Cluster C
Personality Disorders: Cluster C disorders are a classification of personality disorders. People with personality disorders have traits that cause them to feel and behave in in socially distressing ways. The main feature of these disorders is anxiety and fearfulness. There are three major diagnoses that fall under the criteria of Cluster C Personality Disorders. These disorders are usually characterized by negative terms such as hostile, detached, needy, antisocial or obsessive. The three main diagnoses are as follows:

1. Avoidant Personality Disorder - People with this disorder usually display a low desire to be involved in social situations, have feelings of self described inadequacy, are extremely sensitive to negative evaluations by others, and may express unusual behaviors in social atmospheres. People with this disorder can't stop thinking about their own shortcomings, they only form relationships if they are sure they will not get rejected. Rejection and loss is so painful to them that they rather be lonely than risk having these feelings. They tend to avoid activites or jobs having to do with social contact, make potential diffuculties seem worse than they are and also hold the view that they are not good socially, physically unappealing or inferior to others.

Avoidant Personality Disorder affects .5%-1% of the American people. Normally starts during adolescence. Young children are usually afraid of strangers but this goes away with age; for someone with this disorder these feelings increase as they get older. People with AvPD can sometimes have Agoraphobia. Many people diagnosed with AvPD have had painful early experiences of chronic parental and/or societal criticism or rejection. The need to bond with the rejecting parents or peers makes the person with AvPD hungry for relationships, but their longing gradually develops into a defensive shell of self-protection against repeated criticisms. Treatment for this can be receiving social skills training or cognitive therapy. It is imperative that the victim trusts the therapists because they do not want to be rejected. Therapy helps these people challenge their negative beliefs about themselves. They are cautious when it comes to relationships and do not always associate with other people because they do not want to humiliate themselves. As much as they would like to feel wanted, they feel they are unable to enter relationships with others. Anti-depressants can also make people less sensitive to rejection.
However, without treatment this disorder can form secondary disorders inlcuding substance abuse or depression and allow one to lead a life of isolation.

Criteria for Diagnosis (four or more) can include:
1. Avoid occupations with social interaction, fearing criticism/rejection by peers
2. Only enters relationships when guaranteed to be liked
3. Restrains from entering into intimate relationships (fear of ridicule)
4. Spends more time thinking about being criticized or rejected by peers in interpersonal situations
5. Avoids new social situations (fear of inferiority)
6. Believes that they are socially inept and others constantly view them as unappealing
7. Reluctant to take personal risks or to try new activities because of potential embarrassment

Key Vocabulary
  • Catastrophizing- always thinking the worst case scenario.

