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Personality Disorders: Types, Causes and Impacts Essay

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Updated: Jan 23rd, 2020


The personality of an individual influence how he acts and it influences his perception of self and others. While people have different personalities, there are some common behaviors and patterns of thinking that are typical in a healthy personality. People who display deviant personality traits, often characterized by dysfunctional thinking patterns and uncontrolled emotions, are considered to have personality disorders (PD).

Personality disorders affect about 10% of the American population. This considerably high prevalence rate is of great concern since personality disorders are a significant source of psychiatric morbidity (Sperry, 2013). The disorders also lead to functional impairment affecting the everyday life of the individual.

To help increase our understanding of personality disorders, this paper will discuss the various types of disorders. It will highlight the causes and impacts of these disorders and proceed to explain treatments for personality disorders.

Defining Personality Disorders

Personality disorder is the term used to refer to several different subtypes of maladaptive personality traits as identified by the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Stricker and Widiger (2003) assert that personality disorders arise when “personality traits are inflexible and maladaptive and cause significant functional impairment or subjective distress to the individual” (p. 149).

Community based studies of personality disorders reveal that the prevalence rates of personality disorders in the US is between 6 and 10% (Samuels, 2011).

Tyrer (2007) states, “”it is still impossible to conclude with confidence that personality disorders are, or are not, mental illness” (p.1524). The reason for this is that there is an ambiguity in the definition of what personality disorders and at the present, basic information about this condition is still insufficient.

The DSM-IV outlines some general diagnostic criterion that can be used to identify personality disorder. To begin with, a person with this disorder will have demonstrated enduring patterns of inner experience and behavior that is contrary to the socially acceptable behavior.

This pattern of deviant behavior is manifested in how the person perceives and interprets himself and other people, the appropriateness of emotional response, and impulse control (Perry, Presniak & Olson, 2013). This enduring pattern is inflexible and evident in a wide range of a person’s social and personal life. It eventually leads to distress or impairment in a person’s social and professional life.

Personality disorders are recognizable through certain measurable phenomena including surface traits such as impulsiveness, specific behaviors such as self-mutilation, beliefs or cognitions such as an exaggerated feeling of self-importance, and self-reported feelings such as feelings of emptiness (Perry, et al., 2013).

An important consideration with a personality disorder is that it occurs over a long duration of time. In most cases, the condition can be traced back to a person’s adolescence or early adulthood years.

Demographic investigations reveal that personality disorder is associated with younger age with prevalence in the 16 to 39-year-old age group (Fairfax, 2011). The prevalence of personality disorders is influenced by the socioeconomic status of a person with a bias against individuals from lower socioeconomic backgrounds.

Types of Personality Disorders

Paranoid personality disorder (PPD) is a disorder whose primary characteristic is an all-pervasive distrust and suspiciousness of another individual. Stricker and Widiger (2003) state that the person with PPD will show a tendency to read malevolent intentions in innocent or neutral situations. This inflated suspiciousness will make it hard for the individual with PPD to get along with others.

A person with PPD is likely to be overly argumentative and hostile towards others. The person will blame others for his own inadequacies and difficulties in life. This makes it hard for the person to work collaborate or closely with others. Since the individual with PPD tends to be rigid, controlling, critical, and prejudicial, he is hard and unpleasant to work with. PPD generally tends to afflict more men than women (Stricker & Widiger, 2003)

Schizotypal Personality Disorder (SPD) is characterized by introvertedness and the person suffering from this disorder will appear cold and distant. Perry et al. (2013) note that SPD results in disordered thinking and autistic fantasies.

Persons with STPD demonstrate extreme social anxiety due to their paranoid fears. A striking physical attribute of a person with STPD is that he will appear odd, eccentric and with peculiar behavior. Due to the eccentricity and the tendency to misinterpret or over personalize events, the individual will have difficulty being understood by others. If the person has friends outside of his immediate family, they are very few.

People with STPD drift towards fringe groups that support their unusual ideas such as believing in telepathy and clairvoyance. Individuals with STPD often make use of social isolation as a coping strategy.

