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
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
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
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
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
The PD outlook varies. Some personality disorders diminish during middle
age without any treatment, while others persist throughout life despite
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
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.
—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.
—The demonstration of an awareness of and a concern for the good
—An individual's set of emotional, cognitive, and
behavioral patterns learned and accumulated over time.
—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.
—Deviating from the center; conduct and behavior departing from
accepted norms and conventions.
—A quality of the client-centered therapist, characterized by the
therapist s conveying appreciation and understanding of the
client's point of view.
—Having no fixed course; behavior that deviates from common and
—A personal preference for solitary, non-social activities and
—Unsuitable or counterproductive; for example, maladaptive
behavior is behavior that is inappropriate to a given situation.
—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.
—Maladaptive pattern of drug or alcohol use that may lead to
social, occupational, psychological, or physical problems.
—A person's natural disposition or inborn combination of
mental and emotional traits.
Antisocial personality disorder
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American Academy of Child & Adolescent Psychiatry
3615 Wisconsin Ave., NW, Washington, DC 20016–3007. Web site:
American Psychiatric Association.
1000 Wilson Boulevard, Suite 1825, Arlington, Va. 22209–3901. Web
Federation of Families for Children's Mental Health.
1101 King Street, Suite 420, Alexandria, VA 22314. Web site:
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