BPD Related Conditions What Are Personality Disorders in the DSM-5? By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. Learn about our editorial process Updated on February 09, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print SDI Productions / Getty Images Table of Contents View All Table of Contents What Are Personality Disorders? Types Symptoms Diagnosis Causes Treatment Coping What Are Personality Disorders? Personality disorders include 10 diagnosable psychiatric conditions that are recognized and described in the fifth and most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Each is a distinct mental illness defined by personality traits that can be troubling enough to create problems with relating to other people in healthy ways, and can lead to significant distress or impairment in important areas of functioning. Types The DSM-5 organizes personality disorders into three groups, or clusters, based on shared key features. Cluster A These personality disorders are characterized by odd or eccentric behavior. People with cluster A personality disorders tend to experience major disruptions in relationships because their behavior may be perceived as peculiar, suspicious, or detached. Cluster A personality disorders include: Paranoid personality disorder, which affects between 2.3% to 4.4% of adults in the U.S. Symptoms include chronic, pervasive distrust of other people; suspicion of being deceived or exploited by others, including friends, family, and partners. Schizoid personality disorder, which is characterized by social isolation and indifference toward other people. It affects slightly more men than women. People with this disorder often are described as cold or withdrawn, rarely have close relationships with other people, and may be preoccupied with introspection and fantasy. Schizotypal personality disorder, which features odd speech, behavior, and appearance, as well as strange beliefs and difficulty forming relationships. Cluster B The cluster B personality disorders are characterized by dramatic or erratic behavior. People who have a personality disorder from this cluster tend to either experience very intense emotions or engage in extremely impulsive, theatrical, promiscuous, or law-breaking behaviors. Cluster B personality disorders include: Antisocial personality disorder, which tends to show up in childhood, unlike most other personality disorders (most don't become apparent until adolescence or young adulthood). Symptoms include a disregard for rules and social norms and a lack of remorse for other people. Borderline personality disorder, which is characterized by instability in interpersonal relationships, emotions, self-image, and impulsive behaviors. Histrionic personality disorder, which features excessive emotionality and attention seeking that often leads to socially inappropriate behavior in order to get attention. Narcissistic personality disorder, which is associated with self-centeredness, exaggerated self-image, and lack of empathy for others and is often driven by an underlying fragility in the sense of self. Understanding Cluster B Personality Disorders in the DSM-5 Cluster C Cluster C personality disorders are characterized by anxiety. People with personality disorders in this cluster tend to experience pervasive anxiety and/or fearfulness. Cluster C personality disorders include: Avoidant personality disorder is a pattern of social inhibition and avoidance fueled by fears of inadequacy and criticism by others. Dependent personality disorder, which involves fear of being alone and often causes those who have the disorder to do things to try to get other people to take care of them. Obsessive-compulsive personality disorder, which is characterized by a preoccupation with orderliness, perfection, and control of relationships. Though similarly named, it is not the same as obsessive-compulsive disorder (OCD). Symptoms Personality disorders tend to appear in adolescence or early adulthood, continue over many years, and can cause a great deal of distress. They can potentially cause enormous conflict with other people, impacting relationships, social situations, and life goals. People with personality disorders often don't recognize that they have problems and are often confusing and frustrating to people around them (including clinicians). Certain symptoms of personality disorders can fall into two categories: self-identity and interpersonal functioning. Self-identity problems include: Unstable self-imageInconsistencies in values, goals, and appearance Interpersonal problems include: Being insensitive to others (unable to empathize)Difficulty knowing boundaries between themselves and othersInconsistent, detached, overemotional, abusive, or irresponsible styles of relating Diagnosis According to the DMS-5, a person must meet the following criteria to be diagnosed with a personality disorder: Chronic and pervasive patterns of behavior that affect social functioning, work, school, and close relationshipsSymptoms that affect two or more of the following four areas: thoughts, emotions, interpersonal functioning, impulse controlOnset of patterns of behavior that can be traced back to adolescence or early adulthoodPatterns of behaviors that cannot be explained by any other mental disorders, substance use, or medical conditions Differential Diagnosis Before a clinician can diagnose a personality disorder, they must make a differential diagnosis to rule out other disorders or medical conditions that may be causing the symptoms. A differential diagnosis is very important but can be difficult since personality disorders also commonly co-occur with other mental illnesses. A person who meets the criteria for one personality disorder will often also meet criteria for one or more additional personality disorders. One study, funded by the National Institute of Mental