Personality Disorder Cluster B

Cluster ‘B’ Personality Disorder:

Cluster B disorders involve unpredictable, dramatic, or intensely emotional responses to things.

1). Antisocial Personality Disorder.

Antisocial personality disorder, sometimes called sociopathic, is a mental health condition in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others. People with antisocial personality disorder tend to purposely make others angry or upset and manipulate or treat others harshly or with cruel indifference. They lack remorse or do not regret their behavior.

What Are the Symptoms of Antisocial Personality Disorder?

Symptoms of antisocial personality disorder include repeatedly:

  • Ignoring right and wrong.
  • Telling lies to take advantage of others.
  • Not being sensitive to or respectful of others.
  • Using charm or wit to manipulate others for personal gain or pleasure.
  • Having a sense of superiority and being extremely opinionated.
  • Having problems with the law, including criminal behavior.
  • Being hostile, aggressive, and violent or threatening to others.
  • Feeling no guilt about harming others.
  • Doing dangerous things with no regard for the safety of self or others.
  • Being irresponsible and failing to fulfill work or financial responsibilities.

Adults with antisocial personality disorder usually show symptoms of conduct disorder before the age of 15. Symptoms of conduct disorder include serious, ongoing behavior problems, such as:

  • Aggression toward people and animals.
  • Destruction of property.
  • Lying and dishonesty.
  • Theft.
  • Serious violation of rules.

Antisocial personality disorder is considered a lifelong condition. But in some people, certain symptoms ― particularly destructive and criminal behavior ― may decrease over time. It's not clear whether this decrease is a result of the effect aging has on their mind and body, an increased awareness of the impact that antisocial behavior has had on their life, or other factors.

People with antisocial personality disorder often violate the law, becoming criminals. They may lie, behave violently or impulsively, and have problems with drug and alcohol use. They have difficulty consistently meeting responsibilities related to family, work or school.

Diagnostic Criteria

A). A pervasive pattern of disregard for violation of the rights of others, occurring since age 15 years, as indicated by three (or more) of the following:

1. Failure to confirm to social norm with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.

2. Deceitfulness, as indicated by repeated lying. Use of aliases, or conning others for personal profit or pleasure.

3. Impulsivity or failure to plan ahead.

4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults.

5. Reckless disregard for safety of self or other.

6. Consistence irresponsibility, as indicated by repeated failure to sustain consistent work       behavior or honor financial obligation.

7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

B). The individual is at least age 18 years.

C). There is evidence of conduct disorder with onset before age 15 years.

D). The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder.

2). Borderline Personality Disorder

Borderline personality disorder is a mental health disorder that impacts the way you think and feel about yourself and others, causing problems functioning in everyday life. It includes self-image issues, difficulty managing emotions and behavior, and a pattern of unstable relationships.

With borderline personality disorder, you have an intense fear of abandonment or instability, and you may have difficulty tolerating being alone. Yet inappropriate anger, impulsiveness and frequent mood swings may push others away, even though you want to have loving and lasting relationships.

Borderline personality disorder usually begins by early adulthood. The condition seems to be worse in young adulthood and may gradually get better with age.

If you have borderline personality disorder, don't get discouraged. Many people with this disorder get better over time with treatment and can learn to live satisfying lives.

What Are the Symptoms of Borderline Personality Disorder?

Borderline personality disorder affects how you feel about yourself, how you relate to others and how you behave.

Signs and symptoms may include:

  • An intense fear of abandonment, even going to extreme measures to avoid real or imagined separation or rejection
  • A pattern of unstable intense relationships, such as idealizing someone one moment and then suddenly believing the person doesn't care enough or is cruel
  • Rapid changes in self-identity and self-image that include shifting goals and values, and seeing yourself as bad or as if you don't exist at all
  • Periods of stress-related paranoia and loss of contact with reality, lasting from a few minutes to a few hours
  • Impulsive and risky behavior, such as gambling, reckless driving, unsafe sex, spending sprees, binge eating or drug abuse, or sabotaging success by suddenly quitting a good job or ending a positive relationship
  • Suicidal threats or behavior or self-injury, often in response to fear of separation or rejection
  • Wide mood swings lasting from a few hours to a few days, which can include intense happiness, irritability, shame or anxiety
  • Ongoing feelings of emptiness
  • Inappropriate, intense anger, such as frequently losing your temper, being sarcastic or bitter, or having physical fights.

Diagnostic Criteria

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

    1. Frantic efforts to avoid real or imagined abandonment. (Note: do not include suicidal or self-mutilating behavior covered in criterion 5.).
    2. A pattern of unstable and interest interpersonal relationship characterized by alternating between extremes of idealization and devaluation.
    3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
    4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). (Note: do not include suicidal or self-mutilating behavior covered in criterion 5.)
    5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating. Behavior.
    6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
    7. Chronic feeling of emptiness.
    8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequently displays of temper, constant anger, and recurrent physical fights.
    9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

3). Histrionic Personality Disorder.

