Making Sense of Cluster C Personality Disorders (2023)

The Diagnostic and Statistical Manual of Mental Disorders, DSM-5, identifies 10 unique personality disorders, each belonging to one of three groups known as "clusters." Cluster A contains paranoid, schizoid, and schizotypal disorders. In cluster B, one will find borderline, narcissistic, histrionic, and antisocial disorders. In cluster C, discussed below, the DSM outlines diagnostic criteria for avoidant, dependent, and obsessive-compulsive personality disorders.

1. Avoidant Personality Disorder

Avoidant personality disorder is characterized by feelings of extreme social inhibition, inadequacy, and sensitivity to negative criticism and rejection. Yet the symptoms involve more than simply being shy or socially awkward. Avoidant personality disorder causes significant problems that affect the ability to interact with others and maintain relationships in day-to-day life. About 1% of the general population has avoidant personality disorder.


  • Avoiding work, social, or school activities for fear of criticism or rejection. It may feel as if you are frequently unwelcome in social situations, even when that is not the case. This is because people with avoidant personality disorder have a low threshold for criticism and often imagine themselves to be inferior to others.
  • Low self-esteem
  • Self-isolation

When in social situations, a person with avoidant personality disorder may be afraid to speak up for fear of saying the wrong thing, blushing, stammering, or otherwise getting embarrassed. You may also spend a great deal of time anxiously studying those around you for signs of approval or rejection.

A person who has an avoidant personality disorder is aware of being uncomfortable in social situations and often feels socially inept. Despite this self-awareness, comments by others about your shyness or nervousness in social settings may feel like criticism or rejection. This is especially true if you are teased, even in a good-natured way, about your avoidance of social situations.

Social Impact of Avoidant Personality Disorder

Avoidant personality disorder causes a fear of rejection that often makes it difficult to connect with other people. You may be hesitant to seek out friendships unless you are certain that the other person will like you. When you are involved in a relationship, you may be afraid to share personal information or talk about your feelings. This can make it difficult to maintain intimate relationships or close friendships.

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a person diagnosed with avoidant personality disorder needs to show at least four of the following criteria:

(Video) Personality Disorders: Cluster C

  • Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection.
  • Is unwilling to get involved with people unless they are certain of being liked.
  • Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.
  • Is preoccupied with being criticized or rejected in social situations.
  • Is inhibited in new interpersonal situations because of feelings of inadequacy.
  • Views self as socially inept, personally unappealing, or inferior to others.
  • Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.

Avoidant behavior may commonly be seen in children or adolescents, but a diagnosis of a personality disorder cannot be made in childhood because shyness, fear of strangers, social awkwardness, or being sensitive to criticism are often a normal part of child and adolescent development.

2. Dependent Personality Disorder

Dependent personality disorder (DPD) is one of the most frequently diagnosed personality disorders. It occurs equally in men and women, usually in early to middle adulthood.


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Symptoms: People with dependent personality disorder become emotionally dependent on other people and spend great effort trying to please others. People with DPD tend to display needy, passive, and clinging behavior, and have a fear of separation. Other common characteristics of this personality disorder include:

  • Inability to make decisions, even everyday decisions like what to wear, without the advice and reassurance of others.
  • Avoidance of adult responsibilities by acting passive and helpless. Dependence on a spouse or friend to make decisions like where to work and live.
  • Intense fear of abandonment and a sense of devastation or helplessness when relationships end. A person with DPD often moves right into another relationship when one ends.
  • Oversensitivity to criticism.
  • Pessimism and lack of self-confidence, including a belief that they are unable to care for themselves.
  • Avoidance of disagreeing with others for fear of losing support or approval.
  • Inability to start projects due to lack of self-confidence.
  • Difficulty being alone.
  • Willingness to tolerate mistreatment and abuse from others.
  • Placing the needs of the caregivers above others.
  • Tendency to be naive and to fantasize.

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Although the exact cause of DPD is not known, it likely involves both biological and developmental factors. Some researchers believe an authoritarian or overprotective parenting style can lead to the development of dependent personality traits in people who are susceptible to the disorder.

