Medically reviewed by Michael MacIntyre, MD
Personality disorders (PDs) are inflexible and persisting patterns of thinking and behavior that deviate from cultural expectations and norms. Personality disorders can affect every aspect of a person’s life, including self-image and relationships. Personality disorders are categorized into clusters in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).
Cluster C personality disorders fall under the anxious and fearful categories and include avoidant personality disorder (AVPD), dependent personality disorder (DPD), and obsessive-compulsive personality disorder (OCPD) (not to be confused with obsessive-compulsive disorder, or OCD).
This article will also provide treatment and support options for people with cluster C personality disorders and for anyone living with suspected but undiagnosed personality disorder.
Cluster C Personality Disorders: What Makes Them Different
The difference between cluster C personality disorders and others comes down to the way their symptoms are categorized in the DSM-5-TR. Three diagnostic categories or types exist: A, B, and C. Below are the core differences between the types.
Cluster C vs. Cluster A
While cluster C personalities are associated with fear and anxiety, cluster A personalities are considered "odd and eccentric" in the DSM-5-TR.
Cluster A personality disorders include A disorders in the DSM-5-TR:
Schizoid personality disorder
Paranoid personality disorder
There is more research on shizotypal personality disorder than other cluster A personality disorders. This type of personality is in some cases seen as a less-severe schizophrenia but genetically related to it. Another view is that these symptoms reflect variations of typical or common personality traits.
Cluster C vs. Cluster B
Symptoms of cluster B personality disorders are categorized and labeled as “dramatic” or "overly emotional." Cluster B personality disorders include:
Histrionic personality disorder
Both clusters C and B are highly prevalent in clinical settings, such as one-on-one healthcare provider–patient relationships.
Avoidant Personality Disorder
AVPD is explained as feelings of inadequacy that are so severe they lead to social avoidance and isolation. Someone with an AVPD may experience great distress trying to avoid further feelings of inadequacy and rejection.
Symptoms of avoidant personality disorder include ongoing and consistent patterns of:
Rejection sensitivity or hypersensitivity to criticism
Feelings of inadequacy
Lack of agency (personal power)
Avoiding social situations and interactions, especially when they can be evaluated negatively
There isn’t a lot of research to refer to in understanding the causes of avoidant personality disorder or to evaluate current treatment methods. Experts say genetic and environmental causes are at play, including exposure to adverse childhood experiences and as a response to complex trauma.
Dependent Personality Disorder
DPD is when someone struggles to believe they can take care of themselves, and uses submissiveness to garner excessive caregiving work from others.
Symptoms of dependent personality disorder include ongoing and consistent patterns of:
Excessive psychological dependence on other people
Fear of separation or separation anxiety
Passive, clinging, and submissive behavior
Research about the causes of dependent personality disorder is also limited. Causes may include a mix of factors, including cultural and family differences, early childhood traumatic stress, and biologic or genetic susceptibility to anxiety. Growing up with submissiveness, insecurity, and self-effacing behavior have been noted as potential associated risk factors.
Obsessive-Compulsive Personality Disorder
OCPD is associated with a preoccupation with control, rules, and perfectionism, rigid thinking, and a lack of flexibility with life changes both big and small.
A notable difference between people with OCD and OCPD is that while people with OCD may experience unwanted thoughts, people with OCPD believe that their thoughts are correct.
Symptoms of obsessive-compulsive personality disorder can include:
Rigid thinking and overall lack of flexibility
Stubborn behavior patterns leading to difficulty with change (i.e., difficulty throwing things away, asking for help, adjusting to new routines)
Preoccupation with order, rules, self-control, and self-discipline to where it interferes with flexibility, effectiveness, and openness
Excessive devotion to working
The causes of personality disorders like OCPD are always complex, but as with other personality disorders, experts note both genetic and environmental factors may be at play in OCPD.
OCPD is said to occur more often in men than women, although it can impact anyone.
Treatment Options for Cluster C Personality Disorders
Psychotherapy, or talk therapy, is often the first-line treatment for personality disorders. Some forms of talk therapy have proven effective in treating personality disorders, according to the American Psychiatric Association.
Talk therapy provides space for someone to recognize current ways of thinking and associated behavioral patterns and to establish and develop tools and coping strategies for handling big emotions and the everyday demands of life.
There are no medications available for treating personality disorders. However, medications may be recommended to help reduce a wide variety of symptoms, including feelings of anxiety and depression, or sleep difficulties (i.e., insomnia, nightmares, poor sleep).
It can be challenging for someone to know they have a personality disorder let alone for them to go about seeking an official diagnosis. For example, people with cluster B borderline personality disorder may not know they have it.
Support and Resources With an Undiagnosed Personality Disorder
Living with an undiagnosed personality disorder may mean experiencing many symptoms without knowing for sure what is causing them. It may also mean having other mental health diagnoses like an anxiety disorder and other personality disorders. Finding the right support and resources is important.
In addition to your psychotherapist, other forms of support can include working with social workers, counselors, and peer support groups, as well as community-based psychoeducation opportunities through local non-profits or mental health organizations.
Resources and support options include:
National Alliance on Mental Illness (NAMI) HelpLine: Call 800-950-NAMI (6264) or firstname.lastname@example.org.
988 Suicide & Crisis Lifeline: Call or text 988.
Crisis Text Line: Text HELLO to 741741 for free and confidential support 24 hours a day anywhere in the United States.
Crisis Safety Plan: This resource form outlines a safety plan to support those experiencing self-harm and suicidal thoughts.
For more mental health resources, see our National Helpline Database.
The traits of cluster C personality disorders stem from fear and anxiety. Key traits in avoidant personality disorder include feelings of inadequacy. Traits in dependent personality disorder center on a person's fear or anxiety around taking care of themselves. Traits in obsessive-compulsive personality disorder include perfectionism, rigid thinking, and lack of flexibility with change.
Causes include a combination of genetics and environmental factors. Treatment may involve talk therapy and medications to help ease symptoms.
Read the original article on Verywell Health.