This strategy is adopted since the defects in the person’s cognitive-perceptual evaluation lead to discomfort within social situations and misperceptions (Stricker & Widiger, 2003). In extreme cases, STPD might lead to psychotic episodes and a small proportion of persons with STPD end up developing the Axis 1 psychotic disorder, schizophrenia.

Antisocial personality disorder (APD) is a personality disorder distinguished by patterns of behavior that show a high disregard and violation of the rights of other people. The individual with ASPD will have character traits such as deceitfulness, irresponsibility, irritability and predisposition to acts of criminality (Stricker & Widiger, 2003). ASPD patients are also exploitative and lack the ability to empathize with others.

This combined with the impulsivity demonstrated by ASPD patients, makes them prone to committing reckless actions without considering the safety of others. Tyrer (2007) documents that people with ASPD lack remorse even when they have inflicted unnecessary harm on other people.

ASPD has a higher prevalence in men and there is a correlation between this condition and substance abuse. It is also common among those from lower socioeconomic classes.

Borderline personality disorder (BPD) is characterized by a pattern of impulsiveness and high instability in interpersonal relationship and self-image. The severity and chronicity of this disorder’s symptoms make it especially detrimental. A person diagnosed with BPD will have frequent and intense negative emotion.

BPD patients are unsure of their self-image and they have doubts concerning their personal views and even those of others. People diagnosed with BPD have exaggerated fears of being abandoned (Kernberg & Yeomans, 2013).

They may have paranoid ideations and are prone to engaging self-defeating behavior such as substance abuse and making bad decisions that destroy good relationships. BPD predisposes the individual to suicidal ideations and behaviors. The risk of suicide is significantly higher with research indicating that 10% of patients with borderline personality disorder commit suicide (Kernberg & Yeomans, 2013).

In addition to this, BPD is associated with acting out, passive-aggressive behavior and dissociation. There is an overrepresentation of BPD in psychiatric settings, with studies approximating that around 20% of psychiatric patients suffer from this condition (Fairfax, 2011). BPD is more often diagnosed in women with a 75% diagnostic bias in favor of females.

Histrionic personality disorder (HPD) is typified by excessive emotionality and attention-seeking by an individual. The person diagnosed with HPD will engage in behavior that is meant to be provocative or inappropriately intimate. According to Benjamin (2002), the person’s actions will either be flirtatious of focused on physical attractiveness.

In addition to this, the individual will demonstrate superficial emotional expression and tend to be melodramatic.

The HPD patient has a pathological need to be loved and desired and will use any means to be involved with others on an intimate basis (Benjamin, 2002). In most cases, the individual will wrongfully assume that a relationship is more intimate than it actually is since the person has an innate desire for romantic fantasy.

Avoidant personality disorder (AVPD) has extreme timidity and inhibition as the major characteristic. The person with AVPD feels inadequate and demonstrates hypersensitivity in social situations. Livesley (2003) states that the individual diagnosed with AVPD will have a strong belief that he is inept and inferior to that.

This leads to a low self-esteem and social phobia. Due to the high level of sensitivity, the individual is likely to develop mood disorders and anxiety disorders. AVPD is one of the most prevalent personality disorders since timidity, social insecurity, and shyness is common in the clinical setting and the general population.

The final common personality disorder is Obsessive-compulsive personality disorder (OCPD), which is typified by a preoccupation with perfectionism and control. Individuals diagnosed with this condition tend to be rigid and they are preoccupied with rules and details (Livesley, 2003).

Other people view them as inflexible and they are often described as control freaks. Due to the need for perfectionism, persons with OCPD are reluctant to delegate tasks and are often indecisive.

Origins of Personality Disorders

There is a strong relationship between sexual abuse and personality disorders. According to Livesley (2003), upwards of 70% of patients with borderline personality have a history of abuse. A study of patients with borderline personality disorder revealed that about one-third of these patients reported severe abuse involving an incestuous perpetrator, severe sexual acts and high frequency or duration (Livesley, 2003).