How Is Dependent Personality Disorder Diagnosed?

A diagnosis of dependent personality disorder must be distinguished from borderline personality disorder, as the two share common symptoms. In borderline personality disorder, the person responds to fears of abandonment with feelings of rage and emptiness. With dependent personality disorder, the person responds to the fear with submissiveness and seeks another relationship to maintain his or her dependency.

What Are the Complications of Dependent Personality Disorder?

People with DPD are at risk for depression, anxiety disorders, and phobias, as well as substance abuse. They are also at risk of being abused because they are willing to do anything to maintain their relationships with a dominant partner or person of authority.

3. Obsessive-Compulsive Personality Disorder

Obsessive-compulsive personality disorder (OCPD) is a mental health condition in which a person is preoccupied with rules, orderliness, and control.

Causes: OCPD tends to occur in families, so genes may be involved. A person's childhood and environment may also play roles. This disorder can affect both men and women. It most often occurs in men.

Symptoms: OCPD has some of the same symptoms as obsessive-compulsive disorder (OCD). But people with OCD have unwanted thoughts, while people with OCPD believe that their thoughts are correct. In addition, OCD often begins in childhood while OCPD usually starts in the teen years or early 20s.

(Video) 11.5: Cluster C Personality Disorders

People with either OCPD or OCD are high achievers and feel a sense of urgency about their actions. They may become very upset if other people interfere with their rigid routines. They may not be able to express their anger directly. People with OCPD have feelings that they consider more appropriate, like anxiety or frustration.

A person with OCPD has symptoms of perfectionism that usually begin by early adulthood. This perfectionism may interfere with the person's ability to complete tasks, because their standards are so rigid. They may withdraw emotionally when they are not able to control a situation. This can interfere with their ability to solve problems and form close relationships.

Other Signs of OCPD Include:

  • Over-devotion to work
  • Not being able to throw things away, even when the objects have no value
  • Lack of flexibility
  • Lack of generosity
  • Not wanting to allow other people to do things
  • Not willing to show affection
  • Preoccupation with details, rules, and lists

Exams and Tests: OCPD is diagnosed based on a psychological evaluation that assesses the history and severity of the symptoms.

Treatment: Medicines may help reduce anxiety and depression from OCPD. Talk therapy is thought to be the most effective treatment for OCPD. In some cases, combining medicines with talk therapy is more effective than either treatment alone.

When to Contact a Medical Professional

See your health care provider or mental health professional if you or someone you know has symptoms of any of these personality disorders. To find a therapist, please visit the Psychology Today Therapy Directory.

©2021 Kevin Bennett Ph.D. All rights reserved.

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(Video) Cluster C Personality Disorders and Shame


How do you deal with cluster C personality disorder? ›

How are cluster C personality disorders treated? Treatment for cluster C personality disorders often involves a combination of psychotherapy and medications to help manage overlapping symptoms like anxiety and depression. Most cluster C disorders benefit from cognitive behavioral therapy (CBT).

What else is cluster C personality disorders known as? ›

Cluster C is called the anxious, fearful cluster. It includes the Avoidant, Dependent, and Obsessive-Compulsive Personality Disorders. These three personality disorders share a high level of anxiety.

What causes cluster C personality? ›

Although the exact cause of DPD is not known, it likely involves both biological and developmental factors. Some researchers believe an authoritarian or overprotective parenting style can lead to the development of dependent personality traits in people who are susceptible to the disorder.

What coping skills do people with borderline personality disorder have? ›

Coping skills for BPD are often centered around learning to manage moments of emotional instability and/or control anger. Some techniques to help in these situations could include: Using stress-reduction techniques, like deep breathing or meditation. Engaging in light exercise, like walking or yoga.

Which cluster of personality disorders is hardest to treat? ›

Cluster B personality disorders include antisocial personality disorder, borderline personality disorder, narcissistic personality disorder, and histrionic personality disorder. These tend to be the least common disorders but are often the most challenging to treat.

Is cluster C genetic? ›

Conclusion: Cluster C PDs are moderately heritable. No evidence was found for shared environmental or sex effects. Common genetic and individual environmental factors account for a substantial proportion of the variance in AVPD and DEPD.

