Cluster C personality disorders include avoidant, dependent, and obsessive-compulsive personalities.

Personality disorders are mental health conditions that involve a series of personality traits and patterns of thought and behavior that may lead to a great deal of distress and friction in interpersonal relationships.

There are 10 personality disorders and they’re grouped together based on shared dominant features or personality traits.

These are the three clusters of personality disorders:

Cluster C personality disorders are three conditions that share common features like fearfulness and anxiousness.

In other words, besides other specific symptoms, people living with avoidant, dependent, and obsessive-compulsive personality disorders tend to experience strong feelings related to:

  • anxiety
  • fear
  • doubt

These dominant features are typically persistent and evident across situations and over time. This causes a great deal of distress and impacts several areas of life including relationships and self-esteem.

The cause of cluster C personality disorders isn’t yet established. Experts do however theorize it may be a combination of factors, including:

  • genes
  • biology
  • early experiences
  • culture influences
  • traumatic events
  • early relationships

Obsessive-compulsive personality disorder (OCPD) is a condition that involves experiencing intrusive, distressing thoughts as well as compulsive behaviors specific to an urge for order and perfectionism.

When you live with OCPD, you might find perfectionism causes important tasks to be completed until the last moment. You might also notice you have a tendency to avoid relaxation or unwinding time because you feel there are more productive things to do. However, you feel comfortable with your perfectionist behaviors.

OCPD vs. OCD

OCPD is not the same as obsessive-compulsive disorder (OCD), though both conditions involve unwanted intrusive thoughts and compulsive behaviors.

In OCPD, thoughts and urges are focused on rigid management of daily life and the tasks associated with it.

OCD, on the other hand, can impact any area of your life and involves distressing, irrational obsessions followed by compulsions that aim to decrease the distress these thoughts cause you.

OCD obsessions can have many themes, and a large part of your day may be spent performing OCD rituals to help break the cycle of obsessions.

OCD tends to involve a sense of self-awareness — you realize your thoughts and behaviors may be unreasonable. When you live with OCPD, however, you’re likely comfortable with the system of behaviors you’ve developed.

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Symptoms and criteria

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, revised text (DSM-5-TR), a primary reference tool in the U.S. mental health community, notes OCPD patterns commonly appear as perfectionism or a fixation with order, and they come at the cost of personality traits such as efficiency, flexibility, and receptiveness.

To receive an OCPD diagnosis, 4 or more of the following DSM-5-TR criteria must be met:

  • preoccupation with details, organization, or rules that override the activity itself
  • perfectionism that interferes with completing a task
  • inflexibility on morals and ethics
  • extreme work devotion at the expense of social events and relationships
  • inability to get rid of possessions, even if they have no sentimental value
  • stubbornness
  • reluctance to spend money because it might be necessary for future disasters
  • inability to delegate tasks unless they’re performed in an exact way

OCPD is more common in men than in women, and it’s possible to have many traits of OCPD without a fully diagnosed disorder.

When you live with dependent personality disorder, you may experience a persistent fear of separation and exhibit submissive, overly-attached behaviors that come from a deep need to be taken care of.

Unlike other disorders that may share similar fears of abandonment, dependent personality disorder is rooted in an intense need to receive care.

Symptoms and criteria

When you live with this condition, you may find it challenging to make even simple decisions without guidance. You might also engage in extreme people-pleasing and submissive behaviors to ensure your caregiver stays close.

To receive a dependent personality disorder diagnosis, the DSM-5-TR states that five or more of the following criteria must be met:

  • needing someone else to assume responsibility for major life areas
  • difficulty making decisions without direction and reassurance
  • fear of confrontation due to unrealistic fears of disapproval
  • going to extreme, often unpleasant lengths just to feel support and nurturing
  • difficulty showing initiative as a result of self-doubt
  • fears about an inability to care for yourself make being alone uncomfortable
  • intensely seeking a new supportive relationship when the current supportive one ends
  • preoccupation with fears about having to provide self-care

Research into dependent personality disorder is ongoing. Due to its many presentations, additional subtypes have been proposed for inclusion.

Avoidant personality disorder is characterized by feelings of inadequacy, hesitation to engage in social situations, and intense emotional response to criticism. Emotional unavailability may also be a symptom.

Living with this condition can mean fear of rejection or harsh judgment prevents you from establishing interpersonal contact.

You might avoid job promotions, for example, social events with new people, or any situation that may require you to actively interact with others.

If someone does offer you a critique, even the mildest statements may cause intense emotional distress, causing you to question your self-worth.

Symptoms and criteria

In the DSM-5-TR, a diagnosis of avoidant personality disorder is received when four or more of the following criteria are met:

  • active avoidance of social interaction out of fear of disapproval, rejection, or criticism
  • unwillingness to engage with others unless you’re convinced they like you
  • reluctance to try new things out of fear of being embarrassed
  • extremely low sense of self-worth
  • fixation on the possibility of criticism or rejection in social environments
  • feelings of inadequacy prevent performance in new social situations
  • fear of shame or ridicule prevents being fully open in intimate relationships

Limited research exists on avoidant personality disorder, though some experts suggest it may be closely related to social anxiety disorder.

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). This type of psychotherapy supports you in identifying unhelpful thoughts and behaviors — and then helps you to establish new, beneficial ones.

The treatment you receive will depend on which cluster C personality disorder you’re experiencing, the severity of your symptoms, and what areas of your life are heavily impacted.

Cluster C personality disorders share underlying traits of anxiety and fear. Cluster C includes avoidant, dependent, and obsessive-compulsive personality disorders.

Symptoms of these conditions can be managed with the support of a mental health professional.