Cluster B includes histrionic personality disorder, antisocial personality disorder, borderline personality disorder, and narcissistic personality disorder. A personality disorder is a mental health condition that involves long-lasting unhealthy patterns of inner experience and behavior. These fixed patterns often have a negative effect on someone’s ability to function in work, school, relationships,
A personality disorder is a mental health condition that involves long-lasting unhealthy patterns of inner experience and behavior. These fixed patterns often have a negative effect on someone’s ability to function in work, school, relationships, and other aspects of daily life.
According to the National Institute of Mental Health (NIMH), over 9% of U.S. adults meet the diagnostic criteria for a personality disorder. People with cluster B personality disorders—the most common type—tend to exhibit dramatic, emotional, and/or erratic behavior.
The four types of cluster B personality disorders, including histrionic personality disorder (HPD), antisocial personality disorder (ASPD), borderline personality disorder (BPD), and narcissistic personality disorder (NPD). This article will discuss these types, including their traits, causes, diagnosis, and treatment.
The 10 personality disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) are divided into three “clusters” (A, B, and C) based on the maladaptive or harmful personality traits that people with each disorder tend to have.
People with cluster A personality disorders—paranoid personality disorder (PPD), schizoid personality disorder (SPD), and schizotypal personality disorder (STPD)—have odd and eccentric traits.
People with cluster C personality disorders—dependent personality disorder (DPD), obsessive-compulsive personality disorder (OCPD), and avoidant personality disorder (APD)—have excessive fear and anxiety.
There are four types of cluster B (dramatic/emotional) personality disorders: borderline personality disorder (BPD), histrionic personality disorder (HPD), narcissistic personality disorder (NPD), and antisocial personality disorder (ASPD).
Borderline personality disorder involves a pattern of unstable relationships and self-image, overwhelming emotions, and impulsivity. BPD affects approximately 1.4% of the U.S. adult population, although some estimates are much higher. About 75% of the people diagnosed with BPD are women.
Some of the signs and symptoms of BPD include:
Histrionic personality disorder involves excessive attention-seeking and emotional behavior. Estimates of the prevalence of HPD are around 1.8%. It is more common among women than men.
Some of the signs and symptoms of HPD include:
Narcissistic personality disorder involves an inflated sense of self-importance, extreme self-centeredness, and a lack of empathy for other people. Although estimates can vary considerably, one study found about 4% of the population studied had NPD. Between 50% to 75% of the people diagnosed with NPD are men.
Some of the signs and symptoms of NPD include:
Antisocial personality disorder involves long-lasting disregard for the rights, feelings, needs, and safety of others. About 3% to 5% of the general population meets the criteria for ASPD at some point during their lifetime, and it is more common among men than women. It is the most common psychiatric diagnosis among incarcerated people.
Some of the signs and symptoms of ASPD include:
It’s possible to have more than one personality disorder. Someone could have two or more comorbid cluster B personality disorders or personality disorders across multiple clusters.
Each of the four cluster B personality disorders is different. However, they tend to share certain maladaptive personality traits—traits that tend to affect someone’s ability to function, typically in work, school, relationships, and other parts of daily life—in common.
Cluster B personality disorders are associated with the following traits:
Regardless of diagnosis, maladaptive cluster B personality traits are associated with higher rates of physical health issues, divorce, and unemployment. They have also been linked to a higher risk of emotional distress, substance abuse, social isolation, hospitalization, and suicide.
There is no single known cause of cluster B personality disorders. However, there are several possible factors that increase the risk of developing a cluster B personality disorder, including:
Most people are not diagnosed with personality disorders until 18 years old or older. A mental health professional can diagnose you with a cluster B personality disorder using the criteria in the DSM-5.
To be diagnosed with a personality disorder, your symptoms must have lasted for an extended period. They must also negatively affect your functioning and quality of life in at least one major area, such as work, school, family life, or romantic relationships.
With your permission, your healthcare provider may also gain insights into your behavior by talking to your spouse, family members, or other loved ones.
Treatment for HPD, ASPD, BPD, and NPD typically involves psychotherapy as a first-line approach. If you have a cluster B personality disorder, here are some of the possible treatment approaches that may help:
Evidence-based therapies are more widely available for certain cluster B personality disorders than others. For example, there are currently no known, reliably effective treatments for ASPD.
People with ASPD are also unlikely to seek treatment on their own. They often only receive a diagnosis and treatment once they are required to do so, such as in an inpatient setting or as required by a court of law.
By contrast, many people with BPD who receive treatment are able to achieve full remission of their symptoms for a year or more.
Talk to your healthcare provider if you are experiencing any of the following possible signs of a cluster B personality disorder:
If you or someone else is thinking about self-harm, suicide, or harming someone else, seek immediate medical help.
Cluster B personality disorders are chronic mental health conditions that involve long-term patterns of dramatic, emotional, and/or erratic thinking and behavior. The four types of cluster B personality disorders are borderline personality disorder (BPD), histrionic personality disorder (HPD), narcissistic personality disorder (NPD), and antisocial personality disorder (ASPD).
BPD involves emotional instability, turbulent relationships, inconsistent self-image, and an intense fear of abandonment. People with HPD exhibit dramatic, attention-seeking behaviors, such as excessive seductiveness.
NPD involves an inflated sense of self-worth, extreme feelings of entitlement, hypersensitivity to criticism, and a lack of empathy. ASPD refers to a long-standing pattern of disregarding the rights, needs, and feelings of others and a lack of empathy, remorse, and guilt.
There are many possible factors that contribute to the development of cluster B personality disorders, including genetics, environmental factors, childhood trauma, and brain structure.
The first-line treatment for cluster B personality disorders is psychotherapy. In some cases, medication may be prescribed to help with certain symptoms.
Some people with personality disorders may feel ashamed or unwilling to seek diagnosis or treatment. Don’t be afraid to talk to your healthcare provider about your symptoms. Treatment can help you improve your emotional health, relationships, quality of life, and overall well-being.
Every personality disorder is associated with different possible emotional triggers. For example, people with narcissistic personality disorder (NPD) often react strongly to perceived criticism or humiliation.
Meanwhile, people with borderline personality disorder (BPD) have an overwhelming fear of abandonment or the perceived threat of abandonment.
People with histrionic personality disorder (HPD) are often frustrated when they don't feel they're getting the right kind of attention.
People with personality disorders often experience stigmatization and feelings of shame. An open mind, empathy, and a non-judgmental attitude can help you communicate effectively with a person who has a personality disorder.
Lend the person a friendly listening ear, and set boundaries when you need to do so.
If someone you care about or live with has a personality disorder, be compassionate in your communication while looking after your own needs as well. Encourage your friend or loved one to seek help and support.
Make your boundaries and expectations clear, and be willing to hear the other person out about their concerns. As in any situation, it is important to prioritize your own mental health and safety.
If you need to end your relationship with someone with a personality disorder, state your intentions and boundaries clearly and unambiguously.
Seek a therapist if necessary, and reach out to your support system to help. If your safety is at risk, seek emergency help or leave the situation as soon as possible.