Cluster B - Personality Disorders

Disorder
Antisocial
Personality
Disorder

Etiology
Prevalence
3% in men
1% in women

Presentation
Can appear composed and
credible but beneath the
veneer there is tension,
hostility, and rage
Higher incidence in Good at putting up a front
poor urban areas
but are unhappy people
Genetic
Component
Five times
increased risk
among first degree
relatives
Develops in
adolescence

Borderline
Personality
Disorder

Genetics
5xs more common
in 1st degree
relatives

Stand on the border of

neurosis and psychosis
characterized by
extraordinarily unstable
mood, affect, and
behavior
4 main categories of
signs and symptoms
1. Unstable relationships
2. Unstable self-image
3. Unstable emotions
4. Impulsivity

Diagnosis
3 of more:
Failure to conform to
social norms
Deceitful/manipulative
Impulsive
Irritable/aggressive
Recklessness and
disregard for safety of
self or others
Lack of remorse for
others
Irresponsibility/failure to
sustain work or honor
financial obligations

5 of More:
Desperate efforts to avoid
real or imagined
abandonment
Unstable, intense
interpersonal
relationships
Unstable self image
Impulsivity in at least 2
potentially harmful ways
Recurrent suicidal threats
or attempts, selfmutilation
General feeling of

Treatment
Psychotherapy
Hospitalized patients
more amenable
Firm limits a must
They can sex up their
stories be seductive
Therapist must
overcome patients
fear of intimacy they
dont want
relationships

Pharmacotherapy
Many are substance
abusers so be careful
Individual components
of the disorder may
be treated (IE Ritalin
for ADHD)

emptiness
Difficulty in controlling
anger
Transient, stress related
paranoid ideations or
dissociative sx

Disorder
Histrionic

Etiology
Epidemiology
Prevalence: 2-4%
Women > Men

Narcissistic

Epidemiology
Prevalence: <1%
Men > Women

Develops in early
adulthood but not
recognized until
middle adulthood

Presentation
High degree of attention
getting behavior
Exaggerate thoughts and
feelings
Catastrophizes
Gestures and dramatic
punctuation
Temper tantrums, tears
and accusations if not
the center of attention
Seductive
Constant need for
reassurance
May act on sexual
impulses
Grandiose sense of self
importance
Consider themselves
special
Striking sense of
entitlement
Handle criticism poorly
Fragile relationships
Interpersonal exploitive

Diagnosis
Treatment
5 of More:
Psychoanalytical based
Uncomfortable when not
therapy group or
the center of attention
individual
Inappropriately seductive Treat targeted
symptoms medically
Uses physical
IE: anxiety
appearance to draw
attention to self
Dramatic
Easily influenced by
others
Perceives relationships
as more intimate than
they are

5 or More:

Exaggerated sense of
self-importance
Preoccupied w/ fantasies
of unlimited money,
success, brilliance
Believes that he/she is
special and can only
associate w/ other high
stats people
Needs excessive
admiration

 Sense of entitlement
Takes advantages of
others for self-gain
Lacks empathy
Envious of others or
believes others are
envious
Arrogant or haughty