🔑 Key Learning
- Personality disorders are enduring patterns of behaviour that deviate markedly from societal expectations
-
The mainstay of treatment is psychological therapy — most notably dialectical behaviour therapy (DBT) for emotionally unstable PD
- Paranoid, schizoid, and schizotypal PDs fall under cluster A (odd or eccentric)
- Antisocial, borderline, histrionic, and narcissistic PDs are cluster B (dramatic, emotional, erratic)
- Avoidant, dependent, and obsessive-compulsive PDs are cluster C (anxious or fearful)
🧩 Personality Disorder Clusters
Personality disorders are grouped into three clusters based on common behavioural traits:
- Cluster A – Odd or eccentric behaviour
- Cluster B – Dramatic, emotional, or erratic behaviour
- Cluster C – Anxious or fearful behaviour
These clusters help group overlapping traits and guide clinical understanding and treatment approaches.
| Cluster | Type | Core Features | Disorders |
|---|---|---|---|
| A | Odd / Eccentric | Social withdrawal, suspicion, flat affect | Paranoid, Schizoid, Schizotypal |
| B | Dramatic / Emotional | Impulsivity, instability, attention-seeking | Antisocial, Borderline, Histrionic, Narcissistic |
| C | Anxious / Fearful | Avoidance, dependence, perfectionism | Avoidant, Dependent, Obsessive-Compulsive |
🔪 Antisocial Personality Disorder
👀 Clinical Features
- Disregard for social norms and laws
- History of antisocial behaviour, law-breaking
- History of aggression, lying, theft, or violence
- Lack of remorse for causing harm
- Difficulty forming stable relationships
🙈 Avoidant Personality Disorder
👀 Clinical Features
- Preoccupied with fears of rejection or criticism
- Strong feelings of inadequacy
- Avoids social situations due to fear of embarrassment
- Restricts interaction and avoids work involving others
🎭 Borderline (Emotionally Unstable) Personality Disorder
👀 Clinical Features
- Intense fear of abandonment
- Feelings of emptiness
- History of unstable, chaotic relationships
- Emotional instability and impulsivity
- Self-harming behaviour as a coping strategy
- Often associated with a history of trauma/abuse
- Marked mood swings and interpersonal difficulties
🤝 Dependent Personality Disorder
👀 Clinical Features
- Excessive reliance on others for decisions
- Strong need for reassurance and support
- Avoids responsibility and seeks caretaking
- Quickly forms new relationships to avoid being alone
💃 Histrionic Personality Disorder
👀 Clinical Features
- Overly emotional and attention-seeking
- May appear superficial or insincere
- Inappropriate sexual or flirtatious behaviour
- Dramatic mood shifts
👑 Narcissistic Personality Disorder
👀 Clinical Features
- Grandiose sense of self-importance
- Preoccupation with power and success
- Exploits others for personal gain
- Lacks empathy and may be arrogant
- May also harbour underlying feelings of insecurity or worthlessness
📏 Obsessive-Compulsive Personality Disorder
👀 Clinical Features
- Preoccupation with order, perfectionism, and control
- Inflexible about morals, ethics, or routines
- Over-concern with rules, details, and organisation
- Not the same as OCD — lacks true obsessions/compulsions
🕵️ Paranoid Personality Disorder
👀 Clinical Features
- Deep distrust and suspicion of others
- Misinterprets benign actions as threatening
- Holds grudges and is unforgiving
- May be jealous or suspicious of infidelity in relationships
❄️ Schizoid Personality Disorder
👀 Clinical Features
- Emotionally cold and detached
- Lacks interest in relationships or social interaction
- Anhedonic and indifferent to praise or criticism
- Prefers solitary activities
🌌 Schizotypal Personality Disorder
👀 Clinical Features
- Discomfort with close relationships
- Social anxiety and poor social skills
- Unusual beliefs or magical thinking (e.g. telepathy, talking to animals)
- May report perceptual disturbances
💬 Management of Personality Disorders
💡 Mainstay Treatment
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Psychological therapies, especially:
- Dialectical Behaviour Therapy (DBT) — especially effective for borderline PD
- Cognitive Behavioural Therapy (CBT) and other structured talking therapies
📝 Exam Clues & Clinchers
- Suspicious, jealous, unforgiving → Paranoid PD
- Emotionally cold + prefers solitude → Schizoid PD
- Magical thinking + poor social skills → Schizotypal PD
- Antisocial behaviour + no remorse → Antisocial PD
- Self-harm + unstable relationships → Borderline PD
- Attention-seeking + flirtatious → Histrionic PD
- Grandiose + lacks empathy → Narcissistic PD
- Socially anxious + avoids interaction → Avoidant PD
- Clings to others for decisions → Dependent PD
- Rigid, perfectionist, rule-bound → Obsessive-Compulsive PD