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Psychiatry ` Psychiatry—Pathology Psychiatry ` Psychiatry—Pathology sEctiON iii 565

Personality
Personality trait An enduring, repetitive pattern of perceiving, relating to, and thinking about the environment and
oneself.

Personality disorder Inflexible, maladaptive, and rigidly pervasive pattern of behavior causing subjective distress and/or
impaired functioning; person is usually not aware of problem (ego-syntonic). Usually presents by
early adulthood.
Three clusters: A, B, C; remember as Weird, Wild, and Worried, respectively, based on symptoms.

Cluster A personality Odd or eccentric; inability to develop Cluster A: Accusatory, Aloof, Awkward. “Weird.”
disorders meaningful social relationships. No psychosis;
genetic association with schizophrenia.
Paranoid Pervasive distrust (Accusatory), suspiciousness,
hypervigilance, and a profoundly cynical view
of the world.
Schizoid Voluntary social withdrawal (Aloof), limited
emotional expression, content with social
isolation (vs avoidant).
Schizotypal Eccentric appearance, odd beliefs or magical Included on the schizophrenia spectrum.
thinking, interpersonal Awkwardness. Pronounce schizo-type-al: odd-type thoughts.

Cluster B personality Dramatic, emotional, or erratic; genetic Cluster B: Bad, Borderline, flamBoyant, must be
disorders association with mood disorders and substance the Best. “Wild.”
abuse.
Antisocial Disregard for the rights of others with lack of Antisocial = sociopath.
remorse. Involves criminality, impulsivity, Bad.
hostility, and manipulation. Males > females.
Must be ≥ 18 years old with evidence of
conduct disorder onset before age 15.
Diagnosis is conduct disorder if < 18 years old.
Borderline Unstable mood and interpersonal relationships, Treatment: dialectical behavior therapy.
fear of abandonment, impulsivity, self- Borderline.
mutilation, suicidality, sense of emotional
emptiness. Females > males. Splitting is a
major defense mechanism.
Histrionic Attention-seeking, dramatic speech and FlamBoyant.
emotional expression, shallow and labile
emotions, sexually provocative. May use
physical appearance to draw attention.
Narcissistic Grandiosity, sense of entitlement; lacks empathy Must be the Best.
and requires excessive admiration; often
demands the “best” and reacts to criticism
with rage and/or defensiveness. Fragile self-
esteem. Often envious of others.

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