Personality Disorders

Personality Definition:

“Personality is the dynamic organisation within the individual of those psycho-physical systems that determine his unique adjustment to his environment.”

(G. W. Allport)

“The sum total of ways in which an individual reacts to and interacts with others (environment).”

(Stephen P. Robbins)

Understanding Personality Disorders

Our daily life is all about social interactions; whether we are working, studying or spending time with our family. The cardinal attribute determining how we interact with others is directly dependent on our personality. Although personality is considered dynamic, yet the relative stability within the individuals enables them to follow the norms of society. Yet in daily lives we find people whose behavior baffles us. Their actions and rationale of behavior are sometimes difficult to comprehend. These individuals may be successful in their own rights. So, people seldom think about real causes behind the deviations in their normal day to day behavior. But normal individuals who have to deal with them at workplace or in family can face or suffer adverse impact. These deviations in normal behavior can be attributed to what DSM (Diagnostic and Statistical Manual of Mental disorders) describes as personality disorders.

According to Ray (2015), Personality disorder:

  • Is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture
  • Is inflexible, stable and generally begins in adolescence
  • Appears when these individuals find themselves in situations that are beyond their ability to cope.

People with personality disorders are much more common than we assume. They are all around us. It has been estimated that 10 % population or one in every ten is having some or the other personality disorder. Dealing with personality disorders is challenging because the individuals with these disorders rarely approach to seek psychological help. The family members of people suffering with personality disorders somewhat fail to recognize their mental state and generally think that these problems are temporary in nature and the person will change on their own. However, knowledge regarding the symptoms of these disorders can help individuals to recognize people with these disorders.

DSM-5 organizes the 10 disorders into three clusters:

  • Cluster A: Odd-Eccentric personality disorders, including Paranoid, Schizoid and Schizotypal personalities
  • Cluster B: Dramatic emotional personality disorders, including Antisocial, Borderline, Histrionic and Narcissistic personalities.
  • Cluster C: Anxious fearful personality disorders, including Avoidant, Dependent and Obsessive compulsive personalities.

Let’s discuss these personality disorders:

Paranoid personality disorder

Consider a married couple; Husband/wife constantly doubts his/ her spouse about an illicit affair. The affected partner continuously tries to provide arguments/evidence against the allegations. But the tussle never ends. No amount of rational/logical evidence is sufficient to remove the suspicion. Even if temporarily the partner agrees to the logic but the suspicious behavior will return in few days. Now this may be due to a personality disorder known as paranoid personality disorder. This disorder can happen to anyone. It can be with a successful politician who continuously doubts his colleagues and in turn may become vindictive to them without any logic. Continues suspicion without logic is cardinal to this disorder. The major symptoms are:

  • Suspiciousness,
  • Distrust,
  • hold grudges,
  • Refuse to forgive
  • Insults, can display violent behaviours,
  • Inflexibility/rigid behaviour,
  • Hypersensitivity,
  • Highly argumentative
  • Constantly “on guard” for attacks from others

The reason why this disorder develops is debatable. But researchers have attributed its cause to childhood abuse/violence and parental neglect. Genetic factors also have been attributed as causal factor but the overall evidence available is inconclusive.

Schizoid Personality Disorder

Consider the scenario: John was a store supervisor working in a large MNC for last 15 years. He was sincere and never showed any lethargy in his work. He used to work alone and had rarely taken any leave from office. One day the VP of the company noticed and acknowledged his sincerity and promoted him and placed him in the accounts department with higher salary package and designation. The department in which he was posted consisted of 20 people. Generally people become happy with increase salary and higher position. But in John’s case his behaviour started changing very soon. Although he knew the work but he had severe problem dealing with others in the department. He was sent to a team building workshop but that too was not of any help. Ultimately, he had given a written request to transfer him back to his old place. The VP was baffled at this; Why did this happen?

