What do you guys know about personality disorders? My guess: not a whole lot. And not because you're not a well-informed bunch of people, because of course you are! It's just ... I think there's a lot of confusion out there about them.
First, let me explain something. When we diagnose (using the DSM-IV, which is not the only diagnostic system, but is the most commonly used among American mental health professionals), we do so on five "axes". I'll explain the whole system in a future post, but basically:
- Axis I disorders are considered "clinical" disorders, that is, in need of clinical attention. Things like anxiety, depression, schizophrenia, and bipolar disorder are Axis I disorders.
- Axis II disorders are of two types: mental retardation and personality disorders.
Personality disorders signal that a person is showing a relatively inflexible pattern of behaviors, thoughts, and emotions across most of his/her environments, and that inflexible pattern is almost certainly causing the person some trouble in terms of occupational, personal, and relational functioning.
There are three "clusters" of personality disorders outlined in the DSM-IV (and a few more identified in other diagnostic systems, but I won't get in to those today). Below is a tiny snippet about each--keep in mind that, to be diagnosed with a personality disorder, the behavior has to cause impairment, AND it has to be out of the norm for one's culture and society.
Cluster A (the odd or eccentric patterns):
- Paranoid Personality Disorder--irrational suspicions and extreme distrust of others
- Schizoid Personality Disorder--extreme lack of interest in other people and relationships
- Schizotypal Personality Disorder--odd behavior and thinking
Cluster B (the dramatic, emotional, or erratic patterns):
- Antisocial Personality Disorder--pervasive disregard for the law and rights of others
- Histrionic Personality Disorder--pervasive attention-seeking behavior (i.e., inappropriate sexual seductiveness and shallow, exaggerated emotions)
- Borderline Personality Disorder--instability in self-image, relationships, and identity often resulting in impulsivity and self-harm (I'll bet nearly all of y'all have heard of this one)
- Narcissistic Personality Disorder--grandiosity, need for admiration, lack of empathy
Cluster C (the anxious or fearful patterns):
- Avoidant Personality Disorder--social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation
- Obsessive-Compulsive Personality Disorder--precoccupation with orderliness and interpersonal control at the expense of flexibility, openness, and efficiency
- Dependent Personality Disorder--extreme psychological dependence on other people
These disorders really shouldn't be diagnosed until late adolescence or adulthood. The prognosis depends on the disorder. Most people with these disorders don't seek treatment until their behaviors have caused them some real suffering and turmoil in their lives. Studies show that adolescents with personality disorders are twice as likely to develop an Axis I disorder (like depression or anxiety) in adulthood when compared to their non-personality-disordered peers.
In other words, personality disorders make a person more vulnerable to other bad stuff. And also harder to treat.I'll be doing posts on nearly every one of these personality disorders at some point. Although these disorders are not pleasant in real life, they could really make for some powerful, interesting characters in a novel, and you'll see an example of this Wednesday, when I will post about Obsessive-Compulsive Personality Disorder.
So ... are you familiar with the term "personality disorder"? Were you aware it was actually numerous disorders? Which ones have you heard of, and which ones are new to you? Are there any in particular you'd like to know more about sooner rather than later? Have you ever written a character with a personality disorder (either intentionally or unintentionally)?
Today's Monday, so remember to visit Lydia to read her Medical Monday post, and Laura for her Mental Health Monday post.
