Personality Disorders

What is cluster B?

Cluster B is a class of personality disorders listed in the American Psychological Association’s guidebook for diagnosing mental disorders called the Diagnostic Statistical Manual of Mental Disorders (DSM). The term cluster B is used to describe a collection of traits that are characterized by highly dramatic, erratic and overly emotional thinking and behavior. Many people with one personality disorder also have signs and symptoms of at least one additional personality disorder. It’s not necessary to exhibit all the signs and symptoms listed for a disorder to be diagnosed. There are four cluster B personality disorders. They include Narcissistic personality disorder (NPD), Borderline personality disorder (BPD), Histrionic personality disorder (HPD), and Antisocial personality disorder (ASPD).

The following are descriptions of each of the four cluster B personality disorders according to the Mayo Clinic’s website:

Narcissistic personality disorder: People with Narcissistic personality disorder have a pervasive pattern of grandiosity, need for admiration, and a lack of empathy.

  • Egotistical
  • Arrogant
  • Grandiose
  • Preoccupied with fantasies of success, beauty, or achievement
  • See themselves as admirable and superior, and therefore entitled to special treatment
  • Inflated sense of their own importance and a deep need for admiration
  • Believe that they’re superior to others and have little regard for other people’s feelings
Antisocial personality disorder: People with Antisocial personality disorder depict a long pattern of disregard for other people’s rights, a lack of empathy or conscience, and often cross the line and violate these rights. Antisocial personality disorder is sometimes used synonymously with the words, sociopath or psychopath.
  • Disregard for others’ needs or feelings
  • Persistent lying, stealing, using aliases, conning others
  • Recurring problems with the law
  • Repeated violation of the rights of others
  • Aggressive, often violent behavior
  • Disregard for the safety of self or others
  • Impulsive behavior
  • Consistently irresponsible
  • Lack of remorse for behavior
Borderline personality disorder: People with Borderline personality disorder have a pervasive pattern of instability in interpersonal relationships, extreme all or nothing thinking, self-image, identity and behavior often leading to self-harm and impulsivity.
  • Impulsive and risky behavior, such as having unsafe sex, gambling or binge eating
  • Unstable or fragile self-image
  • Unstable and intense relationships
  • Up and down moods, often as a reaction to interpersonal stress
  • Suicidal behavior or threats of self-injury
  • Intense fear of being alone or abandoned
  • Ongoing feelings of emptiness
  • Frequent, intense displays of anger
  • Stress-related paranoia that comes and goes
Histrionic personality disorder: People with Histrionic personality disorder see themselves as attractive and charming. This Disorder is characterized by constant attention-seeking, emotional overreaction, and suggestibility.
  • Constantly seeking attention
  • Excessively emotional, dramatic or sexually provocative to gain attention
  • Speaks dramatically with strong opinions, but few facts or details to back them up
  • Easily influenced by others
  • Shallow, rapidly changing emotions
  • Excessive concern with physical appearance
  • Thinks relationships with others are closer than they really are
These four personality disorders are characterized by life-long, ingrained, rigid, and maladaptive patterns of behavior, severely impairing behavior, lifestyle, and social adjustment. These patterns manifest in impaired judgment, affect, impulse control and interpersonal functioning.

What do these disorders look like in real life?

People with NPD and ASPD are most damaging to others because they lack the ability to empathize and are interpersonally exploitative. They may desire intimate relationships but they lack the capacity for healthy, reciprocal relationships. They vacillate between a deep desire for connection and intimacy and fear of abandonment and rejection. They have unrealistic expectations and high standards of love, nurturing and loyalty from others but do not hold themselves to the same standards.

They have impaired insight into themselves and others but paradoxically can have a keen ability to sniff out the vulnerabilities of others. Their internal emotional world is unstable and unpredictable, sometimes making them appear as if they have Bipolar disorder. Their sense of self is fragile and labile. They alternate between self-loathing and grandiosity, and require the validation and affirmation of others to help regulate their sense of self. Although, they are dependent on others for this type of internal regulation, they have an innate drive for dominance and superiority. Since they lack the capacity for self-reflection and introspection necessary for taking accountability for their actions, they regularly blame others and the world for their failures or anything that is wrong in their life.

People with cluster B are either unconcerned or unaware of their impact on others. If they are cooperative, it is usually to serve their personal agenda. Any chance of a peaceful co-existence is usually thwarted due to their misattribution of negative intentions by others. They are highly threatened by opposing perspectives and viewpoints. A contrary point of view can often incite them into responding with a disproportionate and confusing amount of anger and confrontation or withdrawing completely. Their sense of entitlement manifests in regularly violating the boundaries of others. This often leads to playing the role of the innocent victim and blaming others and the world for their failures and everything that is wrong in their lives.

  • Prone to boredom
  • Novelty/thrill-seeking behavior
  • Hyper-sexuality/deviant sexuality
  • Initially very charming
  • Deceitful
  • Overlapping relationships to fend off feelings of loneliness, boredom and abandonment fears
  • Hypocritical, rules apply to others not themselves
  • Highly critical of others
  • Hypersensitive to criticism
  • Lead parasitic lifestyles
  • Shallow emotions but compensate by the ability to mimic the emotions of others
  • Have a “my way or the highway” attitude
  • May have substance abuse issues/and other addictions
Relationships with people with people with NPD and ASPD can be very exhausting. The relationships are often imbalanced and not reciprocal. They tend to be so self-focused that they lack the ability to empathize with the needs and desires of others. Their self-centeredness blinds them from being able to see others as separate from themselves. Narcissists tend to view their partners in terms of how they fill their needs (or fail to fill their needs). Their partners and children are only valued in terms of how well they meet their needs or further their agenda.


The precise cause of personality disorders is unknown. Personality is formed in early childhood. It’s the combination of a pattern of qualities (thoughts, emotions and behaviors) that make up someone’s unique character. Personality influences how people relate to and interact with others and world. It is believed that personality disorders can be inherited through genes that influence temperament. Although, the expression of personality disorders can either be suppressed or encouraged by environmental factors. Genetics may make a person more vulnerable to developing a personality disorder, while environmental influences may trigger the development.

Risk factors

  • A family history of personality disorders or other mental illness
  • Abusive, unstable or chaotic family life during childhood
  • Being diagnosed with childhood conduct disorder
  • Variations in brain chemistry and structure
  • At least 1%-6% of the adult population suffers from a personality disorder
  • Personality disorders usually begin in adolescence or early adulthood and develop over the course of the individual’s lifetime.
  • Personality is the expression of both environmental factors and biological factors.
  • Environmental factors are believed to play a major role in triggering the expression of personality disorders.
  • Personality disorders are resistant to psychological treatment as an individual must possess insight and a willingness to change for improvement to take place.


Mayo Clinic Staff Print. “Personality Disorders.” Mayo Clinic. N.p., 23 Sept. 2016. Web. 13 Mar. 2017.

Theodore Millon (2004) Personality Disorders in Modern Life. Wiley, 2nd Edition. ISBN 0-471-23734-5. (Google Books Preview)

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