Cluster A Personality Disorders — MCQs

10 questions

A person of 35 years is having firm belief about infidelity involving the spouse. And he does not allow her to go out of home alone. He often locks his house, while going to the office. In spite of all this he is persistently suspicious about her character. The probable diagnosis is -

A patient complains of sadness of mood, increased lethargy, early morning awakening, loss of interest and reports no will to live and hears voices asking her to kill self. What is the diagnosis?

Which of the following treatments cannot be used for management of Obsessive Compulsive Disorder (OCD)?

The primary disturbance in schizophrenia is:

What is the primary characteristic of antisocial personality disorder?

Which of the following is not a characteristic of schizoid personality disorder?

What is considered the most effective treatment for Borderline Personality Disorder?

A young person presents with self-mutilating behaviour and impulsivity. What are they most likely suffering from?

Which is NOT a typical feature of borderline personality disorder?

Q10

A girl exhibits aggressive behavior such as smashing and throwing objects and verbally abusing hospital staff. However, she shows a different demeanor towards a particular resident doctor. What could be the most likely diagnosis?

Cluster A Personality Disorders Indian Medical PG Practice Questions and MCQs

Question 1: A person of 35 years is having firm belief about infidelity involving the spouse. And he does not allow her to go out of home alone. He often locks his house, while going to the office. In spite of all this he is persistently suspicious about her character. The probable diagnosis is -

A. Schizophrenia
B. Othello syndrome (Correct Answer)
C. Clerambault's syndrome
D. Delusional parasitosis

Explanation: ***Othello syndrome*** - This syndrome is characterized by **delusional jealousy**, where an individual holds an unfounded yet firm belief that their partner is being unfaithful. - Also known as **morbid jealousy**, it represents a **monosymptomatic delusional disorder** specifically focused on infidelity, making it distinct from broader psychotic conditions. - The patient's actions, such as not allowing the spouse to leave alone and locking the house, are common **behavioral manifestations** of this strong belief, often leading to controlling and suspicious behavior. *Schizophrenia* - Schizophrenia involves a broader range of symptoms, including **hallucinations**, **disorganized speech**, and **negative symptoms**, which are not described here. - While delusions can occur in schizophrenia, the primary and isolated focus on infidelity without other psychotic features makes **Othello syndrome** a more specific diagnosis. *Clerambault's syndrome* - Also known as **erotomania**, this syndrome involves the delusional belief that another person, typically of higher status, is **in love with the individual**. - This is distinctly different from the described delusion of infidelity and **jealousy**. *Delusional parasitosis* - This is a rare psychotic disorder in which individuals have a **fixed, false belief** that they are infested with parasites despite no medical evidence. - The symptoms described are clearly related to infidelity and jealousy, not a belief in **parasitic infestation**.

Question 2: A patient complains of sadness of mood, increased lethargy, early morning awakening, loss of interest and reports no will to live and hears voices asking her to kill self. What is the diagnosis?

A. Schizophrenia
B. Major depressive disorder plus psychosis (Correct Answer)
C. Schizoaffective disorder
D. Schizotypal personality disorder

Explanation: ***Major depressive disorder plus psychosis*** - The patient presents with classic symptoms of **major depressive disorder**, including persistent sadness, **anhedonia (loss of interest)**, **lethargy**, and **early morning awakening**. - The presence of **auditory hallucinations** (hearing voices asking her to kill herself) indicates **psychotic features** accompanying the severe depression, leading to the diagnosis of major depressive disorder with psychotic features. *Schizophrenia* - While schizophrenia involves psychosis, the primary presentation here is a prominent **depressive syndrome** rather than the typical **positive symptoms (delusions, hallucinations)**, **negative symptoms (alogia, avolition)**, and **disorganized thought** processes characteristic of schizophrenia. - The depressive symptoms are too pervasive and central to the clinical picture to be solely schizophrenia. *Schizoaffective disorder* - This disorder requires a period of **at least two weeks of psychotic symptoms** (hallucinations or delusions) **without prominent mood symptoms**, which is not described. - In this case, the **psychotic symptoms are congruent with the depressed mood** (e.g., voices urging self-harm, reflecting hopelessness), rather than independent. *Schizotypal personality disorder* - This is 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. - It does not involve persistent, severe depressive episodes with overt psychotic symptoms as described, nor significant functional impairment to the extent seen here.

