Dr Sacrifice Chirisa Mental Health Matters
A personality disorder (PD) is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving.

A person with a personality disorder has trouble perceiving and relating to situations and people.

This causes significant problems and limitations in relationships, social activities, work and school.

Individuals usually do not realise that you have a personality disorder because your way of thinking and behaving seems natural to them to the point of blaming others for the challenges they face.

Beginning in the teenage years or early adulthood, there are many types of personality disorders. Some types may become less obvious throughout middle age. Types of PDs are grouped into three main clusters, based on similar characteristics and symptoms. We will discuss cluster A and B this week.

Cluster A: Are characterised by odd, eccentric thinking or behaviour.

Paranoid PD

  • Pervasive distrust and suspicious of others and their motives
  • Unjustified belief that others are trying to harm or deceive you
  • Unjustified suspicion of the loyalty or trustworthiness of others
  • Hesitancy to confide in others due to unreasonable fear that others will use the information against you
  • Perception of innocent remarks or non-threatening situations as personal insults or attacks
  • Angry or hostile reaction to perceived slights or insults
  • Tendency to hold grudges
  • Unjustified, recurrent suspicion that spouse or sexual partner is unfaithful

Schizoid PD

  • Lack of interest in social or personal relationships, preferring to be alone.
  • Limited range of emotional expression
  • Inability to take pleasure in most activities
  • Inability to pick up normal social cues
  • Appearance of being cold or indifferent to others
  • Little or no interest in having sex with another person

Schizotypal PD

  • Peculiar dress, beliefs, speech or behaviour
  • Odd perceptual experiences, such as hearing a voice whisper your name
  • Flat emotions or inappropriate emotional responses
  • Social anxiety and a lack of or discomfort with close relationships
  • Indifferent, inappropriate or suspicious response to others
  • “Magical thinking” influencing people and events with your thoughts
  • Belief that casual incidents or events have hidden messages meant only for you

Cluster B personality disorders: are characterised by dramatic, overly emotional or unpredictable thinking or behaviour. They include:

Antisocial PD

  • Disregard for others needs or feelings
  • Persistent lying, stealing, using aliases, conning others
  • Recurring problems with the law
  • Repeated violation of the rights of others
  • Aggressive, often violent behaviour
  • Disregard for the safety of self or others
  • Impulsive behaviour
  • Consistently irresponsible
  • Lack of remorse for behaviour

Borderline PD

  • Impulsive and risky behaviour, like unsafe sex, gambling or binge eating
  • Unstable or fragile self-image
  • Unstable and intense relationships
  • Up and down moods, often as a reaction to interpersonal stress
  • Suicidal behaviour or threats of self-injury
  • Intense fear of being alone or abandoned
  • Ongoing feelings of emptiness
  • Frequent, intense displays of anger
  • Stress-related paranoia that comes and goes

Histrionic PD

  • Constantly seeking attention
  • Excessively emotional, dramatic or sexually provocative to gain attention
  • Speaks dramatically with strong opinions, but few facts
  • Easily influenced by others
  • Shallow, rapidly changing emotions
  • Excessive concern with physical appearance
  • Thinks relationships are closer than they really are

Narcissistic PD

  • Belief that you’re special and more important than others
  • Fantasies about power, success and attractiveness
  • Failure to recognize others’ needs and feelings
  • Exaggeration of achievements or talents
  • Expectation of constant praise and admiration
  • Arrogance
  • Often taking advantage of others
  • Envy of others or belief that others envy you

Next week we will discuss the remaining cluster of personality disorders and how these disorders can be managed. Characteristics of the above types of personality disorders may vary in individuals; low, medium and high, all should seek medical attention so that they do not further develop.

  • Dr S. M. Chirisa is a passionate mental health specialist who holds an undergraduate medical degree and postgraduate Master’s degree in psychiatry both from the University of Zimbabwe. He is currently working as a Senior Registrar in the Department of Psychiatry at Parirenyatwa Group of Hospitals and is also the current national treasurer of the Zimbabwe Medical Association (ZiMA). He can be reached at [email protected]

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