While sexual abuse does not necessarily cause personality disorder, these statistics demonstrate that abuse increases the probability of psychopathology. Abusive acts contribute to the development of personality disorders since they invalidate the recipient by ignoring personal boundaries, needs, and by violating expectations of autonomy, and freedom of choice.

Low socioeconomic conditions also increase the likelihood that a person will develop a personality disorder. Samuels (2011) reveals that individuals who have dropped out of high school are more likely to suffer from personality disorders than their peers who completed school.

This relationship might be because economic impoverishment contributes to the development of antisocial traits and this increases the likelihood of personality disorders occurring.

There is considerable support from twin and family studies that genetics contribute to the development of personality disorders. The genetic disposition is partly because personality traits are inheritable and these traits play a significant role in personality disorders (Livesley, 2003).

Genetic disposition for lack of mood and impulse control might increase the probability of developing personality disorders such as BPD, ASPD and PPD.

Impacts of Personality Disorders

Some personality disorders cause physical damage to the individual suffering from the condition. Personality disorders such as BPD are accompanied by self-destructive behaviors by the patient. Kernberg and Yeomans (2013) document that a major prognostic issue in severe personality disorders is the presence of para-suicidal tendencies. The patient will engage in self-harming behaviors and also exhibit chronic suicidal tendencies.

The patient will have many repetitive suicidal attempts that are engaged in when he is feeling frustrated or angry. The anger and frustration that lead to the suicide attempt often appear without any trigger or apparent cause. Kernberg and Yeomans (2013) warn that without highly specialized psychotherapeutic treatment, the patient will end up succeeding in killing himself.

As evident from the definition, personality disorders lead to impairment in the individual’s occupation. The social competence of the person is distorted because of personality disorders.

For example, people with ASPD are unlikely to maintain steady employment due to their deceitfulness, aggressiveness and general irresponsibility and lack of regard for others (Livesley, 2003). Those suffering from PPD are difficult to get along with and uncooperative, which makes them unsuited for most work environments.

Personality disorders increase the risk of a person developing a psychotic disorder. While the third revision of the DSM (DSM III) officially recognized personality disorders as being different from psychosis, the relationship between the two is close. Most people with STPD develop major depression that might degenerate into a psychotic condition.

BPD was traditionally considered as a threshold psychotic disorder due to its adverse impacts and while this classification was changed, there is an overrepresentation of BPD in psychiatric settings (Sjastad, Grawe & Egeland, 2012).

Personality disorders increase the health care expenditure of a person leading to financial burdens. Individuals with personality disorders require medical attention to manage the condition. Studies indicate that personality disorders are not transient and a person will not outgrow the disease (Perry et al., 2013).

If a person fails to seek medical help, the condition will impair his social and occupational performance or even worse, lead to psychotic conditions.


A major complication in the treatment of personality disorders is that there is no single established screening or assessment tools and mental health care professionals often have to rely on self-rated questionnaires for personality disorder and structured interviews with the patient. The third revision of the DSM clearly distinguished personality disorders from other psychiatric disorders (Tyrer, 2007).

The DSM III officially recognized personality disorders as being different from psychosis and neurosis since while the condition is characterized by a sense of weak identity, the capacity to test reality is still intact in the individual.

There is a prevalent of biases and fears regarding the diagnosis of personality disorder. Clients and therapists agree that a personality disorder diagnosis can be derogatory and result in the discrimination of the patient due to the stigma attached to this disorder (Fairfax, 2011). Many patients, as well as families, find it hard to accept a diagnosis of personality disorder.

This denial leads to a postponement in the time when adequate treatment can be offered. This exposes patients who have severe personality disorders to additional risks. This greatly impedes on the ability of the disorder to be cured since personality disorder patients do better when the diagnosis is named and described.

Kernberg and Yeomans (2013) assert that in the case of personality disorders, “adequate diagnosis is the first step to an effective treatment” (p.9). Most personality disorders are under-diagnosed or misdiagnosed and this has a negative impact on the patient since effective diagnosis is necessary for appropriate treatment to be offered.