Question 3: Which of the following treatments cannot be used for management of Obsessive Compulsive Disorder (OCD)?

A. Fluoxetine
B. Carbamazepine (Correct Answer)
C. Cognitive Behaviour Therapy
D. Clomipramine

Explanation: ***Carbamazepine*** - **Carbamazepine** is an **anticonvulsant** and **mood stabilizer** primarily used for epilepsy and bipolar disorder. - It does not have established efficacy for the treatment of **Obsessive-Compulsive Disorder (OCD)**. *Fluoxetine* - **Fluoxetine** is a **Selective Serotonin Reuptake Inhibitor (SSRI)** and is a **first-line pharmacotherapy** for OCD. - SSRIs, including fluoxetine, are effective in reducing the severity of **obsessions and compulsions**. *Cognitive Behaviour Therapy* - **Cognitive Behavioural Therapy (CBT)**, specifically **Exposure and Response Prevention (ERP)**, is the **gold standard psychotherapy** for OCD. - It involves gradually exposing patients to feared situations or thoughts while preventing their ritualistic responses. *Clomipramine* - **Clomipramine** is a **tricyclic antidepressant (TCA)** that has potent inhibitory effects on **serotonin reuptake**. - It is one of the **most effective medications** for OCD, often used when SSRIs are insufficient.

Question 4: The primary disturbance in schizophrenia is:

A. Hallucination
B. Illusion
C. Formal Thought Disorder (Correct Answer)
D. Psychomotor Retardation

Explanation: ***Formal Thought Disorder*** - **Formal thought disorder** is considered the primary disturbance in schizophrenia, affecting the structure and organization of thought, leading to symptoms like **loosening of associations**, **tangentiality**, and **word salad**. - It underlies many of the other symptomatic manifestations of schizophrenia, influencing perception, belief, and behavior. *Hallucination* - **Hallucinations** are perceptual disturbances that occur in the absence of an external stimulus, most commonly auditory in schizophrenia. - While prominent in schizophrenia, hallucinations are a *symptom* arising from the underlying thought disorder, not the primary disturbance itself. *Illusion* - An **illusion** is a misinterpretation of an actual external stimulus. - Illusions are much less common in schizophrenia compared to hallucinations and are not considered a primary or defining feature of the disorder. *Psychomotor Retardation* - **Psychomotor retardation** involves a generalized slowing of physical and emotional reactions, and can be seen in conditions like depression or catatonia. - While it can occur in some forms of schizophrenia (e.g., catatonic type), it is not the primary or universal disturbance characterizing the disorder as a whole.

Question 5: What is the primary characteristic of antisocial personality disorder?

A. Violation of rules of society (Correct Answer)
B. Attention-seeking behavior
C. Unstable interpersonal relationship
D. Grandiose behavior

Explanation: ***Violation of rules of society*** - A primary characteristic of Antisocial Personality Disorder (ASPD) is a pervasive pattern of **disregard for and violation of the rights of others**, often manifested by **failure to conform to social norms and laws**. - Individuals with ASPD frequently engage in **deceitfulness, impulsivity, irritability, aggressiveness**, and a consistent **irresponsibility** that leads them to break societal rules. *Attention-seeking behavior* - While some individuals with ASPD might engage in behaviors that attract attention, **attention-seeking is a core feature of Histrionic Personality Disorder**, not ASPD. - Individuals with ASPD are more focused on manipulation and exploitation rather than seeking to be the center of attention for its own sake. *Unstable interpersonal relationship* - **Unstable interpersonal relationships** are a hallmark feature of **Borderline Personality Disorder**, characterized by intense, chaotic, and often short-lived relationships. - In ASPD, relationships are often superficial and formed to exploit others, reflecting a lack of empathy rather than instability driven by fear of abandonment. *Grandiose behavior* - **Grandiose behavior** and an exaggerated sense of self-importance are primary characteristics of **Narcissistic Personality Disorder**. - Although individuals with ASPD may exhibit some self-importance, it is typically linked to their manipulative tendencies and sense of entitlement rather than primary grandiosity.

