, J., Mineka, S., and Hooley, J. (2004). Abnormal Psychology (12th Ed.). Boston: Pearson Education.
Grant, B. F., Hasin, D. S., Stinson, F. S., Dawson, D. A., Chou, S. P., Ruan, W. J., & Pickering, R. P., (2004). Prevalence, Correlates, and Disability of Personality Disorders in the United States: Results From the National Epidemiologic Survey on Alcohol and Related Conditions. The Journal of Clinical Psychiatry, 65(7), 948–958. https://doi.org/10.4088/JCP.v65n0711
Mayo Clinic, (n.d.). Personality disorders. https://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463
Skodol, A. (2019). Overview of Personality Disorders. MerckManuals. https://www.merckmanuals.com/professional/psychiatric-disorders/personality-disorders/overview-of-personality-disorders
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