Straight, No Chaser: Narcissistic, Histrionic, Antisocial and Borderline Personality Disorders

Again, I need to start with a disclaimer, lest all the armchair psychiatrists out there start diagnosing everyone you know. The Cluster B personality disorders are defined by drama, erratic and emotional behaviors. They include narcissistic personality disorder, histrionic personality disorder, antisocial personality disorder and borderline personality disorder. This group of patients is defined by overly emotional or predictable behavior. Remember that symptoms aren’t enough; some degree of social dysfunction must also be present for these diagnoses to be made.


Antisocial personality disorder: think of a dangerous habit of manipulating, exploiting, or violating the rights of others. Typical symptoms will include some of the following.

  • Aggressive, violent and/or criminal behavior
  • Disregard for others’ needs, feelings and safety
  • Disregard for the safety of self or others
  • Disregard and violation of others’ rights
  • Excessively and repeatedly irresponsible
  • Impulsive behavior with lack of remorse
  • Habitual deceit, lying, stealing and cheating
  • Recurring problems with the law


Borderline personality disorder: think of ongoing patterns of unstable emotions that result in impulsive actions and chaotic relationships.

  • Frequent and explosive bouts of anger
  • Impulsive and risky behavior (e.g. habitual gambling, binge eating, unsafe sex)
  • Intense fear of being alone or abandoned
  • Ongoing feelings of emptiness
  • Paranoid worsened by stress
  • Unstable or fragile self-image
  • Unstable and intense relationships
  • Up and down moods, often as a reaction to interpersonal stress
  • Suicidal thoughts, threats and behaviors


Histrionic personality disorder: think of overly dramatic and emotional actions meant to draw attention to oneselves.

  • Constantly seeking and demanding attention
  • Easily influenced by others and believes relationships are closer than they are
  • Excessively concerned with physical appearance
  • Excessively emotional, dramatic or sexually provocative to gain attention
  • Speaks dramatically with strong opinions, but few facts or details to back them up
  • Shallow, rapidly changing emotions


Narcissistic personality disorder: think of an excessive sense of self-importance and self-preoccupation with a lack of empathy for others

  • Arrogance
  • Envy of others or belief that others envy you
  • Exaggeration of achievements or talents
  • Unreasonable expectations of constant praise, admiration, favors and advantages
  • Fantasies about power, success and attractiveness
  • Inability to recognize others’ needs and feelings
  • Unfounded belief that you’re special and more important than others

It is important to remember that everyone can exhibit some of these personality traits now and again. That said, when these patterns of behavior interfere with one’s activities of daily living, lend a hand. Get help.
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