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Mental Health Problems/Diagnoses > Adult

Personality Disorders

What are Personality Disorders?

A person is known through his or her personality. Personality traits are the characteristics that distinguish someone from others. These characteristics include how someone thinks, feels, behaves and relates to their environment. When someone’s traits are rigid, not adaptive to new things, and cause significant difficulty in his/her work and social life, then that individual may have a personality disorder.

Most personality disorders begin as problems in the development of one’s personality and character. These problems can be observed during adolescence and then are defined as personality disorders as one reaches adulthood. Those with a personality disorder have negative underlying beliefs and thoughts about themselves and their relationships, which seem to distort the individual’s reality. This distortion becomes emotionally distressing for the individual and interferes with his/her ability to reach goals.

Someone with a personality disorder can have:

Disturbances in self-image
Difficulty in having successful appropriate relationships with others
Difficulty in understanding themselves, others, and the environment
Difficulty with their impulse control

It is important to take into consideration one’s ethnicity, culture, and social background. Personality disorders should not be confused with one having difficulty getting used to a different culture or with one adhering to customs or religious and political values.

There are different kinds of Personality Disorders, including, but not limited to, the following:

Paranoid Personality Disorder
Antisocial Personality Disorder
Borderline Personality Disorder
Obsessive-Compulsive Personality Disorder

Paranoid Personality Disorder

People with Paranoid Personality Disorder develop a pattern of mistrust and suspicion of others. These individuals assume that others will exploit, harm or deceive them with little or no evidence to support their fear. These individuals are preoccupied with unjustified doubts regarding the trustworthiness of family, friends and acquaintances and have difficulty confiding in others, often finding hidden meanings that they feel are insulting or threatening. When they feel disrespected, they will counterattack with anger and will bear grudges.

Since these individuals have difficulty trusting others, they are often self-sufficient and have a strong sense of independence. In order to protect themselves, they will:

Try to have control in their relationships
Be critical of others
Have great difficulty in accepting criticism of themselves

Antisocial Personality Disorder

Antisocial Personality Disorder is a pervasive pattern of violation and disregard for others’ rights, which begins in childhood and continues into adulthood. These individuals:

Will not conform to social norms, do not respect the law and often perform illegal acts against others
Will deceive and manipulate for their own benefit without considering other's rights, wishes or feelings
Often lack empathy and will be indifferent towards having hurt or mistreated another, often blaming the victim, and minimizing the harmful consequences of their actions
Have poor impulse control
Tend to be consistently irresponsible, as indicated by periods of unemployment, repeated absences with no explanations, or leaving numerous jobs without planning for the future

Borderline Personality Disorder

Borderline Personality Disorder is a pervasive pattern of instability of interpersonal relationships, self-image, and impulse behavior, which begins by early adulthood. Individuals with this disorder fear real or imagined abandonment and will make great efforts to prevent this abandonment. When these individuals suffer loss, they feel that they are bad and experience inappropriate anger. Due to their intolerance of being alone, they often have unstable and intense relationships.

These individuals may participate in impulsive actions, which are potentially self- damaging, such as

Self-mutilation
Suicidal behaviors
Spending money irresponsibly
Binge eating
Substance abuse
Engaging in unsafe sex

These individuals may not be able to cope when they are in an unstructured work or school environment and seem to do better when appropriate boundaries are established and maintained for them.

Obsessive-Compulsive Personality Disorder

Obsessive Compulsive Personality Disorder is a long-term pattern of preoccupation with orderliness, perfectionism and mental interpersonal control, at the expense of flexibility, openness and efficiency, which starts by early adulthood and is present in a number of contexts. Individuals with this disorder may have:

A preoccupation with details, rules, lists, order or schedules to the extent that the major point of the activity is lost

Perfectionism that gets in the way of task completion

Inability to throw away worn-out or worthless items even when they have no sentimental value

Extreme rigidity and stubbornness

An over-conscientiousness and inflexible attitude about morals, ethics or values

What Causes Personality Disorders?

Research has not narrowed down an exact cause of Personality Disorders. However, findings do suggest some possible causes may come from a combination of:

Biological factors
Personality and social development
Parental upbringing

These disorders can increase during times of increased stress, as well as if there is a significant loss in the individual’s life.

It is important not to confuse Personality Disorder with a person having difficulty getting used to a different culture following immigration. It is important to be familiar with the individual’s cultural and religious customs, in order to determine if their behavior is appropriate within their cultural norms.

