3.3 Personality disorders

A Family Guide to Concurrent Disorders - Part I: What are concurrent disorders?

On this page:

• Clusters of personality disorders
• Borderline personality disorder (BPD)

Personality is a way of describing how people think, feel and behave: the particular ways in which they understand and react to situations (e.g., their emotional response to an upsetting situation, their usual way of coping with stress, or how they understand and react to the external world).

Certain types of mental health problems are called personality disorders. As we saw when we looked at Table 3-1: The Dimensional Approach, personality disorders are Axis II disorders. Axis II disorders are much less straightforward and are even harder to diagnose than Axis I disorders. Many of the features of these diagnoses (such as borderline personality disorder or antisocial personality disorder) overlap with many elements of anybody's personality. Personality disorders are often diagnosed when particular elements of a person's behaviours, reactions and perceptions of the world are extreme and lead to significant adverse problems in his or her life.

Personality disorders can have symptoms that are similar to mood, anxiety, psychotic and impulsivity disorders. Diagnosing personality disorders is open to error. The diagnosis is often used to describe a set of symptoms that don't fit into any other category.

Some practitioners do not even consider personality disorders to be mental health problems. Our view is that personality disorders are problems that a person experiences, and need to be seen as problems for which help should be provided.

Clusters of personality disorders

The DSM-IV divides personality disorders into three main groups, each of which fits into one of the dimensions we have previously outlined (psychosis, impulsivity and anxiety).

• Cluster A (psychosis dimension) consists of schizoid personality disorder, schizotypal personality disorder and paranoid personality disorder. It is characterized by disturbances in cognition and perceptual organization in ways that resemble psychotic processes, although are usually less severe.
• Cluster B (impulsivity dimension) includes antisocial personality disorder, borderline personality disorder, narcissistic personality disorder and histrionic personality disorder. This cluster is characterized by impulsive behaviours.
• Cluster C (anxiety dimension) includes avoidant personality disorder, dependent personality disorder and compulsive personality disorder.

We are going to provide more information on borderline personality disorder (BPD) because this diagnosis is one of the most stigmatizing. People who are diagnosed with BPD often have symptoms that make it difficult for them to avoid serious problems in the social world and to get effective help in mental health or social service settings.

Borderline personality disorder

The symptoms of BPD can occur in various combinations. People with the disorder have many, if not all, of the following traits:

• fears of abandonment
• extreme mood swings
• difficulty in relationships
• unstable self-image
• difficulty managing emotions
• impulsive behavior
• self-injuring acts
• suicidal ideation
• transient psychotic episodes.

Many of the characteristics of BPD reflect extreme ways that any person might react to a situation that upsets them. These reactions may be diagnosed as BPD when the person engages in severe self-destructive behaviour when he or she gets angry, or is disappointed, or experiences loss or grief and feels completely abandoned.

Click the link below to print/view the following PDF
Activity 3-1: Identifying mental health problems (PDF)

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