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Ch.8 Borderline, Histrionic, Narcissistic, and Antisocial disorders Pt.II section includes: Borderline PD Histrionic P.D. Narcissistic Personality disorder Antisocial Personality Disorder Cluster B “Psychopaths” Incidence of Antisocial PD Etiolog

Course Code
Kathy Foxall

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Dramatic, emotional, erratic
(Borderline, Histrionic, Narcissistic, and Antisocial disorders)
Borderline PD
2% of population, 3x more women than men receive the diagnosis
comorbidity with mood disorder, eating disorder, substance abuse, PTSD
preoccupation with abandonment – core of BPD
oanger – when fear abandonment, react angrily towards those whom they
feel have abandoned them
unstable mood
poor sense of identity
impulsive and self destructive
may have brief periods of psychosis
oparanoid, feel that others are conspiring against them
ohallucinations, delusions (usually only last 1 day)
intense, unstable relationships
must set strict boundaries; they become very needy
tend to idealize and devalue people
high comorbidity with narcissism
Often threaten suicide (suicide rate 1-14%)
many stalkers have BPD
some came from pampered homes, others were abused as children
they may be quite friendly one day and quite hostile the next
sexual difficulties, such as sexual preoccupation, dissatisfaction, and depression,
have also been observed
they recognize their imaginary voices or other hallucinations as being
unacceptable, alien, and distressful

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Individuals with borderline personality disorders seem to have three basic assumptions:
the world is dangerous and malevolent
I am powerless and vulnerable
I am inherently unacceptable
The following passage is from a novel written by Jonathon Kellerman, a psychologist
who is a successful mystery writer.
The borderline patient is a therapist’s nightmare... because borderlines never really get
better. The best you can do is help them coast, without getting sucked into their
pathology….They’re the chronically depressed, the determinedly addictive, the
compulsively divorced, living from one emotional disaster to the next. Bed hoppers,
stomach pumpers, freeway jumpers, and sad-eyed bench –sitters with arms stitched up
like footballs and psychic wounds that can never be sutured. Their egos are as fragile as
spun sugar, their psyches irretrievably fragmented, like a jigsaw puzzle with crucial
pieces missing. They play roles with alacrity, excel at being anyone but themselves, crave
intimacy but repel it when they fine it. Some of them gravitate toward stage or screen;
others do their acting in more subtle ways…
Borderlines go from therapist to therapist, hoping to find a magic bullet for the
crushing feelings of emptiness. They turn to chemical bullets, gobble tranquilizers and
antidepressants, alcohol and cocaine. Embrace gurus and heaven-hucksters, any
charismatic creep promising a quick fix of the pain. And they end up taking temporary
vacations in psychiatric wards and prison cells, emerge looking good, raising everyone’s
hopes. Until the next letdown, real or imagined, the next excursion into self damage. “
Kellerman, 1989, pp. 113-114. Silent partner. New York: Bantam books.
Histrionic P.D.
attention seeking
overly dramatic
draw attention to themselves
extravagant display of emotions, but quite shallow
self centered
overly concerned with physical attractiveness
need to be the centre of attention

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often inappropriately seductive
may be easily influenced by others associated with depression & poor physical
high comorbidity with bpd
poor relationships
cognitive style is unfocused
ogive you an opinion but often can’t say why they hold them
Narcissistic Personality disorder
less than 1% of population
grandiose view of uniqueness and abilities
seek excessive admiration & constant attention
believe that they can be understood only by other high status people
lack empathy
envious, arrogant
take advantage of others
oexpect a lot from others, but do little or nothing in return
entitled (others are to do special favors for them)
extremely sensitive to criticism, very afraid of failure
few close friendships/relationships
reject others when they feel disappointed
many have fantasies about power or influence, and they constantly overestimate
their talents and importance
people with this disorder may use denial and dissociation to ward off feelings of
inferiority developed from early childhood
Antisocial Personality Disorder
Cluster B
violate the rights of others
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