15-Item Cluster B Personality Disorder Test

Cluster B groups four personality disorders: antisocial, borderline, histrionic and narcissistic. This free 15-question test screens for all four.

Written by PsyMed Editorial Team

Published Nov 7, 2023 Updated Nov 5, 2026

A screening tool for self-reflection, not a diagnosis. How we build our tests

15-Item Cluster B Personality Disorder Test

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Cluster B is the DSM-5-TR’s “dramatic, emotional, or erratic” group of personality disorders: antisocial, borderline, histrionic and narcissistic personality disorder (APA, 2022). This free 15-question test looks at traits from all four. It is a self-assessment, not a diagnosis.

The four Cluster B personality disorders — Borderline (BPD), Narcissistic (NPD), Histrionic (HPD), and Antisocial (ASPD) — are grouped together in the DSM-5-TR’s “dramatic, emotional, or erratic” cluster for a reason. On the surface they look alike. They involve intense emotions, trouble keeping relationships stable, and impulsive behavior. They can also cause real distress, both for the person and for those around them. But underneath, each disorder works differently, has its own core driver, and needs its own treatment.

It helps to know which Cluster B pattern is strongest, in yourself or in someone close to you. The four disorders can look alike but need quite different responses. In BPD, emotional storms are driven by fear of being abandoned. In NPD, using others is driven by entitlement. In HPD, the drama is driven by a need for attention. In ASPD, rule-breaking comes with a lack of care for others. All four can cause similar chaos in relationships.

This free Cluster B Personality Disorder test screens for the most clinically significant features of all four disorders using DSM-5-TR criteria (APA, 2022). 15 questions. Instant results identifying which Cluster B pattern is most prominent in your profile.

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Cluster B Personality Disorder Test

Cluster B personality disorders — Borderline, Narcissistic, Histrionic, and Antisocial — share a core of emotional intensity and dramatic behavior while differing in their specific patterns, underlying dynamics, and treatment approaches. This free Cluster B test screens for the most clinically significant features of all four disorders using DSM-5-TR criteria. 15 questions. Instant results showing which Cluster B pattern is most prominent for you.

1 / 15

I have an intense fear of being abandoned or rejected — even when there is little evidence that this is actually happening.

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2 / 15

My relationships tend to be intense and unstable — I shift between seeing the same person as wonderful and completely terrible.

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3 / 15

I frequently feel unsure of who I am — my sense of self, my values, and what I want shifts significantly depending on who I'm with.

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4 / 15

I have engaged in self-harm, threatened or attempted suicide, or have recurrent thoughts about ending my life.

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5 / 15

I have a strong sense that I am more important, capable, or special than most people around me — and I expect this to be recognized.

Never

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6 / 15

I require constant recognition, admiration, and attention from others — and feel genuinely hurt or angry when I don't receive it.

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7 / 15

I find it difficult to recognize or care about other people's feelings when their needs conflict with what I want.

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8 / 15

I come across as arrogant, dismissive, or contemptuous of people I consider inferior — and I'm aware that others perceive this.

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9 / 15

I consistently fail to conform to social norms and laws — I have repeatedly done things that could result in legal trouble or that violate others' rights.

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10 / 15

I repeatedly lie, use false identities, or manipulate others for personal gain or pleasure — and this is a consistent pattern, not occasional.

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11 / 15

I have a history of physical fights, assaults, or consistent irritability and aggressiveness — getting into conflicts more than most people would consider normal.

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12 / 15

I feel little or no remorse when my actions harm others — or if remorse appears, it passes quickly and doesn't change my future behavior.

Never

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13 / 15

I feel genuinely uncomfortable when I am not the center of attention in social situations — and I actively work to draw attention back to me.

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14 / 15

My emotions shift rapidly, and others describe my reactions as theatrical, exaggerated, or dramatic — even when the feelings are genuine in the moment.

Never

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15 / 15

I feel that relationships are significantly more intimate and important than the other person seems to experience them — and this pattern has been consistent throughout my life.

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Your score is

What Are Cluster B Personality Disorders?

