What is the term for Inflexible maladaptive and stable patterns of thoughts emotions behavior and interpersonal functioning?

Gaslighting: a rare form of psychological abuse, where perpetrators seek to manipulate their victim by making them doubt their own sanity, memory, or perception. The end goal may simply be about control, or destroying someone’s self esteem, but can be for financial gain, or to engineer the break-up of a relationship. It’s name derives from a 1938 play called ‘Gaslight.’ (Leschziner, 107)

Personality Cluster A: odd or eccentric personality disorder. (Hockenbury, 527)

Paranoid Personality Disorder: a personality disorder characterized by the avoidance of accepting deserved blame and an unwarranted view of others as malevolent. The latter is expressed as suspiciousness, hypersensitivity, and mistrust. (MeSH) People who display a deep distrust and suspiciousness of others. (Cardwell, 182) Characterized by a pervasive distrust and suspiciousness of the motives of others without sufficient basis. (Hockenbury, 527)

Personality Cluster B: dramatic, emotional or erratic personality disorders. (Hockenbury, 527)

Antisocial Personality Disorder: people who show a consistent disregard for the rights and feelings of others. (Cardwell, 182) Essential feature is a pervasive pattern of disregard for, and violation of, the rights of others. (MeSH) Manifested in childhood or early adolescence. (NCIt)

Borderline Personality Disorder: a personality disorder marked by a pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts. (MeSH) Characterized by instability of interpersonal relationships, self-image, and emotions, and marked impulsivity. (Hockenbury, 528) A serious mental illness marked by unstable moods and impulsive behavior. People with borderline personality disorder have problems with relationships, family and work life, long-term planning, and self-identity. Symptoms include intense bouts of anger, depression, and anxiety that may lead to self-injury or suicide, drug or alcohol abuse, excessive spending, binge eating, or risky sex. A person with BPD who is diagnosed with cancer may be at an increased risk of suicide. (NCIt)

Personality Cluster C: anxious or fearful personality disorder. (Hockenbury, 527)

Dependent Personality Disorder: a personality disorder characterized by a pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts. (MeSH) People who have total reliance on others and seem incapable of making even minor decisions themselves. (Cardwell, 182) Leads the individual to urgently seek out and submit to another person and allow that person to make decisions that impact all areas of the individual's life. (NCIt)

Schizotypal Personality Disorder
A pervasive pattern of social and interpersonal deficits, marked by acute discomfort with, and reduced capacity for close relationships as well as cognitive or perceptual distortions and eccentricities of behavior.  Need 5 out of 9:1. Ideas of reference (excluding delusions of reference);2. Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (superstitiousness, belief in clairvoyance, telepathy, or 6th sense);3. Unusual perceptual experiences, including bodily illusions;4. Odd thinking and speech (vague, circumstantial, metaphorical, over-elaborate, or stereotyped);5. Suspiciousness or paranoid ideation;6. Inappropriate or constricted affect;7. Odd, eccentric, peculiar behavior or appearance;8. Lacks close friends or confidants, other than first degree relatives;

9. Excessive social anxiety that does not diminish with familiarity, and tends to be associated with paranoid fears rather than negative judgments about self.

CLUSTER B

Antisocial Personality Disorder
A pervasive pattern of disregard for and violation of rights of others occurring since age 15, as indicated by at least 3 of the following:
1. Patient fails to conform to social norms without regard to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest;2. Patient is deceitful, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure;3. Patient is impulsive or fails to plan ahead;4. Patient is irritable/aggressive, has repeated physical fights or assaults;5. Patient has reckless disregard for the safety of self and others;6. Patient is consistently irresponsible, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations;

7. Patient lacks remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

Borderline Personality Disorder
A pervasive pattern of instability of interpersonal relationships, self-image, and affect, and marked impulsivity.  Need 5 out of 9:1. Frantic efforts to avoid real or imagined abandonment;2. A pattern of unstable and intense interpersonal relationships characterized by changing between extremes of idealization and devaluation;3. Identity disturbance:  Markedly unstable self image sense of self;4. Impulsivity in at least two areas that are self damaging (spending, sex, substance abuse, reckless driving, binge eating);5. Recurrent suicidal behavior/gestures/threats; or self-mutilating behavior;6. Affective instability due to marked reactivity of mood (intense episodic dysphoria, irritability, or anxiety lasting a few hours);7. Chronic feelings of emptiness;8. Inappropriate, intense anger or difficulty controlling anger;

9. Transient stress-related paranoid ideation, or severe dissociative symptoms.

Narcissistic Personality Disorder
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy.  Need 5 out of 9:1. Grandiose sense of self-importance (exaggerates achievements);2. Preoccupied with fantasies of unlimited success, power, brilliance, beauty;3. Believes she is special/unique, and can only be understood by or should only associate with other special or high status people (or institutions);4. Requires excessive admiration;5. Has sense of entitlement, expectation of favorable treatment;6. Is interpersonally exploitative;7. Lacks empathy, unwilling to recognize feelings/needs of others;8. Is envious of others and believes others are envious of her;