What are the features of cluster C? ›

Cluster C personality disorders are characterized by anxious, fearful thinking or behavior. They include avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder.

What mental disorder starts with C? ›

Cyclothymia (sy-kloe-THIE-me-uh), also called cyclothymic disorder, is a rare mood disorder. Cyclothymia causes emotional ups and downs, but they're not as extreme as those in bipolar I or II disorder. With cyclothymia, you experience periods when your mood noticeably shifts up and down from your baseline.

Which personality disorder in cluster C has the lowest prevalence rate? ›

Cluster C. Using Part II of the National Comorbidity Survey Replication, it was found that for Cluster C personality disorders prevalence rates were: 5.2% for avoidant, 0.6% for dependent, and 2.4% for OCPD.

What is Type C personality prone to? ›

Type C personality traits have been linked to depression and feelings of hopelessness. Difficulty expressing emotions can play into depression. When you can't express your needs and bottle up anger or frustration, you generally end up feeling denied, resentful, or unwanted.

Is ADHD a cluster C? ›

Background: Attentional deficit hyperactivity disorder (ADHD) in adults is associated with borderline personality characteristics or cluster B (emotional instability), but in certain populations, such as medical students, it might be associated with cluster C traits (perfectionism, dependency, anxiety).

What is the most common personality disorder? ›

Obsessive-compulsive Personality Disorder (not to be confused with obsessive-compulsive disorder, or OCD, a type of anxiety disorder), is the most common personality disorder in the United States.

What should people with BPD stay away from? ›

But with some individuals with BPD, you don't want to get into the habit of allowing certain things such as calls after hours, visits to your home without announcing it, borrowing your things and never returning them, driving your car and keeping it longer than they should, etc.

What foods should borderline personality disorder patients avoid? ›

Consider cutting out all processed food and sugar for a few weeks and observe your energy level and your emotions. Avoid misusing alcohol or caffeine, as these also can intensify mood instability. BPD sometimes includes symptoms of self-harm or substance abuse.

What are people with BPD good at? ›

Bold – Impulsivity is a BPD trait that can be positively linked to being bold, courageous and having the ability to speak one's mind. Creative – The high intensity of emotions can be released into creative endeavours. Many people with BPD put their entire emotional expression into music, art, performance and writing.

What is the deadliest mental illness to live with? ›

If you think depression, schizophrenia, or bipolar disorder are the mental illnesses most commonly linked to an early death, you're wrong. Eating disorders—including anorexia nervosa, bulimia, and binge eating— are the most lethal mental health conditions, according to research in Current Psychiatry Reports.

What is the hardest mental disorder to live with? ›

Why Borderline Personality Disorder is Considered the Most “Difficult” to Treat. Borderline personality disorder (BPD) is defined by the National Institute of Health (NIH) as a serious mental disorder marked by a pattern of ongoing instability in moods, behavior, self-image, and functioning.

What is the most painful mental disorder? ›

Borderline personality disorder (BPD) has long been believed to be a disorder that produces the most intense emotional pain and distress in those who have this condition. Studies have shown that borderline patients experience chronic and significant emotional suffering and mental agony.

How many people have cluster C personality disorders? ›

Results: Cluster C personality disorders are present in approximately 3-9% of the general population. In about half of the cases of mood, anxiety, and eating disorders, there is co-morbid cluster C pathology.

What is cluster C psychology today? ›

Cluster C: Avoidant, Dependent, and Obsessive-Compulsive Personality Disorders. Cluster C personality disorders involve ingrained ways of thinking and relating to others that are colored by anxiety and fear.

Which set of disorders do symptoms of cluster C personality disorders overlap with? ›

Cluster C: Anxious-Fearful

It is often associated with other mental health conditions such as anxiety disorders and social phobia. Dependent personality disorder: Dependent personality disorder is characterized by intense fear and inability to make decisions.

How does fuzzy C-means work? ›

Fuzzy c-means (FCM) is a data clustering technique in which a data set is grouped into N clusters with every data point in the dataset belonging to every cluster to a certain degree.