Cluster B is one of three personality disorder clusters in the DSM-5-TR (APA, 2022). The others are Cluster A (“odd or eccentric”) and Cluster C (“anxious or fearful”). The DSM-5-TR calls Cluster B the “dramatic, emotional, or erratic” cluster. It is marked by intense emotions, dramatic behavior, and unstable relationships.

Together, the four Cluster B disorders affect about 5.5% of the population in Western countries, according to a large 2025 analysis by Lunghi and colleagues (Social Psychiatry and Psychiatric Epidemiology, 2025). Subtype prevalence estimates: HPD 0.8%, NPD 1.2%, BPD 1.9%, and ASPD 3.1% (Lunghi et al., 2025). BPD affects an estimated 0.7–2.7% of the general population and about 22% of psychiatric inpatients (Leichsenring et al., 2024).

All four disorders share the following features per DSM-5-TR (APA, 2022):

— A pervasive, inflexible pattern of inner experience and behavior beginning by early adulthood
— The pattern deviates markedly from the expectations of the individual’s culture
— The pattern is stable over time and leads to distress or functional impairment
— The pattern is not better explained by another mental disorder, substance, or medical condition

Talk therapy is the main proven treatment for all four Cluster B disorders. Therapies built for each disorder work best: DBT for BPD, Schema Therapy and TFP for NPD and ASPD, and psychodynamic therapy for HPD (Lunghi et al., 2025; APA, 2022).

The Four Cluster B Disorders — What Makes Each One Distinct

Borderline Personality Disorder (BPD) — ICD-10-CM F60.3
The core of BPD is fear of abandonment and identity instability. The emotional storms, impulsive acts, self-harm, all-or-nothing views of people, and constant emptiness in BPD all center on the terror of being left and the lack of a stable self. BPD is the Cluster B disorder seen most often in clinics. It also has the best-proven treatment: DBT (Dialectical Behavior Therapy), developed by Dr. Marsha Linehan. Requires ≥5 of 9 DSM-5-TR criteria. Prevalence: 0.7–2.7%; about 72% female in outpatient clinics, but near-equal in the community (3% vs. 2.4%) (Leichsenring et al., 2024).

Narcissistic Personality Disorder (NPD) — ICD-10-CM F60.81
The core of NPD is grandiosity and need for admiration. The self-image is inflated but fragile, and it needs constant outside praise to hold up. The entitlement, using of others, lack of empathy, and arrogance in NPD all serve to protect that inflated self-image. Requires ≥5 of 9 DSM-5-TR criteria. Prevalence: 1.2% (Lunghi et al., 2025); diagnosed 3× more often in males (APA, 2022). The most central criterion: need for admiration (Gori & Topino, Clinical Psychology & Psychotherapy, 2025, N=376).

Histrionic Personality Disorder (HPD) — ICD-10-CM F60.4
The core of HPD is excessive emotionality and attention-seeking. The flirtatiousness, drama, vague speech, shallow emotions, and habit of seeing relationships as closer than they are in HPD all center on the need to be the center of attention. Requires ≥5 of 8 DSM-5-TR criteria. Prevalence: 0.8% (Lunghi et al., 2025), the least common of the four. Diagnosed about 4× more often in females, though bias in diagnosis is known (APA, 2022).

Antisocial Personality Disorder (ASPD) — ICD-10-CM F60.2
The core of ASPD is a persistent disregard for and violation of others’ rights — a pervasive pattern that includes deceitfulness, impulsivity, aggressiveness, reckless disregard for safety, irresponsibility, and a lack of remorse. It is the most common of the four at 3.1% (Lunghi et al., 2025), and about 3 times more common in males (MSD Manual). It requires a history of conduct disorder before age 15 (DSM-5-TR Criterion B) and cannot be diagnosed before age 18. Of the four, it is the closest to psychopathy as used in legal settings.

Cluster B Personality Disorders infographic explaining BPD, NPD, HPD, and ASPD, including prevalence, shared traits, and treatment approaches

Signs You Might Have a Cluster B Personality Disorder

The Cluster B disorders share a family resemblance but have distinct experiential signatures. These signs are organized by the pattern most associated with each disorder — recognize which resonates most consistently.

