Personality disorders are a class of mental health conditions that involve long-term thought patterns and behaviors that can be harmful and difficult to overcome. Personality disorders can be categorized into three distinct clusters: Cluster A, Cluster B, and Cluster C [1].
This article will focus on Cluster C personality disorders, which are characterized by anxious and fearful behavior. Read on to learn how they differ from other personality disorders, their causes, how they are diagnosed and your treatment options.
What are Cluster C personality disorders?
People with cluster C personality disorders typically experience anxious and fearful thoughts and behaviors. They are usually shy, withdrawn and struggle with a low sense of self esteem. They tend to be overly cautious and hesitant, and they avoid situations that may cause them discomfort or embarrassment [1][2]. Disorders in this cluster include:
- Avoidant Personality Disorder (APD): Individuals with APD have an irrational fear of rejection and criticism, leading them to avoid social situations and relationships. They tend to be hypersensitive to criticism and have low self-esteem, which can lead to feelings of inadequacy and inferiority. [3]
- Dependent Personality Disorder (DPD): DPD causes people to over-rely on others to meet their needs. They struggle with decision-making and constantly seek the input of others to validate their thought processes and actions. Due to this inability to trust themselves, they are more prone to forming and staying in damaging, toxic relationships.[4]
- Obsessive-Compulsive Personality Disorder (OCPD): Individuals with OCPD are preoccupied with orderliness, perfectionism, and control. They tend to be inflexible and rigid in their thinking and have difficulty adapting to change. They present similar symptoms to people with obsessive-compulsive disorder (OCD), however they do not experience unwanted, distressing thoughts. Common traits of OCPD include an extreme preoccupation with rules, neglecting all other aspects of life in favor of work and an overall inability to collaborate with others. [5]
How are Cluster C personality disorders different from other types of personality disorders
Cluster C personality disorders vary from other personality disorders, with sufferers typically behaving anxiously and fearfully.
Cluster B personality disorders on the other hand are marked by dramatic, emotional and erratic behavior, while people with Cluster A personality disorders behave oddly and erratically.
All three clusters of personality disorders share commonalities, chief among them are sufferers’ struggles to socially interact with others and maintain relationships. [1]
What causes cluster C personality disorders?
Personality is comprised of a person’s thoughts, behaviors and emotional regulation. Personality disorders typically emerge in late adolescence or early adulthood and are characterized by enduring patterns of behavior, cognition, and an overall emotional state that deviates from cultural expectations.
The exact causes are complex and may involve a combination of genetic, environmental, and developmental factors [6]:
- Genetics: Personality disorders may have a genetic component, as they tend to run in families, although further research on the relationship is required to establish the exact link.
- Environmental factors: Trauma, neglect, or abuse during childhood could increase the risk of developing a personality disorder, with research pointing to links between childhood trauma and APD [7].
- Temperament: Certain temperaments or personality traits, such as shyness or anxiousness, may increase the risk of developing these personality disorders.
- Brain structure: Studies show differences in brain structure in some people with personality disorders, with one showing a reduction in grey matter in the medial temporal cortex of women with BPD, for example [8].
How are cluster C personality disorders diagnosed?
Cluster C personality disorders are diagnosed by mental health professionals following a comprehensive evaluation. If you think you have symptoms of a personality disorder, make an appointment with your healthcare provider and they can refer you to an appropriate specialist [1].
They will assess your symptoms, review your medical history and may administer standardized tests – such as the Minnesota Multiphasic Personality Inventory (MMPI), to assist with the diagnosis [9].
Your symptoms will be assessed against the DSM-V’s diagnostic criteria for Cluster C personality disorders and the doctor will rule out any other potential conditions that could be responsible. Once satisfied, they will provide you with a diagnosis and lay out your treatment options.
How are cluster C personality disorders treated?
Treating personality disorders can be challenging, but immensely rewarding for patients who show dedication and grit.
The treatment option will depend on the severity of your symptoms and whether you have any comorbid conditions, but typically involve a combination of therapy, medication and self-help strategies. These are outlined below:
Therapy
Therapy can help provide you with the skills to handle social situations more comfortably and regulate your emotions. They are typically the frontline treatment approach for personality disorders. [1]
Cognitive behavioral therapy (CBT) can be effective in treating Cluster C personality disorders. CBT helps patients to identify the negative thoughts and behaviors associated with their personality disorder and change them to effect more positive outcomes.
