Mental Health Conditions
Personality disorder
Quick links on this page:
- What is personality disorder?
- What are the different types?
- What causes a personality disorder?
- What about antisocial personality disorder (APD)?
Related page:
What is personality disorder?
Personality disorders usually become noticeable in adolescence or early adulthood, but sometimes start in childhood. They make it difficult for someone to develop friendships, maintain a stable relationship and to work cooperatively with others, because their experience, responses and coping strategies are so limited. Not surprisingly, they can feel very alienated and alone and, unfortunately, the risk of suicide is about three times higher than average. Personality disorders will disrupt people's lives, and those around them, to different degrees, and the extent to which they are treatable also varies.
What are the different types?
Paranoid personality disorder – a continual and unwarranted distrust and suspicion of others is a sign that someone has this problem. They are always on their guard, in case someone harms them.
Schizoid personality disorder – a person with schizoid personality disorder isn't really interested in forming close relationships. He or she tends to be solitary, inward looking and cut off from other people.
Borderline Personality Disorder (BPD) – this may involve:
- intense, unstable relationships
- highly impulsive behaviour
- major mood shifts
- inappropriate anger
- self-harm
- having a weak sense of identity
- long-term boredom and a sense of emptiness
- a fear of being abandoned.
People with BPD may cling on to very damaging relationships, because they don't have a strong sense of identity and are terrified of being alone. Many people with BPD also meet the criteria for histrionic, narcissistic or antisocial personality disorder (see below).
Antisocial Personality Disorder (APD) – this disorder is most closely linked with adult criminal behaviour. Someone with APD is likely to ignore and ride roughshod over other people's rights. Although charming on the surface, they may be callous and self-serving underneath, and lack any empathy with other people.
They may not be able to hold down a job for long or stay in a long-term relationship. They usually behave impulsively, without considering the consequences, and this is often linked to criminal offences, particularly involving violence. Central to the problem is a complete lack of guilt about their behaviour.
Dependent personality disorder – driven by an overwhelming fear of separation and a need to be taken care of, people with dependent personality disorder tend to become very clinging and submissive towards others.
Obsessive-Compulsive Personality Disorder (OCPD) – OCPD sufferers are preoccupied with orderliness, perfectionism and keeping everything under control. They set unrealistically high standards for themselves and others. OCPD is not necessarily linked with Obsessive-Compulsive Disorder (OCD) and the other obsessional disorders, but some people may be diagnosed with both. (OCD is likely to interfere much more with someone's day-to-day life). Someone with OCPD may also suffer from depression or social phobia.
What causes a personality disorder?
Although a great deal of research has concentrated on the causes of antisocial personality disorder (see opposite) there's been little in-depth investigation into the causes of other personality disorders.
There seems to be a strong genetic basis to obsessive-compulsive personality disorder, and there may also be a genetic link between personality disorders and certain mental health problems. There have been reports that relatives of people suffering from schizophrenia and manic depression are more prone than other people to having a personality disorder.
Negative experiences, such as poor parenting, rejection, lack of love, or abuse when young may all play a part. Many people diagnosed with BPD report having been neglected, or physically or sexually abused as children.
What about Antisocial Personality Disorder (APD)?
Antisocial behaviour in childhood seems to be linked to antisocial behaviour in adults. High levels of stress and family problems are important causes of behaviour problems in childhood, and the significant factors here seem to be:
- no warm, intimate and constant relationship with parents
- inconsistent discipline and supervision
- parents who have APD, or who abuse drugs or alcohol.
Children of divorced parents may be at greater risk of getting into trouble, but this seems to be to do with the quality of life at home. Neglectful, quarrelling parents, who stay together, are more likely to produce troubled and troublesome children than more stable single-parent homes. Upbringing is an important cause of APD in adults, according to some experts, but others point out that most people who have had painful childhoods don't go on to develop APD as adults.
Brain chemistry and self-control – serotonin, a brain chemical, affects our ability to control our impulses. If levels are too low, it means people may have less self-control, and are likely to be more irritable, and perhaps prone to impulsive acts of violence. Research shows that people with antisocial or borderline personality disorder, and a reputation for violence of this kind, are likely to have low serotonin levels.
There is also a link between physical and environmental causes, because serotonin levels can be affected by outside factors. For example, feeling socially isolated or deprived makes people stressed, and this will cause levels to drop.
Physical differences – tests involving habitually aggressive men, convicted of violent offences, have shown that they have problems connected with brain function or brain damage. This would make it more difficult for them to think about what they are doing, to judge the consequences, to learn from experience and to feel fear or remorse.
People with antisocial personality disorder don't seem to react with the same anxiety as other people to potential stress. Because of this relative lack of anxiety, they may not learn to avoid threatening situations and, instead, may actively seek out danger in order to feel stimulated and alive.
If you need help right now, visit the Immediate Help page.
