Clusters of Personality Disorders in DSM-5: Detailed Overview Diagnostic Considerations:
Lacks desire for social contact; not distressed by social isolation.
CLUSTER A: Odd or Eccentric Disorders: These disorders share features of Often mistaken for autism spectrum disorder or depressive states.
social detachment, cognitive or perceptual distortions, and eccentric behavior. Usually begins in early adulthood and is more prevalent in males
(Livesley, 2001).
1. Paranoid Personality Disorder (PPD) 3. Schizotypal Personality Disorder
Core Characteristics: Core Characteristics:
A pervasive distrust and suspiciousness of others. Social and interpersonal deficits marked by acute discomfort with close
Belief that others are exploiting, harming, or deceiving them without relationships.
sufficient evidence. Cognitive or perceptual distortions and eccentric behaviors.
Clinical Features: Clinical Features:
Constant suspicion of others' motives. Ideas of reference (excluding delusions).
Hypervigilance, defensive behavior, and hostility in ambiguous situations. Odd beliefs or magical thinking (e.g., telepathy, sixth sense).
Reluctance to confide in others due to unwarranted fear that information Unusual perceptual experiences, including bodily illusions.
will be used maliciously. Suspiciousness or paranoid ideation.
Reads hidden threats into benign remarks or events. Odd thinking and speech (e.g., vague, metaphorical).
Holds grudges persistently and reacts with anger or counterattack. Behavior or appearance that is peculiar, eccentric, or unusual.
Social anxiety that does not diminish with familiarity.
Diagnostic Considerations:
Not due to schizophrenia or other psychotic disorders. Diagnostic Considerations:
More common in males. May precede schizophrenia; strong genetic association.
Can significantly interfere with occupational and social functioning (APA, Often socially isolated and anxious.
2013). Linked to family history of psychotic disorders (Kwapil & Barrantes-
Vidal, 2015).
2. Schizoid Personality Disorder
Core Characteristics:
A pervasive pattern of detachment from social relationships and a
restricted range of emotional expression in interpersonal settings.
Clinical Features:
Preference for solitary activities.
Indifference to praise or criticism.
Emotional coldness, detachment, or flattened affectivity.
Limited interest in sexual or close interpersonal relationships.
Few, if any, close friends or confidants.
CLUSTER B: Dramatic, Emotional, or Erratic Disorders: These disorders Diagnostic Considerations:
involve problems with impulse control and emotional regulation, often leading to More common in females.
dramatic interpersonal relationships. Strong association with childhood trauma, especially abuse or neglect.
High risk of suicide and self-harm.
1. Antisocial Personality Disorder (ASPD) Best managed with DBT (Linehan, 1993).
Core Characteristics: 3. Histrionic Personality Disorder
Disregard for and violation of the rights of others since age 15.
Core Characteristics:
Clinical Features: Excessive emotionality and attention-seeking behaviour.
Failure to conform to social norms; engaging in unlawful behaviours.
Deceitfulness (e.g., lying, conning others). Clinical Features:
Impulsivity or failure to plan ahead. Discomfort when not the center of attention.
Irritability and aggressiveness. Inappropriate sexually seductive or provocative behavior.
Reckless disregard for the safety of self or others. Rapidly shifting and shallow emotional expression.
Consistent irresponsibility in work or financial obligations. Uses physical appearance to draw attention.
Lack of remorse after mistreating others. Speech is impressionistic and lacks detail.
Theatrical, exaggerated expression of emotion.
Diagnostic Considerations: Easily influenced by others or circumstances.
Must be at least 18 years old. Considers relationships to be more intimate than they are.
Evidence of conduct disorder with onset before age 15.
Frequently co-occurs with substance use disorders. Diagnostic Considerations:
More prevalent in males; often associated with criminal behaviour May co-occur with other Cluster B disorders.
More frequently diagnosed in females, though gender bias in diagnosis is
2. Borderline Personality Disorder (BPD) debated.
Can be disruptive in professional or social environments (Millon, 2011).
Core Characteristics:
Instability in interpersonal relationships, self-image, and affects, along
4. Narcissistic Personality Disorder (NPD)
with marked impulsivity.
Core Characteristics:
Clinical Features: Grandiosity, need for admiration, and lack of empathy.
Frantic efforts to avoid real or imagined abandonment.
Pattern of intense and unstable interpersonal relationships. Clinical Features:
Identity disturbance; unstable self-image. Inflated sense of self-importance.
Impulsivity in at least two self-damaging areas (e.g., spending, sex, Preoccupation with fantasies of unlimited success or power.
substance abuse). Believes they are "special" and unique.
Recurrent suicidal behavior or self-mutilation. Requires excessive admiration.
Affective instability and mood reactivity. Sense of entitlement.
Chronic feelings of emptiness. Exploitative in interpersonal relationships.
Intense, inappropriate anger or difficulty controlling anger. Lacks empathy; unwilling to recognize others’ feelings.
Transient stress-related paranoid ideation or dissociation. Envious of others or believes others are envious of them.
Arrogant, haughty behaviors or attitudes.
Diagnostic Considerations: Difficulty making everyday decisions without reassurance.
May mask low self-esteem and vulnerability. Needs others to assume responsibility.
Often seen in high-achieving environments. Difficulty expressing disagreement.
Can create difficulties in therapeutic alliance due to defensiveness Difficulty initiating projects on their own.
(Ronningstam, 2005). Goes to great lengths to obtain nurturance and support.
Feels uncomfortable or helpless when alone.
Urgently seeks another relationship for support when one ends.
Unrealistic preoccupation with fears of being left to care for self.
Diagnostic Considerations:
CLUSTER C: Anxious or Fearful Disorders: This cluster is characterized by Can impair occupational and social functioning.
fearfulness and behavioral inhibition, often resembling anxiety-related symptoms. Frequently co-occurs with depressive and anxiety disorders.
Culturally influenced in societies emphasizing collectivism (Bornstein,
1992).
1. Avoidant Personality Disorder
3. Obsessive-Compulsive Personality Disorder (OCPD)
Core Characteristics:
Social inhibition, feelings of inadequacy, and hypersensitivity to negative Core Characteristics:
evaluation. Preoccupation with orderliness, perfectionism, and control.
Clinical Features: Clinical Features:
Avoids occupational or social activities due to fear of criticism or Preoccupied with rules, lists, order, and organization.
rejection. Perfectionism that interferes with task completion.
Unwilling to get involved with others unless certain of being liked. Excessive devotion to work and productivity.
Shows restraint in intimate relationships. Overconscientious, scrupulous, and inflexible about morals.
Preoccupied with being criticized or rejected in social settings. Hoards worn-out items.
Views self as socially inept, personally unappealing, or inferior. Reluctant to delegate tasks.
Reluctant to take personal risks or engage in new activities. Miserly spending style; money viewed as something to be hoarded.
Rigidity and stubbornness.
Diagnostic Considerations:
Significant overlap with social anxiety disorder. Diagnostic Considerations:
Unlike schizoid PD, the individual desires social contact but avoids it due Distinct from OCD—OCPD is ego-syntonic (behaviors align with self-
to anxiety (Alden & Taylor, 2004). concept).
Common in individuals in rigid professions or high-control environments.
2. Dependent Personality Disorder Can significantly interfere with flexibility and interpersonal functioning
(Cain et al., 2015).
Core Characteristics:
Excessive need to be taken care of, leading to submissive and clinging
behavior.
Clinical Features:
