Medical News Today: What are cluster B personality disorders?

A person with a cluster B personality disorder may have trouble controlling their emotions and display seemingly irrational behaviors. If untreated, this may cause relationship problems. What are the different types and symptoms of cluster B personality disorders?

A personality disorder is a mental health condition that affects the way a person thinks, behaves, and relates to other people. There are many types of personality disorders. To help with diagnosis, doctors organize them into different groups called clusters.

This article explores the different types of cluster B personality disorders, their symptoms, and how they may be treated. It also considers some coping mechanisms that may help those with the condition and their loved ones.

What are cluster B personality disorders?

Emotional woman with mood or personality disorder, lying next to mirrors with hands covering her face.
Cluster B personality disorders are characterized by very emotional or erratic behavior.

Cluster B personality disorders are a group of mental health conditions that affect a person’s emotions and interpersonal relations.

Doctors use a diagnostic manual called The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or (DSM-5), to help diagnose mental health conditions.

DSM-5 defines three main clusters of personality disorders:

  • Cluster A: People diagnosed with cluster A personality disorders may find it hard to relate to others. They may behave in a way that others consider odd, eccentric, or paranoid.
  • Cluster B: People diagnosed with cluster B personality disorders may find it hard to regulate their emotions. This may cause relationship problems. They may behave in a way that others consider overly emotional, dramatic, or erratic.
  • Cluster C: People diagnosed with cluster C personality disorders may be seen by others as antisocial or withdrawn. They may feel very anxious and behave in a fearful manner.

Within each cluster, there is a range of related personality disorders. This article looks at cluster B personality disorders.


Types

There are four types of cluster B personality disorders:


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Symptoms

Experiencing the symptoms of a personality disorder may cause a person to behave in ways that are distressing for them and others.

Understanding the symptoms of cluster B personality disorders may help a person seek treatment. Increased awareness of symptoms may also help friends and relatives support those experiencing a cluster B personality disorder.

The symptoms of each of the cluster B personality disorders are considered below.

Antisocial personality disorder

A person diagnosed with an antisocial personality disorder may behave in ways that suggest they do not care about other people’s needs.

A person diagnosed with the condition may:

  • lie or manipulate the truth
  • break rules or other societal conventions
  • deceive other people
  • use fake names to defraud others

It may seem that they are behaving in this way for their own benefit. A person with this condition may develop behavioral patterns that are:

  • aggressive
  • violent
  • impulsive
  • irresponsible

A person who has an antisocial personality disorder does not usually show remorse or feel sorry for the way they are acting. If they do not get treatment, their behavior may cause problems with law enforcement.

Borderline personality disorder

Couple in street having relationship problems argument
A person with borderline personality disorder may have difficulty maintaining relationships, as their behavior may be considered manipulative.

A person with borderline personality disorder may have low self-esteem and a fragile sense of self. The way they feel about themselves may affect the way they relate to others.

They may feel:

  • afraid of being abandoned or alone
  • empty
  • paranoid about how others think of them or behave toward them

Feeling this way may lead to unhealthy thought patterns and extreme reactions to interpersonal stress.

They may react with intense anger or sadness to minor things other people say or do that would not be considered distressing to most people.

These exaggerated reactions can cause difficulty in relationships. People who spend time with a person with borderline personality disorder may consider their behavior manipulative.

Interpersonal stress may cause unstable patterns in mood, with high and low periods.

Sometimes a person with borderline personality disorder may talk about — or carry out — self-harming behavior. They may experience suicidal thoughts and are at risk of acting on these feelings.

If a person is feeling suicidal — or knows someone who is — they should speak to a doctor immediately. It is best to call 911 or the National Suicide Prevention Lifeline at 800-273-8255.

Histrionic personality disorder

A person diagnosed with histrionic personality disorder may behave in an attention-seeking manner that is not always appropriate.

