Cluster Personality Disorders: Dr. Subhendu Sekhar Dhar
Cluster Personality Disorders: Dr. Subhendu Sekhar Dhar
Cluster Personality Disorders: Dr. Subhendu Sekhar Dhar
DISORDERS
• INTRODUCTION
• DEFINITION OF PERSONALITY DISORDER
• CLUSTERS
• AVOIDANT PERSONALITY DISORDER
• DEPENDENT PERSONALITY DISORDER
• OBSESSIVE-COMPULSIVE PERSONALITY DISORDER
• SUMMARY
• REFERENCES
INTRODUCTION
PERSONALITY
• The understanding of personality and its disorders is what distinguishes
psychiatry fundamentally from all other branches of medicine.
• A person is a self-aware human being, not a machine-like object that lacks self-
awareness.
• Personality refers to all the ways in which someone shapes and adapts in a
unique way to ever-changing internal and external environments.
DEFINITION OF PERSONALITY DISORDER
• The patient with avoidant personality is essentially a shy, inhibited person who
has feelings of inadequacy and low self-esteem.
• These patients are hypersensitive to perceived
criticism, but have the capacity to develop
appropriate relationships if they feel safe and
accepted.
• They may lead socially withdrawn lives.
• These people are commonly described as
having an inferiority complex.
EPIDEMIOLOGY
2. Unwilling to deal with people unless sure of being 6. Views themselves as socially inept, personally
liked. unappealing, or inferior to others.
3. Restraint within intimate relationships due to fear of 7. Unusually reluctant to take risks or to engage in new
being shamed or ridiculed. activities because they may prove embarrassing.
Social Phobia Very difficult to distinguish. In Social Phobia, specific situations rather
than interpersonal contact are avoided.
Panic Disorder with Manifests avoidance usually after the onset of panic attacks.
Agoraphobia
Schizotypal and Social isolation of avoidant personalities is accompanied by the desire for
Schizoid PD social relations, which is not observed in Schizoid and Schizotypal PD
Dependent PD Is focused on being taken care of rather than on the fear of negative
evaluation
COURSE & PROGNOSIS
• A pervasive and excessive need to be taken care of that leads to submissive and clinging
behavior and fears of separation, beginning by early adulthood and present in a variety of
contexts, as indicated by 5 or more of the following:
1. has difficulty making everyday decisions without an 5. goes to excessive lengths to obtain nurturance and
excessive amount of advice and reassurance from support from others, to the point of volunteering to do
others things that are unpleasant
2. needs others to assume responsibility for most major 6. feels uncomfortable or helpless when alone because
areas of his or her life of exaggerated fears of being unable to care for himself
or herself
3. has difficulty expressing disagreement with others 7. urgently seeks another relationship as a source of care
because of fear of loss of support or approval. and support when a close relationship ends
Note: Do not include realistic fears of retribution.
4. has difficulty initiating projects or doing things on his 8. is unrealistically preoccupied with fears of being left
or her own to take care of himself or herself
DIAGNOSTIC CRITERIA (ICD-10)
• Dependent PD characterized by at least 3 of the following:
a. encouraging or allowing others to make most of one’s important life decisions;
b. subordination of one’s own needs to those of others on whom one is dependent,
and undue compliance with their wishes;
c. unwillingness to make even reasonable demands on the people one depends on;
d. feeling uncomfortable or helpless when alone, because of exaggerated fears of
inability to care for oneself;
e. preoccupation with fears of being abandoned by a person with whom one has a
close relationship, and of being left to care for oneself;
f. limited capacity to make everyday decisions without an excessive amount of
advice and reassurance from others.
• Associated features may include perceiving oneself as helpless, incompetent,
and lacking stamina.
DEPENDENT PERSONALITY DISORDER