Hello. My name is Shabani. And I’m going to talk to you today about personality disorders, specifically Cluster C. Some of the learning objectives for this presentation include to understand the difference between a personality trait and a personality disorder, to learn to recognize personality disorders, to learn the characteristics and personality disorders in Cluster C, and to understand the general treatment options for Cluster C personality disorders. The following is an outline of today’s presentation. Cluster C disorders include the following types, avoidant, dependent, and obsessive-compulsive. Individuals in this group often appear anxious or fearful. This is a categorical approach, however. So an individual diagnosed with a personality disorder may have an additional personality disorder from a different cluster. Now, I will discuss each type in more detail. Patients with dependent personality disorder often have an excessive need to be taken care of that leads to submissive and clinging behavior. They have difficulty making everyday decisions without an excessive amount of advice and reassurance from others. They need others, typically, to assume responsibility for most major areas of their life. They often have difficulty expressing disagreement with others because of fear of loss of support or approval. They have difficulty initiating projects or doing things on their own because of a lack of self-confidence in judgment or abilities, rather than a lack of motivation or energy. It goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant. They feel uncomfortable or hopeless when alone because of exaggerated fears of being unable to care for himself or herself. They urgently seek other relationships as a source of care and support when a close relationship ends. They are unrealistically preoccupied with fears of being left to take care of themselves alone. An individual with avoidant personality disorder avoids occupational activities that involve significant interpersonal contact because of fears of criticism, of disapproval, or rejection. They feel inadequate and they’re hypersensitivity to negative evaluation. They’re unwilling to get involved with people unless they’re certain of being liked. They show restraint with intimate relationships because of the fear of being shamed or ridiculed. And they’re constantly preoccupied with being criticized or rejected in social situations. They’re inhibited by new interpersonal situations because of their feelings of inadequacy. They view themselves 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. An obsessive-compulsive person has a pervasive pattern of preoccupation with perfectionism, with mental and interpersonal control, and orderliness at the expense of flexibility, openness, and efficiency. They’re preoccupied with details, with rules, with lists, with order and organization, and schedules to the extent that the major point of the activities is actually lost. They show perfectionism that interferes with task completion. They’re excessively devoted to work and productivity to the exclusion of leisure activities and friendships. They’re overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values that are not accounted for by a cultural reason or a religious identification. They’re typically unable to discard worn out or worthless objects, even when they have really no sentimental value. And they are reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing a particular thing. They adopt a miserly spending style towards both their self and others and money is typically viewed as something to be hoarded for future catastrophes, showing rigidity and oftentimes they can show stubbornness as well. There is no specific medications approved by the US FDA for the treatment of personality disorders. However, patients who present with personality difficulties not infrequently have other psychiatric disorders, such as depression or substance abuse, that should be addressed with appropriate pharmacological treatment. Studies suggest that it’s useful to target specific behavioral difficulties through psychodynamic therapy. Selective serotonin re-uptake inhibitors are often thought of as first-line medical therapy for personality disorders. Mood stabilizers may help stabilize mood and reduce irritability or aggression. In summary, a personality disorder arises when an individual’s personality traits are so inflexible and maladaptive across a wide range of situations that they cause significant impairment and distress. Personality disorders are defined by specific DSM-IV criteria. And specific types of personality disorders are grouped into three clusters and defined separately. Cluster C personally disorders are grouped into the anxious and fearful group. Treatment can include psychotherapy and/or psychopharmacotherapy. Patients with personality disorders may benefit from an early referral to a mental health professional. Patients with personality disorders are at increased risk for adverse outcomes related to physical trauma, suicide, substance abuse, and concurrent psychiatric disorders. Additionally, patients often have difficulty understanding their condition and establishing rapport with their clinician. The following are some key references from this presentation. Thank you.