Question 6: Which of the following is not a characteristic of schizoid personality disorder?

A. Prone to fantasy
B. Introspective
C. Aloof & detached
D. Suspicious (Correct Answer)

Explanation: ***Suspicious*** - **Suspiciousness** and mistrust of others are core features of **paranoid personality disorder**, not schizoid personality disorder. - Individuals with schizoid personality disorder are typically apathetic towards others rather than actively distrustful. *Aloof & detached* - Individuals with schizoid personality disorder are characterized by a pervasive pattern of **detachment from social relationships** and a restricted range of emotional expression. - They often appear emotionally cold and indifferent to praise or criticism, indicating their aloof nature. *Prone to fantasy* - People with schizoid personality disorder frequently engage in **excessive daydreaming** and imaginative fantasy as an escape from reality. - This tendency is a coping mechanism for their limited social interaction and emotional expression. *Introspective* - Schizoid individuals tend to be **preoccupied with their inner world** and thoughts, often to the exclusion of external social interactions. - Their introspective nature contributes to their social withdrawal and isolation.

Question 7: What is considered the most effective treatment for Borderline Personality Disorder?

A. Combination of DBT and pharmacotherapy
B. Cognitive Behavioural Therapy (CBT)
C. Pharmacotherapy alone
D. Dialectical Behaviour Therapy (DBT) (Correct Answer)

Explanation: ***Dialectical Behaviour Therapy (DBT)*** - **DBT** is the **gold standard** and most evidence-based psychotherapy specifically developed for Borderline Personality Disorder - Developed by **Marsha Linehan** specifically to target the core symptoms of BPD including emotional dysregulation, impulsivity, and interpersonal difficulties - Combines **cognitive-behavioral techniques** with mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills - Has the **strongest research evidence** for reducing suicidal behavior, self-harm, and improving overall functioning in BPD patients - Multiple RCTs demonstrate DBT's superiority in treating BPD compared to standard care *Cognitive Behavioural Therapy (CBT)* - While **CBT** is effective for many mental health conditions and can help with certain BPD symptoms, it was not specifically designed for BPD - DBT is actually a specialized adaptation of CBT tailored for BPD, making it more targeted and effective for this specific condition - Generic CBT may help with co-occurring conditions like depression or anxiety but lacks the comprehensive approach needed for core BPD features *Combination of DBT and pharmacotherapy* - This combination is clinically useful, especially when treating **co-morbid conditions** like depression, anxiety, or severe mood instability - However, psychotherapy (particularly DBT) remains the **cornerstone** of BPD treatment, with medications serving an adjunctive role - The question asks for the single most effective treatment, which is DBT alone *Pharmacotherapy alone* - **No medication** is FDA-approved specifically for BPD - Pharmacotherapy may help manage specific symptoms (mood swings, impulsivity, brief psychotic episodes) but does not address the core **personality pathology** - Generally not recommended as monotherapy for BPD; should always be combined with psychotherapy

Question 8: A young person presents with self-mutilating behaviour and impulsivity. What are they most likely suffering from?

