CLUSTER B — Dramatic, Emotional, Erratic Disorders

Antisocial Personality Disorder (ASPD): CLUSTER B — Dramatic, Emotional, Erratic Disorders

• Violates rights/social norms, deceitful, aggressive.

• Fails to comply with social norms

• Impulsive, irresponsible, lacks remorse/empathy.
  
  

• History of conduct disorder before age 15 required.
  
  

• Risky behavior, criminality, manipulative.

Causes/ Etiology: Antisocial Personality Disorder (ASPD): CLUSTER B — Dramatic, Emotional, Erratic Disorders

• Underarousal hypothesis: low cortisol arousal → thrill-seeking.
  
  

• Fearlessness hypothesis: insensitive to fear cues, poor conditioning.
  
  

• Genetic vulnerability + inconsistent parenting, abuse, neglect.
  
  

• Psychopathy related but not identical: more emotional detachment + superficial charm

Treatment Antisocial Personality Disorder (ASPD): CLUSTER B — Dramatic, Emotional, Erratic Disorders

• Very poor prognosis. Rarely self-seek treatment.

• Can be manipulative to therapists
  
  

• Prevention is key: early intervention, parent training.
  
  

High Yield: Antisocial Personality Disorder (ASPD): CLUSTER B — Dramatic, Emotional, Erratic Disorders

 → Conduct disorder in youth + violation of rights in adulthood.
→ No guilt, lack of remorse

Borderline Personality Disorder (BPD): CLUSTER B — Dramatic, Emotional, Erratic Disorders

• Instability in mood, relationships, and self-image.
  
  

• Fear of abandonment, intense emotional reactions.
  
  

• Self-harm, suicidal gestures common.
  
  

• Impulsivity in multiple areas (substances, sex, spending).
  
  

• Splitting: sees people as all good or all bad.
  
  

• Comorbid: depression, bipolar, bulimia, PTSD features.
  
  

Causes/ Etiology : Borderline Personality Disorder (BPD): CLUSTER B — Dramatic, Emotional, Erratic Disorders

• Strong gene-environment interaction.

• Limbic system-> low serotonin
  
  

• Childhood trauma, abuse,

• Emotionally sensitive + poor regulation systems.
  
  

Heightened sensitivity to rejection cues.

Treatment Borderline Personality Disorder (BPD): CLUSTER B — Dramatic, Emotional, Erratic Disorders

• Dialectical Behavior Therapy (DBT) is gold standard → reduces self-harm.

• Medication: tricyclics, antidepressants, lithium
  
  

• Focus on emotion regulation, distress tolerance, building stable identity.
  
  

• Therapist balances acceptance and change.
  
  

High-Yield: Borderline Personality Disorder (BPD): CLUSTER B — Dramatic, Emotional, Erratic Disorders

→  intense mood swings, fear of abandonment, unstable relationships, self harm = BPD.

Histrionic Personality Disorder (HPD): CLUSTER B — Dramatic, Emotional, Erratic Disorders

• Dramatic, attention-seeking, sexually seductive.
  
  

• Uncomfortable not being the center of attention.
  
  

• Rapidly shifting emotions, shallow affect.
  
  

• Impressionistic, exaggerated speech.
  
  

• Uses appearance to draw attention, easily influenced.
  
  

Causes/ Etiology Histrionic Personality Disorder (HPD): CLUSTER B — Dramatic, Emotional, Erratic Disorders

• Possibly culturally reinforced behaviors.
  
  

• Limited strong causal research.
  
  

Treatment: Histrionic Personality Disorder (HPD): CLUSTER B — Dramatic, Emotional, Erratic Disorders

• Reduce attention-seeking behaviors, improve emotion regulation.
  
  

• Interpersonal relationship work, social skills focus.
  
  

High-Yield Histrionic Personality Disorder (HPD): CLUSTER B — Dramatic, Emotional, Erratic Disorders

→ Wants attention/approval, theatrical + sexual behavior.
→ Differs from Narcissistic = wants admiration, superiority not spotlight.

Narcissistic Personality Disorder (NPD) CLUSTER B — Dramatic, Emotional, Erratic Disorders

• Grandiosity, entitlement, need for admiration.
  
  

• Low empathy, exploits others.
  
  

• Fragile ego beneath arrogance.
  
  

• Jealous of successful people: arrogant/ env

Cause/ Etiology: Narcissistic Personality Disorder (NPD) CLUSTER B — Dramatic, Emotional, Erratic Disorders

• Being an infant → demanding 

• Failure of empathic mirroring of parents behaviour

Treatment: Narcissistic Personality Disorder (NPD) CLUSTER B — Dramatic, Emotional, Erratic Disorders

• Limited research 

• Therapy focuses on grandiosity, hypersensitivity to evaluation, and lack of empathy

• Cognitive therapy: replace fantasies with experiences that are real
  
  

High Yield : Narcissistic Personality Disorder (NPD) CLUSTER B — Dramatic, Emotional, Erratic Disorders

 → Admiration-seeking + grandiosity + entitlement.
→ HPD seeks attention/praise socially; NPD seeks admiration/status superiority.