The definition of a personality disorder, as defined by the American Psychiatric Association (APA), is a pattern of inner experiences and behaviors that differ from the cultural experiences of the individual. There are three primary personality disorder clusters. Cluster A includes odd or eccentric disorders. Cluster B includes dramatic, emotional, or erratic disorders. Cluster C includes fear and anxiety disorders. The biggest difference between other mental health problems and personality disorders, which may appear quite similar on the surface, is that symptoms resulting from a personality disorder cannot be changed with negative consequences or with medications. The only way to help a patient with a personality disorder is through therapy, which may allow the patient to see that his or her behavior is unacceptable to society as a whole and encourage the patient to find other, more socially acceptable, ways to express themselves.
There are four subcategories within the larger diagnosis of a Cluster B Personality Disorder, all of which deal with dramatic and erratic behavior. These include Histrionic Personality, Narcissistic Personality, Antisocial Personality, and Borderline Personality.
A histrionic, or hysterical, personality will often seek attention. They may be overly emotional or dramatic and are typically quite concerned with appearance. Because they are so expressive, they are easily able to build relationships; however, these relationships are usually transient in nature and often superficial. This type of personality will often use sexually provocative behavior to garner attention and may seek to sexualize relationships that would otherwise be categorized as nonsexual. Instead of seeking sexual attention, the patient may exaggerate physical ailments to gain the attention they desire.
A narcissistic personality will feel as if they are superior to others and will want to be admired while completely lacking the ability to empathize with those around them. They will have an inflated view of themselves and may be very sensitive to criticism and failure. When they do fail, or are unable to meet their own high expectations, they may become either depressed or very angry. Their behavior is often considered rude or offensive to others and they may be considered arrogant, self-centered, or selfish.
An antisocial personality, historically called sociopathic or psychopathic personality, will show complete disregard for the feelings and rights of others. This type of personality is most often found in men. They are usually dishonest, deceitful, and may attempt to exploit those around them in order to gain an advantage or to make themselves feel better. They tend to be impulsive and irresponsible and are not able to hand frustration well. This type of personality is often found in adults who were abused or neglected as children and may manifest in alcohol or drug addiction.
A borderline personality tends to have an inaccurate self image, unstable moods and behavior, and usually have unhealthy relationships. This type of personality is most often found in women. They have some of the same characteristic traits as the other personality disorders, although most of the negativity is directed inward. They tend to see things as black or white and very rarely classify something as neutral, or grey. This type of personality is the most likely to seek help from a doctor or therapist because they have a strong desire to be cared for.
Have you treated a patient with a Cluster B Personality Disorder? What was your experience like and were you able to help them integrate with societal norms?