Personality disorders are a diagnostic category of psychiatric disorders that affect approximately 10% of the population (Torgersen, 2005). Since everyone has a personality, but not everyone has a personality disorder, these disorders are considered a variant form of normal, healthy personality. This group of disorders is characterized by problematic thinking patterns; problems with emotional regulation; and difficulty achieving a balance between spontaneity and impulse control. However, the most significant and defining feature of personality disorders is the negative effect these disorders have on interpersonal relationships. People with personality disorders tend to respond to differing situations and demands with a characteristically rigid constellation of thoughts, feelings, and behavior. This inflexibility and difficulty forming nuanced responses, represents the primary difference between healthy and disordered personalities.
The diagnosis of personality disorders is often very complex as these disorders frequently co-occur with each other and with other psychiatric categories of disorders. The current diagnostic system of the DSM-5 (APA, 2013) relies upon a categorical approach. An alternative to the categorical diagnostic approach, called a dimensional approach, was presented and discussed. Both methods were compared and contrasted.
The exact cause of personality disorders remains uncertain. However, it is clear there are both biological and, psychosocial factors that influence the development of personality and personality disorders. Several psychological theories of personality disorders attempt to explain the psychosocial origins of personality disorders. The following psychological theories of personality disorders were reviewed: object relations theory, attachment theory (including mentalization), and cognitive-behavioral theory (including dialectical behavior theory and schema theory). In addition to these specific theories of personality disorder, the Structural Analysis of Social Behavior (SASB) that codes social interactions was discussed as it applies to understanding personality disorders. The contributions of neuroscience were discussed as well.
At one time personality disorders were thought to be untreatable. This is no longer the case. There are now several highly effective treatments for personality disorders that derive from the same psychological theories previously reviewed. These treatments include: transference focused therapy (TFP), mentalization based therapy (MBT), cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and schema therapy. Pharmacological interventions are considered an adjunct to treatment and were briefly reviewed as well.
In conclusion, recent technological advancements and improvements to diagnostic methodologies have enabled researchers to study personality and personality disorders as never before. As a result, we now have a much greater understanding of these disorders. Furthermore, this research has facilitated the development of several highly effective treatments for personality disorders that are evidenced-based. As research continues, these treatment approaches will be further refined. Therefore, we can state with confidence there is hope and relief for people affected by these disorders, including their family members and loved ones.