Key Points

Type B personality disorders consist of narcissistic personality disorders, borderline personality disorders, histrionic personality disorders, and antisocial personality disorders.
Negative personality traits can also overlap across specific diagnostic criteria.
An individual does not need to have a clinical diagnosis to exhibit negative personality traits.

Type B personality disorders consist of a group of negative traits organized into four categories: narcissistic personality disorders, histrionic personality disorders, borderline personality disorders, and antisocial personality disorders. Personality disorders as a whole are described as enduring, maladaptive patterns of thoughts and/or behaviors that deviate from one’s culture (APA, 2013). These thoughts, beliefs, and actions are inflexible, highly negative, and pervasive.

Despite our best efforts, we all have negative traits and unhealthy habits. What makes a trait pathological is the inability and unwillingness to change and improve. Even the kindest person on the path to holiness can erupt in a fit of rage and ego. The act of being human comes with free will for thoughts and actions. We all have the innate capacity to be narcissistic; however, what separates non-narcissists from the crowd is the element of self-control and choice. We can choose to use people for our purposes and then get rid of them; we choose to lie and hide; we choose to cheat and sneak. This is one reason why the diagnostic features of Cluster B disorders are so low: individuals with these problems do not seek help because they do not believe they need help in the first place. Of course, to be clinically diagnosed with a particular disorder, you must have a certain number of signs and symptoms. An individual can have narcissistic traits and not be officially classified as a narcissist.

Links Between Narcissistic Personality Disorder and Narcissistic Personality Disorder

Narcissism or Narcissistic Personality Disorder (NPD) is easily recognized by the individual’s lack of empathy and overwhelming ego. However, many victims of narcissism report that their abuser’s tendencies and emotions have been turned into sharp weapons. These sexual and dramatic individuals suffer from what the American Psychiatric Association calls histrionic personality disorder (2013). While narcissistic personality disorder is primarily diagnosed in men, histrionic personality disorder is primarily diagnosed in women. As with most personality disorders, histrionic individuals cannot be treated with prescription medications. Only the co-morbidities, such as depression and anxiety, can be treated. So while depression can be lifted with the right treatment plan, it will do nothing for the person’s selfish actions or cold behaviors. The same is true for histrionic personality disorder.

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Histrionic personality disorder shares many similarities with narcissism but also has distinct differences. The use of drama, emotions, and sexuality contrasts starkly with the cold, self-centered narcissist. However, many of the hallmark traits overlap. Like positive personality traits such as openness or conscientiousness, negative personality traits can also overlap across disorders. Just because an individual exhibits many of the traits of narcissism does not mean that they cannot also act out traits of histrionic personality disorder.

Hysterical individuals have highly exaggerated emotions and an overwhelming need to be noticed. The term histrionic means “dramatic” and “theatrical.” These individuals are known for being drama queens and snobbish people who cannot handle being left out of the spotlight. Hysterics’ self-esteem is highly dependent on the opinions of others and can rise and fall depending on their reputation. When they are pushed back, people with histrionic personality disorder are more likely to experience depression, crying spells, and despair at turning the narrative around that they are the victim. On the other hand, narcissists may become angry, defiant, and generally shunned by negative public opinion. They have been untouchable up until this point. If narcissists keep their negative self-image hidden and covered with an exaggerated ego, hysterics wear their selfish hearts on their sleeves.

Both narcissists and hysterics may use suicide threats as a means of attracting attention or gaining sympathy and forgiveness. Neither type of individual can have a normal relationship for long. Hysterics exhaust their partners with their rapid mood swings; narcissists destroy their partners with abuse and confrontation; and both classifications generally exhaust the ability of friends and lovers to meet their great demands for attention.

Sex as a weapon

The main difference between a hysteric and a narcissist is the use of sex. Narcissists are known to be more prone to cheating in their relationships, but hysterics are more sexually exploitative and provocative. Hysterics use sex and seduction to solve almost any problem that arises and to attract attention to themselves; Narcissists use their sex as a way to control. Narcissists cheat because they feel they can deserve it, or need something done for them in return. In contrast, a histrionic engages in cheating to satisfy a desperate need for attention that they believe they are not getting from their partner. Regardless of whether a person is a narcissist or a histrionic, cheating is not their fault. Jack recalls catching his ex-wife cheating. “She had been cheating for years with different men. She said it was because I didn’t care enough about her, and these men were doing it, and they made her feel beautiful and worthy. It was my fault for not making her feel beautiful.” In comparison, Anthony’s ex-wife tried to deny the charges when presented with evidence of her infidelity, but she also took on the role of the wronged party. Narcissists are masters of lying and acting and can maintain their false persona better and for longer periods than histrionics. Anthony recalls that she eventually began to brag about her infidelity rather than being embarrassed by it. “Cheating wasn’t a flaw in her character,” Anthony says. “It was a flaw in me in some way. She used it to belittle me and make herself the poor victim.”

Again, keep in mind that to be diagnosed as a histrionic, you must meet a certain set of diagnostic criteria. Being confident and in control of your sexuality does not make you histrionic; likewise, being overly dramatic is also not a way to diagnose someone as histrionic. Anyone can be sexual and seductive without being hysterical, and not all con artists have histrionic personality disorder. Female narcissists are particularly dangerous and use their sexuality as a weapon to navigate between Narcissistic Personality Disorder and Histrionic Personality Disorder. Histrionic narcissists use their seductiveness and even their reproductive abilities to dominate a relationship, gain the upper hand, or simply hurt someone. Histrionic women cross into narcissistic territory through the abuse of power, gender roles, and relationship manipulation. Using children, pregnancy, and other family members to get what they want is not outside the realm of possibility for histrionic narcissists.