Signs most consistent with BPD:

The fear of being left is constant — and activates before there’s clear evidence it’s happening. A slight distance, a delayed reply, a shift in someone’s tone — and the abandonment panic is immediate, physical, and complete. The response — clinging, rage, desperate action — is disproportionate to any actual signal.

The people in your life are either wonderful or terrible — and the same person can be both within the same day. Splitting — the alternation between idealization and devaluation — produces a relational world of extremes. Ambivalence (holding love and disappointment simultaneously about the same person) is very difficult to sustain.

You are not sure who you are when you’re not in a relationship — your sense of self shifts significantly depending on who you’re with. This is not ordinary self-consciousness. It is a deeper uncertainty about your values, wants, and identity, which only feels steady in the context of a relationship.

Signs most consistent with NPD:

You expect recognition and deference — and feel genuinely injured when you don’t receive them. Not disappointment but something more like indignation: something owed to you has been withheld. The recognition feels like a right, not a preference.

You find it genuinely difficult to care about others’ feelings when they conflict with what you want. The empathy gap in NPD is not cruelty. It is a built-in difficulty letting others’ feelings outweigh your own needs and goals when the two clash. Empathy can show up in some moments. It fails when it costs something.

Criticism activates anger or contempt rather than reflection. Negative evaluation doesn’t land as information to update your self-model — it lands as a threat to be repelled. The response is typically dismissal of the critic, counterattack, or cold contempt rather than genuine consideration.

Signs most consistent with HPD:

Being unnoticed in a social situation feels genuinely intolerable — not just uncomfortable. The discomfort when not the center of attention that DSM-5-TR Criterion 1 describes is qualitatively different from ordinary preference for recognition. It is a structural inability to tolerate not being the focal point.

Your emotional responses are rapid, intense, and sometimes feel theatrical even to you. In HPD (Criterion 3), emotions shift fast and stay shallow. They are vivid in the moment and fade quickly, in ways others find inconsistent. You can notice this from the inside as well as the outside.

You experience relationships as significantly more intimate and meaningful than the other person seems to. Seeing relationships as closer than they are (Criterion 8) leads to a repeating pattern. You invest deeply in connections that others see as more casual, then feel confused and hurt when they don’t return the intensity.

Signs most consistent with ASPD:

Rules, laws, and social norms feel like constraints that apply to other people — not to you. In ASPD, ignoring social rules doesn’t mainly feel like rebellion. The rules simply feel less binding than they seem to for most people.

You feel very little remorse when your actions harm others — or the remorse that arrives is brief and doesn’t reliably change your behavior. Lack of remorse (Criterion 7) is one of the clearest signs of ASPD. It sets ASPD apart from impulsive behavior that is followed by shame or guilt, which holds people back next time.

You have a history of deceiving, manipulating, or exploiting others for personal gain across multiple relationships and contexts. The pervasive deceitfulness of ASPD (Criterion 2) extends across relationships and contexts, distinguishing it from situational dishonesty or the strategic deception of Machiavellianism.

Cluster B personality disorders infographic comparing common patterns associated with BPD, NPD, HPD, and ASPD

