Understanding the A, B, C's of Personality Disorders:

May is Mental Health Awareness Month!

The A, B, C's of Personality Disorders

At DualDiagnosis.co.za, we offer insights into the complex world of personality disorders and their often-coexistent relationship with addiction. This beginner’s guide aims to demystify the ‘A, B, C’s—the three clusters of personality disorders—and explore their connection with addictive behaviors.

A: The Odd, Eccentric Cluster

Cluster A personality disorders are characterized by odd or eccentric thinking or behavior. They include:

Paranoid Personality Disorder:

Distrust and suspiciousness of others, seeing their motives as malevolent.

Schizoid Personality Disorder:

Detachment from social relationships and a limited range of emotional expression.

 Schizotypal Personality Disorder:

Acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior.


In the realm of addiction, individuals with Cluster A disorders may use substances as a means of escape from their distressing patterns of thought and interaction.

Art piece depicting the volatile emotions associated with Cluster B personality disorders, contrasted with a tranquil half, symbolizing the internal struggle.
A visual portrayal of the stark contrast between the turmoil of Cluster B personality disorders and the resilience symbolized by a red tree.
Illustration of a face with a tree, depicting the intertwined nature of inner turmoil and calm in Cluster B personality disorders.
Reflective imagery capturing the essence of introspection within Cluster C personality disorders alongside the vibrant life of a red tree.

B: The Dramatic, Emotional, or Erratic Cluster

Cluster B personality disorders are marked by dramatic, overly emotional, or unpredictable thinking or behavior. This cluster includes:

Antisocial Personality Disorder:


Disregard for and violation of the rights of others.

Borderline Personality Disorder:


Instability in personal relationships, self-image, and affects, and marked impulsivity.

Histrionic Personality Disorder:


Excessive emotionality and attention-seeking.


Narcissistic Personality Disorder:


A pattern of grandiosity, need for admiration, and a lack of empathy.


Those with Cluster B disorders may turn to addiction as a way to cope with emotional turmoil or to self-medicate.

C: The Anxious, Fearful Cluster

Cluster C personality disorders involve anxious and fearful thinking and behavior. They include: 

Avoidant Personality Disorder

Social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. 

Dependent Personality Disorder

Excessive need to be taken care of, leading to submissive and clinging behavior and fears of separation.


Obsessive-Compulsive Personality Disorder

Preoccupation with orderliness, perfectionism, and control. 

Addiction can develop as individuals with Cluster C disorders seek relief from chronic anxiety and fear.

Artistic depiction of the chaotic emotional landscape of Cluster B personality disorders, with a contrasting serene tree.
Sculptural representation of the fragmented nature of Cluster C personality disorders, with vibrant red foliage depicting moments of emotional breakthrough.

The Interplay Between Personality Disorders and Addiction

Understanding personality disorders is crucial when examining their interplay with addiction. Addiction can be both a symptom and a exacerbating factor of personality disorders. The self-perpetuating cycle of mental health challenges and substance abuse is what defines the dual diagnosis.

Understanding personality disorders and their potential intersection with addiction requires delving into the realm of personality clusters. These clusters are a way of grouping certain personality disorders that share common characteristics.

In the world of psychology, personality disorders are categorized into three clusters: A, B, and C. Imagine these clusters as a wardrobe of traits; each cluster has its distinctive style and patterns.


 Cluster A is like the avant-garde section of the wardrobe, where eccentricity reigns. Here lie the garments that might not conform to the everyday — the paranoid, schizoid, and schizotypal personality disorders. These are the cloaks of suspicion, detachment, and oddness in both thinking and behavior. Individuals with these disorders often appear to be marching to the beat of their own drum, which may seem out of rhythm with societal expectations.


Moving on, Cluster B is the dramatic couture, vibrant and unpredictable, sometimes dangerously so. This is where you find borderline, narcissistic, histrionic, and antisocial personality disorders. If Cluster A is a solitary whisper, Cluster B is a shout — a cry of emotion, a quest for attention, or a disregard for norms. These disorders often lead to intense, unstable relationships and self-images that shift like sands in an emotional desert.


Lastly, Cluster C is akin to comfort wear, not because it’s comfortable to live with, but because it’s about anxiety and fear. Avoidant, dependent, and obsessive-compulsive personality disorders belong here. These are the well-worn paths of caution, the clingy fabrics of neediness, and the stiff, ironed shirts of control and orderliness.


When addiction enters the mix, it’s like throwing a wildcard into this wardrobe. Substance use may become a misguided attempt to self-medicate the distressing symptoms of a personality disorder. It can blur the lines between these clusters, adding layers of complexity to an already intricate pattern of behaviors and experiences.


For example, someone with a Cluster A disorder might use substances to temporarily silence their profound mistrust of the world. A person from Cluster B might seek the intensity of a high to fill an emotional void or to amplify their inherent drama. Meanwhile, an individual with a Cluster C disorder might turn to drugs or alcohol as a release valve from their tightly controlled inner world.


The intertwining of personality disorders and addiction is complex, with each influencing and exacerbating the other. Treating them requires a deep understanding of the person’s unique tapestry of traits, behaviors, and experiences. By recognizing the patterns and the common threads that run through the clusters, professionals can tailor treatment approaches that address both the personality disorder and the addiction, offering hope for a more harmonious inner world.

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