What is a Personality Disorder? | The Three Clusters Explained


three clusters of personality disorders

What is a Personality Disorder? | The Three Clusters Explained

Thursday, July 9th, 2020

Everyone has a unique personality. Each person thinks, feels, and behaves differently. Personality is developed through experiences, environment, and inherited traits. We often speak of someone having a “great personality” as a reason to enjoy that person’s company. So, what is a personality disorder? When aspects of the personality become troublesome for the individual and those around them, they may be diagnosed with a disorder. The diagnoses are generally categorized into three clusters.

What is a Personality Disorder?

A personality typically develops early in life and stays relatively the same as one age. When someone has a personality disorder, their way of thinking or behaving deviates from their culture’s expectations. It causes distress to them and others and problems functioning in daily life.

Personality disorders are categorized into ten specific types within three clusters. The American Psychiatric Association (APA) states that personality disorders affect at least two of the following areas:

  • The way of thinking about oneself and others includes distorted self-perception and persistent negative thoughts about others. Individuals with personality disorders may see themselves in an unrealistically negative or grandiose light and have unfounded suspicions or misinterpretations about other people’s intentions.
  • Way of responding emotionally: Individuals may experience intense and unstable emotions disproportionate to the situation. These emotional responses can be erratic and unpredictable, making it difficult for individuals to regulate their feelings and reactions, often leading to emotional outbursts or prolonged periods of emotional distress.
  • Way of relating to others: They might have difficulty forming and maintaining healthy relationships, often resulting in conflicts. Individuals with personality disorders may struggle with empathy, exhibit inappropriate or extreme reactions in social situations, and have trouble understanding social norms, making it challenging to build and sustain meaningful connections with others.
  • Controlling one’s behavior can involve impulsive actions and poor decision-making that disrupt daily life. Individuals may engage in risky or harmful behaviors without considering the consequences, have difficulty adhering to societal rules and responsibilities, and struggle with maintaining consistency in their actions and plans.

Understanding these key areas can help recognize the presence of a personality disorder and its impact on an individual’s life. If you or someone you know exhibits these signs, seeking professional help for proper diagnosis and treatment is essential.

Cluster A: Odd or Eccentric Disorders

The first of the three clusters, Cluster A, is described as the odd or eccentric cluster of personalities. Social awkwardness and social withdrawal are standard features. Although people with Cluster A personality disorders may have a solid link to a relative who has been diagnosed with schizophrenia, these disorders are typically less extensive and impact daily functioning less than schizophrenia.

People with Cluster A personality disorders tend to have relationship issues because their behavior is seen as peculiar, suspicious, or detached. Three types of personality disorders are included in this cluster:

Paranoid Personality Disorder

Affecting between 1% and 2% of adults in the US, paranoid personality disorder is characterized by chronic and pervasive distrust of other people. Individuals with this disorder often suspect that others are deceiving or exploiting them, even without evidence. Symptoms include:

  • Suspicion of being deceived or exploited: Individuals may frequently believe that friends, family, or partners are untrustworthy and have hidden motives.
  • Angry outbursts in response to perceived deception: They may react with intense anger or hostility when they feel deceived or betrayed.
  • Cold, secretive, or jealous behavior: These individuals often exhibit guarded and secretive behavior and may be excessively jealous without reason.

Schizoid Personality Disorder

Characterized by social isolation and indifference toward other people, schizoid personality disorder affects more men than women. People with this relatively rare disorder are often described as cold or withdrawn. They rarely have close relationships with others and may be preoccupied with introspection and fantasy. Symptoms include:

  • Social isolation: Individuals prefer to be alone and avoid social interactions.
  • Indifference to praise or criticism: They often do not react to feedback from others and appear emotionally detached.
  • Limited emotional expression: These individuals may seem emotionally cold and unresponsive to social cues.

