4- Cluster B (Borderline, Antisocial, Narcissistic, Histrionic) Personality Disorders

Source: https://www.youtube.com/watch?v=QP-zUnPoBZM

Correct Answer: B. Borderline, Antisocial, Narcissistic, Histrionic

Explanation:
Cluster B personality disorders include Borderline, Antisocial, Narcissistic, and Histrionic. They are characterized by emotional instability, impulsivity, and interpersonal dysfunction.

Which group of personality disorders is classified as Cluster B?

A. Paranoid, Schizoid, Schizotypal
B. Borderline, Antisocial, Narcissistic, Histrionic
C. Avoidant, Dependent, Obsessive-Compulsive
D. Bipolar I, Bipolar II, Cyclothymic

Correct Answer: C. Emotional instability with poor self-image

Explanation:
All Cluster B disorders share emotional instability and an unstable or poor self-image. They are not defined by one mood (unlike mood disorders) and empathy deficits are not universal.

Which core feature best links all four Cluster B personality disorders?

A. Presence of psychosis
B. A single dominant mood state
C. Emotional instability with poor self-image
D. Lack of empathy in all cases

Correct Answer: C. Rapid mood shifts and intense emotional states

Explanation:
The intensity and variability of emotions in Cluster B disorders can resemble depression or bipolar disorder. However, Cluster B disorders involve chronic negative emotionality, not discrete mood episodes.

Cluster B personality disorders are frequently misdiagnosed as mood disorders primarily because they involve:

A. Manic episodes
B. Persistent depressive episodes
C. Rapid mood shifts and intense emotional states
D. Seasonal affective changes

Correct Answer: C. Neuroticism

Explanation:
High neuroticism—a tendency toward emotional reactivity, distress, and negative affect—is common across Cluster B disorders.

The tendency toward negative emotions across Cluster B disorders most closely corresponds to which Big Five personality trait?

A. Extraversion
B. Agreeableness
C. Neuroticism
D. Openness

Correct Answer: B. Borderline and Antisocial

Explanation:
Borderline (BPD) and Antisocial (ASPD) personality disorders are associated with higher rates of unemployment, hospitalization, incarceration, and severe functional impairment.

Which two Cluster B personality disorders are generally considered more severe and globally impairing?

A. Narcissistic and Histrionic
B. Borderline and Antisocial
C. Narcissistic and Antisocial
D. Borderline and Histrionic

Correct Answer: C. They are influenced by cultural norms and diagnostic practices

Explanation:
Observed gender differences are strongly influenced by cultural expectations and diagnostic bias, not just biology. Core pathology appears similar across genders.

Which statement about gender differences in Cluster B personality disorders is MOST accurate?

A. They are entirely biologically determined
B. They reflect true prevalence with no diagnostic bias
C. They are influenced by cultural norms and diagnostic practices
D. Men and women are equally diagnosed across all disorders

Correct Answer: C. I DESPAIR

Explanation:
“I DESPAIR” helps recall BPD features such as Identity disturbance, Dysphoria, Emotional instability, Suicidality, Paranoia/dissociation, Anger, Impulsivity, and unstable Relationships.

Which mnemonic is commonly used to recall the core features of Borderline Personality Disorder?

A. SIGECAPS
B. ACID LIAR
C. I DESPAIR
D. DIG FAST

Correct Answer: C. Dialectical Behavior Therapy (DBT)

Explanation:
DBT is the most well-supported treatment for BPD and targets emotional regulation, distress tolerance, and interpersonal effectiveness.

Which treatment has the strongest evidence base for Borderline Personality Disorder?

A. Cognitive Behavioral Therapy (CBT)
B. Electroconvulsive Therapy (ECT)
C. Dialectical Behavior Therapy (DBT)
D. Psychoanalysis alone

Correct Answer: C. Antisocial Personality Disorder

Explanation:
Antisocial Personality Disorder requires the individual to be at least 18 years old, although conduct disorder symptoms may appear earlier.

Which personality disorder cannot be diagnosed before age 18 according to the DSM?

A. Borderline Personality Disorder
B. Narcissistic Personality Disorder
C. Antisocial Personality Disorder
D. Histrionic Personality Disorder

Correct Answer: C. Recurrent criminal behavior and disregard for others’ rights

Explanation:
While emotional instability and poor self-image are shared across Cluster B, persistent violation of others’ rights and criminal behavior are defining features of ASPD.

Which feature distinguishes Antisocial Personality Disorder from other Cluster B disorders?

A. Emotional instability
B. Poor self-image
C. Recurrent criminal behavior and disregard for others’ rights
D. Sensitivity to rejection

Correct Answer: B. A defense against insecurity and fear of rejection

Explanation:
Despite outward confidence, narcissistic behaviors often mask deep insecurity, similar to other Cluster B disorders.

In Narcissistic Personality Disorder, grandiosity primarily functions as:

A. Evidence of genuinely high self-esteem
B. A defense against insecurity and fear of rejection
C. A symptom of psychosis
D. A sign of mood elevation

Correct Answer: D. Histrionic

Explanation:
Histrionic Personality Disorder is typically the least impairing, with less aggression, impulsivity, and destructiveness than BPD or ASPD.

