Cluster B personality disorders are characterised by dramatic, emotional, or erratic behaviour. Which personality disorder is most associated with lack of empathy, grandiosity, and exploitative behaviour WITHOUT the pervasive disregard for and violation of others' rights seen in Antisocial PD?

• A Borderline Personality Disorder
• B Histrionic Personality Disorder
• C Narcissistic Personality Disorder ✓
• D Schizotypal Personality Disorder

Explanation

Narcissistic Personality Disorder (NPD) is characterised by a pervasive pattern of grandiosity, need for admiration, and lack of empathy. Patients exploit interpersonal relationships but the defining feature is self-aggrandisement and entitlement, not callous disregard for others' rights. In contrast, Antisocial PD features deceitfulness, impulsivity, aggression, and reckless disregard for safety of self and others. Borderline PD is marked by identity instability and fear of abandonment. Histrionic PD is characterised by excessive emotionality and attention-seeking without the consistent grandiosity of NPD.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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