Signs Of A Personality Disorder In Teenagers

Personality disorders often involve traits that can lead to difficulties connecting with and being understood by others, and this can contribute to conflict in interpersonal relationships. Many symptoms associated with personality disorders can also be associated with the emotional upheaval and interpersonal instability that tends to be inherent to adolescence. A more complete understanding of what personality disorders are and the ways they can manifest in teenagers might help adolescents and their parents determine if symptoms are cause for concern. Speaking with a licensed mental health professional can offer parents further insight.

What is a personality disorder?

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), which mental health professionals normally use to diagnose mental health conditions, a personality disorder is “an enduring pattern of inner experience and behavior that deviates markedly from the expectation of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.” 

Personality disorders usually impact the following:

• Cognition, or the ways in which people perceive and interpret events, relationships, and concepts
• Affect, or a person’s emotional response, particularly their emotional range and sense of appropriate emotional expression
• Interpersonal function
• Self-control

The DSM-V lists 10 distinct personality disorders:

1. Paranoid personality disorder: A pattern of distrust, suspiciousness, and a belief that other people’s motives are consistently malignant, i.e., “people are out to get me”
2. Schizoid personality disorder: A pattern of detachment from social relationships and a restricted range of emotional expression (which is not the same as a limited emotional capacity; for example, someone with schizoid personality disorder is usually capable of experiencing emotions but not capable of adequately communicating them)
3. Schizotypal personality disorder: A pattern of eccentric and unusual behavior, discomfort in relationships, and cognitive and perceptual distortions that do not rise to the level of hallucinations or delusions; the distortions associated with schizotypal personality disorder usually fall into the category of “magical thinking” and are associated with superstitions and beliefs in clairvoyance and telepathy
4. Antisocial personality disorder: A pattern of disregard for the rights of other people and persistent violation of those rights
5. Borderline personality disorder: A pattern of instability in personal relationships, problems with emotional dysregulation, marked concerns with self-image (often because of low self-esteem), and impulsivity that can lead to self-destructive behavior
6. Histrionic personality disorder: A pattern of attention-seeking behavior and excessive emotional expression
7. Narcissistic personality disorder: A pattern of grandiosity, a need for admiration, and a lack of empathy and concern for other people’s experiences
8. Avoidant personality disorder: A pattern of social inhibition, a sense of inadequacy, and being hypersensitive to criticism
9. Dependent personality disorder: A pattern of submissiveness, clinginess, and needing to be taken care of by other people, even as an adult
10. Obsessive-compulsive personality disorder: A pattern of preoccupation with control, orderliness, and extreme perfectionism, usually at the expense of efficiency, openness, and flexibility (but without the obsessions and compulsions associated with obsessive-compulsive disorder, or OCD)

Signs of a personality disorder in teens

In general, to receive a personality disorder diagnosis, disordered traits must be evident by early adulthood. In some cases, these traits may manifest during adolescence or even childhood, but diagnosis during those life stages can be more complicated.

It is not impossible for personality disorders to be diagnosed in teenagers, though. Personality disorder traits may manifest in different ways in the teenage years than they do in adulthood, and there are several considerations that should be kept in mind when diagnosing adolescents with personality disorders. 

Paranoid, schizoid, and schizotypal personality disorders

These three personality disorders all tend to display similar symptoms if they develop during the teenage years. These indications typically include social anxiety, emotional sensitivity, academic underachievement, and a tendency to be teased by classmates. 

Emotional turmoil can be common in adolescents and may result in some traits associated with schizotypal personality disorder, but many of these traits fade with the greater emotional stability typically accompanying adulthood.

Antisocial personality disorder

Antisocial personality disorder is unique among personality disorders in that it explicitly cannot be diagnosed in anyone under the age of 18. However, to receive a diagnosis as an adult, a person must have displayed symptoms of conduct disorder before the age of 15. These symptoms include the following:

• Aggression toward people or animals
• Destruction of other people’s property
• Theft
• Consistent lying and deceitfulness

Borderline personality disorder (BPD)

Many teenagers display borderline personality disorder symptoms, and research suggests that borderline personality disorder is the most widely diagnosed of the named personality disorders among teenagers. 

However, it can be important to note that much of the instability associated with BPD may be a naturally occurring aspect of adolescence. Many teenagers experience rapid identity changes that contribute to unstable relationships, a situation that can be exacerbated by experimentation with substance use. These behaviors could be indicators of a future BPD diagnosis, or they could be associated with teenage instability that will likely decrease over time.

Narcissistic personality disorder

Teenagers may display a variety of traits commonly associated with narcissistic personality disorder, including a lack of consideration of other people’s feelings, a need for admiration, an entitled or arrogant attitude, a grandiose sense of their own self-importance, and more. However, many of these traits can be typical parts of the developmental stage in which a person develops their individual identity. Such characteristics are usually not cause for concern unless they persist into adulthood. 

Avoidant personality disorder

Avoidant personality disorder may begin to develop in childhood and adolescence and often presents as extreme shyness. While shyness can be quite common in children, shyness that continues into adolescence, a period when social relationships usually become particularly important, can be cause for concern.

Dependent personality disorder

Dependent personality disorder traits may start to emerge during the teenage years. In general, teenagers can be rebellious and reject parental involvement in their lives, so if an adolescent excessively involves their parents in their decision-making, that could be a warning sign. In general, teenagers in the beginning stages of dependent personality disorder may want their parents to decide:

• Their daily outfits
• Who their friends are
• How they spend their free time, and with whom
• What school or college they attend

Typically, anything that goes beyond age-, situation-, and ability-appropriate requests for assistance can be a sign of dependent personality disorder. This condition may be more likely to develop in children and teenagers who experience periods of prolonged physical illness. 

Worried your teenager may have a personality disorder?

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Managing a teenage personality disorder

Even if maladaptive personality traits during the teenage years do not develop into a full-blown personality disorder in adulthood, they may still cause stress and strain for the teenager and those around them. If you are a teen or a parent of a teen in this situation, it may be helpful to speak to a mental health professional. There are several therapeutic options to treat problematic personality traits, including dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT). 

In recent years, the demands of adolescent life may have become more intense than ever before. As a parent, it can be challenging to know how to best support your child, but speaking with a therapist can be helpful. Still, adding an additional in-person appointment to an already full schedule can seem overwhelming. Online therapy may be a more convenient alternative. 

Research has indicated that online therapy may be an effective treatment intervention for personality disorders. One review of a number of studies using online methods for personality disorder treatment concluded that internet-based therapy showed promise in reducing a number of personality disorder symptoms.