A primer on the Cluster B disorders - Clarifying the distinctions

[Susanna]

A lot of our favourite cows fit under the umbrella of the cluster B disorders in one way or another, but farmers often get the particular diagnoses mixed up, so I thought a primer on the distinctions between them might be in order. The cluster B disorders are collectively known as the dramatic personality disorders, because they are characterised by intense emotions, interpersonal conflicts, or a desperate need for attention.

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Cluster B includes four diagnoses:

Antisocial (ASPD)
ASPD is characterised by weak (or absent) emotional affect and empathy. People with ASPD don’t experience shame or guilt, and are often adept liars. They are generally self-serving and will try to get ahead in life however they think they can get away with. Because they have low baseline arousal, they will often suffer intensive boredom. Relationships, when they do form them, tend to be shallow and transactional. ASPD is commonly referred to as sociopathy or psychopathy, but the former isn’t a clinical term at all and the latter only describes a specific subset of ASPD.

Borderline (BPD)
If ASPD is distinguished by its lack of emotionality, BPD is the very opposite. People with BPD experience emotions strongly, often to the point that they cannot control themselves. They’re driven as much by love or hate as they are by fear of rejection. Unlike ASPD they can be highly empathetic (though not always, and not necessarily consistently), but they’re less likely to be effective manipulators, as their lies are primarily reactive and fear-driven rather than purposeful. Self-harm is common.

Histrionic (HPD)
HPD, like BPD, is distinguished by excessive emotionality, but in their case the emotions aren’t necessarily real, but may simply be dramatically exaggerated (though they may feel real at the moment, no matter how extreme). They also tend to be sexually provocative, flirting aggressively even when it doesn’t suit the situation, or perceiving relationships that don’t really exist, or they may simply dream up dramatic stories that centre themselves. Like narcissists they crave attention and validation, and their performances are designed to garner both.

Narcissistic (NPD)
Much of the public perception of ASPD actually closer reflects narcissists. Narcissists are grandiose and crave validation, because behind the facade they present they are actually extremely insecure. Like antisocials they may have impaired empathy, but unlike them they feel shame intensively (though they will mask it, often with angry outbursts), especially if they’ve recently failed at something or received criticism. Unlike histrionics, who seek attention through emotionality, narcissists seek it for validation and admiration. They can be effective manipulators, but unlike ASPD it’s generally deployed to protect their image (including to themselves).

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So how might a cow with one of these disorders behave?

ASPD: Crowdfunds a large sum of money for some ostensibly good goal, then spends it all on coke.

BPD: Posts a video crying about some perceived rejection, then a dozen more videos lovebombing that same person.

HPD: Really dramatic videos with shameless and embarrassing details included just to get as many reactions as possible.

NPD: Gets called a manlet on twitter, and absolutely loses it, replying with a dozen post rant about what a tough guy he is.

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The disorders often overlap, narcissists can often behave histrionically if they’re shameless enough for example, but it’s generally easy enough to tell which one is ”most significant” in any given personality.

 

[Insuficiencia renal]

kill, rape, marry

 

[peachlover669]

All fake bullshit

kill, rape, marry

NPD, BPD, HPD

 

[Dagoth AMOGUS]

This is review for some but I didn’t know a lot about ASPD. I just thought it was autism.

And histrionic does make sense of some of the people I’ve met before.

I dislike the armchair psychologists of the world who learned these terms (half-assed or incorrectly) from TikTok. But it never hurts to have a few new clinal terms memorized.

Not to mention, you have to be aware of the changing English language so you can communicate with your fellow man, no matter how brain rot some slang is now.

I personally hate the way gaslighting is misused. It’s a form of abuse, first of all. But most importantly, lying is not the same as gaslighting. To gaslight is to try and make someone question their sanity. To lie is to save your own skin, to save someone else’s feelings through white lies, or both.

 

[Generic Anime Girl]

Cluster C's shall inherit the Earth

 

[Get the rope Macaulay!]

Where would attachment disorders work in here

 

[Susanna]

Where would attachment disorders work in here

Attachment disorders are often associated with all the cluster B disorders. For example ASPD is generally preceded by conduct disorder, which in turn may develop from abusive or detached parents, and just the same abusive or detached parents can cause a child to develop a fear of abandonment, which is a core feature of BPD.

Cluster C's shall inherit the Earth

Nah, you guys are sadsack losers! Cluster B is obviously superior!

This is review for some but I didn’t know a lot about ASPD. I just thought it was autism.