What is the main purpose of cluster? ›

What is the purpose of clustering? The general purpose of cluster analysis in marketing is to construct groups or clusters while ensuring that the observations are as similar as possible within a group. Ultimately, the purpose depends on the application.

How do you identify a cluster? ›

Clusters are identified by applying a mathematical algorithm that assigns vertices (i.e., users) to subgroups of relatively more connected groups of vertices in the network. The Clauset-Newman-Moore algorithm [8], used in NodeXL, enables you to analyze large network datasets to efficiently find subgroups.

What disorders cause dissociation? ›

There are three major dissociative disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association:
  • Dissociative amnesia. ...
  • Dissociative identity disorder. ...
  • Depersonalization-derealization disorder.
Dec 13, 2022

What is Bipolar C? ›

Cyclothymic disorder is a milder form of bipolar disorder involving many "mood swings," with hypomania and depressive symptoms that occur frequently. People with cyclothymia experience emotional ups and downs but with less severe symptoms than bipolar I or II disorder.

What does OCD C mean? ›

Obsessive-compulsive disorder (OCD) features a pattern of unwanted thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere with daily activities and cause significant distress.

Can cluster C personality disorders be cured? ›

Unfortunately, there are no known cures for personality disorders and the same goes for a majority of mental illnesses. However, there are multiple ways to effectively treat personality disorders and help these individuals better handle the harmful symptoms that come with their given illness.

Which cluster of personality disorders are the most stable over time? ›

Cluster B personality disorders (antisocial, borderline, histrionic, narcissistic) were more stable in their diagnoses and tendencies over the 10 year period than were either cluster A (paranoid, schizoid, schizotypal), or cluster C (avoidant, dependent, obsessive-compulsive).

What is the most common personality disorder cluster? ›

According to a major study, the most prevalent personality disorder is obsessive-compulsive personality disorder. The second most common is narcissistic personality disorder, followed by borderline personality disorder.

Which personality type is the hardest to get along with? ›

INFP: Voted “most likely to start a revolution”

The INFP may be the toughest personality type of all for others to understand. They are seemingly easy-going and carefree, but when it comes to their values, they can become suddenly uncompromising.

How does Type C personality deal with stress? ›

It has been suggested that Type C individual's cope with stress in a way that ignores their own needs, even physical ones, in order to please others. This eventually has negative effects as all stresses are suppressed but still take their toll.

What is the dislike and fears of the type C personality? ›

A tendency to deny or avoid extreme emotions

If they can't control what is going to happen, they can become very self-involved and shut down from external pressure and stress, leading to more stress and anxiety.

What is the rarest subtype of ADHD? ›

The rarest type of ADHD diagnosed is the hyperactive-impulsive type with no indication of inattentive or distracted behavior, according to Johns Hopkins Medicine.

What is ADHD most comorbid with? ›

The most common ADHD comorbidities are learning disabilities, anxiety, depression, sensory processing disorder, and oppositional defiant disorder.

Can ADHD turn into narcissism? ›

Results: Individuals diagnosed with childhood ADHD are at increased risk for personality disorders in late adolescence, specifically Borderline (OR = 13.16), Antisocial (OR = 3.03), Avoidant (OR = 9.77), and Narcissistic (OR = 8.69) personality disorders.

What personality disorder is no empathy? ›

Narcissistic personality disorder (NPD) is associated with an assortment of characteristics that undermine interpersonal functioning. A lack of empathy is often cited as the primary distinguishing feature of NPD.

What is the #1 diagnosed personality disorder? ›

By some estimates, obsessive-compulsive personality disorder (OCPD) is the most common personality disorder. Around 1 in 100 individuals have OCPD, and it is diagnosed in twice as many men as women. OCPD is different from obsessive-compulsive disorder (OCD), Berrill explains.

What is the rarest personality disorder? ›

INFJ is the rarest personality type across the population, occurring in just 2% of the population. It is also the rarest personality type among men. INFJ stands for Introversion, Intuition, Feeling, and Judging. This unique combination is hard to find in most people.

