Dependent personality disorder US Medical PG Practice Questions and MCQs
Practice US Medical PG questions for Dependent personality disorder. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Dependent personality disorder US Medical PG Question 1: 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)
Dependent personality disorder 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.
Dependent personality disorder US Medical PG Question 2: A 21-year-old female was brought to the emergency room after losing large amounts of blood from slicing her wrists longitudinally. A few days later, she was interviewed by the psychiatrist and discussed with him why she had tried to kill herself. "My evil boyfriend of 2 months left me because I never let him leave my side for fear that he would cheat on me and leave me...now I feel so empty without him." Which of the following personality disorders does this female most likely have?
- A. Avoidant
- B. Dependent
- C. Borderline (Correct Answer)
- D. Paranoid
- E. Histrionic
Dependent personality disorder Explanation: ***Borderline***
- The patient exhibits core features of **borderline personality disorder (BPD)**, including **impulsivity** (suicide attempt via wrist-slicing), **unstable relationships** marked by fear of abandonment, and intense feelings of **emptiness**.
- Her statement about her boyfriend refusing to let him leave her side reflects classic BPD traits of **frantic efforts to avoid abandonment** and a **pattern of intense and unstable interpersonal relationships**.
*Avoidant*
- Individuals with **avoidant personality disorder** are characterized by **social inhibition**, feelings of inadequacy, and hypersensitivity to negative evaluation, which are not the primary features presented in this scenario.
- They tend to *avoid* social interactions due to fear of criticism, rather than engaging in intense, unstable relationships and dramatic self-harm as described.
*Dependent*
- While a **dependent personality disorder** involves a pervasive and excessive need to be cared for, leading to submissive and clinging behavior, it typically doesn't manifest with the same level of **impulsivity**, **self-harm**, or extreme relationship instability seen here.
- The "fear that he would cheat on me and leave me" relates more to the **frantic efforts to avoid abandonment** characteristic of borderline personality, rather than general clinginess and submission.
*Paranoid*
- **Paranoid personality disorder** is characterized by pervasive distrust and suspiciousness of others, often interpreting their motives as malevolent.
- The patient's behaviors (suicide attempt, fear of abandonment in a short-term relationship, feeling empty) do not align with the prominent **distrust and suspiciousness** of paranoid personality.
*Histrionic*
- **Histrionic personality disorder** involves excessive emotionality and attention-seeking behavior. While the suicide attempt might be seen as attention-seeking, the underlying **fear of abandonment**, **feelings of emptiness**, and extremely rapid relationship deterioration are more indicative of borderline personality.
- Histrionic individuals tend to be dramatic and theatrical, using physical appearance to draw attention, which is not emphasized in this clinical picture.
Dependent personality disorder US Medical PG Question 3: A 23-year-old woman is brought to the emergency room by her mother after she is found to have cut both of her wrists with razor blades. The patient admits to a history of self-mutilation and attributed this incident to a recent breakup with a man she had been seeing for the previous 2 weeks. On morning rounds, the patient reports that the nurses are incompetent but the doctors are some of the best in the world. The patient's vitals are stable and her wrist lacerations are very superficial requiring only simple dressings without sutures. The patient is discharged a few days later and she feels well. Which of the following is the most appropriate initial treatment for this patient?
- A. Amitriptyline
- B. Fluoxetine
- C. Dialectical behavior therapy (Correct Answer)
- D. Cognitive behavioral therapy
- E. Lithium
Dependent personality disorder Explanation: ***Dialectical behavior therapy***
- The patient's presentation with **recurrent self-harm**, **mood instability** following a brief relationship, and **splitting** ("nurses are incompetent but doctors are the best") are classic features of **borderline personality disorder (BPD)**.
- **Dialectical behavior therapy (DBT)** is the gold-standard and most effective initial treatment for BPD, specifically targeting **emotional dysregulation**, self-harm, and suicidal behaviors.
*Amitriptyline*
- **Amitriptyline** is a **tricyclic antidepressant (TCA)**, primarily used for depression and chronic pain.