Diagnosis: No physical tests can be preformed so in order to diagnose someone with this disorder pyschologists need to rule out other options such as schitzophrenia. They often use things such as questionnaires to figure out if they have avoidant personality disorder. The disorder is an expression of extreme traits of introversion, but cannot be linked to biological causes.
See youtube video below
2. Dependent Personality Disorder-
Dependent Personality disorder is the most prevalent of the personality disorders encountered at mental health clinics. Usually starts at early adulthood.
    • Avoid situations that require them to accept responcibiliy for themselves
    • Fixated in the past
    • Need constant reassurance from someone else
    • Need someone else to help them make decisions, both big and small
    • Submissive and clingy
    • Fear seperation/ Breakups
    • Retain unsophisticated ideas and childlike views of people
    • Like to have a strong caretaker
    • See themselves as inadequate and helpless
    • Believe the world is cold and dangerous and other people can help them with decisions
    • Define themselves as inept and don't have self-responcibility
    • Helpless
    • Lack initiative and abilities
    • No confidence or virtures
    • Like the feeling of being needed
    • Will stay in an unhealthy relationship just to have someone to help them
    • Usually begins in childhood- possibly caused by being humiliated during their developmental years
    • The exact cause of the disorder is unknown, it most likely involves both biological and developmental factors
    • Insecure attachment leading to poor relationships as children and adults
    • Some researchers believe that authoritarian or overprotective parenting styles can lead to this disorder
      • Can lead to this because children learn to always have someone around. Also these parents tend to tell their children what to do and how to do it so they learn to always have people telling them instructions.
Key Vocabulary
Engulfment- The level or attention and dependency on another person.
Millon's subtypes:
      • Psychologist Theodore Million identified 5 subtypes for adult DPD:
        • Disquieted dependant: including avoidant features
        • Accommodating dependant: including histrionic features
        • Immature dependant: variant of pure pattern
        • Ineffectual dependant: including schizoid features
        • Selfless dependant: including masochistic features
Coexistant disorders with DPD:
      • mood disorders
      • anxiety disorders
      • adjustment disorders
      • borderline personality disorder
      • avoidant personality disorder
      • histrionic personality disorder
      • treatment is likely to be sought by individuals suffering from this disorder when stress or other complications withing their life have led to decreased efficiency in life functioning.
      • the most effective psychotherapeutic approach is one which focuses on solutions to specific life problems the patient is presently experiencing
      • the goal of therapy is to help the person become more active and independent, and to learn to form healthy relationships.
      • short-term therapy with specific goals is preferred
      • medication can also be helpful, but mostly just treating underlying problems.
        • example: anxiety problems that can be adding the disorder
Case Study:
Mrs. T is a 53 year old woman with three children in their 20s. After 30 years of marriage her husband left her for another younger woman. Since then she has been unable to do tasks on her own. She has fears everyday and is incapable of making decisions on petty things like whether or not to stay in her house. She is consistently nagging her children for advice and support. Her friends who used to support her are now getting annoyed with her and are not keeping contact with her.
Her friends couldn’t figure out why she was so devastated by her husband leaving her. Her husband was the one making the important decisions that she just went along with. Her husband would make decisions such as where to go on vacation all the way down to what she was to wear on a given day. Mrs. T’s dad died when she was three in WWII, and her mother was a strong woman but treated her like a fragile doll. She made all of her decisions, and Mrs. T even lived at home for the first 3 years of college.
Case Study:
Mona is 32 years old with dependent personality disorder, she talks about her relationship with her partner, even though he is unstable financially, undecided on many aspects of life, has cheated on her and is all around not a good person she feels as if she cannot live without him. Although all of these aspects have been pointed out to her she can't face losing the relationship she has with him. Even though the relationship is one that is unhealthy for her.
Source for all infomation:
3. Obsessive-Compulsive Personality Disorder-
      • childhood upbringing- a child growing up being able to express their independent thoughts and emotions are less likely to develop a "perfectionist" personality
      • genetics- OCDP often occurs in families and men are more affected by OCDP than women
      • culture and society- people will more likely develop OCDP when they are in a culture which promotes rigorous work schedules and has people that are highly devoted to work

Magda is distressed when I reschedule our appointment. When asked about her job and computers this was her response, I just told you, I had to do everything by myself. She hates computers, they are so unreliable and user-hostile. When "these mindless monsters" were first introduced into the workplace, the chaos was incredible: furniture had to be moved, wires laid, desks cleared. She hates such disruptions. "Routine guarantees productivity." Shows how she can’t depend on other things and hates losing control. Hates when things are out of order and hates disruption of order.
  • Abnormal obsession with rules, lists, and orders
  • Not very generous
  • Perfectionist
  • Pack-rat
  • Inflexible to morality
  • Not going to let others to their jobs
  • Runs in families
  • Parenting Styles,Children punished for various bad things and never praised,Is trying to avoid punishment so they set up strict rules in themselves
There are several different well known types of OCPD:
1) conscientious compulsive - has asymptoms above plus dependent features.
2) puritanical compulsive - has paranoid features. The compulsive experiences an extreme conflict between obedience and defiance at one level or another. These individuals often seek the armour of "God's righteousness" to purify, transform and contain them. They are hostile and often vent hositlity by trying to find common enemies or scapegoats. Puritanicals naturally gravitate towards radical fundamentalism. Over the course of history, and even in current politics, they have been an influential force in stirring nationalistic fervor (e.g. Adolf Hitler). They can be found in any institution.
3) bureaucratic compulsive - has the above symptoms but can be narccissist (obssessed with their own image).
4) parsimonious compulsive - has schizoid features. Like Fromm's hoarding orientation, several voices inside theri head, and even irrational phobias and paranoias.
5) bedeviled compulsive - including negativistic (passive-aggressive) features, and is pessimistic.