As a case study the VP investigated about the profile of John and found out that although John was 42 years old but was not married and used to live alone in a studio apartment. Although his parents used to live in the same town, he rarely visited them. In the name of friends, he had only one friend Alex with whom he used to go out once in a month.

The VP concluded that John might be having schizoid personality disorder (SPD). SPD in an individual can be described as a pattern of detachment from social relationships and having a restricted range of emotional expression. Major symptoms of this disorder are:

  • No desire to form social relationships
  • Indifferent to praise or criticism
  • Little or no interest in sexual relationships
  • Emotional coldness, detachment and aloofness
  • Always referring solitary activities

Maladaptive underlying schemas with individual as a self-sufficient loner and view of others as intrusive can be attributed as a causal factor in the development of this disorder.

Schizotypal Personality Disorder

The symptoms are similar to schizoid personality disorder (SPD) however the major difference between the two lies in the fact that in SPD the individual has no desire to form social bonds but schizotypal personality wants to form bonds but has a deep seated fear of people. They are also characterized by odd beliefs and behaviors (e.g., magical thinking).  Major symptoms are:

  • Extreme social anxiety
  • Extreme introversion and sensitivity
  • Pervasive social and interpersonal deficits
  • Odd speech that may be vague or rambling
  • Ideas of reference and paranoid beliefs
  • Cognitive and perceptual deficits
  • Oddities of thought, perception, and speech are also present and similar to schizophrenia

Schizotypal personality disorder is believed to be moderately heritable with a genetic and biological association with schizophrenia. Parenting styles and early trauma can also act as causal factors.

Antisocial Personality Disorder and Psychopathy

Have you ever met people who are charismatic in nature and who can easily impress people with their views? Individuals who have a unique strength of convincing people, selling dreams but in the end deceive all?

These individuals may be psychopaths.

Dutton describes the following careers with highest proportion of psychopaths:

  1. CEO
  2. Lawyer
  3. Media (TV/radio)
  4. Salesperson
  5. Surgeon
  6. Journalist
  7. Police officer

Psychopaths are basically criminals without guilt. However, most of them are white collared individuals roaming all around us; in industry, education, politics etc. Due to the mirage of charm they create with their superiors they are able to climb the corporate ladder very quickly. Their philosophy of ‘using and abusing’ their co-workers and friends utilizing their charm tactics creates an illusion producing an image about themselves in front of their superiors that they are highly goal oriented people working for the interest of organization or humanity. Although they are devoid of empathy but their talent lies in their ability (using intelligence) to produce and project empathy on demand. This disorder is found more among men than women. Major symptoms can be:

  • Deceitful and aggressive
  • Impulsivity and irritability
  • Disregard for the rights of others
  • Infringe the rights of others without guilt
  • Habitual liars
  • Uses charm tactics to convincingly sell their lies
  • Pattern of irresponsibility
  • Symptoms of conduct disorder before the age of 15

Borderline Personality Disorder

1%–2% of population meet diagnostic criterion for this disorder. People with this disorder indulge in gambling, substance abuse, binge eating etc. They have a history of troubled relations. Their mood pattern is highly unstable. Apart from these, the major symptoms can be:

  • Highly self-destructive behaviour
  • Anger, instability, and unpredictability
  • Repetitive self-mutilation
  • Suicide attempts
  • Analgesia (absence of the experience of pain in the presence of a theoretically painful stimulus)

Genetic factors play an important causal role in development of this disorder. Similarly neurotransmitter serotonin may explain the impulsivity–aggression in individuals. Similarly negative or traumatic experiences in childhood and reduction in both hippocampal and amygdala volume has also been attributed as a cause to this disorder.

Histrionic Personality Disorder

Some individuals always want to remain in attention and become uncomfortable if not in the spotlight. For getting attention they can go extremes using self-dramatization. Their relations are often in turmoil as it is always not possible for people around them to fulfil their unrealistic attention seeking demands. Other symptoms can be:

  • Excessive attention-seeking,
  • Emotionality and self-dramatization
  • Self-centered and vain,
  • Overly concerned about approval
  • Tendency to be seductive
  • Occurs more often in women than men

One of the reasons for histrionic personality disorder might be maladaptive schemas involving need for attention to validate self-worth.