They do have similar acronyms (ASD, for autism-spectrum disorder), and some behaviours may look similar, but they’re really quite different. Autists often feel emotions and empathy strongly, but may struggle to understand or express them, and when they break social norms it’s generally because they don’t understand them, rather than because they choose to disregard them, like someone with ASPD would.

I dislike the armchair psychologists of the world who learned these terms (half-assed or incorrectly) from TikTok. But it never hurts to have a few new clinal terms memorized.

Well, I’m not a psychologist either. But I think maybe if people understand the diagnoses better they’ll be less likely to confuse them for each other. Obviously we can’t diagnose people over the internet, but if we know what the difference between a antisocial personality and a narcissistic one is, we’ll use the terms more accurately. But that’s just a personal gripe of mine.

 

[More AWS-8Q Than You]

This is review for some but I didn’t know a lot about ASPD. I just thought it was autism.

ASPD = Sociopathy is the easiest way to think about it. Also psychopathy isn't distinct from sociopathy, common use is really a split between violent and non-violent. Most sociopaths aren't violent and are far more common than you think. Most Cluster Bs are emotional vampires, except for ASPD, who are basically humanity's apex predator side in human form. They are incapable of empathy and will simply do whatever they want, whenever they want to, with no consideration of other people, because no one else is really people to them. Best thing to do is avoid them as much as possible.

NPD: Gets called a manlet on twitter, and absolutely loses it, replying with a dozen post rant about what a tough guy he is.

Malignant or pathological Narcissists are a case of building a false persona around an utterly shattered core personality and their real thing is getting what's called Narcissistic Supply by getting people to acknowledge the false persona. An NPD hates themselves at their core, they are utterly and completely convinced their "true self" is inadequate, which is why they create the false self in the first place. They don't care about whether you give the false self a positive or a negative reaction, so long as you react, which reinforces it. The best way to deal with them is go stone faced, give them no emotional reaction. They'll start to worry that you've seen through them and probably leave you alone. The saddest part is even if they do achieve things, it'll never make them feel better about themselves. If this sounds like most troons, that's because it is. A lot of troons are some weird intersection of NPD and autism.

 

[Susanna]

ASPD = Sociopathy is the easiest way to think about it. Also psychopathy isn't distinct from sociopathy, common use is really a split between violent and non-violent.

Nah, psychopathy is a specific label, and is determined based on how many points on the PCL-R you score. 30 or above (out of 40 total) is generally required, but exceptions can be made. Psychopaths can be just as violent as non-psychopaths, what distinguishes them more is a ”cold” mind, and the boredom-stimulation cycle is more pronounced. They’re often less impulsive and will make plans, especially if they’re high-functioning, but impulsivity is still a diagnostic criterion.

Most sociopaths aren't violent and are far more common than you think. Most Cluster Bs are emotional vampires, except for ASPD, who are basically humanity's apex predator side in human form. They are incapable of empathy and will simply do whatever they want, whenever they want to, with no consideration of other people, because no one else is really people to them. Best thing to do is avoid them as much as possible.

That’s pretty harsh. A lot of criminals are low-functioning antisocials, and you should shun those, but high-functioning individuals will generally find that the benefits society can bring them outweigh the costs of reigning their behaviour in. They’re transactional; if you’re useful to them they’ll be inclined to make themselves useful to you (so that you’ll stick around and remain useful in the future).

 

[More AWS-8Q Than You]

Nah, psychopathy is a specific label, and is determined based on how many points on the PCL-R you score. 30 or above (out of 40 total) is generally required, but exceptions can be made. Psychopaths can be just as violent as non-psychopaths, what distinguishes them more is a ”cold” mind, and the boredom-stimulation cycle is more pronounced. They’re often less impulsive and will make plans, especially if they’re high-functioning, but impulsivity is still a diagnostic criterion.

Then it's a more recent distinction. Which wouldn't surprise me, but the root's the same, lack of empathy.

That’s pretty harsh. A lot of criminals are low-functioning antisocials, and you should shun those, but high-functioning individuals will generally find that the benefits society can bring them outweigh the costs of reigning their behaviour in. They’re transactional; if you’re useful to them they’ll be inclined to make themselves useful to you (so that you’ll stick around and remain useful in the future).

Sure, obviously lack of empathy has value in certain situations, but the transaction is heavily one sided. Once your use to them is over, if you're lucky they'll leave you alone. Or they could just fuck you over because they feel like it. The only thing that matters to them is what they want, using you to get that is just what they do, they don't see you as their equal. If it's harsh it's because it's deserved, they're dangerous.