9. Shows arrogant, haughty behaviors or attitudes.

Histrionic Personality Disorder
A pervasive pattern of excessive emotionality and attention seeking.  5 out of 8:1. Patient is uncomfortable when he is not the center of attention;2. Interaction with others often characterized by inappropriate sexually seductive/provocative behaviors;3. Patient displays rapidly shifting and shallow expression of emotions;4. Patient consistently uses physical appearance to draw attention to self;5. Patient’s style of speech is overly impressionistic and lacking in detail;6. Shows self-dramatization/theatricality/exaggerated expression of emotion;7. Patient is suggestible, easily influenced by others or circumstances;

8. Patient considers relationships to be more intimate than they actually are.

CLUSTER C

Avoidant Personality Disorder
A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Need 4 out of 7:1. Avoids work that involves significant interpersonal contact, because of fears of criticism, disapproval, or rejection;2. Is unwilling to get involved with people unless certain of being liked;3. Shows restraint with intimate relationships because of fears of being shamed or ridiculed;4. Is preoccupied with being criticized or rejected in social situations;5. Is inhibited in new social situations because of feelings of inadequacy;6. Views self as socially inept, personally unappealing, or inferior;7. Is reluctant to take personal risks or engage in new activities because they may prove embarrassing.

Dependent Personality Disorder

8. Is unrealistically preoccupied with fears of being left to care for self.

Obsessive-Compulsive Personality Disorder
A pervasive pattern of preoccupation w orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency. 4 out of 8:1. Preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost;2. Shows perfectionism that interferes with task completion;3. Excessively devoted to work and productivity to the exclusion of leisure activities and friendships;4. Over-conscientious, scrupulous, and inflexible about matters of morality/ethics/values;5. Unable to discard worn-out or worthless objects even when they have no sentimental value;6. Reluctant to delegate tasks or to work with others unless they submit exactly to his or her way of doing things;7. Adopts miserly spending style towards self and others;  money viewed as something to be hoarded for future catastrophes;

8. Shows rigidity and stubbornness.

Additional information

In general, each personality disorder has a prevalence of approximately 1%. Personality disorders are very difficult to treat as they require changing ingrained patterns of behavior. Therefore, psychotherapy and group therapy remain the primary treatments for managing personality disorders.

Schizotypal Personality Disorder and Schizoid Personality Disorder: These personality disorders commonly occur in families with history of Psychotic disorders. This tells us that there are likely genetic links between primary psychotic disorders and cluster A personality disorders. Some experts would argue that Schizotypal and Schizoid personality disorders are part of a spectrum including schizophrenia and related psychotic disorders.

Histrionic Personality Disorder: The most common defense mechanism used by individuals with histrionic personality disorder is “regression.”

Borderline Personality Disorder: Most common defense mechanisms used by individuals with borderline personality disorder are “splitting” and “projection.” Projective identification is a common interpersonal dynamic as well. Other common behaviors include self harm behaviors, manipulation, gaslighting, and substance abuse. A history of sexual trauma or abuse is not uncommon in individuals with borderline personality traits. 

Antisocial Personality Disorder: Antisocial personality disorder usually begins as Conduct Disorder in childhood. Often times there is history of animal cruelty, fighting, and sexual abuse in childhood. Substance abuse and criminal activity is very common. Deceptive tactics and manipulation are often used to get what they want. 

Schizoid vs Avoidant Personality Disorder:  Individuals with schizoid personality traits want to be alone and are content with being alone. Individuals with avoidant personality traits want to be alone but this is due to anxiety and fear (they would rather be social!)

Obsessive Compulsive Disorder (OCD) vs Obsessive Compulsive Personality Disorder (OCPD): In Obsessive Compulsive Disorder, individuals recognize their thoughts and behaviors as irrational and disturbing. That is, their symptoms are ego-dystonic. In Obsessive Compulsive Personality Disorder (OCPD) individuals see their traits as essential to their success. That is, their symptoms are ego-syntonic. 

Psychotherapy remains the first line and most effective treatment for personality disorders. Pharmacological treatment is not first line treatment for personality disorders but because many personality disorders are comorbid with other psychiatric disorders, pharmacological treatment should be used to address any comorbid mood or anxiety disorders. 

Below are the therapy modalities and pharmacological treatments of choice for each personality cluster:

• Cognitive Behavioral Therapy
• Group Therapy
• Antipsychotics may be used for transient psychotic symptoms

• Dialectical Behavioral Therapy
• Contingency-Based Therapies
• Cognitive Behavioral Therapy
• Group Therapy
• Of all the personality disorders, borderline personality disorder is the most likely to respond to mood stabilizers (e.g., lamotrigine, lithium, valproate), Selective Serotonin Reuptake Inhibitors (e.g. Fluoxetine), and atypical antipsychotics (e.g., olanzapine) 

• Cognitive Behavioral Therapy
• Assertiveness Training
• Group therapy
• Exposure Therapy
• Selective Serotonin Reuptake Inhibitors (SSRIs) and beta-blockers are often used for comorbid anxiety and depressive disorders.

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