Personality disorders

Personality disorders US Medical PG Question 1: A 55-year-old male was picked up by police in the public library for harassing the patrons and for public nudity. He displayed disorganized speech and believed that the books were the only way to his salvation. Identification was found on the man and his sister was called to provide more information. She described that he recently lost his house and got divorced within the same week although he seemed fine three days ago. The man was sedated with diazepam and chlorpromazine because he was very agitated. His labs returned normal and within three days, he appeared normal, had no recollection of the past several days, and discussed in detail how stressful the past two weeks of his life were. He was discharged the next day. Which of the following is the most appropriate diagnosis for this male?

• A. Brief psychotic disorder (Correct Answer)
• B. Schizotypal personality disorder
• C. Schizophreniform disorder
• D. Schizophrenia
• E. Schizoid personality disorder

Personality disorders Explanation: ***Brief psychotic disorder*** - This patient exhibited characteristic symptoms such as **sudden onset of psychotic symptoms** (disorganized speech, delusions, public nudity) that lasted **less than one month** and were preceded by a **severe psychosocial stressor** (loss of house, divorce). - The **full return to premorbid functioning** and lack of recollection after the episode further support brief psychotic disorder, distinguishing it from other chronic psychotic disorders. *Schizotypal personality disorder* - Characterized by a pervasive pattern of **social and interpersonal deficits**, cognitive or perceptual distortions, and eccentricities of behavior, which are usually **long-standing** and not episodic. - While there may be odd beliefs or magical thinking, the dramatic and time-limited psychotic episode in the scenario is not typical of schizotypal personality disorder. *Schizophreniform disorder* - This disorder is diagnosed when psychotic symptoms (like those seen in schizophrenia) are present for **at least one month but less than six months**. - Although the patient presented with psychotic symptoms, their rapid resolution within three days makes a diagnosis of schizophreniform disorder unlikely. *Schizophrenia* - Requires continuous signs of disturbance for **at least six months**, including at least one month of active-phase symptoms, along with significant impairment in social or occupational functioning. - The rapid resolution of symptoms and return to baseline within days in this case immediately rules out schizophrenia, which is a chronic condition. *Schizoid personality disorder* - Characterized by a pervasive pattern of **detachment from social relationships** and a restricted range of expression of emotions in interpersonal settings. - This disorder does not involve psychotic symptoms, disorganized speech, or delusions of the intensity described in the patient's presentation.

Personality disorders US Medical PG Question 2: A 19-year-old woman comes to the physician because of a 2-day history of difficulty sleeping. She worries that the lack of sleep will ruin her career prospects as a model. She has been coming to the physician multiple times over the past year for minor problems. She is dressed very extravagantly and flirts with the receptionist. When she is asked to sit down in the waiting room, she begins to cry and says that no one listens to her. When she is called to the examination room, she moves close to the physician, repeatedly intends to touch his cheek, and makes inappropriate comments. She does not have a history of self-harm or suicidal ideation. Which of the following is the most likely diagnosis?

• A. Schizotypal personality disorder
• B. Borderline personality disorder
• C. Dependent personality disorder
• D. Narcissistic personality disorder
• E. Histrionic personality disorder (Correct Answer)

Personality disorders Explanation: ***Histrionic personality disorder*** - This patient displays classic features of **histrionic personality disorder**, including **attention-seeking behaviors** (flirting, extravagant dress, dramatic crying), **inappropriate sexually seductive behavior** toward the physician, and **rapidly shifting and shallow emotions** (cries that no one listens to her, then attempts to touch the physician). - Her excessive emotionality and constant need to be the center of attention, coupled with a tendency to use physical appearance to draw attention to herself, align well with the diagnostic criteria. *Schizotypal personality disorder* - Characterized by a pervasive pattern of **social and interpersonal deficits** marked by acute discomfort with, and reduced capacity for, close relationships, as well as by **cognitive or perceptual distortions** and eccentricities of behavior. - This patient does not exhibit evidence of odd beliefs, magical thinking, unusual perceptual experiences, or paranoid ideation typical of schizotypal personality disorder. *Borderline personality disorder* - Marked by a pervasive pattern of **instability of interpersonal relationships, self-image, and affects**, and marked impulsivity. Patients often exhibit intense fears of abandonment, chronic feelings of emptiness, and self-harming behaviors. - While there is some emotional dysregulation and intense relationships, the patient does not report **self-harm, suicidal ideation**, or the severe identity disturbance common in borderline personality disorder. *Dependent personality disorder* - Individuals with dependent personality disorder exhibit an excessive need to be cared for, leading to **submissive and clinging behavior** and fears of separation. They often have difficulty making everyday decisions without excessive reassurance. - This patient's behaviors are geared towards attracting attention and being the center of it, rather than seeking reassurance or exhibiting submissive behavior. *Narcissistic personality disorder* - Characterized by a pervasive pattern of **grandiosity, a need for admiration**, and a lack of empathy. Patients often believe they are special and unique and expect to be recognized as superior. - While this patient seeks attention, her behavior is more about being dramatic and emotionally expressive rather than a sense of inflated self-importance or a deep need for admiration stemming from grandiosity.