 

[Susanna]

Then it's a more recent distinction. Which wouldn't surprise me, but the root's the same, lack of empathy.

I don’t know when, or even if, the change was made either. It’s been the case since the late 90s at least.

Sure, obviously lack of empathy has value in certain situations, but the transaction is heavily one sided. Once your use to them is over, if you're lucky they'll leave you alone. Or they could just fuck you over because they feel like it. The only thing that matters to them is what they want, using you to get that is just what they do, they don't see you as their equal. If it's harsh it's because it's deserved, they're dangerous.

I think you’re being overly reductive, not every antisocial person is going to be needlessly cruel. I won’t claim you’re always wrong, but generally if an antisocial person hurts you it’s because they’re indifferent to the pain they cause, rather than because they actually want to hurt you. The diagnosis is based on callousness and selfishness, not sadism. If you lose utility or become uninteresting, a psychopath is more likely to just drop contact with you than they are to hunt you down with an axe.

 

[JohnnyG]

Also psychopathy isn't distinct from sociopathy, common use is really a split between violent and non-violent.

Nah, psychopathy is a specific label, and is determined based on how many points on the PCL-R you score. 30 or above (out of 40 total) is generally required, but exceptions can be made. Psychopaths can be just as violent as non-psychopaths, what distinguishes them more is a ”cold” mind, and the boredom-stimulation cycle is more pronounced. They’re often less impulsive and will make plans, especially if they’re high-functioning, but impulsivity is still a diagnostic criterion.

That's interesting, I remember reading the (informal) split being more about being created vs. born (sociopaths often being the product of extreme childhood violence, psychopaths starting out that way), and lacking empathy but understanding it vs. not understanding others at all.

The book "Mask of Sanity" covered a bunch of cases (I think from the 20s/30s) which were surprisingly mundane. People who'd land a new job, behave normally for a week or so, then get drunk and crash their car in a field just because. Or stupid petty thefts that were easily traced to them...more self-destructive impulsiveness than devious scheming.

 

[Ravier Xavenblood]

These get really fun when they're comorbid with autism.

 

[More AWS-8Q Than You]

I don’t know when, or even if, the change was made either. It’s been the case since the late 90s at least.

That's interesting, it's been about a decade or so since I really dove into cluster Bs and that's where I picked up the lack of differentiations, I wonder if it was just where I picked things up from.

I think you’re being overly reductive, not every antisocial person is going to be needlessly cruel. I won’t claim you’re always wrong, but generally if an antisocial person hurts you it’s because they’re indifferent to the pain they cause, rather than because they actually want to hurt you. The diagnosis is based on callousness and selfishness, not sadism. If you lose utility or become uninteresting, a psychopath is more likely to just drop contact with you than they are to hunt you down with an axe.

Maybe I am, but I look at it like Human Pitbulls. Even with their reputation, most Pitbulls aren't going to attack people or maul them, the vast majority aren't. Even so, you don't know when one is going to go off. Most ASPD aren't violent or, as you said, particularly sadistic. Not a risk I prefer to take if I can avoid it. On the other hand, I once I once had a manager who was either NPD or ASPD going by his behavior, and while not physically violent, it was like watching an incredibly manipulative human wrecking ball on an emotional and psychological level. I may just be touchy from personal experience.

 

[Beastie]

Cluster C's shall inherit the Earth

We'll be the survivors since our anxiety will have prevented us from taking stupid risks and dying.

 

[KittyGremlin]

kill, rape, marry

ASPD, NPD, BPD (because none of you know the horrors of living with a histrionic)

 

[Susanna]

That's interesting, I remember reading the (informal) split being more about being created vs. born that way (sociopaths often being the product of extreme childhood violence, psychopaths starting out that way), and lacking empathy but understanding it vs. not understanding others at all.

It does seem to be the case that psychopaths are almost always born, rather than created, but it’s not actually a criterion and there’s not really any way to test for it.

The book "Mask of Sanity" covered a bunch of cases (I think from the 20s/30s) which were surprisingly mundane. People who'd land a new job, behave normally for a week or so, then get drunk and crash their car in a field just because. Or stupid petty thefts that were easily traced to them...more self-destructive impulsiveness than devious scheming.