Group therapy can also be beneficial to people with personality disorders, as it provides individuals with the opportunity to practice social skills in safe and supportive surroundings [10].
Medication
While no medication has been officially approved for the treatment of personality disorders, certain medications can be used to treat certain symptoms of Cluster C personality disorders. For example, antidepressants could be prescribed to treat symptoms of depression or anxiety that occur alongside a Cluster C personality disorder [1][10].
Self-Help
Self-help strategies are a crucial component of a person’s treatment plan for their Cluster C personality disorder. While therapy, supplemented by medication in some cases, is the optimum treatment approach – lifestyle management can optimize your ability to manage your symptoms. These include: [10]
- Regular exercise: Staying physically active is beneficial when managing personality disorders. Find something active you particularly enjoy and implement it into your everyday routine. This could be the gym, swimming or even a recreational activity like dancing.
- Meditation and mindfulness: Managing stress with techniques like meditation, mindfulness and yoga can help provide you with mental clarity and emotional stability.
- Support system: Having a strong support network, whether it be family, friends or even an external support group can feel empowering. You can learn about your condition alongside them, and cohesively form a management plan which best suits everyone’s needs and generates a real community feel.
- Overview of Personality Disorders – Psychiatric Disorders. (n.d.). MSD Manual Professional Edition. https://www.msdmanuals.com/en-gb/professional/psychiatric-disorders/personality-disorders/overview-of-personality-disorders
- Personality Disorders. (2020). https://www.hopkinsmedicine.org/health/conditions-and-diseases/personality-disorders
- Avoidant Personality Disorder (AVPD) – Psychiatric Disorders. (n.d.). MSD Manual Professional Edition. https://www.msdmanuals.com/en-gb/professional/psychiatric-disorders/personality-disorders/avoidant-personality-disorder-avpd
- Dependent Personality Disorder (DPD) – Psychiatric Disorders. (n.d.). MSD Manual Professional Edition. Retrieved September 26, 2023, from https://www.msdmanuals.com/en-gb/professional/psychiatric-disorders/personality-disorders/dependent-personality-disorder-dpd
- Zimmerman, M. (2023, September 5). Obsessive-Compulsive Personality Disorder (OCPD). MSD Manual Professional Edition; MSD Manuals. https://www.msdmanuals.com/en-gb/professional/psychiatric-disorders/personality-disorders/obsessive-compulsive-personality-disorder-ocpd
- American Psychological Association. (2010). What causes personality disorders? Apa.org. https://www.apa.org/topics/personality-disorders/causes
- RETTEW, D. C., ZANARINI, M. C., YEN, S., GRILO, C. M., SKODOL, A. E., SHEA, M. T., MCGLASHAN, T. H., MOREY, L. C., CULHANE, M. A., & GUNDERSON, J. G. (2003). Childhood Antecedents of Avoidant Personality Disorder: A Retrospective Study. Journal of the American Academy of Child & Adolescent Psychiatry, 42(9), 1122–1130. https://doi.org/10.1097/01.chi.0000070250.24125.5f
- Soloff, P., Nutche, J., Goradia, D., & Diwadkar, V. (2008). Structural brain abnormalities in borderline personality disorder: A voxel-based morphometry study. Psychiatry Research: Neuroimaging, 164(3), 223–236. https://doi.org/10.1016/j.pscychresns.2008.02.003
- Langwerden, R. J., van der Heijden, P. T., Soons, P. H. G. M., Derksen, J. J. L., Vuijk, R., & Egger, J. I. M. (n.d.). An Exploratory Study of MMPI-2-RF Personality and Psychopathology Profiles of Adults with Autism Spectrum Disorder without Intellectual Disability. Clinical Neuropsychiatry, 19(5), 335–346. https://doi.org/10.36131/cnfioritieditore20220509
- Treatment. (2020, January). Www.mind.org.uk. https://www.mind.org.uk/information-support/types-of-mental-health-problems/personality-disorders/treatment/
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