31st January 2024

Types

There are 11 main personality disorders, but they are categorised under 3 clusters. The clusters are highlighted in the DSM classification, but they are not mentioned in the ICD classification. Nevertheless, the types of personality disorders are more or less the same in both diagnostic manuals as follows:

DSM-5:

• Paranoid
• Schizoid
• Schizotypal
• Antisocial
• Borderline
• Histrionic
• Narcissistic
• Avoidant
• Obsessive-compulsive
• Dependent
  

ICD-11:

• Paranoid
• Schizoid
• Schizotypal (reclassified as Schizotypal disorder, and it lies under “Schizophrenia and related disorders”)
• Dissocial 
• Emotionally Unstable, Impulsive type
• Emotionally Unstable, Borderline type
• Histrionic
• Anxious/Avoidant
• Anankastic
• Dependent

The 3 Clusters A, B & C are categorised as follows:*

Cluster A

It is mainly characterised by oddness and eccentricity, but following specific features are seen:

Paranoid Personality Disorder: 

• Mistrust and suspiciousness of others. 
• Sensitive to criticism.
• Preoccupied by conspiratorial explanations.

Schizoid Personality Disorder:

• Emotionally cold.
• Lack of interest in others.
  
• Doesn’t seek social relationships
  

Schizotypal Personality Disorder:

• Peculiar and eccentric appearance and ideas.
• Interpersonal discomfort.
• Perceptual and cognitive distortions.

Cluster B 

It is mainly characterised by unstable emotions, but following specific features are seen:

Antisocial Personality Disorder:

• Lack of concern for others.
• Violation of other’s rights.
• Irresponsibility.
• Inability to maintain relationships
• Childhood conduct disorder
  

Emotionally Unstable Personality Disorder, Impulsive Type (Not a cluster B disorder, not in DSM):**

• Difficulty in anger management.
• Emotional & behavioural unpredictability.

Emotionally Unstable Personality Disorder, Borderline Type:***

• Identity conflict.
• Unstable relationships.
• Impulsivity
• Emotional instability.
• Self-harm.

Histrionic Personality Disorder:

• Attention craving.
• Shallow affect.
• Easily suggestible.
• Seductive and provocative attitude
• Excessive dramatisation.
  

Narcissistic Personality Disorder:

• Grandiosity and sense of entitlement
• Lack of empathy
  
• Constant need for admiration
  
• Exploitive
• Fantasies of power

* ** ***Emotionally unstable personality disorder, borderline type, is an ICD term which is parallel to borderline personality disorder in DSM (Cluster B), whereas emotionally unstable personality disorder, impulsive type, is only referred to in ICD but not in DSM.

Cluster C

It is mainly characterised by anxiety and fear, but following specific features are seen:

Avoidant Personality Disorder:

• Fear of criticism
• Avoiding intimate relationship
• Feelings of inferiority
• Feelings of inadequacy
  
• Insecure
• Self-consciousness
  

Obsessive Compulsive Personality Disorder:

• Perfectionism
• Overconscientious 
  
• Preoccupation with orderliness and details
  
• Workaholic
• Inflexible
  

 Dependent Personality Disorder:

• Excessive need for care
• Constant need for reassurance
• Helplessness
• Submissiveness
• Clinginess

References

• Strahl NR. Clinical study guide for the oral boards in psychiatry. American Psychiatric Pub; 2011.