Personality Disorders

What Are Personality Disorders?

Personality disorders are enduring patterns of inner experience and behavior that deviate markedly from cultural expectations. These patterns are inflexible, pervasive across many situations, and lead to distress or impairment in social, occupational, or other areas of functioning.

Common Types

• Borderline Personality Disorder (BPD):
  Instability in relationships, self-image, and emotions; intense fear of abandonment; impulsive behaviors.

• Antisocial Personality Disorder (ASPD):
  Disregard for others’ rights; deceitfulness; lack of remorse; repeated unlawful acts.

• Narcissistic Personality Disorder (NPD):
  Grandiosity; need for excessive admiration; lack of empathy; sense of entitlement.

• Avoidant Personality Disorder:
  Social inhibition; feelings of inadequacy; hypersensitivity to negative evaluation; avoidance of social interaction.

• Obsessive-Compulsive Personality Disorder (OCPD):
  Preoccupation with orderliness, perfectionism, and control at the expense of flexibility and efficiency.

• Dependent Personality Disorder:
  Excessive need to be taken care of; submissive and clinging behavior; fear of separation.

Signs & Symptoms

• Cognitive: Rigid, distorted thinking patterns about self and others

• Emotional: Intense or restricted affect; difficulty regulating emotions

• Interpersonal: Problems with trust, empathy, intimacy, or boundaries

• Behavioral: Impulsive or compulsive actions; avoidance or overdependence in relationships

Causes & Risk Factors

• Genetics & Biology: Family history of personality disorders or mood/anxiety disorders

• Early Life Experiences: Childhood trauma, neglect, or inconsistent caregiving

• Temperament: Inherent traits such as high sensitivity or impulsivity

• Environmental Influences: Stressful life events, unstable relationships, cultural factors

Diagnosis & Assessment

A comprehensive evaluation by a qualified provider typically includes:

1. Clinical Interview: Detailed exploration of long-term patterns of thoughts, feelings, and behaviors across contexts.

2. Structured Questionnaires: Instruments like the Personality Inventory for DSM-5 (PID-5) or Millon Clinical Multiaxial Inventory (MCMI).

3. Collateral Information: Input from family members or past treatment records to confirm longstanding patterns.

4. Mental Status Examination: Assessment of mood, thought content, insight, and behavior.

Treatment & Management

1. Psychotherapy

   • Dialectical Behavior Therapy (DBT): Especially effective for BPD to teach emotion regulation and distress tolerance.

   • Schema Therapy: Targets deep-seated patterns and core beliefs across various personality disorders.

   • Cognitive Behavioral Therapy (CBT): Addresses maladaptive thoughts and behaviors; skills training for social and interpersonal effectiveness.

   • Mentalization-Based Treatment (MBT): Improves understanding of self and others’ mental states.

2. Medication

   • Not primary treatment but may address co-occurring symptoms (e.g., mood stabilizers for mood swings, SSRIs for anxiety or depression).

3. Support & Skills Training

   • Social Skills Training: Builds effective communication and relationship skills.

   • Group Workshops (skill-based): e.g., emotion regulation groups (note: individual therapy only at Fortified Minds).

   • Psychoeducation: Increases awareness and self-management of symptoms.

4. Ongoing Care

   • Regular follow-up to monitor progress and adjust interventions.

   • Coordination with primary care or other specialists as needed.

Helpful Resources

• American Psychiatric Association (APA): Personality Disorders
  https://www.psychiatry.org/patients-families/personality-disorders

• National Institute of Mental Health (NIMH): Borderline Personality Disorder
  https://www.nimh.nih.gov/health/topics/borderline-personality-disorder

• National Education Alliance for Borderline Personality Disorder (NEABPD)
  https://www.borderlinepersonalitydisorder.org/

• Personality Disorder Awareness Network (PDAN)
  https://pdan.org/

• MentalHealth.gov: Personality Disorders
  https://www.mentalhealth.gov/what-to-look-for/personality-disorders

Book an Appointment

• Telehealth Sessions: Confidential online consultations—schedule at https://fortifiedmindsgroup.com/contact

• In-Person Visits: Available in Virginia —find providers at https://fortifiedmindsgroup.com/providers