Wednesday, November 11, 2015

Personality Disorders - Cluster B

As mentioned in my opening post about personality disorderspersonality disorders are split into three clusters -A, B, and C. This post will discuss cluster B. People with these disorders tend to be dramatic, emotional, and erratic. 

Patients with histrionic personality disorder are characterized by self-dramatization, over-concern with attractiveness, tendency to irritability, and temper outbursts if attention-seeking is frustrated. These patients often manipulate their partners with seductive behavior, but they are also tend to be very dependent on the partners' attention. They are generally considered self-centered, vain, shallow, and insincere. These traits are much more commonly seen in women than in men - probably because many of the characteristics (like over-concern with appearance) tend to be "women's traits." In fact, some argue that histrionic personality disorder is just another form of anti-social personality disorder, which is much more prevalent in men. 

In order to be diagnosed with histrionic personality disorder, the patient must have 5 or more of the following traits: 1) she is uncomfortable in situations in which she is not the center of attention; 2) her interactions with others are often characterized by inappropriate sexually seductive or provocative behaviors; 3) she displays rapidly shifting and shallow expression of emotions; 4) she consistently uses physical appearance to draw attention to herself; 5) she has a style of speech that is excessively impressionistic and lacking in detail; 6) she shows self-dramatization, theatricality, and exaggerated expression of emotion; 7) she is suggestible (i.e. easily influenced by others or circumstances); 8) she considers relationships to be more intimate than they actually are. 

This is one of the personality disorders that will be dispensed with if the next DSM moves towards a dimensional model of diagnosis, as mentioned in my earlier post. 

Narcissistic personality disorder is characterized by grandiosity, preoccupation with receiving attention, self-promoting, and lack of empathy. There are two types: grandiosity and vulnerable narcissism. In the former, the patient is convinced of their superiority; in the latter the patient expresses superiority defensively due to a low self-esteem. Narcissistic personality disorder is observed more often in men than in women. 

In order to be diagnosed with narcissistic personality disorder, the patient must meet five or more of the following traits: 1) he has a grandiose sense of self-importance (exaggerates achievements and talents, expects to be recognized as superior); 2) he is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love; 3) he believes that he is "special" and unique and can only be understood by, or should associate with, other special people; 4) he requires excessive admiration; 5) he has a sense of entitlement; 6) he is interpersonally exploitative; 7) he lacks empathy and is unwilling to recognize or identify with the feelings or needs of others; 8) he is often envious of others or believes that others are envious of him; 9) he shows arrogant, haughty behaviors. 

Now, I doubt my ex-boyfriend had a personality disorder, but he did have quite a few of these traits - possibly exacerbated by a lifetime of alcoholism which he had only recently given up when I'd met him. In fact, at one point in our relationship, he went to a neurologist to be checked for long-term side-effects of a past concussion, and he returned with a psychological assessment which said he had "narcissistic personality traits." At the time, I had laughed it off, but later I began to see it. 

This guy thought that he was incredibly smart, good looking, and absolutely amazing at his job. He was always bragging about the quality of his work; however, I saw some of his work a couple of times and found it lacking (which I didn't say, of course). He was always talking about the future - how he had so many offers for jobs (he was unemployed) and how he'd be making well over $300,0000 a year in no time. He surrounded himself with people that he saw as superior (yes, that includes myself - he was always bragging to everyone about how smart and beautiful I was. It was rather embarrassing and over-the-top.) He also showed a surprising lack of empathy - he felt that anxiety was a sign of weakness in others, but when he had anxiety attacks he felt it was uncontrollable rather than a weakness.

Narcissistic personality disorder is one of the disorders that would be dropped if the diagnosis switched to a dimensional rather than cluster approach. 

Because there is a lot of public interest in borderline personality disorder and antisocial / psychopathy, I will mention those Cluster B disorders in another post. 

This is a series of posts summarizing what I'm learning in my Abnormal Psychology course. Much of the information provided comes from reading my James N. Butcher's textbook Abnormal Psychology. To read the other posts, follow these links: 

The Definition of Abnormal
A History of Abnormal Psychology
Abnormal Psychology in Contemporary Society
Contemporary Viewpoints on Treating Mental Illness - Biology
Contemporary Viewpoints on Treating Mental Illness - Psychology
Frontline: New Asylums
Brave New Films: This is Crazy
Clinical Mental Health Diagnosis: Biological Assessment
Clinical Mental Health Diagnosis: Psychological Assessment
Does the DSM Encourage Overmedication?
Post Traumatic Stress Syndrome - The Basics
Panic Disorder
Obsessive Compulsive Disorder
Hoarding and Body Dysmorphic Disorders
Depression - an Overview
Personality Disorders - Clusters and Dimensions
Personality Disorders - Cluster A
Personality Disorders - Cluster B
Personality Disorders - Cluster C
Biological Effects of Stress on Your Body
Somatic Symptom and Related Disorders
Dissociative Disorders
Borderline Personality Disorder
Dialectical Behavioral Therapy
Paraphilic Disorders
Gender Dysphoria - Homosexuality and Transgender
Anxiety Disorders
Bipolar Disorder - The Basics
Suicide - An Overview


Butcher, James N. Hooley, Jill M. Mineka, Susan. (2014) Chapter 10: Personality Disorders. Abnormal Psychology, sixteenth edition (pp. 328-366). Pearson Education Inc.

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