Schizotypal Personality Disorder

Symptoms of schizotypal personality disorder include odd speech, behavior, and appearance, as well as strange beliefs and difficulty forming relationships. People with this disorder may have unusual ways of thinking and perceiving the world. Symptoms include:

  • Odd speech and behavior: Individuals may speak eccentrically or vaguely and behave peculiarly.
  • Strange beliefs or magical thinking: They might hold unusual beliefs, such as thinking they can influence events with their thoughts.
  • Difficulty forming relationships: Forming close relationships can be challenging due to their eccentric behavior and social anxiety.

Understanding and Managing Cluster A Personality Disorders

Managing Cluster A personality disorders often involves psychotherapy aimed at improving social skills, communication, and understanding of their thoughts and behaviors. Cognitive-behavioral therapy (CBT) can be particularly effective in helping individuals challenge and change their distorted thinking patterns. Medication may also be prescribed to manage specific symptoms, such as anxiety or depression.

If you or someone you know exhibits symptoms of a Cluster A personality disorder, seeking professional help is crucial. Early intervention can improve the quality of life and help individuals develop healthier relationships and coping mechanisms.

Cluster B: Dramatic, Emotional, or Erratic Disorders

The second of the three clusters includes disorders described as dramatic, emotional, or erratic. Impulse control and emotional regulation are problems for people with disorders categorized in Cluster B. Healthy relationships are almost impossible for people in this cluster.

People with Cluster B personality disorders tend to experience exceptionally intense emotions or engage in highly impulsive, theatrical, promiscuous, or law-breaking behaviors. Four types of personality disorders are included in Cluster B:

Antisocial Personality Disorder

Antisocial personality disorder often manifests earlier than most other personality disorders, typically showing up in childhood or early adolescence. Symptoms include:

  • Disregard for rules and social norms: Individuals frequently violate laws and ignore societal regulations, engaging in behavior that can be grounds for arrest.
  • Lack of empathy: They have little regard for the feelings or rights of others and often exploit or manipulate people without remorse.
  • Impulsivity and aggression: These individuals are prone to impulsive decisions and aggressive actions, which can lead to frequent conflicts and legal problems.
  • Deceptiveness: Persistent lying or deceit to exploit others is a common trait.

Borderline Personality Disorder

Emotional instability, intense interpersonal relationships, and impulsive behaviors characterize borderline personality disorder (BPD). Symptoms include:

  • Emotional instability: Individuals experience rapid and intense mood swings, often without a clear trigger.
  • Intense and unstable relationships: Relationships are often marked by extremes of closeness and distance, with a tendency to idealize and then devalue others.
  • Impulsivity: Risky behaviors, such as substance abuse, binge eating, or reckless driving, are common.
  • Fear of abandonment: An intense fear of real or imagined abandonment can lead to frantic efforts to avoid being alone.

Histrionic Personality Disorder

People with histrionic personality disorder have a pervasive need to be the center of attention, which often leads to socially inappropriate behavior. Symptoms include:

  • Excessive attention-seeking: Individuals constantly seek approval and are uncomfortable when they are not the focus of attention.
  • Theatrical behavior: They may exhibit exaggerated emotions and gestures to draw attention to themselves.
  • Frequent mood swings: Their emotions can change rapidly, often appearing shallow or insincere.
  • Inappropriate seductiveness: Engaging in provocative or sexually inappropriate behavior to gain attention is expected.

Narcissistic Personality Disorder

Narcissistic personality disorder is associated with self-centeredness, an exaggerated self-image, and a lack of empathy for others. Symptoms include:

  • Grandiose sense of self-importance: Individuals have an inflated sense of their abilities and achievements.
  • Need for admiration: They require excessive admiration and often feel entitlement.
  • Lack of empathy: There is a profound inability to recognize or identify with the feelings and needs of others.
  • Exploitation of others: They may take advantage of people to achieve their ends, showing little regard for the impact on others.