Yeah, that’s the boredom-stimulation cycle. ASPD is intensively boring, and just living a normal life can be unbearable. You seek stimulation in a variety of ways, some of which are, unfortunately, self-destructive. Psychopaths get this worse than the others, since they’re even less emotional than antisocials in general (who can experience self-centred emotions like anger intensively, thus the ”violent sociopath” stereotype). Anger isn’t a positive emotion, but it is still an emotion, and if you can reliably evoke that feeling you won’t have to deal with the emptiness inside, nor will you feel soul-crushingly bored with your daily routine.

That's interesting, it's been about a decade or so since I really dove into cluster Bs and that's where I picked up the lack of differentiations, I wonder if it was just where I picked things up from.


Maybe I am, but I look at it like Human Pitbulls. Even with their reputation, most Pitbulls aren't going to attack people or maul them, the vast majority aren't. Even so, you don't know when one is going to go off. Most ASPD aren't violent or, as you said, particularly sadistic. Not a risk I prefer to take if I can avoid it. On the other hand, I once I once had a manager who was either NPD or ASPD going by his behavior, and while not physically violent, it was like watching an incredibly manipulative human wrecking ball on an emotional and psychological level. I may just be touchy from personal experience.

I’ll admit that my motivations about portraying ASPD as ”not all that bad” are inherently selfish, it’s my own diagnosis after all. You’re probably right that avoiding antisocial people is the rational thing to do, I just wanted to point out that reducing people with the disorder to an evil caricature isn’t helpful, neither to them nor to yourself. If you tell people ”psychopaths are alien predators wearing human skins who will hurt indiscriminately to satisfy their urge for power and control” they’re actually going to be less adept at spotting and interacting with them, because that’s a characterisation that just doesn’t even remotely apply to anyone. People with ASPD aren’t film villains, they’re just selfish and immoral people you might interact with every day. They’re not going to psychologically torture you for not letting them bum a fag, they’re just not going to return your wallet to you if they find it on the street. Even the famous ”psychopathic serial killers” everyone imagines are more likely to have NPD than ASPD, let alone psychopathy. Low-functioning psychopaths go in and out of jail constantly, high-functioning ones are successful professionals with apparently idyllic lives.

 

[More AWS-8Q Than You]

I’ll admit that my motivations about portraying ASPD as ”not all that bad” are inherently selfish, it’s my own diagnosis after all. You’re probably right that avoiding antisocial people is the rational thing to do, I just wanted to point out that reducing people with the disorder to an evil caricature isn’t helpful, neither to them nor to yourself. If you tell people ”psychopaths are alien predators wearing human skins who will hurt indiscriminately to satisfy their urge for power and control” they’re actually going to be less adept at spotting and interacting with them, because that’s a characterisation that just doesn’t even remotely apply to anyone. People with ASPD aren’t film villains, they’re just selfish and immoral people you might interact with every day. They’re not going to psychologically torture you for not letting them bum a fag, they’re just not going to return your wallet to you if they find it on the street. Even the famous ”psychopathic serial killers” everyone imagines are more likely to have NPD than ASPD, let alone psychopathy. Low-functioning psychopaths go in and out of jail constantly, high-functioning ones are successful professionals with apparently idyllic lives.

They're not alien, they're just humans without empathy to hold back our predatory nature. But yes, the smart ones are going to look more like a Bill Gates, although probably better socially.

 

[Susanna]

They're not alien, they're just humans without empathy to hold back our predatory nature.

Okay, but there’s ”no empathy” and ”no empathy”. There’s no affective empathy, sure, an antisocial person isn’t going to actually ”feel” your emotions (in fact I can’t even conceptualise that idea), but there is cognitive empathy, we can usually make a pretty good guess how you’ll react to something. I try not to hurt people, because I like being popular in my social circle. I don’t do anything criminal I’m not entirely certain I can get away with, because I like my job. And so on. Higher functioning individuals aren’t necessarily predatory, even if we’re maybe not good people.

But yes, the smart ones are going to look more like a Bill Gates, although probably better socially.

I’m not so sure about that. He’s pretty big into philanthropy, sure someone antisocial might do that to curate a good image, but you can get away with less than the Gates Foundation. A lot less.

 

[JohnnyG]

He’s pretty big into philanthropy

Strange how his "philanthropy" is centered around further subsidizing africa to breed like rabbits, far beyond any ability to support themselves, and lobbying for Western taxpayers to babysit them forever. But none of those billions are directed at things like helping disaster-struck Americans, or training for those who've lost their jobs to globalism, or bringing back manufacturing, or ending the opioid epidemic...