Antisocial PD

  • Failure to conform to social norms - patients will often have a history of antisocial behaviour, lying, aggression and fighting, law-breaking. 
  • They may demonstrate a lack of remorse for these behaviours, and for causing harm, stealing etc. 
  • Difficulty in maintaining meaningful relationships 

 

Avoidant PD

  • Patients are preoccupied with feelings that they are being judged, criticised or rejected, particularly in social situations. 
  • They may have a fear of being embarrassed and belittled. 
  • May appear very shy and reluctant to engage socially due to feelings of inadequacy 
  • As a result, they AVOID social interactions and limit working/interacting with others

  

Borderline PD (Emotionally unstable)

  • Patients with borderline PD often have fears of abandonment
  • Feelings of emptiness
  • They may have a history of unstable & chaotic relationships with friends/family/partners.
    • Fears of abandonment 
  • Emotionally unstable
  • Impulsive behaviour, with a history of self harm, often as a coping mechanism
  • "Ups and downs"
  • There is usually a history of previous trauma

  

Dependent PD

  • DEPEND on excessive reassurance in order to make decisions.
  • They prioritise making relationships with others, so that they might be able to seek help/reassurance & care from these relationships.
  • Need others to take responsibility for their decisions and choices 
  • Moving quickly into a new relationship if the last one ends. 

 

Histrionic PD

  • Excessively outwardly emotional which can appear insincere
  • May behave inappropriately, with flirtation, seduction, attention-seeking
  • Inappropriate sexual behaviour
  • Swinging moods

 

Narcissistic PD

  • Patients with Narcissistic PD may be self-centred / self important & see themselves as better than, or superior to other people
  • Preoccupied with power, success and hierarchy
  • They may take advantage of others to achieve success, and may have a lack of empathy. 
  • May come across as arrogant and exaggerate their abilities and achievements
  • Feelings may be interspersed with fearing that they are worthless

 

Obsessive compulsive PD

  • Classically obsessed with minute details, organisation and may be 'perfectionists' in nature. 
  • They are meticulous and also might have inflexible moral or ethical views. 

  

Paranoid PD

  • Highly distrusting, even of friends and colleagues
  • Overly sensitive, and may be unforgiving to people by whom they feel insulted. 
  • They might be paranoid and preoccupied by perceived attacks on their personality/ character
  • Worried that their partner is unfaithful or people are acting against them 

  

Schizoid PD

  • Patients with schizoid PD may show indifference and a lack of interest to many things, anhedonic. 
  • They often have limited relationships, prefer solidarity
  • Emotionally cold, detached or blunt. 

  

Schizotypal PD

  • Poor social skills and avoidance of social situations due anxiety
  • Delusions or unusual beliefs - e.g. that they can communicate with animals, or that they are able to telecommunicate 
  • They may describe a history of unusual perceptual disturbances / experiences 

   

Management of Personality Disorders

  • The mainstay of management for PD is talking therapies / psychotherapies - dialectical/talking behaviour therapy.