- While antidepressants might be used *adjunctively* for comorbid mood symptoms in BPD, they are not the primary or most appropriate *initial* treatment for the core features of BPD itself, and TCAs have a high overdose risk.
*Fluoxetine*
- **Fluoxetine** is a **selective serotonin reuptake inhibitor (SSRI)**, commonly used for depression, anxiety disorders, and some eating disorders.
- Similar to other antidepressants, SSRIs may treat comorbid depressive or anxiety symptoms in BPD but do not address the fundamental **personality organization issues** or behavioral patterns like self-harm and splitting characteristic of BPD.
*Cognitive behavioral therapy*
- **Cognitive behavioral therapy (CBT)** is effective for a wide range of mental health conditions, including depression and anxiety, by focusing on changing negative thought patterns and behaviors.
- While elements of CBT are incorporated into DBT, **DBT is specifically adapted and more effective for BPD** due to its emphasis on **emotion regulation**, distress tolerance, and interpersonal effectiveness skills, which are crucial for this patient's presentation.
*Lithium*
- **Lithium** is a mood stabilizer primarily used to treat **bipolar disorder**.
- Although there can be some overlap in symptoms (e.g., mood swings), the patient's presentation is more indicative of BPD due to the **recurrent self-harm, interpersonal instability**, and **splitting**, rather than the distinct mood episodes seen in bipolar disorder.
Dependent personality disorder US Medical PG Question 4: 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
Dependent personality disorder 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.
Dependent personality disorder US Medical PG Question 5: 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)
Dependent personality disorder 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.
Dependent personality disorder US Medical PG Question 6: A 7-year-old girl is brought to the physician by her mother because she has been increasingly reluctant to speak at school over the past 4 months. Her teachers complain that she does not answer their questions and it is affecting her academic performance. She was born at 35 weeks' gestation and pregnancy was complicated by preeclampsia. Previous well-child examinations have been normal. Her older brother was diagnosed with a learning disability 4 years ago. She is at 65th percentile for height and weight. Physical examination shows no abnormalities. She follows commands. She avoids answering questions directly and whispers her answers to her mother instead who then mediates between the doctor and her daughter. Which of the following is the most likely diagnosis?
- A. Selective mutism (Correct Answer)
- B. Social anxiety disorder
- C. Rett syndrome
- D. Autism spectrum disorder
- E. Reactive attachment disorder
Dependent personality disorder Explanation: ***Selective mutism***
- The child's reluctance to speak in specific social situations (school) despite being able to speak in others (whispering to her mother), and the impact on academic performance, are classic signs of **selective mutism**
- **Selective mutism** typically involves anxiety and a consistent failure to speak in situations where speaking is expected, despite speaking in other situations
- This diagnosis fits the **DSM-5 criteria**: consistent failure to speak in specific social situations for >1 month, interfering with educational achievement
*Social anxiety disorder*
- While social anxiety can be **comorbid** with selective mutism, the hallmark of this presentation is the **specific refusal to speak** in certain settings, rather than generalized anxiety about social interactions
- A child with generalized social anxiety might interact nervously but would likely attempt to speak, which is not described here
*Rett syndrome*
- **Rett syndrome** is a neurodevelopmental disorder almost exclusively affecting girls, characterized by **normal early development followed by regression** of acquired skills, loss of purposeful hand use, and deceleration of head growth
- The presented symptoms of reluctance to speak in specific settings, without other regressive signs or developmental abnormalities, do not fit the diagnosis of Rett syndrome
*Autism spectrum disorder*
- **Autism spectrum disorder** is characterized by persistent deficits in **social communication and social interaction** across multiple contexts, and **restricted, repetitive patterns of behavior**
- This child's ability to speak to her mother and follow commands suggests intact communication skills in some contexts, making autism less likely than selective mutism for the primary presentation
*Reactive attachment disorder*
- **Reactive attachment disorder** typically arises from patterns of **extremely insufficient care** in early childhood, leading to emotionally withdrawn behavior toward caregivers and limited positive affect
- The child's selective non-speaking in school in this scenario, with normal previous well-child examinations and interaction with her mother, is inconsistent with the characteristic features of reactive attachment disorder
Dependent personality disorder US Medical PG Question 7: A 27-year-old woman is brought to the physician by her parents because they are concerned about her mood. They say that she has “not been herself” since the death of her friend, who was killed 3 weeks ago when the fighter jet he piloted was shot down overseas. She says that since the incident, she feels sad and alone. She reports having repeated nightmares about her friend's death. Her appetite has decreased, but she is still eating regularly and is otherwise able to take care of herself. She does not leave her home for any social activities and avoids visits from friends. She went back to work after taking 1 week off after the incident. Her vital signs are within normal limits. Physical examination shows no abnormalities. On mental status examination, she appears sad, has a full range of affect, and is cooperative. In addition to taking measures to evaluate this patient's anxiety, which of the following is the most appropriate statement by the physician at this time?