Why do borderlines cheat? ›

Borderline personality disorder relationships and cheating may occur due to the impulsivity associated with this mental health condition. Recent research has shown people with BPD are more sexually impulsive and likely to engage in risky sexual behavior than those without BPD.

Is BPD the hardest mental illness to live with? ›

But in the shadows are a cluster of conditions that continue to face deep discrimination: schizophrenia, psychosis, bipolar disorder, and BPD. BPD in particular is one of the lesser-known mental illnesses, but all the same it is one of the hardest to reckon with.

Why is BPD the hardest to live with? ›

People with BPD experience intense mental-emotional pain as their baseline mood. Emotions are extremely intense, leading to episodes of depression, anxiety or anger.

What is a favorite person for BPD? ›

This is where the term “favorite person” comes from in the borderline community. There is usually one of two people that we absolutely idolize and want to spend all our time with, and if they are busy and can't spend time with us we tend to get angry and feel abandoned.

How do you keep a borderline happy? ›

The following 9 strategies can help you support a person with BPD:
  1. Learn about BPD. ...
  2. Show confidence and respect. ...
  3. Be trustworthy. ...
  4. Manage conflict with attachment. ...
  5. Encourage Professional Help. ...
  6. Identify strengths. ...
  7. Have fun together. ...
  8. Take suicide seriously.

What vitamin helps with BPD? ›

Vitamin A (VA) supplementation reduces the risk of developing bronchopulmonary dysplasia (BPD).

Are borderlines highly intelligent? ›

Learn About Borderline Personality Disorder

Many individuals with BPD are highly intelligent and are aware that their reactions may seem strong. These individuals often report feeling that emotions control their lives or even that they feel things more intensely than other people.

What IQ level is BPD? ›

Borderline intellectual functioning is an important and frequently unrecognised comorbid condition relevant to the diagnosis and treatment of any and all psychiatric disorders. In the DSM-IV-TR, it is defined by IQ in the 71–84 range.

Are borderlines gifted? ›

This clinical study of 23 borderline outpatients and 38 outpatients with other personality disorders provides evidence that individuals who become borderline frequently have a special talent or gift, namely a potential to be unusually perceptive about the feelings of others.

What mental illness starts with C? ›

Starting With C
  • Caffeine Addiction.
  • Cannabis Addiction.
  • Catatonic disorder.
  • Catatonic schizophrenia.
  • Childhood amnesia.
  • Childhood Disintegrative Disorder (now part of Autism Spectrum Disorder)
  • Childhood Onset Fluency Disorder (formerly known as Stuttering)
  • Circadian Rhythm Disorders.

What is the most painful mental illness? ›

Borderline personality disorder (BPD) has long been believed to be a disorder that produces the most intense emotional pain and distress in those who have this condition. Studies have shown that borderline patients experience chronic and significant emotional suffering and mental agony.

What is the least treatable personality disorder? ›

Of the ten personality disorders described in the DSM-5, the four in Cluster B: Antisocial, Borderline, Narcissistic and Histrionic, have been the ones considered to be the most difficult to treat.

What is the rarest mental illness ever? ›

Factitious disorder tends to affect less than 0.5% of the population. Also known as 'imposter syndrome' or Capgras Delusion. People with this mental health condition believe that someone in their life that plays a significant role what been replaced with an imposter.

What is the least common personality disorder? ›

Cluster A: These personality disorders are characterized by eccentric behavior and include the following: paranoid, schizoid, schizotypal. “Cluster A personality disorders are the least common,” Hollon says.

What are the characteristics of cluster C? ›

Cluster C personality disorders are characterized by anxious, fearful thinking or behavior. They include avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder.

Which cluster of personality disorders are most commonly diagnosed? ›

Borderline personality disorder and antisocial personality disorder are the most frequently diagnosed personality disorders.

What is cluster A vs cluster B vs cluster C? ›

Cluster A disorders are defined by “odd” thinking and behaviors like paranoia or a lack of emotional responses. Cluster C disorders are defined by anxious thoughts and behavior. Cluster B. Cluster B disorders involve unpredictable, dramatic, or intensely emotional responses to things.


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