A. Dependent personality disorder
B. Adjustment disorder
C. Borderline personality disorder (Correct Answer)
D. Paranoid personality disorder

Explanation: ***Borderline personality disorder*** - **Self-mutilating behavior** (e.g., cutting) and **impulsivity** are hallmark features of borderline personality disorder. - Individuals with BPD often experience intense emotional dysregulation, unstable relationships, and a fear of abandonment, leading to these behaviors. *Dependent personality disorder* - Characterized by an excessive need to be cared for, leading to submissive and clinging behavior, and fears of separation. - While it can involve unstable relationships due to dependency, it typically does not manifest with recurrent **self-mutilating behaviors** or significant **impulsivity** as core features. *Adjustment disorder* - This disorder is a short-term, stress-related condition that occurs in response to a specific **identifiable stressor**. - While individuals might exhibit behavioral symptoms, it is by definition time-limited and reactive to an external event, and **self-mutilating behavior** and chronic **impulsivity** are not primary diagnostic criteria. *Paranoid personality disorder* - Defined by a pervasive distrust and suspicion of others, interpreting their motives as malevolent. - This disorder is primarily characterized by paranoid ideation and guardedness, rather than the intrinsic **impulsivity** and **self-harm** seen in borderline personality disorder.

Question 9: Which is NOT a typical feature of borderline personality disorder?

A. Fear of abandonment
B. Impulsivity
C. Intense relationships
D. Stable sense of self (Correct Answer)

Explanation: ***Stable sense of self*** - A **stable sense of self** is contradictory to the defining characteristic of **identity disturbance** seen in borderline personality disorder (BPD). - Individuals with BPD often experience a profoundly **unstable self-image** and chronic feelings of emptiness. *Fear of abandonment* - **Frantic efforts to avoid real or imagined abandonment** are a core diagnostic criterion for BPD. - This fear often leads to intense and unstable interpersonal relationships. *Impulsivity* - **Impulsivity** in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating) is a key feature of BPD. - This impulsivity can contribute to significant functional impairment and distress. *Intense relationships* - A pattern of **unstable and intense interpersonal relationships**, characterized by alternating between extremes of idealization and devaluation, is hallmark of BPD. - These relationships are often tumultuous and difficult to maintain.

Question 10: A girl exhibits aggressive behavior such as smashing and throwing objects and verbally abusing hospital staff. However, she shows a different demeanor towards a particular resident doctor. What could be the most likely diagnosis?

A. Bipolar disorder
B. Schizoaffective disorder
C. Antisocial personality
D. Borderline personality disorder (Correct Answer)

Explanation: ***Borderline personality disorder*** - Patients with **borderline personality disorder** often exhibit **impulsivity**, intense mood swings, and a pattern of unstable interpersonal relationships, leading to aggressive outbursts. - Their unpredictable behavior and tendency to form intense, unstable attachments or a "favorite person" dynamic are characteristic, as seen in her differing demeanor towards a particular resident doctor. *Bipolar disorder* - While bipolar disorder involves **mood swings**, the behavioral patterns are typically characterized by distinct episodes of **mania** or hypomania and depression, with less emphasis on chronic interpersonal instability and aggression. - The aggression in bipolar disorder is often associated with the manic phase but lacks the consistent pattern of relationship instability and "favorite person" dynamic described. *Schizoaffective disorder* - This disorder involves a combination of **psychotic symptoms** (like delusions or hallucinations) and **mood symptoms** (like depression or mania), which are not explicitly described here as the primary issue. - The aggressive behavior is not primarily driven by psychosis, and the specific interpersonal dynamic with staff is more suggestive of a personality disorder. *Antisocial personality* - **Antisocial personality disorder** is characterized by a pervasive pattern of disregard for and violation of the **rights of others** and may include aggression, but it often involves a lack of empathy and manipulativeness rather than the intense emotional dysregulation and unstable interpersonal patterns seen in borderline personality. - While aggressive behavior is present, the specific description of verbally abusing staff while showing a "different demeanor" towards a particular doctor points away from the typical presentation of antisocial disregard for others.

Want unlimited practice?

Get full access to all questions, explanations, and performance tracking.

Start For Free