How Can Personality Disorders Be Treated?

In order to treat Personality Disorders, the individuals must want to change the pattern of personality. These individuals must want to gain better insight into themselves and their behaviors in order to change how they think about themselves and their relationships. Medications and therapy can help if the individuals decide to be in control of their lives and healing.

Three proven techniques for treatment are:

Behavior Therapy/Behavior Modification
Cognitive Therapy
Cognitive-Behavioral Therapy
Dialectical-Behavior Therapy

Behavior Therapy/Behavior Modification

This treatment focuses on changing unwanted behavior through rewards and reinforcements. This treatment also relies on involvement from informal supports, such as family and close friends, to reinforce the desired behavior.

Cognitive Therapy

This treatment assists individuals in identifying distorted thinking patterns that lead to negative feelings and possibly troublesome and self-defeating behaviors. This treatment will assist individuals in incorporating more positive and empowering thinking.

Cognitive-Behavior Therapy (CBT>

This treatment is a combination of cognitive and behavioral therapies and helps individuals identify and change their negative thought patterns and beliefs in order to modify their self-harming behaviors.

It is important for individuals with Personality Disorders to have strong support systems, either through family, close friends, therapy or self-help groups. Support groups can help educate not only the individuals but also their family and friends regarding the nature of the disorder and teach them skills to cope with stressors in a healthier way.

The section below provides links to web sites that give additional information about Personality Disorders as well as a link to Westchester County Mental Health Services, a database which includes local service providers who treat Personality Disorders.

Dialectical Behavior Therapy (DBT)

DBT is a specific form of cognitive behavioral therapy that blends traditional CBT with aspects of Eastern philosophies. The treatment was originally designed for individuals with borderline personality disorder, as well as others with suicidal and self-injurious behaviors. It has since been applied to a variety of disorders including depression and substance abuse. One of the main components of DBT is the teaching of important life skills including mindfulness, emotion regulation, interpersonal effectiveness and distress tolerance. Overall, DBT helps people who tend to think and act in extremes, approach their lives in a more balanced way.

Additional Information about Personality Disorders

National Institute of Mental Health (NIMH)
http://www.nimh.nih.gov/publicat/bpd.cfm
NIMH is an agency of the United States government, which does research in order to reduce the burden of mental illness and behavioral disorders. This page provides a summary of information on the symptoms, treatments and research findings of Borderline Personality Disorder.

National Mental Health Association (NMHA)
http://www.nmha.org/infoctr/factsheets/91.cfm
NMHA is a nonprofit organization that is dedicated to promoting mental health through education and advocacy. This page gives a comprehensive summary of personality disorders, their symptoms and the treatment that is available.

http://www.nmha.org/infoctr/factsheets/borderline.cfm
This page provides brief information on the symptoms, causes and treatment of Borderline Personality Disorder.

National Alliance for the Mentally Ill (NAMI)
http://www.nami.org
NAMI is a grass roots family movement that was formed over 20 years ago. They strive to provide effective self-help and advocacy for people with mental illness.

http://www.nami.org/Template.cfm?Section=By_Illness&template=/ContentManagement/ContentDisplay.cfm&ContentID=7671
This page provides brief information on the Borderline Personality and the treatment modalities that are often used.

Treatment and Research Advancements National Association for Personality Disorders (TARA APD)
http://www.tara4bpd.org/dyn/index.php?option=content&task=view&id=3
TARA APD is a not for profit organization that is dedicated to the education and research of personality disorders. This site promotes further education and research on the causes and most effective treatment modalities for these disorders.

http://www.tara4bpd.org/dyn/index.php?option=content&task=view&id=30
This page provides a brief but thorough description of all of the Personality Disorders and their symptoms. A comprehensive overview of the symptoms, research and treatment for Borderline Personality is also included on this site.

Westchester County Mental Health Services
For information about mental health services offered in Westchester and Putnam counties in the state of New York, consult our database of these services.

General instructions for using the database are displayed before you click on the [Search Westchester Services] button.

To focus on services for adults who may have Personality Disorders, use the Keyword feature. Click on the [Keyword Search] button in the lower right corner of the database. When the next screen comes up:

Enter Personality Disorders in the left box
Click on the “Any Words” button
Click on the [Search] button

From the list of services displayed, click on the one closest to your area of interest.

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