Personality Disorders: Cluster B

Antisocial personality disorder

Persistently disregard and violate others' rights

Indicators of antisocial personality disorder

Repetitive lying, impulsivity, little regard for safety or others, sadistic and violent tendencies

Psychodynamic theories for antisocial

Absence of parental love during infancy leads to lack of basic trust and childhood stress (poverty, violence, abuse, etc)

Behavioral theory for antisocial

Learned through operant conditioning

Unintentional teaching of antisocial behavior by parents

Rewarding a child's aggression or giving in to their violent behavior to restore peace

Cognitive theory for antisocial

Difficulty recognizing others' viewpoints or feelings, trivializing the importance of others' needs

Biological theory for antisocial

Lower serotonin activity, dysfunctional brain circuits, low brain and bodily arousal, need for excitement and arousal

Ineffectiveness of therapy for antisocial

Lack of conscience, desire to change, or respect for therapy

CBT goal for antisocial

Guide clients to think about moral issues and the needs of others

Borderline personality disorder

Characterized by instability, major shifts in mood, unstable self-image, and impulsivity

Indicators of borderline personality disorder

Unstable, intense relationships, emotions in constant conflict with the world, self-destructive activities

Relationships with BPD

Idealizing others, violating boundaries, feeling rejected when expectations aren't met

Psychodynamic theory for borderline

Early parental relationships lead to fear of abandonment

Object relations theory for borderline

Lack of early acceptance or abuse/neglect by parents leads to loss of self-esteem and increased dependence

Biological theory for borderline

Genetic predisposition, lower serotonin activity, abnormal brain structure/circuit activity and anatomy

Sociocultural theory for borderline

Impact of rapidly changing cultures on identity, sense of emptiness, high anxiety, and fears of abandonment

Biosocial theory for borderline

Combination of internal and external forces

Internal factors for borderline

Difficulty identifying and controlling emotions, social skill deficits, abnormal neurotransmitter activity

External factors for borderline

Environment where a child's emotions are punished, ignored, trivialized, or disregarded

Developmental psychopathology theory for borderline

Childhood traumas and dysfunctional parental attachments lead to flawed capacity for healthy relationships

Disorganized attachment style

Severely flawed capacity for healthy relationships

Mentalization

Capacity to understand one's own mental states and those of others

Reasons for seeking therapy with BPD

Interpersonal problems or mood changes

Therapist-patient relationship with BPD

Hard for therapists to strike a balance between empathy and challenging the person's way of thinking

Transference focused therapy

Therapists take a supportive posture and focus on issues within the therapist-patient relationship

Dialectical behavior therapy

Includes individual and group sessions, with emphasis on self-harm and distress tolerance

Mindfulness

Non-judgmental awareness of the present moment, including thoughts and emotions

Emotional regulation

Changing unwanted emotions and reaching vulnerability to emotions

Distress tolerance

Learning to tolerate emotions in a crisis situation without making things worse

Interpersonal effectiveness

Improving and maintaining relationships and self-respect

Key feature in borderline personality disorder

Instability in mood, self-concept, and interpersonal relationships

Histrionic personality disorder

Individuals are extremely emotional and continually seek attention

Indicators of histrionic personality disorder

Changing themselves to attract and impress an audience, including opinions and beliefs

Psychodynamic theory for histrionic

Unhealthy relationships with cold, controlling parents in childhood

Cognitive-behavioral theory for histrionic

Less interested in knowing about the world, self-focused and emotional

Sociocultural theory for histrionic

Encouragement of childlike dependency throughout development

Challenges in therapy with histrionic

Dealing with demands, tantrums, and seductiveness

Cognitive-behavioral therapy for histrionic

Changing beliefs of helplessness and developing better problem-solving skills

Narcissistic personality disorder

Grandiose, attention-seeking, lack of empathy

Indicators of narcissism

Exaggeration of talents, expecting recognition as superior, lack of interest in others' feelings

Psychodynamic theory of narcissism

Feelings of dissatisfaction, rejection, unworthiness, striving for perfection

Object relations theory of narcissism

Focus on grandiose self-presentation to convince themselves of self-sufficiency

Cognitive-behavioral theory of narcissism

Development when treated too positively in early life, acquiring a superior attitude

Sociocultural theory of narcissism

Breakdown of family values and social ideals, producing self-centered and materialistic individuals

Challenges in treating narcissism

Inability to acknowledge weaknesses, appreciate the effect on others, or incorporate feedback

Psychodynamic treatment of narcissism

Recognizing and working through insecurities and defenses

Cognitive-behavioral treatment of narcissism

Redirecting focus onto others' opinions, increasing empathy