Personality refers to the innate and enduring characteristics that influence an individual’s attitudes, behaviours, and experience of themselves, others, and the world. Historically, personality disorders were conceptualised as enduring and pervasive disturbance in an individual’s patterns of thinking, feelings, and behaviours. This disturbance results in significant disturbance in their psychosocial functioning and interpersonal relationships The diagnosis of personality disorders in people with intellectual disability can be a contentious issue. The chapter presents an overview of the condition, the treatments with medication available, and their relevance.

Other categories of personality disorders, apart from borderline personality disorder are encountered in clinical practice and these are described and named in DSM-5 but not in ICD-11. The clinical features and diagnostic criteria of all these types are reviewed here. They are grouped into three clusters: Cluster A, the eccentric PDs – which include paranoid, schizoid and schizotypal PDs – and Cluster B, the dramatic group. The most important of these is antisocial personality disorder as well as borderline and histrionic PDs. Cluster C, which are the avoidant or fearful PDs, include avoidant, dependent and obsessive-compulsive types.

Also included in this chapter are a category of conditions known as ’impulse disorders’, where subjects experience an impulse to commit some action which may give them pleasure and are said to be ego-syntonic, yet result in distress to the individual or harm to others. These include gambling, gaming disorder, intermittent explosive disorder, kleptomania and pyromania.

The proportion of the population living into old age has been increasing worldwide. For the first time in history, there are more older people than children under 5 years of age. The task for public health is to understand the relationships between ageing, health and the environment (physical, social and economic) in which people live, to promote healthy ageing and prevent the disability and subsequent dependency that is often associated with growing old.

This chapter examines the factors that lead to ageing populations and explores the health, social and economic consequences of the change in the population structure. It then goes on to outline strategies that can lead to healthy ageing and other public health actions that could help to manage the challenges posed – and the opportunities afforded – by the relative and absolute increase in the number of older people.

The clause is a special kind of phrase with a verb phrase (VP) as its head, also called its predicate. The subject is an external complement (outside the VP). Though traditional definitions of the subject fail, subjects have some characteristic properties. Notably, they usually precede the VP, but some interrogative constructions feature subject-auxiliary inversion, in which the subject is preceded by an auxiliary verb; subject pronouns are usually nominative case. Semantically, subjects are typically the predicand, a semantic term for what a predicate applies to. Objects are internal complements, and pronoun objects are usually accusative case. Some verbs license two objects: direct and indirect. The verb ‘be’ and a few others take predicative complements. Like objects, predicative complements are internal complements. Unlike objects, they can be adjective phrases and they never correspond to any passive subject. There are ascriptive and specifying uses of ‘be’. Internal complements also include various subordinate-clause and preposition-phrase complements.

In the DSM-5 main section for clinical diagnoses, psychopathology in Cluster C (Anxious-Fearful) is represented by three personality disorders: Avoidant, Dependent, and Obsessive-Compulsive. However, characterization of persistent anxious-fearful psychopathology has varied historically, and it appears that the cluster formation may not be retained with the next iteration of personality disorder diagnoses. This chapter examines the historical development of anxious-fearful personality disorders, and examines the different ways that associated symptoms and problems have been characterized and grouped to elucidate core features in order to clarify visions looking forward. There is an emphasis on avoidant behaviors, when describing the clinical manifestation of these personality disorders, and it is suggested that focusing on mechanisms for this kind of personality pathology, as well as explicitly addressing the issue of grain size, would enhance continuing efforts to improve diagnostic conceptualizations of personality pathology involving anxiety, fear, and avoidance.

This rejoinder responds to commentaries offered by Cain (this volume) and Arntz (this volume). The authors reiterate their view that incorporating mechanisms into research will open new pathways for understanding the nature of anxious fearful personality pathology and for improving diagnosis. They agree with and value the interpersonal theory for better understanding personality disorders, and for guiding treatment. They further argue that particular attention be paid to grain size in the study and conceptualization of anxious fearful personality pathology.