- A. I can see that you have gone through a lot recently, but I think that your reaction is especially severe and has persisted for longer than normal. Would you be open to therapy or medication to help you manage better?
- B. I am worried that you may be having an abnormally severe reaction to what is an understandably stressful event. I recommend attending behavioral therapy sessions to help you deal with this challenge.
- C. Your grief over the loss of your friend appears to have a negative effect on your social and functional capabilities. I recommend starting antidepressants to help you deal with this challenge.
- D. I'm so sorry, but the loss of loved ones is a part of life. Let's try to find better ways for you to deal with this event.
- E. I understand that the sudden loss of your friend has affected you deeply. Sometimes in situations like yours, people have thoughts that life is not worth living; have you had such thoughts? (Correct Answer)
Dependent personality disorder Explanation: ***I understand that the sudden loss of your friend has affected you deeply. Sometimes in situations like yours, people have thoughts that life is not worth living; have you had such thoughts?***
- This statement empathetically acknowledges the patient's grief while **directly assessing for suicidal ideation**, which is crucial in any evaluation of a patient experiencing significant emotional distress, especially after a recent loss.
- The patient's presentation, including sadness, social withdrawal, decreased appetite, and nightmares, is consistent with **grief**, but the physician must rule out more severe conditions like **major depressive disorder (MDD)**, for which suicidal thoughts are a key diagnostic criterion and safety concern.
*I can see that you have gone through a lot recently, but I think that your reaction is especially severe and has persisted for longer than normal. Would you be open to therapy or medication to help you manage better?*
- This statement is somewhat judgmental ("especially severe and has persisted for longer than normal") for a patient only three weeks out from a traumatic loss, which could invalidate her feelings.
- While therapy or medication might be considered, it's generally too early to classify her normal grief response as an abnormal or prolonged reaction without first screening for immediate safety concerns like suicidal ideation.
*I am worried that you may be having an abnormally severe reaction to what is an understandably stressful event. I recommend attending behavioral therapy sessions to help you deal with this challenge.*
- Similar to the previous option, labeling her reaction as "abnormally severe" at this early stage (3 weeks post-loss) can be perceived as invalidating and may make the patient less open to further discussion or treatment.
- Recommending therapy without first assessing for suicidal ideation or a more comprehensive diagnostic evaluation is premature and misses a critical screening step.
*Your grief over the loss of your friend appears to have a negative effect on your social and functional capabilities. I recommend starting antidepressants to help you deal with this challenge.*
- While her social and functional capabilities are affected, grief is a normal human response, and recommending antidepressants after only 3 weeks post-loss, without a full psychiatric evaluation or ruling out suicidal ideation, is often premature.
- **Antidepressants** are typically considered for **MDD** or **prolonged grief disorder**, usually after a longer period (e.g., 6 months for adults) or if symptoms are markedly severe and debilitating, especially with an immediate safety concern.
