Antisocial Personality Disorder vs Histrionic and Narcissistic Personality Disorders
Antisocial Personality Disorder and Histrionic and Narcissistic Personality Disorders are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Antisocial Personality Disorder vs Histrionic and Narcissistic Personality Disorders at a glance
- Antisocial Personality Disorder: Pervasive disregard for and violation of the rights of others since age 15, with conduct disorder before age 15.
- Histrionic and Narcissistic Personality Disorders: Cluster B (dramatic/emotional/erratic): histrionic features excessive emotionality and attention-seeking; narcissistic features grandiosity, need for admiration, and lack of empathy.
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Side-by-side comparison
| Feature | Antisocial Personality Disorder | Histrionic and Narcissistic Personality Disorders |
|---|---|---|
| At a glance | Pervasive disregard for and violation of the rights of others since age 15, with conduct disorder before age 15. | Cluster B (dramatic/emotional/erratic): histrionic features excessive emotionality and attention-seeking; narcissistic features grandiosity, need for admiration, and lack of empathy. |
| Classic presentation | >=3 of 7 criteria since age 15: failure to conform to social/legal norms (arrests); deceitfulness (lying, conning); impulsivity; irritability and… | — |
| Workup / key labs | DSM-5-TR: (A) >=3 of 7 antisocial criteria since age 15; (B) >=18 years old; (C) Conduct disorder with onset before age 15; (D) Antisocial behavior not… | General PD criteria + ≥5 disorder-specific items by early adulthood; pervasive; impairment; not better explained by other disorder or substance.; Clinical… |
| Imaging | Not routinely indicated | Not indicated |
| First-line treatment | Treat comorbid substance use disorder — often the most modifiable contributor to behavior; Treat comorbid depression, anxiety, and ADHD; avoid stimulants and… | Individual psychotherapy is the mainstay; HPD: psychodynamic, supportive, or cognitive therapy targeting attention-seeking patterns and shallow emotional… |
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