Personality disorders US Medical PG Question 3: A 29-year-old woman is brought to the physician by her father because of a change in her behavior over the past 8 months. The father says that his daughter has become increasingly withdrawn; she has not answered any phone calls or visited her family and friends. The patient says that she has to stay at home because a foreign intelligence service is monitoring her. She thinks that they are using a magnetic field to read her mind. Mental status exam shows disjointed and perseverative thinking. She is anxious and has a flat affect. Which of the following is the most likely diagnosis?

• A. Delusional disorder
• B. Schizophrenia (Correct Answer)
• C. Paranoid personality disorder
• D. Schizophreniform disorder
• E. Schizoid personality disorder

Personality disorders Explanation: ***Schizophrenia*** - The patient's presentation with **delusions of persecution and thought broadcasting**, accompanied by **disjointed, perseverative thinking**, and **flat affect** for 8 months, is highly indicative of schizophrenia. - Schizophrenia is characterized by a combination of positive symptoms (delusions, hallucinations, disorganized speech), negative symptoms (flat affect, social withdrawal), and cognitive symptoms (disorganized thinking) lasting for at least 6 months. *Delusional disorder* - Delusional disorder is characterized by the presence of **non-bizarre delusions for at least 1 month** without other significant psychotic symptoms or marked impairment in functioning. - The patient's symptoms include **disorganized thinking and flat affect**, which are not typical of delusional disorder and suggest a broader psychotic illness. *Paranoid personality disorder* - Characterized by a pervasive distrust and suspicion of others, where their motives are interpreted as malevolent, but **without the presence of frank delusions or other psychotic symptoms**. - The patient is experiencing **fixed, false beliefs (delusions)** involving mind reading and foreign intelligence, which goes beyond the pervasive distrust seen in paranoid personality disorder. *Schizophreniform disorder* - Schizophreniform disorder presents with symptoms identical to schizophrenia, but the **duration is between 1 and 6 months**. - Since the patient's symptoms have been present for **8 months**, it exceeds the diagnostic criteria for schizophreniform disorder, making schizophrenia a more likely diagnosis. *Schizoid personality disorder* - Characterized by a pervasive pattern of **detachment from social relationships** and a restricted range of expression of emotions in interpersonal settings. - While the patient exhibits social withdrawal, this condition does **not involve delusions, disorganized thinking, or other psychotic features**.

Personality disorders US Medical PG Question 4: A 23-year-old man is brought to the emergency department by his girlfriend because of acute agitation and bizarre behavior. The girlfriend reports that, over the past 3 months, the patient has become withdrawn and stopped pursuing hobbies that he used to enjoy. One month ago, he lost his job because he stopped going to work. During this time, he has barely left his apartment because he believes that the FBI is spying on him and controlling his mind. He used to smoke marijuana occasionally in high school but quit 5 years ago. Physical and neurologic examinations show no abnormalities. On mental status examination, he is confused and suspicious with marked psychomotor agitation. His speech is disorganized and his affect is labile. Which of the following is the most likely diagnosis?

• A. Schizophreniform disorder (Correct Answer)
• B. Schizoid personality disorder
• C. Delusional disorder
• D. Schizoaffective disorder
• E. Brief psychotic disorder

