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Personality Disorders

Background

A personality disorder, as defined in the Diagnostic and Statistical Manual of the American Psychiatric Association, Fifth Edition (DSM-5) is an enduring pattern of inner experience and behavior that differs markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment. (See Prognosis and Presentation.)

Although the most common etiologies for personality disorders are multifactorial, these conditions may also be secondary to biologic, developmental, or genetic abnormalities. Stressful situations may often result in decompensation, revealing a previously unrecognized personality disorder. Indeed, personality disorders are aggravated by stressors, external or self-induced. Individuals may have more than 1 personality disorder. (See Pathophysiology and Etiology.)

Cluster

Ten personality disorders, grouped into 3 clusters (ie, A, B, C), are defined in the DSM-5.
Cluster A disorders include the following (see Prognosis and Treatment):

Paranoid personality disorder

Schizoid personality disorder

Schizotypal personality disorder

Cluster B disorders include the following:

Antisocial personality disorder

Borderline personality disorder

Histrionic personality disorder

Narcissistic personality disorder

Cluster C disorders include the following:

Avoidant personality disorder

Dependent personality disorder

Obsessive-compulsive personality disorder

Personality

A concept has emerged that personality may be expressed in terms of the following 5 basic dimensions:

Extraversion

Agreeableness

Conscientiousness

Neuroticism

Openness to experience

This model is termed the 5-factor model, and it has developed a significant amount of acceptance among personality psychologists.

The model has been used to describe the different accepted types of personality disorders. Most current research suggests that personality disorders may be differentiated by their interactions among the 5 dimensions rather than differences on any single dimension.

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