*I'm so sorry, but the loss of loved ones is a part of life. Let's try to find better ways for you to deal with this event.*
- This statement, particularly "the loss of loved ones is a part of life," can come across as dismissive and insensitive to the patient's individual pain and trauma.
- It minimizes her experience and does not create an empathetic environment necessary for a patient to open up about potentially sensitive topics, such as suicidal thoughts.
Dependent personality disorder US Medical PG Question 8: A 45-year-old woman repetitively visits the general surgery clinic worried that her inguinal hernia is incarcerated. 2 months ago, she was seen in the emergency department where she presented with a left lower abdominal swelling. The mass was easily reduced and the patient was referred to the general surgery clinic for elective surgical repair. Because her condition was deemed not urgent, she was informed that she was down on the surgical waiting list. Despite this, she continues to visit the clinic and the ED worried that her bowels are ‘trapped and dying.’ Each time she is reassured and any protrusion present is quickly reduced. She has previously frequently visited her primary care physician for complaints of abdominal pain and inconsistent bowel habits, but no etiology could be identified. She continues to intermittently have these symptoms and spends hours every day worrying about what may be going on. She has no other significant past medical history. Which of the following is the most appropriate diagnosis?
- A. Illness anxiety disorder
- B. Conversion disorder
- C. Factitious disorder
- D. Malingering
- E. Somatic symptom disorder (Correct Answer)
Dependent personality disorder Explanation: ***Somatic symptom disorder***
- This patient exhibits **multiple somatic symptoms** (abdominal pain, inconsistent bowel habits, fear of incarcerated hernia), along with excessive thoughts, feelings, and behaviors related to these symptoms, causing significant distress and functional impairment.
- Her persistent worry about the incarcerated hernia despite reassurance, and frequent clinic visits for unrelated physical complaints without identifiable etiology, align with the diagnostic criteria for **somatic symptom disorder**.
*Illness anxiety disorder*
- Characterized by a preoccupation with having or acquiring a serious illness, but with **minimal or no somatic symptoms** present.
- In this case, the patient clearly has actual physical symptoms (abdominal pain, inconsistent bowel habits, and the inguinal swelling itself), differentiating it from illness anxiety disorder where the primary concern is the *fear* of illness rather than the experience of symptoms.
*Conversion disorder*
- Involves neurological symptoms (e.g., paralysis, blindness, seizures) that are **incompatible with recognized neurological conditions** and are not intentionally produced.
- The patient's symptoms are primarily somatic and not neurological, and she is worried about an *existing* medical issue (hernia) rather than developing unexplained neurological deficits.
*Factitious disorder*
- Individuals **consciously feign or induce symptoms** to assume the sick role, without obtaining external rewards.
- There is no indication the patient is intentionally producing her symptoms or faking her medical concerns; her distress appears genuine, and she is not seeking a "sick role" but rather relief from her worries.
*Malingering*
- Characterized by the **intentional production of false or grossly exaggerated physical or psychological symptoms** with an obvious external motivation (e.g., avoiding work, obtaining money, evading criminal prosecution).
- The patient's presentation does not suggest any clear external incentives for her exaggerated concerns; her anxiety about her health appears to be the primary driver.
- Note: Malingering is not classified as a mental disorder in DSM-5, but rather as a condition that may be a focus of clinical attention.
Dependent personality disorder US Medical PG Question 9: A 13-year-old boy has been suspended 5 times this year for arguing with teachers. He has presented a pattern of negativism and hostility that has lasted for about 8 months. When asked about the suspensions, he admits that he loses his temper easily and often blames the principal for not being fair to him. He usually finds an argument before finishing his homework. At home, he goes out of his way to annoy his siblings. He gets furious if his legal guardian finds out about it and confiscates his smartphone. Which of the following is the primary behavior characteristic of this patient's most likely diagnosis?
