Introduction
A personality disorder is a mental illness that comprises thinking patterns and behaviors that make it difficult for individuals to adapt to their social environment. As a result, these individuals tend to struggle with interpersonal relationships and self-identity. Personality disorders represent enduring behavior patterns with inflexible responses to various personal and social circumstances. They indicate extreme or substantial deviations from how a typical person perceives, thinks, feels, and connects with others. It affects about 10 % of the general population; the prevalence is much higher in clinical settings and among psychiatric outpatients.
How Are Personality Disorders Classified?
Though the classification of personality disorders has been a subject of debate, according to the Statistical and Diagnostic Manual of Mental Disorders, Fifth Edition (DSM-5), the ten personality disorders are categorized into three clusters based on similarities in symptoms and diagnosis:
Cluster A: Known as the odd-eccentric cluster. Schizoid, schizotypal, and paranoid personality disorders fall under this category.
Cluster B: The four disorders under this cluster are antisocial, narcissistic, borderline, and histrionic personality disorders. This is called the intense emotional or dramatic cluster.
Cluster C: The anxious or fearful cluster-avoidant, dependent, and obsessive-compulsive personality disorders.
An individual does not need to express all the traits of a certain personality disorder; most of the time, features overlap considerably.
What Are Cluster C Personality Disorders?
The central features of Cluster C personality disorders are fear, anxiety, and doubt. These impede day-to-day life on professional and personal fronts. In addition, the affected individuals may often be ridden with self-doubt and suffer from low self-esteem. Combined, these can cause constant emotional distress and affect the quality of life. Individuals with cluster C personality disorder long to belong, unlike those with cluster A disorders, who do not prefer to be around others. Cluster C disorders are more frequently reported.
What Is the Cause of Personality Disorders?
Several experts have put forth theories to explain the development of personality disorders. It is a multifactorial phenomenon and has no single cause. A complex interaction between genetics, neurobiology, and the environment is at play. Early relationships, experiences, stressors, and traumatic events mold personality development during childhood. Personality disorders begin early in life and remain consistent through various stages.
What Are the Features and Diagnostic Criteria of Cluster C Personality Disorders?
1. Avoidant Personality Disorder
Individuals with this disorder perceive the world to be hostile. It may stem from childhood adversities such as parental neglect or emotional abuse. These individuals feel unworthy and avoid social interactions for fear of rejection. Diagnosis is made if an individual exhibits more than four of the following:
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Avoids occupations involving interpersonal contact due to fear of disapproval.
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Do not mingle with people unless they know they are liked.
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Restrained intimate relationships due to fear of being shamed or ridiculed.
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Deeply concerned about negative criticism.
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Due to feelings of inadequacy, exhibit inhibitions in new relationships.
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Feels inferior to others, deems themselves uninteresting, and socially incapable.
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Does not take up new activities easily.
An avoidant personality disorder is present in about 5.2 % of the general population and is common in individuals with social phobia. These individuals are evasive and usually do not provide straightforward answers to questions. To win the trust of individuals with this disorder, one must present oneself as non-judgmental and validate their concerns.
2. Dependent Personality Disorder
The need for constant care and reassurance of selected people close to the individual characterizes it. These individuals exhibit submissiveness and try to please others; they also show fear of separation and are clingy. This is the least prevalent personality disorder in Cluster C. Diagnostic criteria according to DSM are as follows:
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Indecisive and seeks advice and reassurance from others.
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Hands over major responsibilities in one's own life to others.
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Does not express disagreement due to fear of losing people's favor.
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Do not trust their judgment and will not start any independent venture.
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Does things against their wishes to win people's support and approval.
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Uncomfortable with being alone, scared of having to handle themselves.
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Dives into a relationship if another just ended.
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Scared of having to fend for themselves.
Exhibiting five or more of these traits results in a diagnosis of dependent personality disorder.
3. Obsessive-Compulsive Personality Disorder
An obsessive-compulsive personality disorder is associated with an obsession with perfection and orderliness. Individuals showing this disorder have very rigid thinking and lack flexibility which causes friction in personal and professional spaces. It develops in early adulthood. The following are the criteria for diagnosis:
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Very particular about rules, lists, order, schedules, etc.
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Has strict standards for perfectionism, which causes a delay in task completion.
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Tend to be workaholics, focused on productivity to the extent of neglecting friends and leisure activities.
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Not flexible in issues concerning morals or ethics.
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Tend to be hoarders. They do not discard useless articles even when no sentimental value is attached to them.
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Prefers work to be done their way and cannot tolerate deviation from their work style. For this reason, they are reluctant to work with others or delegate tasks.
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They are careful in spending money; they use the bare minimum and save for the future.
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They are stubborn and will not budge.
Four or more of the listed criteria are required for a diagnosis.
Is Obsessive-Compulsive Personality Disorder the Same as Obsessive-Compulsive Disorder?
The answer is no. Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by repeated irrational and compulsive thoughts and acting on those compulsive thoughts to lessen mental distress. Much time is spent on OCD rituals; it has an earlier onset, a higher frequency of obsessions, and impairs life to a greater extent. Affected individuals understand that their behavior is unreasonable and causes difficulties for others. It is a much more serious condition. Obsessive-compulsive personality disorder, on the other hand, involves the urge to control aspects of daily life. These individuals are oblivious to their behavior and its impact on others. It is limited to the management and control of situations.
What Is the Treatment?
Individuals with personality disorders require compassionate therapy and support from loved ones. It is important to understand that these disorders are neurobiological. Treatment depends on specific symptoms, severity, and impact on quality of life. A combination of psychotherapy and pharmacological treatment is used. The use of drugs for personality disorders is debatable but still widely practiced. Psychotherapy involves sessions with professionals where affected individuals talk about their feelings, moods, and behaviors and will be guided to take control of the disorder. Sessions may be individual or group sessions with others experiencing similar difficulties. Medications used include mood stabilizers, antidepressants, antipsychotics, and anxiety medicines. Cognitive behavior therapy (CBT) may be beneficial. This involves identifying and eliminating unfavorable behaviors and consciously incorporating new, favorable behaviors.
Conclusion
Cluster C personality disorders are typically characterized by fear and anxiety. It consists of three disorders, avoidant, dependent, and obsessive-compulsive personality disorders. Coping with these disorders requires support and patience from the people around. Psychotherapy helps one understand oneself and modify behaviors.
