Chapter 9: Personality Disorders
Our personalities reflect our characteristic manner of thinking, feeling, behaving and relating to others. Personality traits are integral to a person’s sense of self.
While there are many theories of personality, one of the most well researched is the Five Factor Model, which organizes literally hundreds of traits into five broad dimensions: Neuroticism/Emotional Stability, Extraversion/Introversion, Openness/Closedness, Agreeableness/Antagonism, and Conscientiousness/Disinhibition.
When personality traits result in significant distress, social impairment, and/or occupational impairment, they might be considered to be a personality disorder. Personality disorders are characterized by a pervasive, consistent, and enduring pattern of behaviour and internal experience that differs significantly from that which is usually expected in the individual’s culture.
Personality disorders typically have an onset in adolescence or early adulthood, persist over time, and cause distress or impairment.
Each of the 10 personality disorders is a constellation of maladaptive personality traits, not one particular trait. In this regard, they are syndromes. These can be mapped onto the Five Factor Model.
The personality disorders are grouped into 3 clusters, based on their predominant symptoms. Cluster A personality disorders involve odd or eccentric thinking or behaviour (paranoid, schizoid, and schizotypal personality disorder). Cluster B personality disorders are marked by dramatic, overly emotional, or unpredictable thinking or behaviour (antisocial, borderline, histrionic, and narcissistic personality disorder). Cluster C personality disorders involve anxious, fearful thinking or behaviour (avoidant, dependent, and obsessive-compulsive personality disorder.
The validity of personality disorders is an issue of controversy.
Personality disorders are generally ego syntonic, meaning that people are largely comfortable with themselves and their personality serves them well.
One personality disorder for which we have a well developed treatment is borderline personality disorder, which is treated with Dialectical Behaviour Therapy.
Cognitive Therapy can also be used to treat personality disorders.
Personality disorders are among the most difficult to treat disorders, because they involve well-established behaviours that are integral to a client’s self-image.