Personality disorders – Avoidant, dependent and OCPD

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Cluster C consists of three disorders namely avoidant, dependent and obsessive compulsive personality disorders (OCPD) where shyness and fear of rejection from others are common traits.

Personality disorders - Avoidant, dependent and OCPDAvoidant personality disorder

This disorder is characterised by feelings of social inadequacy, fear of rejection or disapproval and limited inter-personal relationships as a result.

Causes of avoidant personality disorder

A complex intermingling of social factors (how a person interacts with family and peers), psychological factors (a person’s temperament and ability to deal with stress) and genetic make-up lead to the avoidant disorder. It affects about one per cent of the population and has no gender bias.

Symptoms of avoidant personality disorder

  • Fear of being rejected by others
  • Shy, timid and introverted nature
  • Have limited friends as they avoid making friends due to fear of being criticized
  • Not opening up in close relationships due to low self-esteem
  • Has an inferiority complex and is awkward in social situations
  • Does not opt for a job which requires interaction with others

Diagnosis and treatment of avoidant personality disorder

Generally, people with this condition avoid getting help unless life stressors or events become too difficult to tackle. The symptoms described above help the psychologist or psychiatrist to diagnose this condition. The treatment revolves around psychotherapy (psychodynamic psychotherapy and cognitive behaviour therapy) as well as medication like anti-depressants. This disorder cannot be diagnosed before eighteen years of age like all personality disorders because until that time the personality is still forming. This disorder decreases in intensity as age advances.

Dependent personality disorder

This is one of the most common personality disorders. It begins in childhood and involves a person having excessive dependence on another person for his emotional and physical needs.

Causes of dependent personality disorder

The cause is unknown but a combination of factors, as mentioned in the Avoidant disorder is thought to be responsible.

Symptoms of dependent personality disorder

  • Wants others to take responsibility for his actions
  • Wants others to make important decisions regarding his life
  • Feels a need to jump into a new relationship when the previous one ends
  • Feels a need for reassurance and praise from others
  • Avoids confronting others or disagreeing due to fear of disapproval from others

Diagnosis and treatment of dependent personality disorder

The person rarely seeks treatment on their own. A trained mental health professional can make the diagnosis after finding out the patient’s history and current problems. Treatment involves psychotherapy or drugs or both.

Obsessive compulsive personality disorder

At the outset let me clarify that this is different from obsessive compulsive disorder or OCD. People having this disorder are perfectionists, sticklers for rules and hoarders; they cannot bear to throw broken or unnecessary things.

Causes of obsessive compulsive personality disorder

This problem tends to run in families and a person’s childhood environment also plays a role. Obsessive compulsive personality disorder usually manifests in early adulthood.

Symptoms of obsessive compulsive personality disorder

  • Following a set of rules and expecting others to follow them too
  • High standards of doing things, not letting anyone else do tasks
  • Inflexibility, lack of generosity
  • Workaholics, may not get things done on time because of perfectionism
  • Inability to throw away useless things

Diagnosis and treatment of obsessive compulsive personality disorder

The correct diagnosis can be arrived at after a thorough history. These patients have a better prognosis than other personality disorders. They may have relationship problems, anxiety or depression. Long-term psychotherapy is recommended along with medication for other problems if required.

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Written by Dr Nisreen Nakhoda, General Physician 

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