Personality disorders cluster B

Question 1

Cluster B: “The Dramatic Cluster”

Answer 1

• Consists of Borderline, Histrionic, Narcissistic, and Antisocial PDs
  
  • All the disorders in Cluster B involve attention seeking
  • “Disordered” behavior will draw attention from others
  • The attention-seeking behavior may be intentional or unintentional

Question 2

Borderline Personality Disorder

Answer 2

• Pattern of intense instability in self-image, emotions, and interpersonal relationships
  - Generally unstable moods and emotions
  - Rapid shifts between love and hate relationships
  - Extreme fear of being alone or being abandoned
  - Impulsive behavior (drug abuse, casual sex)
  - Suicide threats/attempts, self mutilation, often to control others
  - Often associated with childhood abuse
  - More often diagnosed in women (3:1 ratio)
  
  • Can show short-term paranoid and dissociative symptoms
    
    • On the border of psychosis
  • Often meet criteria for other mental health diagnoses
    
    • High comorbidity with depression
  • Borderline PD may be related to mood disorders

Question 3

Linehan’s Daithesis-Stress theory: Etiology of BPD

Answer 3

• Begins with difficulty regulating emotions as a child (diathesis)
  
  • Family fails to acknowledge the child’s feelings, is abusive or dismissive (stress)
  • Creates a vicious cycle: child only receives attention when emotionally distraught, reinforcing extreme emotional responding to stress in the future

Question 4

Histrionic Personality Disorder

Answer 4

• Pattern of excessive emotionality and attention seeking
  - Constant need to be center of attention
  - Emotions overly dramatic for the situation
  - Poor delay of gratification
  - Great focus on personal appearance, often dress and act seductively
  - Often charming but shallow
  - Unsatisfying relationships with others
  - Prevalence rates between 2 and 3 percent, more often diagnosed in women

Question 5

Narcissistic Personality Disorder

Answer 5

Pattern of grandiosity, self importance, lack of empathy

	- Extreme arrogance
	- View self as special, deserving special treatment
	- Fantasies of unlimited power and success
	- Fragile self-esteem, react strongly to criticism
	- May exploit others to meet needs
	- Jealous of others, believes others jealous of him/her
- Person is generally preoccupied with how others view him or her
- Has a distorted view of interpersonal relationships
- Unlikely to seek therapy or perceive a need for therapy; therapeutic relationships often difficult
- Prevalence is less than 1%, often comorbid with Borderline PD

Question 6

Antisocial Personality Disorder

Answer 6

• Category designed to explain chronic criminal behavior
  
  • Involves presence of Conduct Disorder before age 15
    
    • Pattern of truancy, property crime, aggressive behavior, lying
    • Pattern continues into adulthood
  • Additional criteria
    
    • Pattern of lying for pleasure or profit
    • Impulsive behaviors, disregard for safety of self and others
    • Irritability and aggressiveness, physical violence
    • Lack of remorse for actions or empathy for others
  • Family issues may play a role in development
    
    • Lack of affection
    • Severe parental rejection
    • Inconsistent (or no) discipline

Question 7

-Psychopaths

Answer 7

• Have reduced gray matter in frontal lobes
  - Perform more poorly on tests of frontal lobe functioning
  - Supportive of a key role for impulsivity in psychopathy
  - Skin conductance: much lower in comparison to non-psychopaths in presence of distress of others
  - no differences for other stimuli
  - demonstrates lack of empathy