Which Cluster B personality disorder is considered least impairing overall and least likely to present as a primary diagnosis?

A. Borderline
B. Antisocial
C. Narcissistic
D. Histrionic

Correct Answer: B. It shares vulnerabilities with other Cluster B disorders but often involves fewer developmental stressors

Explanation:
HPD likely shares underlying vulnerability with other Cluster B disorders, but evidence for childhood abuse is weaker, not absent.

Which statement about Histrionic Personality Disorder (HPD) is most accurate?

A. It is strongly linked to childhood abuse in all cases
B. It shares vulnerabilities with other Cluster B disorders but often involves fewer developmental stressors
C. It commonly leads to incarceration
D. It lacks emotional instability

Correct Answer: C. Shared emotional instability is a teaching framework, not a literal DSM claim

Explanation:
The idea of a shared “core pathology” is a useful conceptual model, but the DSM does not claim identical mechanisms across Cluster B disorders.

Which statement best reflects the conceptual clarification about Cluster B disorders?

A. All Cluster B disorders have identical pathology
B. The DSM explicitly states a single cause for Cluster B disorders
C. Shared emotional instability is a teaching framework, not a literal DSM claim
D. Severity does not differ among Cluster B disorders

Correct Answer: C. Marked emotional instability and intense affect

Explanation:
The term “wild cluster” refers to the emotional intensity, volatility, and reactivity common across Cluster B disorders, not psychosis or criminality alone.

Cluster B personality disorders are sometimes referred to as the “wild cluster” primarily because of:

A. Their association with criminal behavior
B. Their strong genetic basis
C. Marked emotional instability and intense affect
D. Frequent psychotic symptoms

Correct Answer: B. Chronic negative emotionality across situations

Explanation:
Cluster B disorders involve a persistent tendency toward negative emotions of many kinds, rather than discrete mood episodes seen in mood disorders.

Which feature best distinguishes Cluster B personality disorders from mood disorders such as major depressive disorder or bipolar disorder?

A. Presence of sadness and irritability
B. Chronic negative emotionality across situations
C. Periodic mood elevation
D. Response to antidepressants

Correct Answer: B. Heightened sensitivity to rejection and criticism

Explanation:
Patients with Cluster B disorders are often deeply wounded by minor perceived slights, reflecting heightened emotional sensitivity.

The metaphor of having “thin emotional skin” in Cluster B personality disorders refers to:

A. Reduced emotional awareness
B. Heightened sensitivity to rejection and criticism
C. Blunted affect
D. Dissociative detachment

Correct Answer: C. A shared feature across Cluster B personality disorders

Explanation:
While most prominent in BPD, identity instability and poor self-image are common across all Cluster B disorders.

An unstable sense of identity is best described as:

A. Unique to Borderline Personality Disorder
B. Found only in severe personality disorders
C. A shared feature across Cluster B personality disorders
D. A symptom of psychosis

Correct Answer: C. Viewing others as all good or all bad

Explanation:
Splitting is a black-and-white cognitive style in which people and situations are seen in extremes, especially in close relationships.

In Borderline Personality Disorder, splitting most accurately refers to:

A. Dissociative identity changes
B. Alternating depressive and manic states
C. Viewing others as all good or all bad
D. Avoidance of close relationships

Correct Answer: B. They are behaviorally different but share core emotional pathology

Explanation:
Despite different outward behaviors (self-harm vs aggression), both share emotional instability and poor self-image at their core.

Which statement best captures the relationship between Borderline Personality Disorder and Antisocial Personality Disorder?

A. They share no underlying features
B. They are behaviorally different but share core emotional pathology
C. ASPD lacks emotional instability
D. BPD is less severe than ASPD

Correct Answer: C. Better impulse control

Explanation:
NPD generally involves better impulse control and less reckless behavior than BPD or ASPD, contributing to higher occupational functioning.

Compared with Borderline and Antisocial Personality Disorders, individuals with Narcissistic Personality Disorder typically demonstrate:

A. Greater impulsivity
B. More severe functional impairment
C. Better impulse control
D. Higher rates of incarceration

Correct Answer: C. High suggestibility and susceptibility to peer pressure

Explanation:
Suggestibility and being easily influenced by others are hallmark features of HPD.

Which feature is particularly characteristic of Histrionic Personality Disorder but not emphasized in Narcissistic Personality Disorder?

A. Need for admiration
B. Grandiosity
C. High suggestibility and susceptibility to peer pressure
D. Entitlement

Correct Answer: C. It causes less severe functional impairment

Explanation:
Although socially disruptive, HPD usually does not cause severe occupational or legal impairment, reducing clinical presentation rates.

Histrionic Personality Disorder is least likely to come to clinical attention as a primary diagnosis mainly because:

A. It resolves spontaneously
B. It lacks emotional intensity
C. It causes less severe functional impairment
D. It is rare