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9.1 Overview of Clusters and Personality Disorders

Section Learning Objectives

  • Describe the symptoms associated with each cluster A personality disorder.
  • Describe the epidemiology of cluster A personality disorders.
  • Describe the treatments for cluster A personality disorders.

9.1.1 Overview 

In order to be diagnosed with any personality disorder, the individual must exhibit a pervasive and long-lasting pattern of inflexible behavior that violates cultural norms and is manifested in at least two of the following four areas: distorted thinking patternsproblematic emotional responsesover- or under-regulated impulse control, and interpersonal difficulties. While these four core features are common among all ten personality disorders, the DSM-5 divides the personality disorders into three different clusters based on symptom similarities. The pattern of behavior must persist since adolescence or early adulthood and must result in significant distress or impairment. Without distress or impairment, the pattern should be considered a personality trait rather than a disorder.

9.1.2 Cluster A 

Cluster A is described as the odd/eccentric cluster and consists of paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. The common feature of these three disorders is social awkwardness and social withdrawal (APA, 2013). Often these behaviors are similar to those seen in schizophrenia.  In fact, there is a strong relationship between cluster A personality disorders among individuals who have a relative diagnosed with schizophrenia (Chemerinksi & Siever, 2011). However, the symptoms of cluster A personality disorders tend to be less extensive and less impactful on daily functioning relative to those experienced in schizophrenia.

9.1.3 Cluster B 

Cluster B is typically described as the dramatic, emotional, or erratic cluster and consists of antisocial personality disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder. Individuals with these personality disorders often experience problems with impulse control and emotional regulation (APA, 2013). Due to the dramatic, emotional, and erratic nature of these disorders, it is nearly impossible for individuals to establish healthy relationships with others.

9.1.4 Cluster C 

Cluster C is characterized as the anxious/fearful cluster and consists of avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder. As you read through the descriptions of these disorders, you will see an overlap with symptoms of anxiety and depressive disorders. Likely due to the similarity in symptoms with mental health disorders that have effective treatment options, cluster C disorders have the most treatment options of all personality disorders.

 

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