Understanding Mental Health

Personality Disorders

 

What is Personality? 

Every person has an individual personality made up of traits that come from both one’s genetic make-up and life experiences. The word ‘personality’ usually refers to the pattern of thoughts, feelings and behaviour that makes each of us who we are. Most people do not always think, feel and behave in exactly the same way – it depends on the situation, one’s past experiences, the people one engages with, their mood and other similar circumstances. However despite this, an individual’s general pattern of behaviour is also somewhat predictable. By adolescence, people tend to behave in particular ways that are unique to them, thus reflecting their individual personality. For example, a person who is described as having an ‘outgoing’ personality tends to be talkative, social and engage easily with people around him/her.

While personality remains relatively stable after early adulthood, it is adaptable to one’s life experiences. Most people tend to be able to learn from past experiences, change their behaviour and cope with challenging circumstances regardless of their dispositional personality traits.

 

What is a personality disorder? 

A personality disorder is a type of mental disorder that occurs when one’s pattern of thinking, feeling and behaviour is extreme, inflexible and maladaptive. It is also often associated with significant distress to the person and those around him/her. There are 10 different types of personality disorders that are categorized into 3 groups: Cluster A: odd and eccentric behaviours, Cluster B: dramatic and erratic behaviours, and Cluster C: anxious and fearful characteristics.

Categorization is based on the specificity and pervasiveness of the behaviour, as well as on the impact it has on daily functioning. Typically, diagnosis of a personality disorder requires a comprehensive evaluation by a psychiatric team, and is not diagnosed until adolescence or early adulthood.

 

Warning Signs For Educators

There are many warning signs that emerge in childhood that are known to be predictive of personality disorder development. Often, these warning signs can be identified through a child’s classroom behaviour. Although it is important to note that symptoms may vary widely and do not always result in the development of a personality disorder.

Listed below are common warning signs, organized within the 3 categories, which may be seen by a teacher in a classroom. It is important to note that while many behaviours are specific to the category they fall in, others may overlap between categories.

Cluster A:
Characterized by: odd and eccentric behaviours. Disorders: schizoid, schizotypal, and paranoid personality disorders. Common precursors: Lack of close friends, social anxiety, academic underachievement, peculiar thoughts, language and fantasies, interpersonal sensitivity.  

Cluster B:
Characterized by: dramatic, emotional and erratic behaviours. Disorders: narcissistic personality disorder, histrionic personality disorder, borderline personality disorder and antisocial personality disorder. Common precursors (Narcissistic, histrionic and borderline): failure to emotionally respond to others, lack of dependency, tendency to think one deserves care and attention, failure to show gratitude, self-dramatization, attention seeking, emotion deregulation, anger episodes, vulnerability to separation, anxiety and mood problems, depression, self-harming behaviour and problems with eating and sleeping. Common precursors (Antisocial personality disorder): aggression towards people and animals, destruction of property, serious violation of rules, running away from home, deceitfulness or theft. Often manifested as conduct disorder in younger children.

Cluster C:
Characterized by: anxious and fearful characteristics. Disorders: obsessive compulsive, dependent and avoidant personality disorders. Common precursors: continuous writing and erasing, tearing up homework, desiring control, over-compliance to rules, over-conscientiousness, clingy behaviour, fear of separation, hypersensitivity to negative evaluations, social inhibition, feelings of inadequacy and fear of being shamed or ridiculed.  

 

Risk Factors

It is not entirely clear how personality disorders develop. However, research on personality disorders has suggested a variety of risk factors that are both environmentally and genetically based. It is often a combination of these risk factors that contribute to the development of a personality disorder. Risk factors include, but are not limited to the following:

  • Difficult childhood circumstances such as poor parenting, lack of attachment, neglect or abuse.

  • Early and severe trauma during childhood (e.g., parental death, social isolation)

  • Familial financial difficulties (e.g., low socioeconomic status, single-parent families, welfare support)

  • A family history of personality disorders or other significant mental health problems (e.g., psychopathology, substance abuse) can lead to a predisposition to develop a personality disorder.

 

How to support students showing signs of personality disorder development:

The following are suggested strategies educators can use in the classroom when a child demonstrates difficult behaviour. Please note that if the behaviour becomes too difficult to control, it is important to consult with the appointed school psychologist.

  • Collaborate with psychiatric treatment team, school mental health professionals and parents in developing strategies that can best support the needs of the student

  • Become attuned to the associated symptoms or warning signs that trigger symptoms (e.g., anger outbursts) to prevent them from occurring

  • Help identify coping strategies such as: talking to someone trustworthy, writing your feelings down, learning to walk away, positively reframe conflicts, consider the bigger picture, and setting smaller goals.

  • Offer emotional support, understanding, patience, and encouragement

  • Implement support systems that are consistent with the ones the family may be using at home

  • Promote pro-social interactions with peers at school

  • Allow the student a “Cool-Down’ break

  • Listen actively and ask open-ended questions to the child when asking about a conflict (e.g., what do you think made you angry when interacting with Billy?)

  • Increase the ‘reinforcement quality’ of the classroom (e.g., increase motivation to engage in academic activities by structuring lessons or assignments around a topic of high interest)

  • Have a positive spin on teacher requests (e.g., “I will help you with your work once you take a seat” compared to “I will not help you until you take a seat”)

  • Enforce positive reinforcement strategies for constructive, cooperative and helpful behaviour

  • Problem solve with the student for solutions to problems the student may be experiencing

 

Useful links for further information on this topic:  


References used:
Bernstein, D. P., Cohen, P., Skodol, A., Bezirganian, S., & Brook, J. S. (1996). Childhood antecedents of adolescent personality disorders. The American journal of psychiatry, 153(7), 907.

De Clercq, B., & De Fruyt, F. (2007). Childhood antecedents of personality disorder. Current Opinion in Psychiatry, 20(1), 57-61.

ve Ergenlerde, K. B. Ç., & Bulguları, Ö. (2015). Precursors of Personality Disorders in Children and Adolescents.  

 

 

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