Narcissistic Personality Disorder

Have you seen people who are self-obsessed with themselves. They like themselves so much that they can’t see anything beyond themselves. For them, they are the most beautiful or knowledgeable individual in the world. If anybody disagrees with them they become very uncomfortable and sometimes very vindictive. These are the characteristics of a person with narcissistic personality disorder. If you get a boss or spouse who has narcissistic personality disorder, then it might becomes obligatory for you to praise him/her on their appearance as well as everything they do and that to; day in and day out, otherwise you can become a part of their hit-list. Their philosophy of governance or management can be summarised as “My way or highway”. Major symptoms of this disorder can be:

  • Highly self-obsessed
  • Exaggerated sense of self-importance
  • High need for attention
  • Lack of empathy
  • Hypercritical and retaliatory
  • Fragile self-esteem underlies grandiosity

The reason for developing such personality can be parental overvaluation during young age or physical or emotional abuse during childhood. Cold parenting has also been associated with narcissist personality.

Avoidant Personality Disorder

The people with this disorder avoid situations where they can be evaluated. So they avoid social situations and close relationships. Thus, developing a feeling of inadequacy, social inhibition, and hypersensitivity due to the fear of negative social evaluations. Other major symptoms can be:

  • Hypersensitivity
  • Loneliness
  • Want social interaction but fear of rejection persistent
  • Extreme social inhibition

Dependent Personality Disorder

People with this order have complete dependence on others and panic when they are alone. Approximately 1.5% of population has this disorder. There dependency can be so high that they can tolerate even abuse to stay in the relation. It is more common in women than men. Other symptoms may be:

  • Lack of self-confidence
  • Clinging and submissive behaviour
  • Depending on others for decision-making
  • Indiscriminate selection of partner

Overall they have difficulty making everyday decisions without reassurance from others. The causal factors can be authoritarian and overprotective parents. Similarly, maladaptive schemas about weakness and competence and needing others to survive can also be a causal factor.

Obsessive-Compulsive Personality Disorder

We find some individuals who are excessively preoccupied with order, neatness and perfectionism. Their main motive is to control one’s environment. Rigidity, stubbornness, and a lack of warmth are common features of them. Other symptoms are:

  • Overly involved in details
  • Mental and interpersonal control is maintained
  • Dysfunctional obsession with perfectionism
  • Excessively obsessed with finding small errors
  • Sacrifices leisure activities
  • Some overlap with narcissistic, antisocial, and schizoid personality disorders

It has been observed that individuals with obsessive compulsive personality disorder have excessively high levels of conscientiousness, high level of assertiveness, and a low level of compliance. They also have low levels of novelty seeking but high levels of harm avoidance tendency.

Understanding personality disorders can be beneficial for everyone as these disorders are much more prevalent than normally assumed. Knowledge and ability to recognize the symptoms can help all in recognizing and dealing with these individuals. You can have a narcissistic, paranoid or psychopath boss or colleague at workplace whose behaviour you are not able to comprehend because you believe in just world hypothesis. On the other hand, such individuals with these disorders might have a different cognitive orientation about the world than the normal individual. So dealing with them will be a challenge. Similarly you can have someone close to you who may be schizoid, schizotypal, histrionic etc., who need proper psychological help.

References

Allport, G. W. (1937). Personality: A psychological interpretation. New York: Holt.

Dutton, K. (2012). The Wisdom of Psychopaths: What saints, spies, and serial killers can teach us about success. London: William Heinemann.

Ray, W.J. (2015). Abnormal psychology. California: Sage publications.

Robbins, S.P., Judge, T.A., Vohra, N. (2012). Organizational Behavior. Delhi: Pearson.