Abnormal Psychology

572 CHAPTER 13

feature (see Table 13.2). Cluster A personality disorders are characterized by odd or

eccentric behaviors that have elements related to those of schizophrenia. Cluster B

personality disorders are characterized by emotional, dramatic, or erratic behaviors

that involve problems with emotional regulation. Cluster C personality disorders

are characterized by anxious or fearful behaviors.

Table 13.3 provides an overview of facts about personality disorders in general.

In the subsequent discussions of the individual personality disorders, you may notice

that adding the prevalence rates for the various disorders gives a higher total than

the overall prevalence rate of 14% listed in Table 13.3. This mathematical discrep-

ancy is explained by the high comorbidity, also noted in the table: Half of people

who have a personality disorder will be diagnosed with at least one other personal-

ity disorder (and in some cases, with more than one other personality disorder).

Criticisms of the DSM-IV-TR Category of Personality Disorders

The category of personality disorders, as defi ned in DSM-IV-TR, has been criticized

on numerous grounds. One criticism is that DSM-IV-TR treats personality disorders

as categorically distinct from normal personality (Livesley, 2001; Saulsman & Page,

2004; Widiger & Costa, 2002; Widiger & Lowe, 2008; Widiger & Trull, 2007).

In contrast, most psychological researchers currently view normal personality and

personality disorders as being on continua. In DSM-IV-TR terms, two people might

differ only slightly in the degree to which they exhibit a personality trait, but one

person would be considered to have a personality disorder and the other person

would not. A related criticism is that the DSM-IV-TR criteria for personality dis-

orders create an arbitrary cutoff on the continuum between normal and abnormal

(Livesley, 2001; Widiger & Trull, 2007).

Another criticism pertains to the clusters, which were organized by superfi cial

commonalities. Research does not necessarily support the organization of person-

ality disorders into these clusters (Blais et al., 1997; Sheets & Craighead, 2007).

Moreover, the specifi c personality disorders are not clearly distinct from each other

Cluster A involves odd or

eccentric behaviors:

Paranoid personality disorder is characterized by mistrust and suspicion of others.

Schizoid personality disorder is characterized by few close relationships and a

limited range of emotional expression.

Schizotypal personality disorder is characterized by few close relationships and

eccentric perceptions, thoughts, and behaviors.

Cluster B involves

emotional, dramatic, or

erratic behaviors:

Antisocial personality disorder is characterized by repeated violation of or

disregard for the rights of others.

Borderline personality disorder is characterized by rapidly changing emotions,

unstable relationships, and impulsivity.

Histrionic personality disorder is characterized by exaggerated emotions and

excessive attention-seeking behaviors.

Narcissistic personality disorder is characterized by an excessive sense of self-

importance and diffi culty appreciating other people’s perspectives.

Cluster C involves anxious

and fearful behaviors:

Avoidant personality disorder is characterized by a heightened sensitivity to

rejection and social inhibition.

Dependent personality disorder is characterized by submissive, clingy behavior

intended to elicit care from others, along with dependence on others for decision

making and reassurance.

Obsessive-compulsive personality disorder is characterized by orderliness,

perfectionism, and control at the expense of spontaneity and fl exibility.

Source: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Text Revision, Fourth Edition,

(Copyright 2000) American Psychiatric Association.

Table 13.2 • DSM-IV-TR Personality Disorders, by Cluster

Cluster A personality disorders
Personality disorders characterized by odd
or eccentric behaviors that have elements
related to those of schizophrenia.

Cluster B personality disorders
Personality disorders characterized by
emotional, dramatic, or erratic behaviors that
involve problems with emotional regulation.

Cluster C personality disorders
Personality disorders characterized by
anxious or fearful behaviors.