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About Personality Disorder
A personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations 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. There are 10 specific personality disorders. They are as follows:
- Paranoid personality disorder – a pattern of distrust and suspiciousness such that others' motives are interpreted as malevolent.
- Schizoid personality disorder – a pattern of detachment from social relationship and a restricted range of emotional expression.
- Schizotypal personality disorder – a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior.
- Antisocial personality disorder – a pattern of disregard for, and violation of, the rights of others.
- Borderline personality disorder – a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity.
- Histrionic personality disorder – a pattern of excessive emotionality and attention seeking.
- Narcissistic personality disorder – a pattern of grandiosity, need for admiration, and lack of empathy.
- Avoidant personality disorder – a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.
- Dependent personality disorder – a pattern of submissive and clinging behavior related to an excessive need to be taken care of.
- Obsessive compulsive personality disorder – a pattern of preoccupations with orderliness, perfectionism, and control.
JAN's Accommodation Solutions: Executive Functioning Deficits is a publication detailing accommodations for individuals with limitations related to executive functioning. These ideas may be helpful in determining accommodations.
Personality Disorder and the Americans with Disabilities Act
The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Personality Disorder
People with personality disorders may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with personality disorders will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Situations and Solutions:
The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.
An employee with obsessive compulsive personality disorder works as an administrative assistant for a physician's office.
After being hired, she discloses her condition and requests accommodations in the form of written instructions, checklists, and a private workspace. The employer agrees to the accommodations. A few weeks into the job, the employee tells her supervisor she does not like the documentation system the office is using, and will be making changes as she sees fit. The supervisor explains that will not be tolerated, that she needs to follow their protocol, but the employee follows through with making her own changes. The supervisor takes disciplinary action and tells the employee if she continues to go against the employer's protocol that she could be terminated. The employee responds by writing an e-mail to the supervisor outlining how her way of doing things is better and why the employer should make the changes she is suggesting. The employer insists it will not make the changes and the employee needs to comply. The employee continues to defy the employer's instruction and is terminated.
An employee with borderline personality disorder works as a hairstylist in a beauty salon.
At times, she becomes very upset and leaves work abruptly. The supervisor meets with her regarding these occurrences and the employee discloses her disability and explains that because of her work schedule, she has been unable to attend therapy and psychiatrist appointments, which has resulted in an exacerbation of her symptoms. The employer suggests providing her a consistent schedule, allowing her to keep the early part of the day open for her therapist and doctor appointments. The employer also agrees to allow the employee to take two additional unpaid breaks per shift. The accommodations result in the employee getting the treatment she needs, allowing her to continue working successfully in her position.
An employee with antisocial personality disorder works as a construction worker.
One day while at work, the employee tells a coworker he does not like him and that the coworker should watch his back. The coworker reports this to the supervisor who then addresses the employee about the comment. The supervisor asks what the problem is, and the employee responds only by saying he just does not like the coworker. The supervisor tells the employee that if he threatens his coworker again he will be terminated. A week later the employee threatens his coworker again. The supervisor terminates the employee. In response, the employee discloses that he has antisocial personality disorder. The employer has no obligation to rescind the termination because it occurred prior to the employee's disclosure.
An employee with schizoid personality disorder has worked in a call center as a customer service representative for two years.
Due to business necessity, the employer restructures the employee's position to include face to face interactions with customers. The employer begins receiving complaints from customers that the employee is acting in a rude and generally unfriendly manner. When the issue is brought up during a performance evaluation, the employee discloses his schizoid personality disorder, and explains that it affects his ability to show appropriate affect. He generally appears unenthusiastic regardless of what is happening. As a result, he may appear to be acting rude or disinterested when interacting with customers in person. The employer reassigns the employee to a position where he can work on the phones exclusively again.
An employee with avoidant personality disorder works as a vocational specialist for a disability insurance company.
Originally, the employee's position allowed him to work from home full time. Recently, the company decides to begin transitioning some of its teleworking employees back into the office. The employee discloses his condition and requests he be allowed to continue working from home as an accommodation. The employee provides medical documentation explaining that he experiences intense feelings of inadequacy and discomfort when around others and would not be able to perform at the same level in an office environment as he would at home. As a result, the employer allows the employee to continue working from home.
An employee with histrionic personality disorder works in a cubicle environment as an insurance claims processor.
She is regularly talking and distracting her coworkers, at times talking about very personal issues and having crying fits. At other times the employee will be very physical with coworkers, hugging and talking about how much she loves being around them. The employee's behavior is generally disruptive, and when the supervisor confronts her about this, the employee discloses her condition. The employee provides medical documentation that states that she would benefit from working in a more private space where it is not so easy for her to talk to coworkers and listening to music on earphones while doing work off the phones. The employer is able to provide these accommodations, which prove to be effective.
An employee with schizotypal personality disorder just started working as a cashier in a small department store.
Within three weeks, the employer receives four comments from customers regarding the employee's behavior, that the employee had begun talking to them about strange things including aliens and various conspiracy theories. The employer meets with the employee to discuss these occurrences, at which point the employee discloses her disability. The employee provides medical documentation that states that the employee will at times have episodes where she will think and talk about things that are not grounded in reality and that while medication can help to prevent such occurrences, they will inevitably occur on an almost daily basis. Because it is an essential function to be able to communicate effectively with customers, and the employee's eccentric behavior is not in compliance with the employer's conduct standards, the employer determines the employee is not qualified for the position. Because the employee wasn't qualified for the position from the point of hire, the employer does not have an obligation to consider reassignment, but does anyway, reassigning the employee to a position as a stock clerk, which requires much less interaction with customers.
An employee with narcissistic personality disorder is hired as a project manager for a software development company.
The employee tells his subordinates that he will be replacing the "incompetent" president of the company within two years, so they had better respect him. One of his subordinates tells the vice president of the company, who tells the president. The president puts the employee on probation, explaining that the next such conduct violation would result in termination. Three months later, the project manager sends out a memo to everyone on his team outlining his accomplishments and how he deserves the praise of his team members and the company. He ends the memo by signing off as the future president of the company. The memo makes its way to the president who then terminates the employee. The employee then discloses he has a personality disorder. The employer follows through with the termination as there is no obligation to excuse prior conduct violations that occur before the employer is made aware of the condition.
An individual with paranoid personality disorder is working as a financial consultant for a large marketing firm.
Due to his condition, he often feels like coworkers and supervisors are looking for ways to hurt or sabotage him. He has been going to therapy and is aware that at least some of his beliefs are not true. He decides to disclose his disability and requests more frequent interactions with the supervisor to insure effective communication, the ability to have a support person present for performance evaluations, and a flexible schedule to allow for continued therapy appointments. The employer agrees to provide the accommodations and the employee is able to remain in his position and continue to work effectively.
JAN Publications & Articles Regarding Personality Disorder
Consultants' Corner Articles
- Accommodating Social Anxiety Disorder (Social Phobia)
- Accommodations for Difficulties with Assisting Others on the Telephone Due to Stress, Anxiety, and Interpersonal Communications
- Cognitive Impairment and the Interactive Process
- Communication Difficulties in the Workplace
- I Understand You Are Stressed...But Aren’t We All?
- My Disability Made Me Do It! When It Does and Doesn’t Matter
- Return to Work After Hospitalization for Mental Health Treatment