Personality disorders Explanation: **Correct: Schizophreniform disorder** - This patient presents with ***psychotic symptoms*** (delusions, disorganized speech, agitation) and ***negative symptoms*** (withdrawal, anhedonia, loss of job), which have been present for approximately ***3 months***. - The ***duration of symptoms (1-6 months)*** is the key differentiating factor for schizophreniform disorder compared to brief psychotic disorder (<1 month) or schizophrenia (>6 months). - Meets DSM-5 criteria: psychotic symptoms with functional impairment lasting between 1 and 6 months. *Incorrect: Schizoid personality disorder* - Characterized by a pervasive pattern of ***detachment from social relationships*** and a restricted range of emotional expression, which are ***ego-syntonic*** and typically stable over time. - This is a personality disorder with chronic traits, not an acute psychotic disorder. - Does not include acute psychotic symptoms like delusions or disorganized speech. *Incorrect: Delusional disorder* - Defined by the presence of ***non-bizarre delusions*** for at least one month, without other significant psychotic symptoms or major functional impairment. - This patient has ***bizarre delusions*** (FBI controlling his mind), ***disorganized speech***, ***psychomotor agitation***, and ***marked functional impairment***, which exceed the criteria for delusional disorder. *Incorrect: Schizoaffective disorder* - Requires the presence of a ***major mood episode*** (depressive or manic) concurrent with symptoms of schizophrenia, AND ***delusions or hallucinations for at least 2 weeks*** in the absence of a major mood episode. - While the patient exhibits labile affect, there is no evidence of a distinct, prolonged major mood episode (major depression or mania) as required for schizoaffective disorder. *Incorrect: Brief psychotic disorder* - Characterized by the sudden onset of psychotic symptoms (delusions, hallucinations, disorganized speech or behavior) that last for ***at least one day but less than one month***, followed by full return to premorbid functioning. - The patient's symptoms have been ongoing for approximately ***3 months***, which exceeds the duration criteria for brief psychotic disorder.

Personality disorders US Medical PG Question 5: A 29-year-old man comes to the physician with his wife because she has noticed a change in his behavior over the past 2 weeks. His wife reports that he is very distracted and irritable. His colleagues have voiced concerns that he has not been turning up for work regularly and behaves erratically when he does. Previously, her husband had been a reliable and reasonable person. The patient says that he feels “fantastic”; he only needs 4 hours of sleep each night and wakes up cheerful and full of energy each morning. He thinks that his wife is overreacting. The patient has been healthy except for a major depressive episode 5 years ago that was treated with paroxetine. He currently takes no medications. His pulse is 98/min, respirations are 12/min, and blood pressure is 128/62 mm Hg. Mental status examination shows frenzied speech and a flight of ideas. Which of the following is the strongest predisposing factor for this patient's condition?

• A. Advanced paternal age
• B. Genetic predisposition (Correct Answer)
• C. Higher socioeconomic class
• D. Maternal obstetric complications
• E. Being married

Personality disorders Explanation: ***Genetic predisposition*** - A strong **genetic predisposition** is a primary predisposing factor for bipolar disorder, as evidenced by a significantly higher concordance rate in monozygotic twins compared to dizygotic twins or the general population. - The patient's presentation with **manic symptoms** (decreased need for sleep, euphoria, irritability, frenzied speech, flight of ideas, erratic behavior) following a history of a **major depressive episode** is highly suggestive of **bipolar I disorder**. *Advanced paternal age* - While advanced paternal age has been associated with an increased risk of some neurodevelopmental disorders like **schizophrenia** and **autism spectrum disorder**, its link to bipolar disorder is less robust and not considered the strongest predisposing factor. - The primary risk factor for bipolar disorder involves heritability rather than specific parental age. *Higher socioeconomic class* - There is **no consistent evidence** to suggest that higher socioeconomic class is a predisposing factor for bipolar disorder. - Bipolar disorder affects individuals across all socioeconomic levels. *Maternal obstetric complications* - Maternal obstetric complications, such as **prenatal infections** or **hypoxia**, have been implicated in the development of certain psychiatric disorders, particularly **schizophrenia**. - However, for bipolar disorder, genetic factors play a far more significant and direct role than obstetric complications. *Being married* - **Marital status** does not serve as a predisposing factor for the development of bipolar disorder. - While relationship challenges can be a consequence or stressor for individuals with bipolar disorder, marriage itself is not a cause.

Personality disorders US Medical PG Question 6: A 28-year-old woman is brought to a counselor by her father after he found out that she is being physically abused by her husband. The father reports that she refuses to end the relationship with her husband despite the physical abuse. She says that she feels uneasy when her husband is not around. She adds, “I'm worried that if I leave him, my life will only get worse.” She has never been employed since they got married because she is convinced that nobody would hire her. Her husband takes care of most household errands and pays all of the bills. Physical examination shows several bruises on the thighs and back. Which of the following is the most likely diagnosis?

