Signs and symptoms of personality disorders

The different types of personality disorder that might need treatment can be broadly grouped into one of three clusters, calledA, B or C.

Cluster A personality disorders

A person with a cluster A personality disorder tends to have difficulty relating to others and usually shows patterns of behaviourmost people would regard as odd and eccentric.

The main personality disorders in this category are listed below.

Paranoid personality disorder

A person with a paranoid personality disorder is extremely distrustful and suspicious. Other features include:

• thinking other people are lying to them or trying to manipulate them
• feeling they cannot really trust their friends and associates
• worrying that any confidential information shared with others will be used against them
• thinking there are hidden meanings in remarks mostwould regard as innocent
• worrying that their spouse or partner is unfaithful, despite a lack of evidence

Schizoid personality disorder

Someone with a schizoid personality disorder may appear cold and detached, andavoid making close social contact with others. Otherfeatures include:

• preferring to take part in activities that do not require interaction with others
• having little desire to form close relationships, including sexual relationships
• being uninterested when receiving criticism or praise
• having a limited ability to experience pleasure or joy

Schizotypal personality disorder

A person with a schizotypal personality disorder is likely to have poor social skills and delusional thoughts, and behave in unusual ways. Otherfeatures include:

• attaching undue and misguided significance to everyday eventssuch as thinking newspaper headlines are secret messages to them
• believing in special powerssuch as telepathy or the ability to influence other peoples emotions and actions
• having unusual ways of speakingsuch as long, rambling vague sentences or going off on a tangent
• experiencing excessive anxiety in social situationseven if they have known a particular person or group of peoplea long time

Cluster B personality disorders

Someone with a cluster B personality disorder struggles to relate to others.As a result, theyshowpatterns of behaviourmostwould regard as dramatic, erratic and threatening or disturbing.

The main personality disorders in this category are listed below.

Antisocial personality disorder

A person with an antisocial personality disorder sees other people as vulnerable and may intimidate or bully others without remorse. They lack concern about the consequences of their actions.

Symptoms include:

• lack of concern, regret or remorse about other people's distress
• irresponsibility and disregard for normal social behaviour
• difficulty in sustaining long-term relationships
• little ability to tolerate frustration and to control their anger
• lack of guilt, or not learning from their mistakes
• blaming others for problems in their lives

The National Institute for Health and Care Excellence (NICE) has published guidelines on how people with antisocial personality disorders should be treated. For more information, seeNICE: antisocial personality disorder (PDF, 250kb).

Borderline personality disorder

A person with borderline personality disorder is emotionally unstable, has impulses to self-harm, and has very intense and unstable relationships with others.

They may act as if they have an inflated sense of their own importance and show an intense need for other people to look up to them.

Other symptoms include:

• exaggerating their own achievements and abilities
• thinking they are entitled to be treated better than other people
• exploiting other people for their own personal gain
• lacking empathy for other people's weaknesses
• looking down on people they feel are "beneath" them, while feeling deeply envious of people they see as being "above" them

Cluster C personality disorders

Someone with a cluster C personality disorder fears personal relationships and shows patterns of anxious and fearful behaviour around other people. Others may be withdrawn and reluctant to socialise.

The main personality disordersin this category are listed below.

Avoidant personality disorder

A person with avoidant personality disorder appears painfully shy, is socially inhibited, feels inadequate and is extremely sensitive to rejection.

Unlike people with schizoid personality disorders, they desire close relationships with others, but lack the confidence and ability to form them.

Dependent personality disorder

A person with dependent personality disorder feelsthey have no ability to be independent. They may show an excessive needfor others to look after them and are "clingy". Otherfeatures include:

• finding it difficult to make decisions without other peoples guidance
• needing others to take responsibility over what should be their own important life choices
• not being able to express disagreement with other people
• finding it difficult to start new activities due to a lack of confidence
• going to extremes to obtain support and comfort
• feeling helpless and uncomfortable when alone
• urgently needing to start a new relationship once a previous relationship comes to an end
• having an unrealistic and constant fear they will be left alone to fend for themselves

Obsessive compulsive personality disorder

A person with obsessive compulsive personality disorder is anxious about issues that seem out of control or "messy". They are preoccupied with orderliness and ways to control their environment, and may come across to others as a "control freak".

Otherfeatures include:

• having an excessive interest in lists, timetables and rules
• being so concerned with completing a task perfectly that they have problems completingit (perfectionism)
• being a workaholic
• having very rigid views about issues such as morality, ethics and how a person should behave in daily life
• hoarding items that seem to have no monetary or sentimental value
• being unable to delegate tasks to other people
• disliking spending money, as they think it is always better to save for a "rainy day"

This personality disorder differs from obsessive compulsive disorder (OCD), a related mental health condition, in several important ways:

• People with OCD are aware that their behaviour is abnormal and are anxious about it.Most people with obsessive compulsive personality disorder think their behaviour is perfectly acceptable and have no desire to change it.
• Somepeople with OCD are compelled to carry out rituals, such as having to touch every second lamppost as they walk down the street. This is not usually the case with people with obsessive compulsive personality disorder.
• People with OCD may feel compelled to make lists or organise items in their house, but feel anxious about doing so.People with obsessive compulsive personality disorder find relieffrom anxiety when doing such tasks and may become irritated whenprevented from doing so.