Understanding and Managing Cluster B Personality Disorders

Managing Cluster B personality disorders often requires a multifaceted approach, including psychotherapy and, in some cases, medication. Dialectical behavior therapy (DBT) is particularly effective for borderline personality disorder, helping individuals develop healthier ways to manage emotions and relationships. Cognitive-behavioral therapy (CBT) can also be beneficial in addressing maladaptive thoughts and behaviors.

If you or someone you know exhibits symptoms of a Cluster B personality disorder, seeking professional help is crucial. Early intervention can improve outcomes and help individuals develop healthier coping mechanisms and relationships.

Cluster C: Anxious or Fearful Disorders

The third of the three clusters is the anxious or fearful cluster. This group features an overlap of symptoms common to anxiety and depressive disorders. People with Cluster C personality disorders often exhibit chronic fearfulness and behaviors aimed at avoiding perceived threats or criticism.

There are three personality disorders included in Cluster C:

Avoidant Personality Disorder

Chronic feelings of inadequacy, extreme sensitivity to criticism, and social inhibition characterize avoidant personality disorder. Despite a desire for close relationships, individuals with this disorder often avoid social interactions due to fear of rejection or ridicule. Symptoms include:

  • Social inhibition: Individuals avoid social situations and interactions due to fear of rejection.
  • Feelings of inadequacy: They often feel inferior and preoccupied with their perceived shortcomings.
  • Hypersensitivity to criticism: People are intensely sensitive to negative feedback, leading them to avoid situations where they might be judged or criticized.
  • Reluctance to take risks: They may avoid new activities or taking risks due to fear of embarrassment.

Dependent Personality Disorder

Dependent personality disorder involves a pervasive and excessive need to be taken care of, leading to submissive and clinging behaviors and fears of separation. Individuals with this disorder often struggle with decision-making and rely heavily on others for support and guidance. Symptoms include:

  • Difficulty making decisions: Individuals frequently seek advice and reassurance from others before making decisions.
  • Fear of being alone: They go to great lengths to avoid being alone, often remaining in unhealthy or abusive relationships.
  • Submissive behavior: There is a tendency to agree with others and comply with their wishes to avoid conflict or disapproval.
  • Urgent need for new relationships: When a close relationship ends, individuals with this disorder may urgently seek another source of support and care.

Obsessive-Compulsive Personality Disorder (OCPD)

A preoccupation with orderliness, perfectionism, and control characterizes obsessive-compulsive personality disorder. This is distinct from obsessive-compulsive disorder (OCD), which involves specific obsessions and compulsions. Individuals with OCPD often struggle with flexibility, openness, and efficiency. Symptoms include:

  • Preoccupation with order and details: Individuals may become excessively focused on rules, lists, and schedules, obscuring the main activity.
  • Perfectionism: They may set unrealistically high standards for themselves and others, leading to significant distress and impairment.
  • Control over relationships: People often need to control situations and relationships, which can lead to rigidity and stubbornness.
  • Inability to delegate tasks: Individuals may struggle to work with others because they believe their way is the only correct way.

Understanding and Managing Cluster C Personality Disorders

Managing Cluster C personality disorders often involves a combination of psychotherapy and, in some cases, medication. Cognitive-behavioral therapy (CBT) is particularly effective in helping individuals challenge and change their maladaptive thoughts and behaviors. Building self-esteem and developing healthier coping mechanisms are critical components of treatment.

If you or someone you know exhibits symptoms of a Cluster C personality disorder, seeking professional help is crucial. Early intervention can significantly improve the quality of life and help individuals develop healthier relationships and coping strategies.

