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Personality Disorders


Personality disorders (PD) are a group of psychiatric conditions characterized by experience and behavior patterns that cause serious problems with respect to any two of the following: thinking, mood, personal relations, and the control of impulses.


Most personality disorders are associated with problems in personal development and character which peak during adolescence and are then defined as personality disorders. Children and adolescents with a personality disorder have great difficulty dealing with others. They tend to be inflexible, rigid, with inadequate response to the changes and demands of life. They have a narrow view of the world and find it hard to participate in social activities. There are many formally identified personality disorders, each with its own types of associated behaviors. Most PDs, however, fall into three distinct categories or clusters, namely: cluster A, which includes disorders characterized by odd or eccentric behavior; cluster B, which includes disorders marked by dramatic, emotional or erratic behavior; and cluster C, which includes disorders accompanied by anxious and fearful behavior. The most common disorders in each cluster are given below.

These disorders include the following:

Cluster B disorders include the following:

Cluster C disorders include the following:


In 2001 to 2002, fully 16.4 million Americans (7.9% of all adults) had obsessive-compulsive personality disorder; 9.2 million (4.4%) had paranoid personality disorder; 7.6 million (3.6%) had antisocial personality disorder; 6.5 million (3.1%) had schizoid personality disorder; 4.9 million (2.4%) had avoidant personality disorder; and 1.0 million (0.5%) had dependent personality disorder. According to the National Institutes of Health, nearly 31 million Americans meet criteria for at least one personality disorder. A 2004 survey showed that nearly 14.8 percent of adult Americans met diagnostic criteria for personality disorders as defined by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. The risk of having avoidant, dependent, and paranoid personality disorders is greater for females than males, whereas risk of having antisocial personality disorder is greater for males than females. There are no gender differences in the risk of having compulsive or schizoid personality disorders. In general, other risk factors contributing to the emergence of personality disorders include being Native American or African American; being a young adult; having a low socioeconomic status; and having any other status than married.

Causes and symptoms

The exact cause of personality disorders is unknown. However, evidence points to genetic and environmental factors such as a history of personality disorders in the family. Some experts believe that traumatic events occurring in early childhood exert a crucial influence upon behavior later in life. Others propose that people are genetically predisposed to personality disorders or that they have an underlying biological disturbance (anatomical, electrical, or neurochemical).

Symptoms vary widely depending on the specific type of PD, but according to the American Psychiatric Association, individuals with personality disorders have most of the following symptoms in common:

An appointment should be made with a healthcare provider or a mental health professional if a child has persistent symptoms of a personality disorder. Parents are often concerned about their child's emotional health or behavior, but they do not know where to start to get help. The mental health system can also be complicated and difficult for parents to understand. When worried about their child's behavior, parents can start by talking to the child's pediatrician or family physician about their concerns. Personality disorders require treatment and parents should try to find a mental health professional with advanced training and experience with children, adolescents, and families. Parents should always ask about the professional's training and experience. It is also very important to find a good match between child, family, and the mental health professional.


The character of a person is shown through his or her personality, by the way the person thinks, feels, and behaves. When the behavior is inflexible, maladaptive, and antisocial, then that individual is diagnosed with a personality disorder. Personality disorders are diagnosed following a psychological evaluation that records the history and severity of the symptoms. A personality disorder must fulfill several criteria. A deeply ingrained, inflexible pattern of relating, perceiving, and thinking that is serious enough to cause distress or impaired functioning defines a personality disorder. Personality disorders are usually recognizable by adolescence or earlier, continue throughout adulthood, and become less obvious in middle age.


There are many types of help available for the different personality disorders. Treatment may include individual, group, or family psychotherapy. Medications, prescribed by a patient's physician, may also be helpful in relieving some of the symptoms of personality disorders, such as problems with anxiety and delusions. Psychotherapy is a form of treatment designed to help children and families understand and resolve the problems due to PD and modify the inappropriate behavior. In some cases a combination of medication with psychotherapy may be more effective. PD psychotherapy focuses on helping patients see the unconscious conflicts that are causing their disorder. It also helps them become more flexible and is aimed at reducing the behavior patterns that interfere with everyday living. In psychotherapy, patients have the opportunity to learn to recognize the effects of their behavior on others. The different types of psychotherapies available to children and adolescents include the following:

Alternative treatments are available for personality disorders and most are complementary to conventional psychotherapy. They include the following:

The notion that foods and nutrients influence brain function and behavior generated in the early 2000s widespread interest in the general public and in the scientific community. However, the evaluation data are still ambiguous when it comes to establishing a direct link between personality disorders and diet, aside from recommending the avoidance of alcoholic and stimulant beverages.