Before the mid-1950s, personality disorders were considered untreatable and clinicians expressed a sense of dread and hopelessness while dealing with these disorders. However, this changed in the late 1990s when research enabled clinicians to utilize effective and successful treatments (Dignfelder, 2004).

Since then personality disorders, including the most difficult, which is borderline personality disorder, are increasingly treatable. Dignfelder (2004) states that while the various personality disorders manifest in varied ways, they are similar in that for the vast majority of cases, these mental illnesses require professional intervention in order for remittance to occur.

There are a number of unique psychotherapies that can be used to treat personality disorders. Cognitive-behavioral therapy helps the patient to identify maladaptive behaviors or beliefs and make the necessary changes, therefore, reducing the negative moods and anxiety symptoms prevalent in some forms of PD.

It can also. Cognitive-behavioral treatment can help patients who have chronic suicidal tendencies due to their personality disorders. By using integrative cognitive cognitive-behavioral treatment, health care professionals can help to manage the condition (Livesley, 2003).

The second type of psychotherapy is dialectical behavior therapy, which helps the patient develop a healthy sense of mindfulness. Using this therapy, the individual diagnosed with PD is taught how to be aware of the current situation and to gain greater control of his emotions (Samuels, 2011). This reduces the extreme emotions that result in irritability or self-destructive behaviors among PD patients.

The final type of psychotherapy is Schema-focused therapy and it tries to change the way the individual views himself (Samuels, 2011). Since some personality disorders are caused by a dysfunctional self-image, it is possible that helping people to view themselves differently can alleviate the condition.

Health care professionals prescribe medications to personality disorder patients. Research indicates that medication does not cure personality disorders but it helps to reduce the symptoms.

Anti-anxiety medication can be used to overcome the physical symptoms that personality disorder patients suffering from excess anxiety have (Livesley, 2003). Since personality disorders predispose the person to get depressed, antidepressants can be used to manage depressive moods. Mood stabilizers can be used to reduce symptoms of aggression in the personality disorder patient.

Sperry (2013) asserts that the effectiveness of treatment outcomes is largely a function of how well treatment is suited for the particular disorder and the overall functioning of the patient. Personality disorders are characterized by pervasive patterns in psychosocial and character on the one hand and deficiencies in biological and temperamental tendencies.

Effective treatment for these disorders must, therefore, take into consideration these two unique perspectives. There is no single treatment approach to personality disorders. Instead, a combined and integrative approach that uses the various forms of therapy and medication management should be used.


Personality disorders are a major problem that might impede on the life of an individual. This paper has discussed the various types of personality disorders and some of their possible causes. It was then revealed the impacts that these disorders have. It has noted that personality disorders lead to high costs in terms of health care services utilization and cause immense human suffering.

The paper has shown that personality disorders can be managed or treated using psychotherapy and medications for symptoms of the specific disorder. However, the paper has acknowledged that personality disorders are difficult to diagnose correctly. With proper diagnosis, a patient can be treated successfully and this will enable him to live a normal life without the disabling personality disorder.


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Kernberg, O., Yeomans, F.E. (2013). Borderline personality disorder, bipolar disorder, depression, attention deficit/hyperactivity disorder, and narcissistic personality disorder: Practical differential diagnosis. Bulletin of the Menninger Clinic. 77 (1), 1-22.

Livesley, J. (2003). Practical management of personality disorder. NJ: Guilford Press.

Perry, J.C., Presniak, M.D., & Olson, T. (2013). Defense Mechanisms in Schizotypal, Borderline, Antisocial, and Narcissistic Personality Disorders. Psychiatry, 76(1), 32-52.

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Stricker, G., & Widiger, T. (2003). Clinical Psychology. NY: John Wiley & Sons.

Tyrer, P. (2007). Personality diatheses: A superior explanation than disorder. Psychological Medicine, 37, 1521–1525.

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