Cluster C (anxious/inhibited): Dependent, Avoidant, Obsessive-Compulsive Personality Disorders

cont. from

Dependent personality: Persons with this disorder surrender responsibility for major areas of their lives to others and allow the needs of those they depend on to supersede their own needs. They lack self-confidence and feel intensely insecure about their ability to take care of themselves. They often protest that they cannot make decisions and do not know how or what to do. This behavior is due partly to a belief that others are more capable and partly to a reluctance to express their views for fear of offending persons they need with their aggressiveness (ie, a form of aggression against self). Dependency occurs in other personality disorders where it may be hidden by obvious behavioral problems; eg, histrionic or borderline behaviors mask underlying dependency.

Avoidant personality: Persons with this personality disorder are hypersensitive to rejection and fear starting relationships or anything new because they may fail or be disappointed. This personality disorder is a spectrum variant of generalized social phobia. Because of their strong conscious desire for affection and acceptance, persons with an avoidant personality disorder, unlike those with a schizoid personality disorder, are openly distressed by their isolation and inability to relate comfortably to others. Unlike those with a borderline personality disorder, they respond to rejection with withdrawal, not temper tantrums. Persons with an avoidant personality disorder tend to have an incomplete or a weak response to anxiolytic drugs.

Obsessive-compulsive personality: Persons with this personality disorder are conscientious, orderly, and reliable, but their inflexibility often makes them unable to adapt to change. Because they are cautious and weigh all aspects of a problem, they may have difficulty making decisions. They take responsibilities seriously, but because they hate mistakes and incompleteness, they can become entangled with details and forget the purpose of or have trouble completing their tasks. As a result, their responsibilities cause them anxiety, and they rarely enjoy much satisfaction from their achievements.

Most obsessive-compulsive traits are adaptive, and as long as they are not too marked, persons who have them often achieve much, especially in the sciences and other academic fields in which order, perfectionism, and perseverance are desirable. However, they can feel uncomfortable with feelings, interpersonal relationships, and situations in which they lack control or must rely on others or in which events are unpredictable.

Other Personality Types

Passive-aggressive, cyclothymic, and depressive types of personality disorders are not classified in the DSM-IV. Yet, they can be useful diagnoses.

Passive-aggressive (negativistic) personality: Persons with this personality disorder typically appear inept or passive, but these behaviors are covertly designed to avoid responsibility or to control or punish others. Passive-aggressive behavior is often evident in procrastination, inefficiency, or unrealistic protests of disability. Frequently, such persons agree to perform tasks they do not want to perform and then subtly undermine completion of the tasks. Such behavior usually serves to deny or conceal hostility or disagreements.

Cyclothymic personality: In persons with this personality disorder, high-spirited buoyancy alternates with gloom and pessimism; each mood lasts weeks or longer. Characteristically, the rhythmic mood changes are regular and occur without justifiable external cause. This personality disorder is a spectrum variant of manic-depressive illness (bipolar disorder), but most cyclothymic persons do not develop bipolar disorder. Cyclothymic personality is considered a temperament, present in many gifted and creative people.

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Reviewed: 04/2006