Personality Disorders

Personality disorders are mental health conditions characterized by enduring patterns of thinking, feeling, and behaving that deviate significantly from cultural norms. These patterns are pervasive and inflexible, leading to distress or impairment in personal, social, and occupational functioning. Below are definitions, signs and symptoms, etiological factors, considerations for children and adolescents, and treatment options for some common personality disorders.

Borderline Personality Disorder (BPD)

Borderline Personality Disorder (BPD) is a disorder characterized by unstable moods, behaviors, and relationships. People with BPD may experience intense episodes of anger, depression, and anxiety that can last from a few hours to days.

Signs and symptoms include emotional instability, feelings of worthlessness, insecurity, impulsivity, and impaired social relationships. Individuals with BPD often have an intense fear of abandonment and may exhibit self-destructive behavior, such as self-harm or suicidal ideation.

The exact cause of BPD is unknown, but it is believed to be a combination of genetic, environmental, and social factors. A history of childhood abuse or neglect is common among individuals with BPD.

Early signs in children may include mood swings, difficulties in relationships, and impulsive behavior. It is important to provide a supportive environment and early intervention to prevent the development of more severe symptoms.

Treatment typically includes psychotherapy, such as dialectical behavior therapy (DBT) or cognitive-behavioral therapy (CBT). Medications may be prescribed to address specific symptoms like mood instability and anxiety.

Antisocial Personality Disorder (ASPD)

Antisocial personality disorder (ASPD) is characterized by a long-term pattern of disregard for, and violation of the rights of others. Individuals with ASPD often exhibit a lack of empathy and a propensity for manipulative or deceitful behavior.

Signs and symptoms include a persistent disregard for the law, impulsive and aggressive behavior, deceitfulness, and a lack of remorse after harming others. These individuals may also have difficulties maintaining employment and stable relationships.

The cause of ASPD is believed to result from a combination of genetic predisposition, environmental factors, and neurological abnormalities. Childhood trauma, such as abuse or neglect, is a significant risk factor.

Conduct disorder in children, characterized by aggressive behavior, rule-breaking, and deceitfulness, is often a precursor to ASPD. Early intervention is crucial to address these behaviors and reduce the risk of developing ASPD.

Treatment for ASPD is challenging and often focuses on managing symptoms and reducing harmful behaviors. Psychotherapy, particularly cognitive-behavioral approaches, can be beneficial. Medications may be used to treat co-occurring conditions, such as depression or anxiety.

Narcissistic Personality Disorder (NPD)

Narcissistic personality disorder (NPD) is characterized by a long-term pattern of exaggerated self-importance, a need for excessive admiration, and a lack of empathy for others.

Signs and symptoms of individuals with NPD may include exhibiting grandiosity, a sense of entitlement, a preoccupation with fantasies of unlimited success or power, and a tendency to exploit others for personal gain. They may also have difficulty accepting criticism and exhibit arrogant behavior.

The development of NPD is thought to be influenced by a combination of genetic, environmental, and social factors. Childhood experiences, such as excessive pampering or neglect, may contribute to the development of NPD.

Early signs in children may include a lack of empathy, difficulty with peer relationships, and a strong need for admiration. Addressing these behaviors early can help prevent the development of more severe symptoms.

Treatment Options may include psychotherapy, particularly cognitive-behavioral therapy (CBT), is the primary treatment for NPD. Therapy focuses on helping individuals develop healthier self-esteem, improve interpersonal relationships, and increase empathy.

Avoidant Personality Disorder (AvPD)

Avoidant personality disorder (AvPD) is characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.

Signs and symptoms include extreme shyness, fear of rejection, avoidance of social interactions, and a strong desire for acceptance and affection. Individuals with AvPD often feel socially inept and may have low self-esteem.

The exact cause of AvPD is unknown, but it is believed to involve a combination of genetic, environmental, and social factors. A history of childhood rejection or criticism is common among individuals with AvPD.

Early signs in children may include excessive shyness, avoidance of social interactions, and fear of criticism. Early intervention and supportive environments can help reduce the risk of developing AvPD.

Treatment typically includes psychotherapy, such as cognitive-behavioral therapy (CBT), which focuses on building self-esteem and improving social skills. Medications may be prescribed to address symptoms of anxiety and depression.

Treatment and management of personality disorders may be challenging, but with proper diagnosis and treatment, children and adolescents can learn to thrive and be successful. 

Please contact our office if you have concerns that you or your child may have a personality disorder, of if already diagnosed, to discuss treatment options.