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Personality Disorders

DSM-5 The Ten Personality Disorders: Cluster C

Simone Hoermann, Ph.D., Corinne E. Zupanick, Psy.D. & Mark Dombeck, Ph.D.

Cluster C is called the anxious, fearful cluster.  It includes the Avoidant, Dependent, and Obsessive-Compulsive Personality Disorders.  These three personality disorders share a high level of anxiety.

man alone under treeThe Avoidant Personality Disorder* is characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and a hypersensitivity to negative evaluation. People with this disorder are intensely afraid that others will ridicule them, reject them, or criticize them. This leads them to avoid social situations and to avoid interactions with others. This further limits their ability to develop social skills. People with Avoidant Personality Disorders often have a very limited social world with a small circle of confidants. Their social life is otherwise rather limited..

Their way of thinking about and interpreting the world revolves around the thought that they are not good enough, and that others don't like them. They think of themselves as unappealing and socially inept. These types of thoughts create feelings of intense anxiety in social situations, along with a fear of being ridiculed, criticized, and rejected. The intensity of this fearful anxiety, and the discomfort it creates, compels them to avoid interpersonal situations. They might avoid parties or social events, and may have difficulty giving presentations at work or speaking up in meetings. Others might perceive them as distant or shy. They likely come across as stiff and restricted. All this will likely interfere with their ability to make friends, or to move ahead professionally.

The core feature of the Dependent Personality Disorder* is a strong need to be taken care of by other people. This need to be taken care of, and the associated fear of losing the support of others, often leads people with Dependent Personality Disorder to behave in a "clingy" manner; to submit to the desires of other people. In order to avoid conflict, they may have great difficulty standing up for themselves. The intense fear of losing a relationship makes them vulnerable to manipulation and abuse. They find it difficult to express disagreement or make independent decisions, and are challenged to begin a task when nobody is available to assist them. Being alone is extremely hard for them. When someone with Dependent Personality Disorder finds that a relationship they depend on has ended, they will immediately seek another source of support.

Persons with Obsessive-Compulsive Personality Disorder* are preoccupied with rules, regulations, and orderliness. This preoccupation with perfectionism and control is at the expense of flexibility, openness, and efficiency. They are great makers of lists and schedules, and are often devoted to work to such an extent that they often neglect social relationships. They have perfectionist tendencies, and are so driven in their work to "get it right" that they become unable to complete projects or specific tasks because they get lost in the details, and fail to see the "forest for the trees." Persons with Obsessive-Compulsive Personality Disorder tend to be rigid and inflexible in their approach to things. It simply isn't an option for them to do a "sub-standard" job just to get something done. Often, they are unable to delegate tasks for fear that another person will not "get it right." Sometimes people with this disorder adopt a miserly style with both themselves and others. Money is regarded as something that must be rigidly controlled in order to ward off future catastrophe. People with this disorder are often experienced as rigid, controlling, and stubborn.

* It is important to remember that everyone can exhibit some of these personality traits from time to time. To meet the diagnostic requirement of a personality disorder, these traits must be inflexible; i.e., they can be repeatedly observed without regard to time, place, or circumstance. Furthermore, these traits must cause functional impairment and/or subjective distress. Functional impairment means these traits interfere with a person's ability to functional well in society. The symptoms cause problems with interpersonal relationships; or at work, school, or home. Subjective distress means the person with a personality disorder may experience their symptoms as unwanted, harmful, painful, embarrassing, or otherwise cause them significant distress.Richer, more detailed descriptions of these disorders are found in the section describing the four core features of personality disorders