• A. Schizoid personality disorder
• B. Separation anxiety disorder
• C. Avoidant personality disorder
• D. Dependent personality disorder (Correct Answer)
• E. Borderline personality disorder

Personality disorders Explanation: ***Dependent personality disorder*** - This patient exhibits a pervasive and excessive need to be taken care of, leading to **submissive and clinging behavior, and fears of separation**. Key features include difficulties making decisions, avoiding disagreement due to fear of loss of support, and preoccupation with fears of being left to care for herself. - Her comments about her life getting worse if she leaves her husband, her inability to seek employment, and her husband managing all household affairs are consistent with her **reluctance to leave an abusive relationship** because of an exaggerated fear of being alone or unable to care for herself. *Schizoid personality disorder* - Characterized by a pervasive pattern of **detachment from social relationships** and a restricted range of emotional expression. - Individuals with this disorder typically show **little interest in forming close relationships**, in contrast to the patient's clinging behavior. *Separation anxiety disorder* - Primarily marked by **excessive anxiety concerning separation from home or from those to whom the individual is attached**, often seen in childhood, but can occur in adults. - While there is some anxiety about separation, the patient's broader pattern of submissive behavior, difficulty with independent functioning, and belief she cannot care for herself points more strongly to a **personality disorder** rather than an anxiety disorder focused solely on separation. *Avoidant personality disorder* - Involves extreme social inhibition, feelings of inadequacy, and **hypersensitivity to negative evaluation**. - These individuals **desire social connection but avoid it due to fear of rejection**, which contrasts with the patient's clinging and submissive efforts to maintain a relationship. *Borderline personality disorder* - Characterized by significant **instability in moods, interpersonal relationships, self-image, and behaviors**. - While there can be fear of abandonment, this disorder typically involves **impulsivity, intense anger, and frantic efforts to avoid abandonment**, which are not the primary features described in this patient.

Personality disorders US Medical PG Question 7: A 23-year-old woman is brought to the emergency department by her boyfriend 10 minutes after ingesting at least 15 acetaminophen tablets. She has been admitted to the hospital several times in the past few months after attempted self-harm. She claims that her boyfriend is “extremely selfish” and “does not care for her.” She says she feels lonely and wants her boyfriend to pay attention to her. Her boyfriend says that they have broken up 10 times in the past year because she is prone to outbursts of physical aggression as well as mood swings. He says that these mood swings last a few hours and can vary from states of “exuberance and affection” to states of “depression.” On examination, the patient appears well-dressed and calm. She has normal speech, thought processes, and thought content. Which of the following is the most likely diagnosis?

• A. Dependent personality disorder
• B. Borderline personality disorder (Correct Answer)
• C. Bipolar II disorder
• D. Cyclothymic disorder
• E. Narcissistic personality disorder

Personality disorders Explanation: ***Borderline personality disorder*** - Patients with **borderline personality disorder** often exhibit a pattern of **unstable relationships**, impulsive behaviors (like self-harm attempts), intense mood swings lasting hours, and efforts to avoid abandonment, consistent with this patient's presentation. - The patient's description of her boyfriend, her history of self-harm attempts, and her rapid, fluctuating mood states ("exuberance and affection" to "depression") are characteristic features. *Dependent personality disorder* - This disorder is characterized by an excessive need to be cared for, leading to **submissive and clinging behavior**, and fears of separation. While she fears abandonment, the **mood swings** and **aggressiveness** point away from this diagnosis. - Patients with dependent personality disorder rarely exhibit the **impulsive self-harm** and dramatic, aggressive outbursts described. *Bipolar II disorder* - Bipolar II disorder involves episodes of **hypomania** and **major depression**, with mood episodes typically lasting days to weeks, not just "a few hours" as described here. - The prominent features of **unstable relationships**, impulsivity, and chronic feelings of emptiness are more characteristic of a personality disorder than bipolar II. *Cyclothymic disorder* - Cyclothymic disorder involves chronic, fluctuating moods with numerous periods of **hypomanic symptoms** and **depressive symptoms** over at least two years, but these symptoms are less severe and do not meet criteria for full hypomanic or major depressive episodes. - While there are mood fluctuations, the **intensity**, **self-harm behavior**, and **interpersonal instability** observed are more typical of borderline personality disorder. *Narcissistic personality disorder* - Narcissistic personality disorder is characterized by a pervasive pattern of **grandiosity**, a need for admiration, and a lack of empathy. - While the patient blames her boyfriend, her primary motivation appears to be a fear of abandonment and a desire for attention, rather than a sense of entitlement or inflated self-importance.

