According to the Mayo Clinic, a personality disorder s a type of mental disorder in which a person has a “rigid and unhealthy pattern of thinking, functioning and behaving.” This pattern of behavior is deeply ingrained and varies widely from generally accepted social standards. This condition’s symptoms usually become evident during the teen years and causes chronic difficulties in interpersonal relationships or social functioning.
The core traits of personality disorders include the following:
- Distorted thinking patterns
- Problematic emotional responses
- Dysregulated impulse control
- Interpersonal difficulties
These four features are central to all personality disorders. Before a diagnosis can be determined, an individual must display significant and persistent challenges in at least two of these areas.
These four fundamental characteristics combine in various ways to form ten specific personality disorders, as issued in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Each condition lists criteria that reflect the discernible attributes associated with that disorder.
A person’s thoughts, functioning, and behavior must satisfy the minimum number of criteria designated for that disorder or the individual to be diagnosed with a personality disorder. Also, to meet a psychiatric disorder’s diagnostic requirements, the symptoms must significantly impair function or cause distress. This means the symptoms are reported as distressing to the individual with the condition and make it challenging for them to function in society adequately.
The Three Clusters
The ten distinct personality disorders are filed into three clusters based on descriptive similarities in each group. These include the following:
- Cluster A (odd, eccentric)
- Cluster B (dramatic, emotional, and erratic)
- Cluster C (anxious, fearful)
Notably, an individual can be diagnosed with more than one personality disorder. Studies have suggested that there is a propensity for personality disorders grouped into the same cluster to co-exist. An alternative model in development endeavors to overcome this overlap by using a dimensional approach instead of a categorical one.
Cluster A Personality Disorders
As noted, Cluster A is commonly referred to as the odd, eccentric cluster. This group includes paranoid, schizoid, and schizotypal personality disorders. In this cluster, common characteristics include social ineptness and withdrawal, further marked by distorted thought.
Paranoid Personality Disorder
Paranoid personality disorder (PPD) is characterized by extreme distrust and wariness of others’ intentions. Individuals with this condition believe that others are out to harm them, take advantage of them, or embarrass them somehow. They tend to put great effort into protecting themselves and distancing themselves from others.
Persons affected by PPD are also known to last out at those by whom they feel endangered. They tend to hold grudges, are antagonistic, and their jealousy is pathological. Their misunderstanding of the environment includes perceiving harmless comments or behavior as malicious. For these reasons, they do not usually confide in others or permit themselves to foster intimate relationships.
Schizoid Personality Disorder
Schizoid personality disorder (SZPD) is a relatively uncommon condition hallmarked by persistent social detachment and limited emotional expression. For this reason, individuals with this disorder are often socially withdrawn and isolated and do not appear to seek out or experience enjoyment from participating in close interpersonal relationships.
Instead, individuals affected by this personality disorder type almost always prefer to engage in solitary activities that entail little or no human interaction. They also appear to feel little pleasure in life.
Emotionally, individuals with SZPD present as aloof, indifferent, and cold. They are often oblivious to social nuances and cues, which causes them to appear to others as socially inept and superficial. Their limited emotional range and inability to reciprocate feelings, expressions or gestures can make them seem vapid or absent-minded.
Schizotypal Personality Disorder
Consistent social and interpersonal restrictions characterize individuals with schizotypal personality disorder (STPD). They often encounter significant distress in social environments and a diminished capacity for intimate relationships. For these reasons and others, like other Cluster A disorders, affected persons tend to be socially withdrawn, cold, and reserved.
Unlike people with SZPD, however, individuals with STPD also experience perceptual and cognitive distortions and may engage in odd or eccentric behavior. These distortions may include seeing flashes of light others do not or identifying strange shadows or objects in the corner of their eye before coming to the realization that nothing is there.
Persons with schizotypal personality disorder tend to have strange ideas. For example, an individual with STPD may falsely believe they can read others’ thoughts or that their own thoughts seem to have been somehow “stolen” from their heads. These odd or superstitious ideas and fantasies are incompatible with current cultural standards.
Schizotypal personality disorder tends to be more common in families in which another member has been diagnosed with schizophrenia, another, often more debilitating mental health condition with defining features that are psychotic in nature. And indeed, there is some mounting evidence that these two different disorders do share some genetic overlap.
Personality Disorders and Addiction
Substance abuse or addiction is diagnosed in about 50 percent of those who experience a personality disorder. However, those who abuse prescription or illegal drugs are diagnosed with personality disorders more commonly than those who use alcohol excessively. Antisocial, borderline, dependent, and narcissistic personality disorders are the most common comorbid diagnoses for substance abusers.
A personality disorder usually exists before the addiction. Once individuals find that substances offer an escape from their inner loneliness and emotional conflicts, addiction can develop without effort. Once a person has established abuse or dependence, he or she will likely be forced to associate with others that encourage their addictive behaviors, such as bartenders or dealers. This development then usually worsens addiction as well as mental health issues.
Treatment for Cluster A Personality Disorders and Addiction
When administered separately, treatment for both substance abuse and cluster A personality disorder typically involves using a combination of medications, behavioral therapy, health and wellness education, mindfulness therapy, and peer support groups. Dual diagnosis programs work by addressing psycho-emotional issues and drug addiction simultaneously instead of two wholly different disorders.
Medical detox—a process that involves the gradual removal of substances from the user’s system—is usually the first step in treatment for co-existing disorders. During this process, the individual is supervised by health providers 24/7 for several days while the person’s body eliminates toxic substances such as drugs and alcohol.
Following detox, a clinical team can better assess the person’s personality disorder symptoms and discern the most effective course of treatment. Antipsychotics and mood-stabilizing medications are often prescribed to help alleviate symptoms of Cluster A personality disorders. While using medicine to control symptoms, persons affected by a dual diagnosis can also participate in several therapies to address the various factors contributing to their conditions.
For example, cognitive-behavioral therapy (CBT) is among the most common therapy forms used to treat co-occurring addiction and personality disorders. CBT helps the person learn how to identify particular behaviors or ways of thinking that contribute to their addiction or mental health issues and teaches strategies for managing symptoms.
Just Believe Detox and Just Believe Recovery centers offer comprehensive programs in partial hospitalization and residential formats that provide those we treat with all of the therapies, tools, and support they need to recover fully and sustain long-lasting wellness.