Skip to main content

Personality Disorders

  • Chapter
  • First Online:
Atlas of Psychiatry

Abstract

This chapter discusses personality disorders (PDs) as these disorders are frequently encountered in clinical settings and have impacts on morbidity and mortality and significant treatment implications. In this chapter, we discuss the history of personality diagnoses and the importance of personality diagnoses, recognizing patients with personality disorders, and review the most common and most researched disorders including: antisocial, avoidant, borderline, narcissistic, obsessive compulsive, and schizotypal personality disorders. This chapter concludes with a discussion of the psychopharmacological and psychotherapeutic management of these disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Crocq MA. Milestones in the history of personality disorders. Dialogues Clin Neurosci. 2013;15:147–53.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Paris J. Controversies in the classification and diagnosis of personality disorders. In: Lejuez CW, Gratz KL, editors. The Cambridge handbook of personality disorders. Cambridge University Press; 2020.

    Google Scholar 

  3. Trull TJ, Widiger TA. Dimensional models of personality: the five-factor model and the DSM-5. Dialogues Clin Neurosci. 2013;15:135–46.

    Article  PubMed  PubMed Central  Google Scholar 

  4. American Psychiatric Association, editor. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.

    Google Scholar 

  5. World Health Organization. International classification of diseases for mortality and morbidity statistics (11th Revision); 2018.

    Google Scholar 

  6. Sharp C, Wright AGC, Fowler JC, et al. The structure of personality pathology: both general (‘g’) and specific (‘s’) factors? J Abnorm Psychol. 2015;124:387–98.

    Article  PubMed  Google Scholar 

  7. Caspi A, Moffitt T. All for one and one for all: mental disorders in one dimension. Am J Psychiatry. 2018;175:831–44.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Links PS, Boursiquot P, Links M. Assessing and managing suicide risk. In: Skodol OJ, editor. Textbook of personality disorders. 3rd ed. American Psychiatric Association; in press.

    Google Scholar 

  9. Links PS, Eynan R, Shah R. Comorbidity of personality disorders with clinical disorders: current status and future directions. In: Widiger T, editor. Handbook of personality. Oxford Press; in press.

    Google Scholar 

  10. Zanarini MC, Frankenburg FR, Reich DB, Fitzmaurice G. Time to attainment of recovery from borderline personality disorder and stability of recovery: a 10-year prospective follow-up study. Am J Psychiatry. 2010;167:663–7.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Skodol AE. Impact of personality pathology on psychosocial functioning. Curr Opin Psychol. 2018;21:33–8.

    Article  PubMed  Google Scholar 

  12. Glenn AL, Johnson AK, Raine A. Antisocial personality disorder: a current review. Curr Psychiatry Rep. 2013;15:1–8.

    Article  Google Scholar 

  13. Weinbrecht A, Schulze L, Boettcher J, Renneberg B. Avoidant personality disorder: a current review. Curr Psych Rep. 2016;18:29.

    Article  Google Scholar 

  14. Lampe L, Malhi G. Avoidant personality disorder: current insights. Psychol Res Behav Manag. 2018;11:55–66.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Bateman A, Fonagy P. Mentalization-based treatment for personality disorders: a practical guide. Oxford: Oxford University Press; 2016.

    Book  Google Scholar 

  16. Lieb K, Zanarini MC, Schmahl C, et al. Borderline personality disorder. Lancet. 2004;364:453–61.

    Article  PubMed  Google Scholar 

  17. Paris J. Half in love with easeful death: the meaning of chronic suicidality in borderline personality disorder. Harv Rev Psychiatry. 2004;12:42–8.

    Article  PubMed  Google Scholar 

  18. Bender D, Dolan R, Skodol A, et al. Treatment utilization by patients with personality disorders. Am J Psychiatry. 2001;158:295–302.

    Article  CAS  PubMed  Google Scholar 

  19. Paris J, Zweig-Frank H. A 27-year follow-up of patients with borderline personality disorder. Compr Psychiatry. 2001;42:482–7.

    Article  CAS  PubMed  Google Scholar 

  20. Zanarini MC, Frankenburg FR, Hennen J, et al. Prediction of the 10-year course of borderline personality disorder. Am J Psychiatry. 2006;163(5):827–32.

    Article  PubMed  Google Scholar 

  21. Temes CM, Frankenburg FR, Fitzmaurice GM, Zanarini MC. Deaths by suicide and other causes among patients with borderline personality disorder and personality-disordered comparison subjects over 24 years of prospective follow-up. J Clin Psychiatry. 2019;80(1):30–6.

    Article  Google Scholar 

  22. Perry JC, Fowler JC, Bailey A, et al. Improvement and recovery from suicidal and self-destructive phenomena in treatment-refractory disorders. J Nerv Ment Dis. 2009;197(1):28–34. https://doi.org/10.1097/NMD.0b013e3181927598.

    Article  PubMed  Google Scholar 

  23. Links PS, Kolla NJ, Guimond T, McMain S. Prospective risk factors for suicide attempts in a treated sample of patients with borderline personality disorder. Can J Psychiatr. 2013;58(2):99–106.

    Article  Google Scholar 

  24. Geissbuhler M, Links P. Prospective risk factors for suicide attempts in borderline personality disorder. Curr Psychiatry Rep. 2009;11(1):53–4.