Health, found that about 85% of people with borderline personality disorder (BPD) also meet diagnostic criteria for at least one other personality or mood disorder. Mixed Personality Disorder Definition, Diagnosis, and Criteria Causes Personality disorders don’t discriminate. Roughly 10% of the general population and up to half of psychiatric patients in clinical settings have a personality disorder. Although experts are yet to fully understand the causes of personality disorders, they believe that both genetic and environmental factors play a role. Roughly 50% of personality disorders are attributed to genetic factors and family history. Genetic vulnerabilities may make people more susceptible to these conditions, while experiences and other environmental factors may act as a trigger in the development of a personality disorder. There is also a significant association between a history of childhood trauma as well as verbal abuse. One study found that children who experience verbal abuse were three times more likely to have borderline, narcissistic, obsessive-compulsive or paranoid personality disorders in adulthood. High reactivity in children, including sensitivity to light, noise, texture, and other stimuli, has also been linked to certain personality disorders. Treatment Compared to mood disorders such as clinical depression and bipolar disorder, there have historically been relatively few studies on how to effectively treat personality disorders. Many experts believe that personality disorders are difficult to treat because they are, by definition, long-standing patterns of personality. However, there are an increasing number of evidence-based treatments that are being found effective for personality disorders. In general, the goal of personality disorder treatment includes the following: Reducing subjective distress and symptoms such as anxiety and depressionHelping people to understand the aspect of their problems that are internal to themselvesChanging maladaptive and socially undesirable behaviors, including recklessness, social isolation, lack of assertiveness, and temper outburstsModifying problematic personality traits like dependency, distrust, arrogance, and manipulativeness Psychotherapy The National Alliance on Mental Illness (NAMI) lists several types of psychotherapy that may be useful in the treatment of personality disorders: Dialectical behavior therapy (DBT), which teaches coping skills and strategies for dealing with urges related to self-harm and suicide, regulating emotions, and improving relationships. Cognitive behavior therapy (CBT), the goal of which as stated by NAMI is "to recognize negative thoughts and learn effective coping strategies." Mentalization-based therapy (MBT), which teaches people to notice and reflect on their internal states of mind and those of others. Psychodynamic therapy, which places a large emphasis on the unconscious mind, where upsetting feelings, urges, and thoughts that are too painful for us to directly look at are housed. Family therapy, during which family members learn to change unhealthy reactions to each other and learn effective communication skills. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. Medication Medication can be useful to treat associated or co-morbid depression or anxiety. Depending on your symptoms, your healthcare provider may prescribe one or more of the following: Anti-anxiety medication Antidepressant Antipsychotic Mood stabilizer Coping Learning how to cope with a personality disorder is key to functioning at your best. In addition to seeking professional support, it's important to reach out to a supportive friend or family member who can help when you are struggling with strong emotions. If you don’t have someone in mind that is supportive and you are in a crisis, call a helpline. Become an expert. The more you know about your condition, the better able you’ll be to understand and cope with symptoms. Education about your condition can also help motivate you to stay the treatment course.Play an active role in your treatment. Take time to think about your treatment goals during and after therapy sessions. Even if you’re not feeling well, don’t skip your sessions or stop taking your medications without talking to your healthcare professional. Similarly, be sure to stick with regular appointments.Practice self-care strategies. Regular exercise and consistent eating and sleeping schedules can help prevent mood swings and manage anxiety, stress, and depression. It’s also important to avoid drugs and alcohol, which can worsen symptoms and interact with medications. How to Cope With a Personality Disorder For Loved Ones If you have a loved one with a personality disorder, you may also find it helpful to talk to a mental health professional. A professional can help you learn coping skills and how to set boundaries and practice self-care strategies. Group therapy and support groups may also be helpful resources of support and information. If you or a loved one are struggling with a personality disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Merck Manual. Overview of Personality Disorders. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington D.C.: 2013. Grant BF, Chou SP, Goldstein RB, et al. Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2008;69(4):533-545. Johnson JG, Cohen P, Smailes EM, Skodol AE, Brown J, Oldham JM. Childhood verbal abuse and risk for personality disorders during adolescence and early adulthood. Compr Psychiatry. 2001;42(1):16-23. doi:10.1053/comp.2001.19755 American Psychological Association. What causes personality disorders?. National Alliance on Mental Illness. Psychotherapy. Additional Reading National Institute of Mental Health. Borderline Personality Disorder. By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for BPD Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.