Personality Disorders

What are Personality Disorders?

According to the Diagnostic and Statistical Manual (DSM-IV), a personality disorder is an “enduring pattern of inner experience and behavior that deviates markedly from the expectation 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.” Because these disorders are chronic and pervasive, they can lead to serious impairments in daily life and functioning.

How are Personality Disorders Diagnosed?

In order to be diagnosed with a personality disorder, an individual must exhibit symptoms that meet the diagnostic criteria established in the DSM-IV.

  • These patterns of behavior must be chronic and pervasive, affecting many different aspects of the individual?s life, including social functioning, work, school and close relationships.
  • The individual must exhibit symptoms that affect two or more of the following areas: thoughts, emotions, interpersonal functioning and impulse control.
  • The pattern of behaviors must be stable across time and have an onset that can be traced back to adolescence or early adulthood.
  • These behaviors cannot be explained by any other mental disorders, substance abuse or medical conditions.

What are the Different Types of Personality Disorders?

Personality disorders are described on Axis II of the Diagnostic and Statistical Manual. The DSM-IV lists a total of ten different personality disorders. These disorders are classified into three separate clusters.

Cluster A – Odd or Eccentric Disorders

  • Paranoid Personality Disorder: Paranoid personality disorder is a chronic and pervasive condition characterized by disruptive patterns of thought, behavior, and functioning. This disorder is thought to affect between one to two-percent of U.S. adults. Symptoms may often resemble schizophrenia and some research indicates that there may be a genetic link between the two disorders. Individuals with paranoid personality disorder are at a greater risk for experiencing depression., substance abuse, and agoraphobia.
  • Schizoid Personality Disorder: Schizoid personality disorders is a chronic and pervasive condition characterized by disruptive patterns of thought, behavior, and functioning. This type of personality disorder is believed to be relatively rare and tends to affect more men than women. Individuals with schizoid personality disorder are also at risk for experiencing depression..
  • Schizotypal Personality Disorder: Schizotypal personality disorder is a chronic condition characterized by a pervasive pattern of distorted thought, behavior, and functioning. This type of personality disorder is thought to affect approximately three-percent of adults in the United States. Individuals with this disorder are more prone to experience depression. and psychotic disorders.

Cluster B – Dramatic, Emotional, or Erratic Disorders

  • Antisocial Personality Disorder / Conduct Disorder: Conduct Disorder is a serious behavioral problem involving repeated violations of the rights of others, or violation of basic age-appropriate social rules expected of a child. Conduct disorder involes a pattern of aggressive behavior toward people or animals, destruction of property, a pattern of deceitfulness, and/or serious violations of social rules at home or at school.
  • Borderline Personality Disorder: According to the National Institute of Mental Health (NIMH), borderline personality disorder is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual’s sense of self-identity.
  • Histrionic Personality Disorder: Individuals with histrionic personality disorder Display excessive but shallow emotions and attention-seeking behaviors. These individuals are constantly performing in order to gain attention. Experience fleeting moods, opinions, and beliefs. They are also very suggestible and quick to respond to fads.
  • Narcissistic Personality Disorder: Narcissistic personality disorder is a pervasive disorder characterized by self-centeredness, lack of empathy, and an exaggerated sense of self-importance. As with other personality disorders, this disorder is an enduring and persistent pattern of behavior that negatively impacts many different life areas including social, family, and work relationships.

Cluster C ? Anxious or Fearful Disorders

  • Avoidant Personality Disorder: Avoidant personality disorder is characterized by a chronic and pervasive pattern of distorted thought, emotion, behavior, and functioning. This type of personality disorder is thought to affect approximately one-percent of adults in the United States. Individuals with this disorder are also more prone to anxiety disorders, including agoraphobia and social phobia.
  • Dependent Personality Disorder: Dependent personality disorder is an enduring pattern of distorted thought, behavior, and life functioning. Individuals with this type of personality disorder are more prone to experience anxiety disorders and affects a greater number of women than men.
  • Obsessive-Compulsive Personality Disorder: Obsessive-Compulsive Disorder (OCD) is a potentially disabling anxiety disorder. People afflicted with OCD become trapped in a pattern of repetitive, senseless thoughts and behaviors that are very difficult to overcome. Left untreated, a severe case of OCD can destroy a person?s capacity to function at work or school?or to lead a comfortable existence at home.

Differential Diagnosis

Before a clinician can diagnose a personality disorder, they must rule out other disorders or medical conditions that may be causing the symptoms. The symptoms that characterize personality disorders are often similar to those of other disorders and illnesses. Personality disorders also commonly co-occur with other illnesses.

The following are potential differentials that must be ruled out before diagnosing an individual with a personality disorder:


American Psychiatric Association. (2000) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). 4th ed. Washington, DC: Author.

What is Five Gates Program?

The Five Gates Program is a form of Cognitive or Person Centered Psychotherapy. It is unique for its Fifth Gates which operates through a powerful healing principle Dr. Kesselman has labeled The Inverted Pyramid Effect, which is the remarkable healing engine by which people in reviewing sequentially the events in their lives and finding a logical explanations for each of their psychological pains specially Anxieties and Depressions, are able to experience the triggering of Clearing healing all of the later consequences and confusions associated with the psychological difficulties that has caused them to want to take the Five Gates Program.