Understanding Cluster B Personality Disorders

Overview of Cluster B

• Cluster B includes:
  • Borderline Personality Disorder (BPD)
  • Antisocial Personality Disorder (ASPD)
  • Narcissistic Personality Disorder (NPD)
  • Histrionic Personality Disorder (HPD)
• Known as the "wild cluster," associated with emotional instability.
• Common in clinical settings.
• Emotional instability leads to misdiagnosis as mood disorders.
• Defined by negative emotions, high neuroticism, low self-esteem, unstable identity, and sensitivity to criticism.
• Core pattern: Emotional instability + poor self-image.

Common Characteristics

• Emotional unbalance: Feelings of sadness, dissatisfaction, anger, irritability, emptiness.
• High neuroticism: Common trait in all four disorders.
• Low self-esteem and sensitivity to rejection or criticism.
• Emotional instability and poor self-image.

Differences in Clinical Presentation

• Severity:
  • BPD and ASPD are more disabling.
  • NPD and HPD are less impairing.
• Gender:
  • BPD and HPD more common in women.
  • ASPD and NPD more common in men.
• Cultural influences on expression of emotion and distress.

Detailed Exploration of Each Disorder

Borderline Personality Disorder (BPD)

• Core Symptoms (Mnemonic: I DESPAIR):
  • Identity disturbance, poor self-image, chronic dysphoria, feelings of emptiness.
  • Emotional instability, suicidal acts, self-harm.
  • Psychosis-like symptoms under stress, chronic anger, impulsivity, unstable relationships.
  • Splitting: seeing things in black and white.
• Severity:
  • Severe, difficulty in maintaining employment and relationships.
• Gender:
  • More common in women.
• Treatment:
  • Dialectical Behavior Therapy (DBT).

Antisocial Personality Disorder (ASPD)

• Core Symptoms (Mnemonic: ACID LIAR):
  • Criminal behavior, impulsivity, disregard for safety, deceit, irresponsibility.
  • Aggression, violence, remorselessness.
• Severity:
  • Severe, often results in criminal records.
• Gender:
  • More common in men.
• Treatment:
  • Difficult, poor motivation for treatment.

Narcissistic Personality Disorder (NPD)

• Characteristics:
  • Inflated self-importance, need for admiration, sense of entitlement.
  • Arrogance, fantasies of success, lack of empathy.
• Severity:
  • Less severe, often successful in careers but struggle in relationships.
• Gender:
  • More common in men.

Histrionic Personality Disorder (HPD)

• Characteristics:
  • Attention seeking, exaggerated behaviors, seductive, provocative.
  • Flashy appearance, theatrical speech, unstable affect.
• Severity:
  • Least impairing, often does not come to clinical attention.
• Gender:
  • More common in women.
• Notable:
  • Lack of clear relationship to childhood abuse.

Conclusion

• Cluster B disorders share a core pathology: emotional instability and poor self-image.
• Differences primarily in severity and cultural expression related to gender.
• Upcoming exploration of the final cluster of personality disorders.