Histrionic personality disorder  is one of a group of conditions called "Cluster B" or "dramatic" personality disorders. People with these disorders have intense, unstable emotions and distorted self-images. For people with histrionic personality disorder, their self-esteem depends on the approval of others and does not arise from a true feeling of self-worth. They have an overwhelming desire to be noticed, and often behave dramatically or inappropriately to get attention. The word histrionic means "dramatic or theatrical."

This disorder is more common in women than in men and usually is evident by adolescence or early adulthood

What Are the Symptoms of Histrionic Personality Disorder?

In many cases, people with histrionic personality disorder have good social skills; however, they tend to use these skills to manipulate others so that they can be the center of attention.

A person with this disorder might also:

  • Be uncomfortable unless they are the center of attention
  • Dress provocatively and/or exhibit inappropriately seductive or flirtatious behavior
  • Shift emotions rapidly
  • Act very dramatically, as though performing before an audience, with exaggerated emotions and expressions, yet appears to lack sincerity
  • Be overly concerned with physical appearance
  • Constantly seek reassurance or approval
  • Be gullible and easily influenced by others
  • Be excessively sensitive to criticism or disapproval
  • Have a low tolerance for frustration and be easily bored by routine, often beginning projects without finishing them or skipping from one event to another
  • Not think before acting
  • Make rash decisions
  • Be self-centered and rarely show concern for others
  • Have difficulty maintaining relationships, often seeming fake or shallow in their dealings with others
  • Threaten or attempt suicide to get attention.

Diagnostic Criteria

A pervasive pattern of excessive emotionally and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

    1. Is uncomfortable in situation in which he or she is not the center of attention.
    2. Interactive with others is often characterized by inappropriate sexually seductive or provocative behavior.
    3. Displays rapidly shifting and shallow expression of emotions.
    4. Consistently uses physical appearance to draw attention to self.
    5. Has a style of speech that is excessive impressionistic and lacking in detail.
    6. Shows self-dramatization, theatricality, and exaggerated of emotion.
    7. Is suggestible (i.e., easily influenced by others or circumstances).
    8. Considers relationships to be more intimate than they actually are.

 

4). Narcissistic Personality Disorder.

Narcissistic personality disorder is a mental health condition in which people have an unreasonably high sense of their own importance. They need and seek too much attention and want people to admire them. People with this disorder may lack the ability to understand or care about the feelings of others. But behind this mask of extreme confidence, they are not sure of their self-worth and are easily upset by the slightest criticism.

A narcissistic personality disorder causes problems in many areas of life, such as relationships, work, school or financial matters. People with narcissistic personality disorder may be generally unhappy and disappointed when they're not given the special favors or admiration that they believe they deserve. They may find their relationships troubled and unfulfilling, and other people may not enjoy being around them.

Treatment for narcissistic personality disorder centers around talk therapy, also called psychotherapy.

Narcissistic personality disorder affects more males than females, and it often begins in the teens or early adulthood. Some children may show traits of narcissism, but this is often typical for their age and doesn't mean they'll go on to develop narcissistic personality disorder.

What Are the Symptoms of Narcissistic Personality Disorder?

Symptoms of narcissistic personality disorder and how severe they are can vary. People with the disorder can:

  • Have an unreasonably high sense of self-importance and require constant, excessive admiration.
  • Feel that they deserve privileges and special treatment.
  • Expect to be recognized as superior even without achievements.
  • Make achievements and talents seem bigger than they are.
  • Be preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate.
  • Believe they are superior to others and can only spend time with or be understood by equally special people.
  • Be critical of and look down on people they feel are not important.
  • Expect special favors and expect other people to do what they want without questioning them.
  • Take advantage of others to get what they want.
  • Have an inability or unwillingness to recognize the needs and feelings of others.
  • Be envious of others and believe others envy them.
  • Behave in an arrogant way, brag a lot and come across as conceited.
  • Insist on having the best of everything — for instance, the best car or office.

At the same time, people with narcissistic personality disorder have trouble handling anything they view as criticism. They can:

  • Become impatient or angry when they don't receive special recognition or treatment.
  • Have major problems interacting with others and easily feel slighted.
  • React with rage or contempt and try to belittle other people to make themselves appear superior.
  • Have difficulty managing their emotions and behavior.
  • Experience major problems dealing with stress and adapting to change.
  • Withdraw from or avoid situations in which they might fail.
  • Feel depressed and moody because they fall short of perfection.
  • Have secret feelings of insecurity, shame, humiliation and fear of being exposed as a failure.

Diagnostic criteria

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievement).

2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.

3. believes that he or she is “special” and unique and can only be understood by, or should associated with, other special or high-status people (or institutions).

4. requires excessive admiration.

5. Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations.

6. is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).

7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.

8. is often envious of others or believes that others are envious of him or her.

9. shows arrogant, haughty behaviors or attitudes.

 

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