The following traits may be noticeable in a person with this condition:

  • behavior that is overly emotional or sexually provocative
  • speech that uses lots of dramatic expressions and emphasis
  • a tendency to be overly keen to express strong opinions that may seem unsubstantiated
  • believing and behaving as if people are closer to them than they are

Like borderline personality disorder, this condition is also linked to suicidal behavior. If a person with histrionic personality disorder experiences suicidal thoughts, they should call a suicide prevention line or emergency medical services immediately.

Narcissistic personality disorder

A person diagnosed with narcissistic personality disorder may act in a way that suggests they believe they are superior to others. They may:

  • overreact to criticism
  • believe they are very important
  • focus on grand plans and visions of success
  • have a strong need for admiration
  • act with a sense of entitlement
  • have trouble empathizing with others

Others may feel that a person with narcissistic personality disorder is using or manipulating them to improve their own situation.


Causes

The exact cause of personality disorders is not understood. However, researchers believe they are likely influenced by both environmental and genetic factors.

Some studies have shed light on some potential causal factors:

  • Sexual trauma: A 2002 study suggests a link between experiencing sexual trauma and personality disorders.
  • Verbal abuse in childhood: A 2001 study found a link between childhood verbal abuse and risk of personality disorder.
  • Brain development: A 2017 study found that people diagnosed with a personality disorder shared similar types of brain development.
  • Family history: A 2017 study found that having a sibling with a personality disorder is related to personality disorder development.

More research is needed to understand the causes of personality disorders fully.

Diagnosis

Recognizing some of the symptoms listed above does not mean a person has a cluster B personality disorder. Most people show some of these behaviors at certain times in their lives.

A person should not attempt to diagnose themselves or others. If a person thinks they or someone they know may have a cluster B personality disorder, they should speak to a doctor.

A doctor can refer a person to a mental health professional who can help diagnose the condition. The mental health professional will use DSM-5 as a reference for diagnosis.

To determine if a person meets the criteria for a condition, they will ask a person questions about their:

  • life
  • thoughts
  • feelings
  • behavior

They may want to talk to a person’s family or partner to get a more rounded picture of their behavior. This will remain confidential.

According to DSM-5, to be diagnosed with a cluster B personality disorder, symptoms must:

  • start when a person is an adolescent or young adult
  • have gone on for over a year if a person is under 18
  • be consistent over time, place, and different circumstances
  • lead to distress and affect the person’s well-being
  • not be due to another disorder
  • not be due to an isolated stressful situation


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Treatment

Psychiatrist doctor in counseling therapy session with depressed patient.
Talk therapy and cognitive behavioral therapy are treatment options that may help those with cluster B personality disorders.

There is a range of treatments available for cluster B personality disorders. What works for one person may not work for someone else, so a doctor will help individuals find the best treatment.

Available treatments include:

  • Talk therapy: Talk therapy or psychotherapy allows a person to express themselves to a therapist verbally. The therapist will listen to their thoughts and feelings without judgment and may offer advice.
  • Cognitive behavioral therapy (CBT): This helps a person examine their thought patterns and behaviors to find practical ways to change them.
  • Dialectical behavioral therapy (DBT): This teaches people new skills, with the aim of making positive changes in their life.
  • Medication: There are no specific drugs for personality disorders. However, mood stabilizers, antidepressants, antipsychotics, and antianxiety medications may improve specific symptoms or may be used if there are co-occurring mental health disorders, such as anxiety or depression.

Coping and support

Speaking to a doctor and accessing treatment is the first step toward coping with a personality disorder.

Sometimes, a person may feel that a loved one who is experiencing a personality disorder has overstepped a personal boundary. If this is the case, they should be honest about it and discuss the situation with the person affected without passing judgment.

If anyone believes a person with a personality disorder is at risk of harming themselves or others they should call emergency services immediately.

As with any mental health condition, mindfulness, meditation, and exercise may also help improve a person’s overall well-being.


Outlook

If left untreated, cluster B personality disorders may make it hard for a person to maintain positive relationships.

With treatment, however, many people with cluster B personality disorders can manage their condition well.

A person with a cluster B personality disorder may sustain healthy, happy, relationships with the right support, treatment, and understanding.

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