How the Four Cluster B Disorders Relate and Differ

Feature	BPD	NPD	HPD	ASPD
Core dynamic	Fear of abandonment + unstable identity	Grandiosity + need for admiration	Excessive emotionality + attention-seeking	Persistent disregard for others’ rights
Emotional style	Intense, reactive, dysregulated — driven by interpersonal triggers	Controlled; rage when ego threatened; flat between challenges	Rapid, shallow, theatrical — expressed for audience effect	Flat or callous; anger as a tool; low guilt and remorse
Relationship pattern	Intense splitting; frantic abandonment avoidance; idealization-devaluation	Exploitation; idealize those who validate; devalue those who don’t	Seductive; overestimates intimacy; focused on exciting new connections	Exploitative without guilt; relationships as means to ends; serial deception
Self-harm / suicide risk	High — Criterion 5; ~2–5% die by suicide over 5–14 years of follow-up; self-harm as emotion regulation	Lower but present; narcissistic injury can produce suicidality	Moderate — suicidal gestures can be attention-seeking but carry real risk	Elevated due to impulsivity; accidental harm and reckless behavior
Prevalence	1.9% (0.7–2.7%)	1.2%	0.8%	3.1%
Sex distribution	Female > male in clinical; roughly equal in community	3× more diagnosed in males	4× more diagnosed in females (diagnostic bias documented)	~3:1 male to female (MSD Manual)
DSM code	F60.3	F60.81	F60.4	F60.2
Primary treatment	DBT (gold standard); MBT; TFP	Schema Therapy; TFP	Psychodynamic therapy; CBT; Schema Therapy	CBT; contingency management; limited evidence base
PsyMed test	BPD Test	NPD Test	HPD Test	ASPD Test

How This Cluster B Personality Disorder Test Works

This Cluster B test screens for the key features of all four DSM-5-TR Cluster B disorders in 15 questions: 4 on BPD, 4 on NPD, 4 on ASPD, and 3 on HPD. The mix reflects how common each disorder is and how well each question tells them apart. The questions target the core features that best separate each disorder.

Answer based on your consistent pattern over the past 12 months across different situations and relationships — not isolated incidents or your best or worst periods. The test can also be answered about someone in your life by responding based on how they typically behave.

Never = 0
Rarely = 1
Sometimes = 2
Often = 3
Always = 4

Total range: 0–60. Your result will identify your overall Cluster B indicator level and highlight which Cluster B pattern scored highest based on your answers. Only a qualified mental health professional can diagnose any personality disorder.

Understanding Your Cluster B Personality Disorder Test Score

Score Range	Category	What It Suggests
0 – 15	Low — Few Cluster B Indicators	Few significant Cluster B personality disorder patterns present. Normal emotional intensity and relationship challenges may be present without a pattern consistent with Cluster B disorders.
16 – 30	Mild — Some Cluster B Patterns	Some Cluster B-related features present across one or more disorder domains. May reflect subclinical traits or early-stage patterns. Note which disorder’s questions scored highest for the most relevant picture.
31 – 45	Moderate — Significant Cluster B Pattern	Significant Cluster B features across multiple criterion domains. Consistent with a Cluster B personality disorder presentation. Professional evaluation is recommended.
46 – 60	High — Strong Cluster B Indicators	Pervasive Cluster B pattern across most domains. Strongly consistent with a Cluster B personality disorder diagnosis. Professional evaluation and specialized treatment are urgently recommended.

What Causes Cluster B Personality Disorders?

No single cause explains the Cluster B disorders. Several factors combine: genes, childhood experience, and brain biology. How much each matters differs by disorder.

Genetic factors. BPD heritability was estimated at 46% in a Swedish population study (Leichsenring et al., 2024), and ASPD has a strong heritable component (MSD Manual). Genes likely shape inborn tendencies: strong emotional reactions in BPD and HPD, being at odds with others in NPD, and impulsiveness and coldness in ASPD. These combine with childhood experience to produce the full disorder.

Developmental and attachment factors. Adverse Childhood Experiences (ACEs) — including abuse, neglect, and attachment disruption — are significantly associated with all Cluster B disorders. A 2024 prospective longitudinal study by Broekhof and colleagues (Journal of Personality Disorders, 2024(38)) found that ACEs are significantly associated with personality disorder development. BPD shows the strongest trauma connection; ASPD frequently involves childhood conduct disorder preceding adult presentation.

Neurobiological factors. Each Cluster B disorder has known brain differences. In BPD, the amygdala overreacts and the prefrontal cortex is weaker at calming it. In NPD, there are structural differences in parts of the insula tied to empathy. In ASPD, the amygdala reacts less to fear, and the prefrontal cortex works less well. HPD has been studied less, but is linked to greater sensitivity to reward.