Personality disorders US Medical PG Question 8: A 35-year-old man comes to the Veterans Affairs hospital because of a 2-month history of anxiety. He recently returned from his third deployment to Iraq, where he served as a combat medic. He has had difficulty readjusting to civilian life. He works as a taxi driver but had to take a leave of absence because of difficulties with driving. Last week, he hit a stop sign because he swerved out of the way of a grocery bag that was in the street. He has difficulty sleeping because of nightmares about the deaths of some of the other soldiers in his unit and states, “it's my fault, I could have saved them. Please help me.” Mental status examination shows a depressed mood and a restricted affect. There is no evidence of suicidal ideation. Which of the following is the most appropriate initial step in treatment?

• A. Dialectical behavioral therapy
• B. Venlafaxine therapy
• C. Cognitive behavioral therapy (Correct Answer)
• D. Motivational interviewing
• E. Prazosin therapy

Personality disorders Explanation: ***Cognitive behavioral therapy*** - **Cognitive Behavioral Therapy (CBT)** is considered a first-line psychological treatment for **Post-Traumatic Stress Disorder (PTSD)**, which the patient's symptoms (deployments, intrusive thoughts, nightmares, avoidance, guilt) strongly suggest. - CBT helps individuals identify and challenge **maladaptive thought patterns** and behaviors related to the trauma, fostering new coping mechanisms. *Dialectical behavioral therapy* - **Dialectical Behavioral Therapy (DBT)** is primarily used for individuals with **Borderline Personality Disorder** or severe emotional dysregulation. - While it can help with emotional regulation, it is not the **first-line therapy** specifically targeting trauma-related cognitive distortions and avoidance behaviors seen in PTSD. *Venlafaxine therapy* - **Venlafaxine**, an SNRI, is an antidepressant that can be effective for PTSD symptoms. However, current guidelines recommend **psychotherapy (like CBT)** as the initial step, especially when feasible. - While pharmacotherapy can be used, it's typically considered **adjunctive** or for cases where psychotherapy alone is insufficient or not preferred. *Motivational interviewing* - **Motivational interviewing** is a patient-centered counseling style used to address ambivalence and enhance a person's **intrinsic motivation** for change. - It is often utilized in substance abuse treatment or when patients are resistant to treatment, but it is not a primary, standalone treatment for the core symptoms of PTSD. *Prazosin therapy* - **Prazosin** is an alpha-1 antagonist used off-label to treat **PTSD-related nightmares** and sleep disturbances. - While it can be helpful for a specific symptom, it does not address the broader spectrum of PTSD symptoms, such as intrusive thoughts, avoidance, or negative cognitions.

Personality disorders US Medical PG Question 9: A 24-year-old man comes to the physician with a wound on his forearm. He says that he injured himself by absentmindedly walking into a glass door. He does not have health insurance. He has had 5 jobs in the past 8 months. He quit each job after 3–4 weeks because he found the work beneath him. He was imprisoned 6 years ago for credit card fraud. He was released from prison on parole a year ago. He was expelled from school at the age of 13 years for stealing school property and threatening to assault a teacher. He has fathered 6 children with 4 women. He says that he does not provide child support because he needs the money for his own personal expenses. The patient's vital signs are within normal limits. Examination of the forearm shows a 6 cm long, 0.5 cm deep wound with neat edges on the dorsal surface of the left forearm. There are bruises on the left shoulder, back, and the proximal phalanges of the right hand. On mental status examination, the patient is alert and calm. His mood is described as cheerful. His thought process, thought content, and speech are normal. Which of the following is the most likely diagnosis?

• A. Antisocial personality disorder (Correct Answer)
• B. Intermittent explosive disorder
• C. Oppositional defiant disorder
• D. Narcissistic personality disorder
• E. Conduct disorder

