Personality disorders are characterized by enduring patterns of inner experience and behavior that deviate significantly from cultural norms, causing distress or impairment in functioning. If you've been a social worker (or, really, just a person in the world) for a little while, then you've likely encountered at least a few of them. Treatment is tricky, but ASWB exam questions on the topic don't have to be, if you know your stuff.

The List

The ten personality disorders in DSM-5 are categorized into three clusters:

Cluster A - Odd or Eccentric Behavior:

  • Paranoid Personality Disorder: Characterized by distrust and suspicion of others' motives, often assuming that others are trying to harm or deceive them.
  • Schizoid Personality Disorder: Involves a lack of interest or desire for close relationships, as well as limited emotional expression.
  • Schizotypal Personality Disorder: Features peculiar behavior, unusual beliefs or magical thinking, and difficulty with close relationships.

Cluster B - Dramatic, Emotional, or Erratic Behavior:

  • Antisocial Personality Disorder: Marked by disregard for the rights of others, lack of empathy, impulsivity, and a history of antisocial behavior.
  • Borderline Personality Disorder: Involves unstable relationships, self-image, and emotions, as well as impulsive behaviors and a fear of abandonment.
  • Histrionic Personality Disorder: Characterized by excessive attention-seeking behaviors, emotional shallowness, and a need for approval.
  • Narcissistic Personality Disorder: Features an inflated sense of self-importance, a lack of empathy, and a need for excessive admiration.

Cluster C - Anxious or Fearful Behavior:

  • Avoidant Personality Disorder: Involves social inhibition, feelings of inadequacy, and hypersensitivity to criticism or rejection.
  • Dependent Personality Disorder: Characterized by a pervasive need to be taken care of, submissive behavior, and difficulty making decisions independently.
  • Obsessive-Compulsive Personality Disorder: Features a preoccupation with orderliness, perfectionism, and control, often at the expense of flexibility and openness.

If you're not a social worker, a caution: t's important to note that personality disorders are diagnosed based on a thorough assessment by a mental health professional, as well as consideration of the individual's history and experiences. Additionally, individuals may exhibit traits from multiple personality disorders, and the presentation can vary widely among individuals.

While we're on the topic, here's something that's worth an extra minute: Telling the difference between schizoid and schizotypal personality disorders. Both are in Cluster A,  both are characterized by odd or eccentric behavior. However, they have distinct features:

Schizoid Personality Disorder (SPD):

  • Individuals with SPD typically display emotional detachment and a preference for solitary activities.
  • They have limited interest in forming close relationships and may seem indifferent to praise or criticism.
  • They often appear unemotional and have a restricted range of emotional expression.
  • Social interactions are challenging, and they may prefer to engage in solitary hobbies.

Schizotypal Personality Disorder (STPD):

  • People with STPD exhibit eccentric behavior, odd beliefs, and cognitive distortions.
  • They might experience unusual perceptual experiences, such as illusions or magical thinking.
  • They may have difficulties with social relationships due to their peculiar behavior and odd beliefs.
  • STPD individuals may also show social anxiety and discomfort in social situations.

Restating: schizoid personality disorder is characterized by emotional detachment and a lack of interest in relationships; schizotypal personality disorder involves odd beliefs, perceptual experiences, and difficulties with social interactions.


Treating personality disorders typically involves a combination of psychotherapy, medication (in some cases), and support. Here are the general approaches to treating personality disorders:

  1. Psychotherapy: Various forms of psychotherapy are commonly used to treat personality disorders. Some effective approaches include:

    • Cognitive-Behavioral Therapy (CBT): Helps individuals identify and change negative thought patterns and behaviors that contribute to their difficulties.

    • Dialectical Behavior Therapy (DBT): Especially helpful for borderline personality disorder, DBT focuses on emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness.

    • Psychodynamic Therapy: Explores early life experiences and unconscious conflicts that might contribute to personality disorders.

  2. Medication: Medication is not typically the primary treatment for personality disorders, but it can be used to manage specific symptoms, such as depression, anxiety, or mood swings. The choice of medication depends on the individual's symptoms and needs.

  3. Supportive Interventions: Individuals with personality disorders may benefit from support groups, family therapy, vocational training, and social skills training to improve their functioning and relationships.

  4. Stabilization and Crisis Management: In some cases, individuals with severe symptoms, such as those with borderline personality disorder, might require short-term hospitalization or intensive outpatient programs during periods of crisis.

  5. Long-Term Commitment: Treating personality disorders often requires a long-term commitment, as changing entrenched patterns of thinking and behavior takes time. Consistency and ongoing therapeutic relationships are important.

  6. Individualized Treatment Plans: Treatment should be tailored to each individual's specific symptoms, needs, and goals. A comprehensive assessment by mental health professionals is essential for creating an effective treatment plan.

Got it? Great.

Free Practice Question

Here's how this material may look on the social work licensing exam:

A social worker is assessing a client who consistently displays an inflated sense of self-importance, a lack of empathy, and a need for excessive admiration. The client often exaggerates achievements and expects special treatment from others. These behaviors are most characteristic of which personality disorder?

A) Borderline Personality Disorder
B) Histrionic Personality Disorder
C) Schizoid Personality Disorder
D) Narcissistic Personality Disorder

Know it?

The client's traits of an inflated sense of self-importance, lack of empathy, seeking excessive admiration, exaggerating achievements, and expecting special treatment are indicative of Narcissistic Personality Disorder (NPD). NPD is characterized by an excessive preoccupation with oneself and a grandiose view of one's own abilities and importance.

That's just one question. Really put your personality disorder knowledge (and lots of other knowledge) to the test with SWTP's realistic, real-time practice tests.

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August 17, 2023
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