Kevin Lutz, MD, FACP
Sep 1 2019

Personality disorders are deeply-ingrained, rigid ways of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and last over time. 

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Personality is the way of thinking, feeling and behaving that makes a person different from other people. An individual’s personality is influenced by experiences, environment and inherited characteristics. A person’s personality typically stays the same over time. Personality disorders are deeply-ingrained, rigid ways of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and last over time. Personality disorders vary significantly in their manifestations, but all are believed to be caused by a combination of genetic and environmental factors.

Cluster A personality disorders are characterized by odd, eccentric thinking or behavior. People with Cluster A personality disorders tend to experience major disruptions in relationships because their behavior may be perceived as peculiar, suspicious, or detached.

Schizotypal Personality Disorder features peculiar dress, thinking, beliefs, speech or behavior. Speech may include digressions, odd use of words or display "magical thinking," such as a belief in clairvoyance and bizarre fantasies. They typically have few, if any, close friends, and feel nervous around strangers.

Paranoid Personality Disorder affects between 1 - 2% of adults in the U.S. Symptoms include chronic, pervasive distrust of other people. They will not confide in others due to unreasonable fear that others will use the information against them. People with this personality disorder may have an unjustified, recurrent suspicion that a spouse or sexual partner is unfaithful.

Schizoid Personality Disorder is characterized by social isolation and indifference toward other people. It affects more men than women. People with this relatively rare disorder often are described as cold or withdrawn, chooses not to have close relationships with other people and may be preoccupied with introspection and fantasy. There is evidence indicating the disorder shares an underlying genetic architecture with schizophrenia. Social withdrawal is a characteristic of both disorders. Importantly, people with schizoid personality disorder are in touch with reality, unlike those with schizophrenia or schizoaffective disorder. 

Cluster B personality disorders are characterized by dramatic or erratic behavior. People who have a personality disorder from this cluster tend to either experience very intense emotions or engage in extremely impulsive, theatrical, promiscuous, or law-breaking behaviors.

Borderline Personality Disorder is characterized by emotional instability, intense interpersonal relationships, and impulsive behaviors. People with this personality disorder often exhibit up and down moods, suicidal behavior or threats of self-injury, intense fear of being alone or abandoned and ongoing feelings of emptiness.

Histrionic Personality Disorder is characterized by constant attention-seeking, emotional overreaction, and seductive behavior. People with this condition tend to overdramatize situations, which may impair relationships and lead to depression. Yet they are highly suggestible, easily susceptible to the influence of others. People with this disorder may have frequent mood swings as well.

Antisocial Personality Disorder tends to show up in childhood, unlike most other personality disorders that do not appear until adolescence or young adulthood. Symptoms include a pattern of disregarding or violating the rights of others. A person with antisocial personality disorder may not conform to social norms, may repeatedly lie or deceive others and usually have lack of remorse for their behavior.
Narcissistic Personality Disorder is associated with self-centeredness, exaggerated self-image, and lack of empathy for others. People with this condition are frequently described as arrogant, self-absorbed, manipulative, and demanding. They may also have grandiose fantasies and may be convinced that they deserve special treatment. 

Cluster C personality disorders are characterized by anxiety. Individuals with personality disorders in this cluster tend to experience pervasive anxiety and/or fearfulness.

Dependent Personality Disorder involves a pattern of needing to be taken care of and submissive and clingy behavior. People with dependent personality disorder may have difficulty making daily decisions without reassurance from others or may feel uncomfortable or helpless when alone because of fear of inability to take care of themselves. These individuals tend to be passive and allow other people (normally one other person) to take the initiative and assume responsibility for most major areas of their lives.

Obsessive-Compulsive Personality Disorder is characterized by a preoccupation with orderliness, an excessive focus on details, order and rules, and the need to achieve a perfect outcome, often in a way that interferes with daily life. They can be stubborn, insisting that things must be done their way. The desire for order, perfection, productivity and control can inhibit their ability to finish tasks, to collaborate with other people, and to treat social activities or hobbies as purely recreational. People with this personality disorder do not have unwanted thoughts that compel them to create routines or rituals, as do those with Obsessive Compulsive Disorder (OCD).

Avoidant Personality Disorder is characterized by extreme shyness and fear of rejection makes it difficult for people to interact socially and professionally. People with avoidant personality disorder may avoid work activities or decline job offers because of fears of criticism from others. They may be inhibited in social situations as a result of low self-esteem and feelings of inadequacy. Loss and rejection are so painful to these individuals that they will choose loneliness rather than risk trying to connect with others.

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