Which Personality Disorders are in Cluster B?

Courtesy of Godoy Medical Forensics

Cluster B personality traits are dramatic, emotional and attention seeking. They include:

  • Antisocial Personality Disorder
  • Borderline Personality Disorder
  • Histrionic Personality Disorder
  • Narcissistic Personality Disorder

The following is an example of how an individual with a cluster B personality disorder may require the services of a criminal attorney:

John is a 25-year-old construction worker who was arrested for stealing from his employer. His attorney learned that John had a chaotic home environment when he was a child. His father was a violent alcoholic who physically abused John and his mother. His school records showed that he achieved passing grades, though he was frequently truant. His teachers described him as a bright student who did not work up to his potential. He bullied other students and was frequently involved in fights. He was evaluated by a school psychologist who diagnosed him as having a conduct disorder. John quit school at age 16 and joined a gang. He was arrested as a teen for stealing a car and drug possession. He spent time in a juvenile detention center. John denied any prior criminal history when he met with his attorney. He also said that he did not steal from his employer. He insisted that the employer gave him money to buy building supplies and equipment and was now changing his story.

Antisocial Personality Disorder

John from our case study is a fictional example of a client who has an antisocial personality disorder, demonstrating a pattern of disregard for the rights of others. He meets the criteria of having a conduct disorder with onset before age 15. An individual must also meet three of the following criteria to be diagnosed with an antisocial personality disorder:

  • Repeatedly performing acts that are grounds for arrest;
  • Deceitfulness, repeated lying or conning others for personal profit;
  • Impulsivity;
  • Disregard for the safety of self or others;
  • Irritability or aggressiveness;
  • Consistent irresponsibility;
  • Lack of remorse.
    (American Psychiatric Association, 2013)

Individuals who have an antisocial personality disorder become involved with the legal system due to traits of aggression and irresponsibility. They are rarely able to delay gratification. It is important for the attorney to maintain clear professional boundaries when representing clients who have ASPD. These clients can be difficult to work with because they may not trust their attorney and use manipulation to meet their needs. They can be initially charming but can become verbally and physically abusive if they are frustrated. These individuals may abuse drugs and alcohol which can exacerbate their symptoms. Not everyone who has antisocial personality disorder is a criminal. Some individuals are successful in a career that is compatible with the competitive, risk-taking aspects of their personality, such as professional sports, politics, military, or business professions.

Borderline Personality Disorder

Individuals with a borderline personality disorder demonstrate a pattern of unstable and intense personal relationships. They experience frequent life crises. These individuals have difficulty tolerating being alone and may react to feelings of abandonment with anxiety, depression, and unhealthy behaviors, such as rage, suicidal gestures, and self- mutilation. The character played by Glenn Close in Fatal Attraction is an example of someone with a severe borderline personality disorder. Clients with BPD may have a history of physical, emotional, or sexual abuse and may have an additional diagnosis of PTSD. Clients with BPD may become involved with the criminal justice system because of poor impulse control or difficulty managing anger. They may idealize, then devalue their attorney. They may also be manipulative. This manipulation is to gain nurturance, rather than for profit or power, as compared to an individual with antisocial personality traits. Attorneys need to be aware that their clients with BPD are at risk for self-harm due to intense feelings of anxiety and depression that are difficult for them to manage in addition to poor impulse control. Suicidal threats should be taken seriously and appropriate action taken to protect the client.

Histrionic Personality Disorder

An individual with histrionic personality disorder has a pattern of attention seeking and overly emotional behavior. They need to be the center of attention and may be sexually inappropriate. It may be difficult for the attorney to obtain accurate and detailed information from their client with a histrionic personality because they tend to be superficial and exaggerate. They can be inconsistent and unpredictable. These clients may demand constant attention from their attorney. Unlike clients with antisocial traits, they don’t need to feel superior. They may be willing to be fragile and helpless in order to gain attention.

Narcissistic Personality Disorder

Clients with a narcissistic personality disorder are self-centered and unable to empathize with others. They are grandiose and require admiration. They may experience depression if they experience criticism or failure. Individuals who have a narcissistic personality are not usually self-destructive, impulsive, and do not have abandonment concerns, as do other cluster B disorders. These individuals believe that they are superior and only the most successful attorney can represent them. They may wish to act as their own attorney. It is important to monitor your own emotional reactivity when working with these clients and avoid taking their behavior personally. It can be helpful to direct them to goals that will benefit them.



Don’t miss the Godoy Medical Forensics newsletter! Topics covered are:

Assault / Trauma
DUI / General Medical
Child & Elder Abuse / Neglect
Mental Health / Toxicology
Sign up here.