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:
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.