    PubMed  Google Scholar 

  25. Ronningstam E. Narcissistic personality disorder: facing DSM-V. Psychiatr Ann. 2009;39:111–21.

    Article  Google Scholar 

  26. Pincus AL, Lukowitsky MR. Pathological narcissism and narcissistic personality disorder. Annu Rev Clin Psychol. 2010;6:421–46.

    Article  PubMed  Google Scholar 

  27. Gabbard GO. Transference and countertransference: developments in the treatment of narcissistic personality disorder. Psychiatr Ann. 2009;39:129–36.

    Article  Google Scholar 

  28. Ogrodniczuk JS, Kealy D. Interpersonal problems of narcissistic patients. In: Ogrodniczuk JS, editor. Understanding and treating pathological narcissism. Washington, DC: American Psychological Association; 2013. p. 113–28.

    Chapter  Google Scholar 

  29. Ronningstam E. Narcissistic Personality disorder in DSM V- in support of retaining a significant diagnosis. J Personal Disord. 2011;25:248–59.

    Article  Google Scholar 

  30. Links PS. Pathological narcissism and the risk of suicide. In: Ogrodniczuk JS, editor. Understanding and treating pathological narcissism. Washington, DC: American Psychological Association; 2013. p. 167–82.

    Chapter  Google Scholar 

  31. Miller JD, Widiger TA, Campbell WK. Narcissistic personality disorder and the DSM-V. J Abnorm Psychol. 2010;119:640–9.

    Article  PubMed  Google Scholar 

  32. Miller JD, Campbell WK, Pilkonis PA. Narcissistic personality disorder: relations with distress and functional impairment. Compr Psychiatry. 2007;48:170–7.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Dhawan N, Kunik ME, Oldham J, Coverdale J. Prevalence and treatment of narcissistic personality disorder in the community: a systematic review. Compr Psychiatry. 2010;51:333–9.

    Article  PubMed  Google Scholar 

  34. Yakeley J. Current understanding of narcissism and narcissistic personality disorder. Br J Psychiatry Advances. 2018;24:305–15. https://doi.org/10.1192/bja.2018.20.

    Article  Google Scholar 

  35. Ronningstam EF, Maltsberger JT. Pathological narcissism and sudden suicide-related collapse. Suicide Life Threat Behav. 1998;28:261–71.

    CAS  PubMed  Google Scholar 

  36. Shapiro D. Neurotic styles. New York: Basic Books; 1999.

    Google Scholar 

  37. Diedrich A, Voderholzer U. Obsessive-compulsive personality disorder: a current review. Curr Psych Rep. 2015;17:2.

    Article  Google Scholar 

  38. McWilliams N. Psychoanalytic diagnosis. New York: The Guilford Press; 2011.

    Google Scholar 

  39. Kirchner SK, Roeh A, Nolden J, Hasan A. Diagnosis and treatment of schizotypal personality disorder: evidence from a systematic review. NPJ Schizophr. 2018;4:1–18.

    Article  CAS  Google Scholar 

  40. Raine A. Schizotypal personality: neurodevelopmental and psychosocial trajectories. Annu Rev Clin Psychol. 2006;2:291–326.

    Article  PubMed  Google Scholar 

  41. Debbané M, Eliez S, Badoud D, et al. Developing psychosis and its risk states through the lens of schizotypy. Schizophr Bull. 2015;41:S396–407.

    Article  PubMed  Google Scholar 

  42. National Institute for Health and Clinical Excellence. Borderline personality disorder: recognition and management. 2015. https://www.nice.org.uk/guidance/cg78/resources/borderline-personality-disorder-recognition-and-management-pdf-975635141317.

  43. American Psychiatric Association. Practice guideline for the treatment of patients with borderline personality disorder. Am J Psychiatry. 2001;158:1–52.

    Google Scholar 

  44. Gunderson JG, Links PS. Handbook of good psychiatric management for borderline personality disorder. Washington, DC: American Psychiatric Publishing; 2014.

    Google Scholar 

  45. Choi-Kain LW, Finch EF, Masland SR, Jenkins JA, Unruh BT. What works in the treatment of borderline personality disorder. Curr Behav Neurosci Rep. 2017;4:21–30.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Schiavone FL, Links P. Common elements for the psychotherapeutic management of patients with self-injurious behaviour. Child Abuse Negl. 2013;37:233–8.

    Article  Google Scholar 

  47. Gunderson JG, Herpertz SC, Skodol AE, et al. Borderline personality disorder. Nat Rev Dis Primers. 2018;4:18029. https://doi.org/10.1038/nrdp.2018.29.

    Article  PubMed  Google Scholar 

  48. Starcevic V, Brakoulias V. New diagnostic perspectives on obsessive-compulsive personality disorder and its links with other conditions. Curr Opin Psych. 2014;27:62–7.

    Article  Google Scholar 

  49. Yang X, Hu L, Zeng J, et al. Default mode network and frontolimbic gray matter abnormalities in patients with borderline personality disorder: a voxel-based meta-analysis. Sci Rep. 2016;6:34247. https://doi.org/10.1038/srep34247.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Paul S. Links .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Links, P.S., Ross, J., Boursiquot, PE. (2023). Personality Disorders. In: IsHak, W.W. (eds) Atlas of Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-031-15401-0_24

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-15401-0_24

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-15400-3

  • Online ISBN: 978-3-031-15401-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics