Personality Disorders – DSM-IV

The DSM-IV defines personality disorder as “enduring pattern of inner experience and behaviour that deviates markedly from the expectation of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.”  

Our personality develops in various ways, at times this can make it difficult to live with ourselves and/or other people.  A person with a personality disorder may find it difficult to

  •  Make or maintain relationships
    – With people at work
    – With friends
    – With family members
  • Stay out of trouble
  • Control their feelings or behaviour
  • Are unhappy or distressed
  • Are often upset
  • Harm themselves or other people

Because some personality disorders are chronic and pervasive, they can lead to serious impairments in daily life and functioning.

A definite cause of personality disorder has not been established, due to the ongoing debate between the influence of genetics (nature) on personality disorders and the influence of early experiences (nurture) on personality disorders. Disorders are likely to be a combination of both genetics and life experiences.

In order to be diagnosed with a personality disorder, an individual must exhibit symptoms that meet the diagnostic criteria established in the DSM-IV.

  • Patterns of behaviour must be chronic and persistent, affecting many different aspects of the individual’s life, including social functioning, work, school and close relationships.
  • The individual must exhibit symptoms that affect two or more of the following areas
    – Thoughts
    – Emotions
    – Interpersonal functioning
    – Impulse control
    – Pattern of behaviours must be stable across time and have an onset that can be traced back to adolescence or early adulthood.
    – These behaviours cannot be explained by any other mental disorders, substance abuse or medical conditions.

There are different kinds of personality disorders that tend to fall into three groups, according to their emotional flavour”

Cluster A: Odd or Eccentric Disorders

  • Paranoid Personality Disorder
  • Schizoid Personality Disorder
  • Schizotypal Personality Disorder

Cluster B: Dramatic, Emotional, or Erratic Disorders

  • Antisocial, or Dissocial Personality Disorder
  • Borderline Personality Disorder or Emotionally Unstable
  • Histrionic Personality Disorder
  • Narcissistic Personality Disorder

Cluster C: Anxious or Fearful Disorders

  • Obsessive-Compulsive Personality Disorder (Anankastic)
  • Avoidant Personality Disorder (Anxious/Avoidant)
  • Dependent Personality Disorder

Before a clinician can diagnose a personality disorder, they must rule out other disorders or medical conditions that may be causing the symptoms. The symptoms that characterize personality disorders are often similar to those of other disorders and illnesses. Personality disorders also commonly co-occur with other illnesses.

The following are potential differentials that must be ruled out before diagnosing an individual with a personality disorder:

  • Substance Abuse
  • Anxiety Disorders
  • Depression
  • Dissociative Disorders
  • Social Phobia
  • Post Traumatic Stress Disorder
  • Schizophrenia

As you read through the descriptions of each type, you may well recognise some aspects of your own personality. This doesn’t necessarily mean that you have a personality disorder. Some of these characteristics may even be helpful in some areas of your life. However, if you do have a personality disorder, these aspects of your personality will be quite extreme. They may make your life, and often the lives of those around you very difficult.

People may display the signs of more than one personality disorder.

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