Treatment Options for Personality Disorders

Effective treatment options for personality disorders within the three clusters primarily include psychotherapy. Psychotherapy allows individuals to gain insight and a better understanding of their disorders and symptoms. During therapy sessions, individuals can discuss their thoughts, feelings, and behaviors, which is crucial for treatment. Here are some critical aspects of psychotherapy and other treatment options:


Psychotherapy, often referred to as talk therapy, is a cornerstone in treating personality disorders. Various types of psychotherapy can be employed, depending on the specific needs of the individual:

  • Cognitive-behavioral therapy (CBT) helps individuals identify and change negative thought patterns and behaviors. This therapy focuses on developing coping strategies and problem-solving skills to manage symptoms effectively.
  • Dialectical Behavior Therapy (DBT): Particularly effective for borderline personality disorder, DBT combines CBT techniques with mindfulness strategies. It helps individuals regulate emotions, improve relationships, and reduce self-destructive behaviors.
  • Psychodynamic Therapy: This therapy aims to uncover unconscious patterns of thought and behavior that influence current issues. By exploring past experiences, individuals can gain insight into their present behavior and emotions.
  • Schema Therapy: This integrative approach combines CBT, psychodynamic therapy, and attachment theory elements. It targets deeply ingrained patterns or schemas that affect how individuals view themselves and the world.

Goals of Psychotherapy

The goals of psychotherapy for personality disorders include:

  • Gaining Insight: Individuals learn to understand the underlying causes of their disorder and recognize how their thoughts and behaviors affect their lives and relationships.
  • Improving Emotional Regulation: Therapy helps individuals develop healthier ways to manage intense emotions and reduce impulsive behaviors.
  • Enhancing Relationships: Individuals can build and maintain healthier relationships by improving communication skills and empathy.
  • Developing Coping Strategies: Therapy provides tools and techniques to cope with stress, anxiety, and other symptoms associated with personality disorders.


While psychotherapy is the primary treatment, medication may also be prescribed to manage specific symptoms or co-occurring conditions such as depression or anxiety. Types of medication that may be used include:

  • Antidepressants: These can help with symptoms of depression and anxiety, which often accompany personality disorders.
  • Mood Stabilizers: Used to manage mood swings and reduce impulsive behavior.
  • Antipsychotic Medications: These may be prescribed for severe symptoms, such as paranoia or delusions.
  • Anti-anxiety Medications: Help reduce anxiety and improve overall functioning.

Holistic and Complementary Therapies

In addition to traditional psychotherapy and medication, holistic and complementary therapies can support overall mental health and well-being. These may include:

  • Mindfulness and Meditation: Techniques that promote relaxation and present-moment awareness, helping individuals manage stress and emotional reactivity.
  • Art and Music Therapy: Creative therapies that provide alternative ways to express emotions and process experiences.
  • Exercise and Nutrition: Regular physical activity and a balanced diet can positively impact mental health and improve overall well-being.
  • Support Groups: Joining support groups allows individuals to connect with others with similar experiences, providing a sense of community and shared understanding.

Seeking Help

If you or someone you know is struggling with a personality disorder, it is essential to seek professional help. Early intervention and comprehensive treatment can significantly improve the quality of life and help individuals develop healthier ways of thinking, feeling, and behaving.

You Can Get Control of Your Life with R&A Therapeutic Partners

We offer personalized sessions in a comfortable, supportive environment that will help you understand and manage the symptoms you may be experiencing. Please contact us for help moving toward a healthy change in your life. We also help individuals and families with therapeutic placement when the challenges someone may be experiencing require a more intensive and structured treatment approach. Contact the Miami therapeutic consultants, Raymond Estefania and Ana Moreno, to learn more about ​​R&A Therapeutic Partners’ offers. Call us at 786-452-7352 to schedule your appointment.

At R&A Therapeutic Partners, Raymond Estefania and Ana Moreno specialize in substance use and mental health disorder evaluations, treatment, intervention, and therapeutic/educational consulting for clients throughout the greater South Florida area, nationally and internationally. For more resources and information, please visit Therapeutic-Partners.com or Facebook.

At R&A Therapeutic Partners Raymond Estefania and Ana Moreno specialize in substance use and mental health disorder evaluations, treatment, intervention and therapeutic/educational consulting for clients throughout the greater South Florida area, as well as nationally and internationally. For more resources and information please visit Therapeutic-Partners.com or on Facebook.

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