Personality Disorders in the Cluster B

Personality Disorders in the Cluster B. The DSM-IV-TR (2000) defines Personality Disorders in the Cluster BA as an enduring pattern of inner experience and behavior that deviates from the expectations of the culture. There are ten distinct personality disorders in the DSM (Paranoid, Schizotypal, Antisocial, Borderline, Histrionic, Narcissistic, Avoidant, Dependent, Obsessive-compulsive) and one catch-all category, Personality Disorders NOS (Not Otherwise Specified). Clusters are not valid theoretical constructs and have never been rigorously tested or verified. Cluster B includes Borderline Personality Disorder, Narcissistic Personality Disorder, Antisocial Personality Disorder, Histrionic Personality Disorder, and Schizotypal Personality Disorder. Borderline is characterized by emotional lability, self-image is volatile, self-worth is erratic, affect is unpredictable, and impulse control is impaired.

Narcissistic and Antisocial are characterized by fantasies of grandiosity, brilliance, perfection, and power. Histrionic is characterized by a desire for attention, but it is usually limited to sexual conquests and displays of the histrionic's ability to seduce others.

A personality disorder is defined as "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individuals culture (and is manifested in two or more of his or her areas of mental life:) cognition, affectivity, interpersonal functioning, or impulse control," according to the DSM-IV-TR (2000).

A pattern like this is rigid, long-term (stable), and recurring. It appears in all aspects of life (it is pervasive). It is not the result of substance abuse or a medical condition (such as head trauma). It makes the subject dysfunctional "in social, occupational, or other important areas," causing distress.

There are ten distinct personality disorders in the DSM (Paranoid, Schizotypal, Antisocial, Borderline, Histrionic, Narcissistic, Avoidant, Dependent, Obsessive-compulsive) and one catch-all category, Personality Disorders NOS (Not Otherwise Specified).

Personality disorders that share significant similarities are classified as clusters.

The Paranoid, Schizoid, and Schizotypal Personality Disorders are all part of Cluster A (the Odd or Eccentric Cluster).

Antisocial, Borderline, Histrionic, and Narcissistic Personality Disorders are included in Cluster B (the Dramatic, Emotional, or Erratic Cluster).

Avoidant, Dependent, and Obsessive-compulsive Personality Disorders are all included in Cluster C (the Anxious or Fearful Cluster).

The Clusters are not valid theoretical constructs and have never been rigorously tested or verified. They are merely a convenient shorthand and thus provide little additional insight into the personality disorders that comprise them.

We begin our tour with Cluster B because the personality disorders it contains are common. You are far more likely to have encountered a Borderline, a Narcissist, or a Psychopath than a Schizotypal.

First, a summary of Cluster B:

Instability characterizes Borderline Personality Disorder. The patient is an emotional roller coaster (this is called emotional lability). She (the majority of Borderlines are women) struggles to maintain stable relationships and dramatically attaches to, clings to, and violently detaches from an apparently endless stream of lovers, spouses, intimate partners, and friends. Self-image is volatile, self-worth is erratic and precarious, affect is unpredictable and inappropriate, and impulse control is impaired (the patient's frustration threshold is low).

The Antisocial Personality Disorder is characterized by a contemptuous attitude toward others. The psychopath disregards or actively violates the rights, choices, wishes, preferences, and emotions of others.

The Narcissistic Personality Disorder is built on fantasies of grandiosity, brilliance, perfection, and power (omnipotence). The narcissist lacks empathy, is exploitative, and obsessively seeks narcissistic supply (attention, admiration, adulation, fear, etc.) to bolster his False Self - a fabricated "person" aimed at inspiring awe and extracting compliance and subservience from others.

Finally, the Histrionic Personality Disorder is characterized by a desire for attention, but it is usually limited to sexual conquests and displays of the histrionic's ability to irresistibly seduce others.