Spotlight on Cluster B Personality Disorders: Histrionic, Narcissistic, Borderline and Antisocial

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The American Psychiatric Association defines a personality disorder as, “an enduring pattern of inner experience and behavior that differs 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. Personality disorders are a long-standing and maladaptive pattern of perceiving and responding to other people and to stressful circumstances.”


Personality disorders are grouped into three different classifications referred to as clusters.

  • Cluster A - Paranoid Personality, Schizoid Personality and Schizotypal Personality
  • Cluster B - Histrionic (Hysterical) Personality, Narcissistic Personality, Borderline Personality and Antisocial Personality
  • Cluster C - Avoidant Personality, Dependent Personality and Obsessive-Compulsive Personality

Some personalities are not classified in either A, B, or C cluster because they are not a disorder but a type of personality.

  • Passive-Aggressive (Negativistic) Personality
  • Cyclothymic Personality
  • Depressive Personality

Cluster B

There are many factors that contribute to the cause of a personality disorder. The person who has been classified as having a cluster B personality disorder appears to be erratic and dramatic in their behavior. Most symptoms appear in adolescence but are not usually diagnosed till adulthood. In some cases there has been some form of abuse as a child.


Behavior of Histrionic Personality

  • Blow things out of proportion and become overly dramatic
  • Extremely delicate emotionally and almost childlike at times
  • Obsessed with his/her appearance and may appear to be frivolous and superficial
  • Wants to be the center of attention and sometimes seeks attention by acting out sexually

Those with histrionic personality disorder sometimes seek attention by being alluring and enjoying the behavior of acting to entice others through erotic behavior but not always to seek sex. Some may also appear to be neurotic and complain of physical medical problems to have the attention focused back on them.


Behavior of Narcissistic Personality

  • Feeling superior to others
  • Need for great respect
  • Lack of compassion or understanding
  • Feeling grandiose
  • Hung up on failing, being defeated or someone criticizing them

When challenged with feelings of failure or criticism from others they may become aggressive or depressed due to the superior feeling they have about themselves. They feel like others want to be like them and are envious. Narcissists believe they are entitled to what they want and others are beneath them; that their needs are met first before anybody else’s. Often times people view them as arrogant.


Behavior of Antisocial Personality (previously referred to as psychopathic or sociopath personality)

  • Disregard the rights and feelings of others
  • Deceptive and insincere
  • Take advantage of others for material gain or personal enjoyment
  • Impulsive and neglectfully respond to conflict
  • Easily frustrated and may become antagonistic or violent
  • No feelings of regret or guilt

Most with antisocial personality are men. Often times the person who has antisocial personality will blame others for things that have gone wrong. They tend to justify their actions to make them feel better about a situation. Any type of penalty does not help in improving their behavior instead it usually confirms their ideas of how bad the world is and the people who live in it. They are likely to be alcoholic and have drug-related problems, and be sexually deviant and promiscuous. Staying employed at one place usually does not occur and often times they fail at their jobs. Usually there is a family history of antisocial behavior, substance abuse, divorce, and physical abuse.


Behavior of Borderline Personality

  • Unstable in self image, mood, behavior and interpersonal relationships
  • Act out aggression toward self
  • Impulsive, angry and confused about their identity

Borderline personality becomes more obvious in early adulthood but is less likely in older age. Most people who have borderline personality are women. They often need nurturing from others because they feel empty inside. When they are in a caring and healthy relationship they may fear abandonment, and this sometimes results in anger. Sometimes they feel not real or out of touch with reality almost as if events are not really happening to them. Sometimes this results in hallucinations or brief psychotic episodes. Sometimes they are quick and rash with their actions, engage in promiscuity and have substance abuse problems or cause self harm.


Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fourth Edition (2000)

The Merck Manuals Online Medical Library, Personality Disorders May 2006 by John G. Gunderson, MD

AllPsych Online, Personality Disorders