Cluster A – odd or eccentric
- Paranoid (pervasive mistrust)
- Schizoid (socially detached)
- Schizotypal (socially isolated, distorted perception)
Cluster B – dramatic, emotional, erratic
- Antisocial (discounts others, no empathy)
- Borderline (unstable, impulsive)
- Histrionic (dramatic attention seeking)
- Narcissistic (needs admiration)
Cluster C – anxious or fearful
- Avoidant (socially inhibited, inadequate)
- Dependent (submissive, separation fear)
Anti-Social Personality Disorder
People with Anti-social Personality Disorder; appear to experience a limited range of emotions, which can explain their lack of empathy regarding the suffering of others. People with the disorder may be prone to substance abuse or risk-seeking behaviour as a method of attempting to escape their feelings of emptiness.
It has been stated, through research that a client’s disregard for the consequences of their actions and their lack of empathy is related to the fact that they are indifferent to the possibility of physical pain or many punishments and that they show no signs of fear when so threatened.
Before 15 years of age, for at least 12 months, the client has repeatedly violated rules, shown by at least three of the following:
- Failure to social norms – repeatedly performing acts that are grounds for arrest
- Deceitfulness, indicated by repeated lying, conning others for personal profit or pleasure
- Failure to plan ahead or impulsivity
- Aggressiveness and irritability, indicated through repeated assaults and fights
- Reckless disregard for their own safety or that of others
- Consistent irresponsibility, as indicated by continuous failure to sustain consistent work behaviour or honour financial obligations
- Lack of remorse shown through indifference to having mistreated, stolen or hurt another
Avoidant Personality Disorder
People with Avoidant Personality Disorder are characterised by a complex pattern of feelings of inadequacy and extreme sensitivity to what other people think of them. People with the disorder frequently consider themselves to be personally unappealing and socially inept. They will often avoid social situations due to fearing humiliation or being disliked by others. It is believed that this stems from perceived or actual rejection by parents or peers during childhood.
The disorder usually manifests itself by early adulthood and is particularly common amongst those with anxiety disorders. It has been suggested that between 10 and 50 percent of people with panic disorder or agoraphobia, also have Avoidant Personality Disorder.
In order for a diagnosis for Avoidant Personality Disorder to be made, the client must display at least four of the following criteria:
- Fears disapproval, rejection or criticism
- Unwilling to become involved with people unless they are certain of being liked
- Restrained within a physical relationship due to fear of being shamed
- Preoccupied with rejection or criticism in social situations
- Experiences inhibitions in new relationship situations due to feelings of inadequacy
- Regards themselves as being socially inept, inferior or unappealing
- Avoids taking personal risks or taking part in new activities due to fear of embarrassment
Dependant Personality Disorder
People with Dependent Personality Disorder feel the need to be taken care of. They are fearful of separation or abandonment which can lead to clingy behaviour. This behaviour in turn can lead to others taking advantage of them. As people with Dependent Personality Disorder require constant reassurance, they may find it difficult to make decisions and to complete tasks or projects on their own. They have a tendency to belittle themselves and to agree with people, even when they know the person is wrong.
In order for Dependent Personality Disorder to be diagnosed, the client must meet at least five of the following criteria:
- Requires excessive reassurance from others in order to make decisions
- Needs others to assume responsibility for major areas of life
- Finds it difficult to express disagreement for fearing loss of approval or support
- Finds it difficult to carry out projects on own
- Will go to excessive lengths to gain nurture and support, even by volunteering for unpleasant tasks
- When alone feels discomfort or helplessness
- Urgently seeks another relationship after a close one is lost
- Is preoccupied to an unrealistic extent with fears of being abandoned and left to take care of themselves.
Histrionic Personality Disorder
People with Histrionic Personality Disorder display a pattern of excessive emotionality and attention-seeking behaviour. Usually beginning by early adulthood, they display an excessive need for approval from others as well as being inappropriately seductive. They have an excessive concern regarding physical appearance and need to be the centre of attention. Their rapidly changing emotional states may make them appear shallow, as well as them being easily influenced by others.
For a diagnosis of Histrionic Personality Disorder to be made, the client must meet at least five of the following criteria:
- Not being the centre of attention makes them uncomfortable
- Relationships with others are characterised by inappropriate sexually seductive or provocative behaviour
- Emotions are rapidly shifting and shallow
- Frequently uses physical appearance to draw attention to self
- Speech style is vague and lacking in detail
- Emotion is expressed over dramatically
- Easily influenced by others or circumstances
- Considers relationships to be more intimate than they really are
Narcissistic Personality Disorder
The term ‘Narcissistic Personality Disorder’ was first coined by Heinz Kohut in 1971 and describes people who have a grandiose sense of self-importance, a thirst for admiration and a lack of empathy.
People with Narcissistic Personality Disorder often make themselves appear “larger than life” and exaggerate their accomplishments. However, they also have a very fragile self-esteem and believe that they are flawed in some way, which they feel makes them unacceptable to others. It has been stated that “Psychologists commonly believe that narcissism results from an impairment in the quality of the person’s relationship with their primary caregivers, usually their parents, in that the parents were unable to form a healthy, empathic attachment to them. This results in the child conceiving of themselves as unimportant and unconnected to others. The child typically comes to believe that he or she has some defect of personality which makes them unvalued and unwanted” .
A narcissistic person’s job performance may also be affected by the disorder. Despite the fact they are ambitious, they are unable to tolerate setbacks or criticism which can make it difficult for them to work with others.
There has been very little research of this disorder carried out, but it is estimated that it affects less than 1% of the general population and affects more men than women.
In order for Narcissistic Personality Disorder to be diagnosed, the client needs to meet at least five of the following criteria:
- Has a grandiose sense of self-importance
- Preoccupied with fantasies of brilliance, power, unlimited success or beauty
- Believes they are unique or “special” and can only be understood by those of a high status
- Needs excessive admiration
- Possesses a sense of entitlement
- Tries to achieve personal goals through the exploitation of others
- Lacks empathy
- Is frequently envious of others or believes that others envy them
- Haughtiness or arrogance in attitude or behaviour
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