Comorbidities. The four Cluster B disorders co-occur with each other and with Axis I conditions at high rates. PTSD and Cluster B disorders frequently co-occur, particularly BPD and NPD. ADHD shares impulsivity and emotional dysregulation with BPD and ASPD. Major depressive disorder is the most common comorbid Axis I condition across all four disorders.

Frequently Asked Questions

What are Cluster B personality disorders?

Cluster B personality disorders are the four DSM-5-TR disorders grouped under the “dramatic, emotional, or erratic” classification: Borderline Personality Disorder (BPD, F60.3), Narcissistic Personality Disorder (NPD, F60.81), Histrionic Personality Disorder (HPD, F60.4), and Antisocial Personality Disorder (ASPD, F60.2). Together they affect about 5.5% of the population in Western countries (Lunghi et al., Social Psychiatry and Psychiatric Epidemiology, 2025). By type: HPD 0.8%, NPD 1.2%, BPD 1.9%, ASPD 3.1%. All four meet the DSM criteria for personality disorders: rigid patterns that show up everywhere, begin in early adulthood, differ from cultural norms, and cause distress or problems in daily life.

Can you have more than one Cluster B disorder?

Yes. Research shows that Cluster B disorders often occur together. BPD and NPD share all-or-nothing views of people, swinging between idealizing and devaluing, and often occur together. BPD and ASPD share impulsiveness and trouble controlling emotions, and can occur together. HPD and NPD both involve seeking attention and look alike in some ways. Having more than one personality disorder diagnosis is common in clinical settings, and the four Cluster B disorders can overlap. This is one reason the individual disorder tests — the BPD Test, NPD Test, HPD Test, and ASPD Test — give a more detailed picture than this combined screening.

How are Cluster B disorders different from Cluster A and Cluster C?

The three clusters describe distinct personality disorder patterns. Cluster A (“odd or eccentric”) includes Paranoid, Schizoid, and Schizotypal Personality Disorders — characterized by unusual thinking, social isolation, and eccentric behavior. Cluster B (“dramatic, emotional, or erratic”) includes the four disorders covered in this test — characterized by emotional intensity, impulsivity, and interpersonal drama. Cluster C (“anxious or fearful”) includes Avoidant, Dependent, and Obsessive-Compulsive Personality Disorders — characterized by anxiety, fear, and inhibition. The clusters are descriptive groupings rather than etiological categories — disorders within each cluster share surface similarities but have distinct causes and treatments.

Which Cluster B disorder is most common?

ASPD is the most common Cluster B disorder, at about 3.1% of the Western population (Lunghi et al., 2025). It is about 3 times more common in males (MSD Manual) and is found in roughly half of male prisoners (47%; Fazel & Danesh, 2002). BPD affects 0.7–2.7% of the general population but about 22% of psychiatric inpatients (Leichsenring et al., 2024). NPD affects approximately 1.2% and HPD approximately 0.8% (Lunghi et al., 2025).

Are Cluster B personality disorders treatable?

Yes. The old view that personality disorders can’t be treated no longer holds. All four Cluster B disorders respond to the right specialized treatment:

BPD has the strongest evidence. DBT (Dialectical Behavior Therapy), by Dr. Marsha Linehan, greatly reduces suicidal behavior, self-harm, and emotional storms.
NPD responds to Schema Therapy and Transference-Focused Psychotherapy (TFP).
HPD responds to psychodynamic therapy and CBT.
ASPD has the least evidence, but structured CBT and reward-based programs (contingency management) bring some improvement.

Talk therapy is the main treatment for all four. Medication is an add-on, not the main treatment (Lunghi et al., 2025).

What distinguishes Cluster B personality disorders from normal emotional intensity?

The difference lies in three features the DSM-5-TR requires for any personality disorder:

pervasiveness: the pattern shows up in many situations and relationships, not just a few
stability: the pattern has been steady since early adulthood, not a reaction to recent events
impairment: the pattern causes real distress or problems in important areas of life

Everyone has intense emotions, relationship trouble, self-centered moments, and impulsive acts now and then. These are normal. What sets Cluster B disorders apart is how rigid the pattern is, how widely it shows up, how long it lasts, and how much harm it causes.