- A. Destruction of property and theft
- B. Hostile and disobedient behavior towards authority (Correct Answer)
- C. Physical aggression
- D. Violating the rights of others
- E. Killing and/or harming small animals
Dependent personality disorder Explanation: ***Hostile and disobedient behavior towards authority***
- This is the **primary characteristic of Oppositional Defiant Disorder (ODD)**, which best fits this clinical presentation
- The patient demonstrates a **pattern of angry/irritable mood, argumentative/defiant behavior** lasting 8 months with significant functional impairment (5 suspensions)
- Key ODD features present: **loses temper easily, argues with authority figures (teachers), deliberately annoys others (siblings), blames others** for his mistakes
- ODD is defined by a pattern of **negativistic, hostile, and defiant behavior** toward authority figures, not physical aggression
*Physical aggression*
- Physical aggression is **NOT a primary feature of ODD** - it would suggest **Conduct Disorder** instead
- The vignette describes **verbal defiance, arguing, and annoying behaviors**, but **no physical violence** or aggression toward people
- The anger described (getting furious) represents emotional dysregulation, not physical acting out
*Destruction of property and theft*
- These are characteristic behaviors of **Conduct Disorder**, a more severe diagnosis involving violation of societal norms
- The patient shows **oppositional behavior without property destruction or stealing**
- ODD may progress to Conduct Disorder if untreated, but this patient hasn't crossed that threshold
*Violating the rights of others*
- This is a core feature of **Conduct Disorder**, including behaviors like **bullying, intimidation, theft, or forced sexual activity**
- While the patient annoys siblings, this **doesn't constitute serious violation of basic rights** seen in Conduct Disorder
- The behavior is better characterized as **oppositional and defiant rather than rights-violating**
*Killing and/or harming small animals*
- Animal cruelty is a **serious red flag for Conduct Disorder** and potentially future antisocial behavior
- This represents **severe lack of empathy and callousness** not present in this case
- No evidence in the vignette suggests the patient engages in animal harm
Dependent personality disorder US Medical PG Question 10: A parent-teacher conference is called to discuss the behavior of a 9 year-old boy. According to the boy's teacher, he has become progressively more disruptive during class. When asked to help clean up or read out-loud, he replies with "You're not the boss of me." or "You can't make me." He refuses to participate in gym class, but will play the same games during recess. He gets along with and is well-liked by his peers. His mother reports that her son can "sometimes be difficult," but he is helpful around the house and is very good playing with his 7-year-old sister. What is the most likely diagnosis?
- A. Conduct disorder
- B. Attention deficit disorder
- C. Separation anxiety disorder
- D. Oppositional defiant disorder (Correct Answer)
- E. Antisocial personality disorder
Dependent personality disorder Explanation: ***Oppositional defiant disorder***
- The boy exhibits a pattern of **defiant and disobedient behavior** towards authority figures (teacher) but a generally good relationship with peers and family, which is characteristic of ODD.
- His refusal to participate in formal class activities while still engaging in informal play highlights a specific defiance towards structured rules rather than a general aversion to activity.
*Conduct disorder*
- This disorder involves a more severe pattern of **aggression, destruction of property, deceitfulness, or serious rule violations**, which are not described in the boy's behavior.
- The boy's ability to get along with peers and be helpful at home suggests he does not meet the criteria for significant social impairment or callousness seen in conduct disorder.
*Attention deficit disorder*
- This disorder is characterized by **inattention, hyperactivity, and impulsivity**, which are not the primary symptoms described here.
- While defiance might be a secondary issue, the core problem is not difficulty sustaining attention or controlling impulsive behaviors.
*Separation anxiety disorder*
- This involves **excessive fear or anxiety concerning separation from home or attachment figures**, which is not indicated by any of the behavioral descriptions.
- The boy's issues are related to defiance and authority, not fear of separation.
*Antisocial personality disorder*
- This diagnosis can only be made in individuals **18 years or older** and requires a pervasive pattern of disregard for and violation of the rights of others.
- The boy's age (9 years old) and his reported positive relationships with peers and family rule out this diagnosis.
More Dependent personality disorder US Medical PG questions available in the OnCourse app. Practice MCQs, flashcards, and get detailed explanations.
