Article ID: WMC005089 ISSN 2046-1690 Personality Disorders: A Review of the Current State of Knowledge Peer review status: No Corresponding Author: Dr. Kevin Volkan, Professor of Psychology, California State University Channel Islands, 2386 Madera Hall, CSUCI, 93012 - United States of America Submitting Author: Dr. Kevin Volkan, Professor of Psychology, California State University Channel Islands, 2386 Madera Hall, CSUCI, 93012 - United States of America Article ID: WMC005089 Article Type: Review articles Submitted on:26-Apr-2016, 09:56:32 PM GMT Published on: 28-Apr-2016, 11:48:07 AM GMT Article URL: http://www.webmedcentral.com/article_view/5089 Subject Categories:PSYCHOLOGY Keywords:Personality Disorders, Borderline Personality Disorder How to cite the article:Volkan K. Personality Disorders: A Review of the Current State of Knowledge. WebmedCentral PSYCHOLOGY 2016;7(4):WMC005089 Copyright: This is an open-access article distributed under the terms of the Creative Commons Attribution License(CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Source(s) of Funding: None Competing Interests: None WebmedCentral > Review articles Page 1 of 16 WMC005089 Downloaded from http://www.webmedcentral.com on 28-Apr-2016, 11:48:08 AM Personality Disorders: A Review of the Current State of Knowledge Author(s): Volkan K Abstract important areas of functioning. 7. The pattern is stable and cf long duration, and Its onset can be traced back at least to adolescence or early adulthood. Personality disorders are the most common serious 8. The enduring pattern is not better explained as a mental illness. People suffering from these disorders manifestation or consequence of another mental tend to exhibit emotional patterns and behaviors that disorder. seem troubling to the majority of people and are not 9. The enduring pattern is not attributable to the necessarily explicable by immediate environmental physiological effects of a substance (e.g., a drug of stimuli. Nevertheless, many clinicians are unfamiliar abuse, a medication) or another medical condition with the most recent research on these disorders and (e.g., head trauma). (p.646-647) the latest approaches to treatment. This study will review the current diagnostic conceptualization of There are ten types of personality disorders personality disorders, their clinical treatment, and their recognized in the DSM V: Schizotypal, Paranoid, relationship to cultural characteristics and Schizoid, Antisocial, Borderline, culture-specific disorders. Obsessive-Compulsive, Dependent, Avoidant, Introduction - Diagnosis of Narcissistic, and Histrionic. Briefly, these can be Personality Disorders understood to have the following characteristics: Antisocial Personality Disorder: People suffering from this disorder are characterized as having a disregard In the creation of the new DSM-V there was some for moral or legal standards of their culture. They have debate about what to do with the diagnostic category trouble getting along with others and/or following the for personality disorders. In the end the creators of the rules of society. They used to be called psychopaths DSM-decided to holdover the different types of or sociopaths. personality disorders from the DSM-IV but to remove these disorders from a separate axis. The DSM-V also Avoidant Personality Disorder: People suffering from keeps the same cluster structure as in the DSM-IV. this disorder have heightened social inhibitions The DSM-V: Diagnostic and Statistical Manual of combined with feelings of inadequacy. These people Mental Disorders (American Psychiatric Association, generally are extremely sensitive to criticism. 2013) defines the following criteria for the diagnosis of a personality disorder: Borderline Personality Disorder: People with this disorder lack a stable identity. They may be An enduring pattern of inner experience and behavior emotionally labile and have unusually intense, yet that deviates markedly from the expectations of the unstable relationships with others. Persons suffering individual’s culture. This pattern is manifested in two from this disorder also have marked impulsivity, and (or more) of the following areas: often are dissociated from their emotions. 1. Cognition (i.e., ways of perceiving and interpreting Dependent Personality Disorder: People with this self, other people, and events). disorder have an extreme need of other people. They 2. Affectivity (i.e., the range, intensity, lability, and have trouble doing anything on their own and are often appropriateness of emotional response). unable to make decisions or be independent in any 3. Interpersonal functioning. aspects of their lives. They have an intense fear of 4. Impulse control. separation, which may manifest itself in extremely 5. The enduring pattern is inflexible and pervasive submissive and conciliating behavior. People with this across a broad range of personal and social situations. disorder lack self-confidence and self-esteem. 6. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other Histrionic Personality Disorder: People with this WebmedCentral > Review articles Page 2 of 16 WMC005089 Downloaded from http://www.webmedcentral.com on 28-Apr-2016, 11:48:08 AM disorder are overly dramatic with highly exaggerated Other specified personality disorder and unspecified and/or inappropriate emotional displays. They personality disorder is a category provided for two manifest sudden and rapidly shifting expression of situations: 1) the individual's personality pattern meets emotions that often seem fake or shallow. the general criteria for a personality disorder, and traits of several different personality disorders are present, Narcissistic Personality Disorder: People with this but the criteria for any specific personality disorder are disorder see themselves as most important person in not met; or 2) the individual's personality pattern the universe, emanating grandiosity and omnipotence. meets the general criteria for a personality disorder, They also lack empathy toward others while at the but the individual is considered to have a personality same time needing other people’s admiration and disorder that is not included in the DSM-5 attention. This lack of empathy makes it difficult for classification (e.g., passive-aggressive personality them to understand other’s points of view making them disorder). (American Psychiatric Association, 2013, p. intolerant and hypersensitive to criticism. 645) Obsessive-Compulsive Personality Disorder: People The DSM-V (2013), organizes personality disorders suffering from this disorder tend to be perfectionists into three groups or clusters, with three or four and are inflexible. The disorder manifests as repetitive disorders per group: patterns of thought and/or behavior that the person feels are out of his or her control. Cluster A - Eccentric Personality Disorders: Paranoid, Schizoid, Schizotypal: Paranoid Personality Disorder: This disorder is People suffering from these disorders often appear characterized by an extreme distrust of others. This odd or peculiar and begin to demonstrate these distrust can become extreme to the point where a aspects of the disorder by early adulthood and in person’s paranoid beliefs (i.e. that others are various contexts. exploiting, harming, or trying to deceive) are thought disordered, containing their own set of internal logic Cluster B - Dramatic Personality Disorders: Antisocial, unrelated to consensus reality. People suffering from Borderline, Histrionic, and Narcissistic: this disorder often believe that they have been People suffering from these disorders have intense, betrayed and that there is hidden significance in the unstable emotions, distorted self-perception, and are behavior of others. People with this disorder are often often behave in impulsive ways. unforgiving and hold grudges. Cluster C - Anxious Personality Disorders: Avoidant, Schizoid Personality Disorder: Those suffering from Dependent, Obsessive-Compulsive: People suffering this disorder have a very limited range of emotional from these disorders are often anxious and fearful. expression and experience. They present as being They begin to demonstrate these aspects of the very ‘flat’, withdrawn and uninterested in social disorder by early adulthood and in various contexts. relationships. Also included in Cluster C are the diagnoses of Schizotypal Personality Disorder: This disorder is Personality Change Due to Another Medical Condition, similar to schizophrenia except that it does not include Other Specified Personality Disorder and Unspecified frankly psychotic features such as hallucinations. Like Personality Disorder. The diagnosis of Personality schizophrenia however, it does include disordered Change Due to Another Medical Condition is related to thoughts, magical beliefs and thought patterns[1]. severe personality changes that are caused by an People with this disorder may appear or behave in an underlying physical or medical condition. The DSM V eccentric or disordered fashion as well as evincing includes eight types under this diagnosis: labile type, belief in things that make no logical sense. disinhibited, aggressive, apathetic, paranoid, other, combined, and unspecified. This diagnostic category Also included in the DSM-V are two further categories, should be a reminder for the clinician to make sure which are self-explanatory: that any patients suspected