One dramatic episode, a hard stretch of life, or one very stressful relationship is not a personality disorder. It is the lasting pattern, across different relationships, settings, and stages of life, that meets the clinical bar (APA, 2022; Lunghi et al., 2025).

How is this test different from the individual Cluster B disorder tests?

This test is a broad screen of all four Cluster B disorders at once. Its 15 questions cover the key features of each disorder. It is meant to show which Cluster B pattern is strongest and point you to the right individual test for a fuller look. The individual tests — BPD Test (18 questions covering all 9 criteria), NPD Test (15 questions covering all 9 criteria), HPD Test (15 questions covering all 8 criteria), and ASPD Test — give much more detail on each disorder.

About this test: The questions were written by the PsyMed Editorial Team from the DSM-5-TR criteria for the four Cluster B personality disorders. It is an original educational scale that has not been clinically validated, so the score bands are a guide rather than clinical cutoffs. Read how we build our tests and who we are.

Related Tests

Borderline Personality Disorder Test — full 18-question BPD screening covering all 9 DSM-5-TR criteria; gold-standard reference for the most common Cluster B clinical presentation
Narcissistic Personality Disorder Test — full NPD screening covering all 9 criteria, including both grandiose and covert presentations
Histrionic Personality Disorder Test — full HPD screening covering all 8 DSM-5-TR criteria
Antisocial Personality Disorder Test — full ASPD screening; the most prevalent Cluster B disorder
Covert Narcissism Test — vulnerable narcissism assessed via the MCNS framework; captures the NPD subtype most frequently missed by standard assessments
Dark Triad Test — measures subclinical narcissism, Machiavellianism, and psychopathy across 15 questions; overlaps with NPD and ASPD dimensions
Psychopath Test (PCL-R) — clinical psychopathy assessment; ASPD and psychopathy overlap significantly but are not identical
PTSD Test — PTSD and BPD frequently co-occur and are among the most important differentials; trauma assessment is essential alongside Cluster B screening
Bipolar Test — bipolar disorder is among the most commonly confused conditions with BPD; important differential for emotional dysregulation
Empathy Test — reduced empathy is a shared feature of NPD, ASPD, and psychopathy; complementary assessment
Full Personality Disorder Test Hub — all ten DSM-5-TR personality disorder types across Clusters A, B, and C

References

American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Cluster B Personality Disorders (pp. 748–771). psychiatry.org
Lunghi, C., Cailhol, L., Massamba, V., et al. (2025). Cluster B personality disorders and psychotropic medications: a focused analysis of trends and patterns across sex and age groups. Social Psychiatry and Psychiatric Epidemiology, 60, 1499–1509. link.springer.com
Leichsenring, F., Fonagy, P., Heim, N., et al. (2024). Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry, 23(1), 4–25. pmc.ncbi.nlm.nih.gov
ScienceDirect. (2025). Understanding borderline personality disorder: Clinical features, neurobiological insights, and therapeutic strategies. sciencedirect.com
Broekhof, R., Nordahl, H.M., Eikenæs, I.U., & Selvik, S.G. (2024). Adverse Childhood Experiences Are Associated With Personality Disorder: A Prospective, Longitudinal Study. Journal of Personality Disorders, 38(1), 19–33. pubmed.ncbi.nlm.nih.gov
Gori, A., & Topino, E. (2025). DSM-5-TR Criteria and Domains for Narcissistic Personality Disorder: Evidence From Network Analysis. Clinical Psychology & Psychotherapy, 32(6), e70179. doi.org
Cleveland Clinic. (2025). Cluster B Personality Disorders: What They Are and Traits. my.clevelandclinic.org
MSD Manual Professional Edition. (n.d.). Overview of personality disorders. Merck & Co. msdmanuals.com
MSD Manual Professional Edition. (n.d.). Antisocial personality disorder (ASPD). Merck & Co. msdmanuals.com
Fazel, S., & Danesh, J. (2002). Serious mental disorder in 23 000 prisoners: A systematic review of 62 surveys. The Lancet, 359(9306), 545-550. pubmed.ncbi.nlm.nih.gov