Personality disorders Explanation: **Antisocial personality disorder** - The patient exhibits a pervasive pattern of **disregard for and violation of the rights of others**, including impulsive behavior, chronic unemployment, criminal history (**credit card fraud, parole violation**), and lack of remorse for not supporting his children. These behaviors are hallmarks of **antisocial personality disorder**. - The history of behavioral problems starting at age 13 with **stealing and threatening a teacher** (a pattern consistent with childhood conduct disorder transforming into antisocial personality disorder in adulthood) further supports this diagnosis. *Intermittent explosive disorder* - Characterized by recurrent behavioral outbursts representing a failure to control aggressive impulses, often involving verbal aggression or physical aggression toward property, animals, or other individuals. - While the patient has a history of aggression (threatening a teacher), the primary features in the vignette are more consistent with a pervasive pattern of disregard for others' rights and law-breaking, not solely explosive outbursts. *Oppositional defiant disorder* - Characterized by a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months, typically seen in childhood and adolescence. - The patient's behaviors, such as credit card fraud, chronic unemployment, multiple children with different partners, and lack of child support, extend far beyond just oppositional defiance and involve serious violations of societal norms and laws. *Narcissistic personality disorder* - Involves a pervasive pattern of grandiosity, a need for admiration, and a lack of empathy; the patient's statement about work being "beneath him" hints at grandiosity. - However, the prominent features of **criminality, impulsivity, and disregard for others' rights** are more consistent with antisocial personality disorder than narcissistic personality disorder. *Conduct disorder* - This is a diagnostic category for persistent patterns of behavior in childhood and adolescence where the basic rights of others or major age-appropriate societal norms or rules are violated. - While the patient's history at age 13 (stealing, threatening a teacher) would likely meet criteria for **conduct disorder**, this diagnosis is for individuals under 18. At 24 years old, the adult equivalent is antisocial personality disorder.

Personality disorders US Medical PG Question 10: A 34-year-old female presents to a counselor at the urging of her parents because they are concerned that she might be depressed. After recently breaking up with her long-term boyfriend, she moved back in with her parents because she could not handle making decisions alone. Soon after their breakup, she started going on 5–7 dates a week. She has been unemployed for 3 years, as her boyfriend took care of all the bills. In the past year, she thought of looking for a job but never felt confident enough to start the process. Her mom arranges her doctor's appointments and handles her car maintenance. She describes feeling uneasy when she is alone. She has hypothyroidism treated with levothyroxine. She does not smoke or drink alcohol. Vital signs are normal. Mental status exam shows a neutral affect. Neurologic examination shows no focal findings. Which of the following is the most likely diagnosis?

• A. Avoidant personality disorder
• B. Histrionic personality disorder
• C. Borderline personality disorder
• D. Separation anxiety disorder
• E. Dependent personality disorder (Correct Answer)

Personality disorders Explanation: ***Dependent personality disorder*** - The patient exhibits a pervasive and excessive need to be cared for, leading to **submissive and clinging behavior** and fears of separation, as evidenced by her inability to make decisions, reliance on parents, and discomfort when alone. - Her history of unemployment and reliance on her boyfriend, followed by moving back with parents and having her mom handle appointments and car maintenance, strongly supports an inability to function independently and an excessive need for reassurance and support, characteristic of **dependent personality disorder**. *Avoidant personality disorder* - This disorder is characterized by a pervasive pattern of **social inhibition**, feelings of inadequacy, and hypersensitivity to negative evaluation, which are not the primary features here. - While she may lack confidence in looking for a job, her constant search for new relationships (5-7 dates a week) and reliance on others for decision-making point away from the **social avoidance** central to this diagnosis. *Histrionic personality disorder* - This disorder is marked by **excessive emotionality** and **attention-seeking behavior**, often through seductive or provocative means. - Although she is actively dating, the core issue appears to be her need for care and support rather than a desire to be the center of attention or dramatize her emotions. *Borderline personality disorder* - Characterized by a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity, such as **frantic efforts to avoid abandonment** or **recurrent suicidal behavior**. - While she might fear abandonment (expressed as uneasiness when alone), the overall clinical picture lacks the impulsivity, mood swings, self-harm, or intense anger typically seen in borderline personality disorder. *Separation anxiety disorder* - This disorder typically manifests with excessive fear or anxiety concerning separation from attachment figures, often seen in childhood, but can occur in adults. - While she expresses **uneasiness when alone**, the pervasive pattern of **submissive behavior**, difficulty making decisions, and chronic dependency on others for all aspects of life points more towards a personality disorder rather than an anxiety disorder primarily focused on separation.

Personality disorders Flashcard 1 of 3

Question: What is the treatment for borderline personality disorder? _____

Answer: Dialectical behavioral therapy

Personality disorders Flashcard 2 of 3

Question: Which personality disorder is characterized by impulsivity, criminality, and disregard for/violation of rights of others with lack of remorse? _____

Answer: Antisocial (cluster B)

Personality disorders Flashcard 3 of 3

Question: People with cluster _____ personality disorders are described as anxious or fearful

Answer: C