The PD outlook varies. Some personality disorders diminish during middle age without any treatment, while others persist throughout life despite treatment.


The prevention of personality disorders is an area surrounded with pessimism and controversy. Many mental health specialists believe that these disorders are untreatable, that individuals with personality disorder have little capacity for change; therefore not surprisingly, they remain skeptical about prevention prospects. However, even though the innate temperament of a person cannot be modified, understanding the factors that influence the development of personality disorders (such as genetic risks and environmental factors) may help prevention. Accordingly, some mental health professionals advocate primary prevention steps, which should include education of parents and primary healthcare workers, as well as early psychotherapy and protection of traumatized children, which can be carried out by child developing services. Some evidence suggests that traditional doctor-patient relationships are of much less value than programs which enable parents to see their own role as crucial and their own actions as able to bring changes for the better in their child's behavior. High quality parenting plays a critical role in child development and, thus, in the prevention of personality disorders.

Parental concerns


Anxiety —Worry or tension in response to real or imagined stress, danger, or dreaded situations. Physical reactions, such as fast pulse, sweating, trembling, fatigue, and weakness, may accompany anxiety.

Caring —The demonstration of an awareness of and a concern for the good of others.

Character —An individual's set of emotional, cognitive, and behavioral patterns learned and accumulated over time.

Delusion —A belief that is resistant to reason or contrary to actual fact. Common delusions include delusions of persecution, delusions about one's importance (sometimes called delusions of grandeur), or delusions of being controlled by others.

Eccentric —Deviating from the center; conduct and behavior departing from accepted norms and conventions.

Empathy —A quality of the client-centered therapist, characterized by the therapist s conveying appreciation and understanding of the client's point of view.

Erratic —Having no fixed course; behavior that deviates from common and accepted opinions.

Introversion —A personal preference for solitary, non-social activities and settings.

Maladaptive —Unsuitable or counterproductive; for example, maladaptive behavior is behavior that is inappropriate to a given situation.

Personality —The organized pattern of behaviors and attitudes that makes a human being distinctive. Personality is formed by the ongoing interaction of temperament, character, and environment.

Substance abuse —Maladaptive pattern of drug or alcohol use that may lead to social, occupational, psychological, or physical problems.

Temperament —A person's natural disposition or inborn combination of mental and emotional traits.

See also Antisocial behavior ; Antisocial personality disorder ; Anxiety .


Moskovitz, Richard, A. Lost in the Mirror: An Inside Look at Borderline Personality Disorder. Lanham, MD: Taylor Trade Publishing, 2001.

Kantor, Martin. Distancing: Avoidant Personality Disorder. Westport, CT: Praeger Publishers, 2003.

Chiesa, M. et al. "Residential versus community treatment of personality disorders: a comparative study of three treatment programs." American Journal of Psychiatry 161, no. 8 (August, 2004): 1463–70.

Gothelf, D., et al. "Life events and personality factors in children and adolescents with obsessive-compulsive disorder and other anxiety disorders." Comprehensive Psychiatry 45, no. 3 (May-June, 2004): 192–98.

Haugaard, J. J. "Recognizing and treating uncommon behavioral and emotional disorders in children and adolescents who have been severely maltreated: borderline personality disorder." Child Maltreatment 9, no. 2 (May, 2004): 139–45.

Krueger, R. F., and S. R. Carlson. "Personality disorders in children and adolescents." Current Psychiatry Reports 3, no. 1 (February, 2001): 46–51.

American Academy of Child & Adolescent Psychiatry (AACAP). 3615 Wisconsin Ave., NW, Washington, DC 20016–3007. Web site:

American Psychiatric Association. 1000 Wilson Boulevard, Suite 1825, Arlington, Va. 22209–3901. Web site:

Federation of Families for Children's Mental Health. 1101 King Street, Suite 420, Alexandria, VA 22314. Web site:

National Mental Health Association (NMHA). 2001 N. Beauregard Street, 12th Floor, Alexandria, VA 22311. Web site:

Lebelle, Linda. "Personality Disorders." Focus Adolescent Services. Available online at (accessed October 13, 2004).

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