Personality Disorders Practice Questions

Q: Which of the following is a temperament type?

Novelty seeking. ### Explanation The correct answer is **Novelty seeking**. **1. Why Novelty Seeking is Correct:** This question is based on **Cloninger’s Tridimensional (later Biosocial) Model of Personality**. According to Cloninger, personality is composed of two components: **Temperament** (genetically determined, biological) and **Character** (learned through experience). * **Temperament types (4):** Novelty seeking (dopamine), Harm avoidance (serotonin), Reward dependence (norepinephrine), and Persistence. * **Character types (3):** Self-directedness, Cooperativeness, and Self-transcendence. **Novelty seeking** is the tendency to respond strongly to novelty and cues for reward, mediated primarily by the **dopaminergic** system. **2. Why the Other Options are Incorrect:** * **Histrionic (B), Anankastic (C), and Narcissistic (D)** are not temperament types; they are specific **Personality Disorders** as defined by the DSM-5 and ICD-10. * **Histrionic and Narcissistic** belong to Cluster B (dramatic/erratic). * **Anankastic** is the ICD-10 term for **Obsessive-Compulsive Personality Disorder (OCPD)**, which belongs to Cluster C (anxious/fearful). **3. High-Yield Clinical Pearls for NEET-PG:** * **Neurotransmitter Correlation:** Remember the "D-S-N" mnemonic for Cloninger’s temperaments: **D**opamine = **N**ovelty seeking; **S**erotonin = **H**arm avoidance; **N**orepinephrine = **R**eward dependence. * **Anankastic Personality:** Frequently tested as a synonym for OCPD. Key features include perfectionism, rigidity, and preoccupation with rules. * **Temperament vs. Character:** Temperament is considered "hard-wired" at birth, while Character develops throughout adulthood.

Q: Mentalization-Based Therapy is primarily used in the treatment of which of the following personality disorders?

Borderline personality disorder. **Explanation:** **Mentalization-Based Therapy (MBT)** is a psychotherapeutic approach specifically developed by Anthony Bateman and Peter Fonagy to treat **Borderline Personality Disorder (BPD)**. 1. **Why BPD is correct:** Mentalization is the capacity to understand the mental states (emotions, beliefs, and intentions) of oneself and others. Patients with BPD often have a deficit in this capacity, leading to emotional dysregulation, impulsive behavior, and unstable relationships. MBT focuses on improving this "reflective functioning," helping patients stabilize their sense of self and better manage interpersonal stressors. 2. **Why other options are incorrect:** * **Antisocial PD:** While MBT is being researched for antisocial traits, the primary gold-standard treatment remains behavioral management or specialized cognitive therapies. * **Obsessive-Compulsive PD:** The mainstay of treatment is Cognitive Behavioral Therapy (CBT) or psychodynamic psychotherapy focusing on rigidity and perfectionism. * **Avoidant PD:** This is typically managed with Social Skills Training, CBT, or exposure therapy to address social inhibition and feelings of inadequacy. **High-Yield Clinical Pearls for NEET-PG:** * **Gold Standard for BPD:** **Dialectical Behavior Therapy (DBT)** is the most frequently tested first-line treatment, but **MBT** and **Schema Therapy** are high-yield alternatives. * **Pharmacotherapy in BPD:** No FDA-approved drug exists; however, SSRIs (for mood/impulsivity) and low-dose antipsychotics (for cognitive-perceptual symptoms) are used symptomatically. * **Key Feature of BPD:** "Splitting" (viewing people as all good or all bad) is the hallmark defense mechanism.

Q: Which DSM-IV personality disorder is not classified as a personality disorder in ICD-10 and is placed with schizophrenia?

Schizotypal. ### Explanation The correct answer is **Schizotypal Personality Disorder**. **1. Why Schizotypal is the Correct Answer:** In the **DSM-IV (and DSM-5)**, Schizotypal disorder is classified as a **Cluster A Personality Disorder**, characterized by odd beliefs, magical thinking, and social deficits. However, in the **ICD-10**, it is not listed under "Specific Personality Disorders" (F60). Instead, it is classified under **F21: Schizotypal Disorder**, grouped within the same category as **Schizophrenia and Delusional Disorders**. This is because ICD-10 views Schizotypal disorder as a "prodromal" or genetic variant of schizophrenia rather than a distinct personality type. **2. Analysis of Incorrect Options:** * **A. Schizoid:** Characterized by emotional coldness and detachment from social relationships. Both DSM and ICD-10 classify this as a Personality Disorder. * **B. Paranoid:** Characterized by pervasive distrust and suspiciousness. Both systems classify this as a Personality Disorder. * **C. Narcissistic:** Characterized by grandiosity and lack of empathy. While it is a major diagnosis in DSM, it is notably **absent** as a specific category in ICD-10 (often placed under "Other specific personality disorders"). However, it is not grouped with schizophrenia. **3. NEET-PG High-Yield Pearls:** * **Cluster A (Odd/Eccentric):** Includes Paranoid, Schizoid, and Schizotypal. * **Schizotypal vs. Schizoid:** Schizotypal involves *eccentricity/magical thinking*, whereas Schizoid involves *social isolation/apathy*. * **ICD-11 Update:** In the latest ICD-11, Schizotypal disorder remains grouped with Schizophrenia, further emphasizing the "Schizophrenia Spectrum" concept. * **Key Feature:** Schizotypal patients often experience "Ideas of Reference" (not delusions of reference).

Q: A 25-year-old gentleman has repeated thoughts that he has not locked his car door properly and frequently checks it while driving. He also repeatedly checks locks in his house. What is the most likely diagnosis?

Obsessive-Compulsive Disorder (OCD). ### Explanation **Correct Answer: A. Obsessive-Compulsive Disorder (OCD)** The patient presents with classic symptoms of **Obsessive-Compulsive Disorder (OCD)**. The underlying medical concept involves two components: 1. **Obsessions:** Recurrent, intrusive, and distressing thoughts (e.g., the doubt that the car door is unlocked). 2. **Compulsions:** Repetitive behaviors performed to neutralize the anxiety caused by the obsession (e.g., frequent checking). Crucially, these symptoms are **Ego-dystonic** (the patient recognizes the thoughts as irrational or excessive and finds them distressing), which is the hallmark of OCD. **Why other options are incorrect:** * **B. Obsessive-Compulsive Personality Disorder (OCPD):** Unlike OCD, OCPD is **Ego-syntonic**. Individuals with OCPD are preoccupied with perfectionism, orderliness, and control, but they do not typically have discrete obsessions or compulsions. They believe their way of doing things is "correct" and do not feel the need to resist their behaviors. * **C. Phobia:** This involves an intense, irrational fear of a specific object or situation leading to avoidance. It does not involve the ritualistic "checking" behaviors seen here. * **D. Somatoform disorder:** This involves physical symptoms (like pain or fatigue) that suggest a medical condition but cannot be fully explained by one. It does not involve intrusive thoughts or repetitive rituals. **High-Yield Clinical Pearls for NEET-PG:** * **Ego-dystonic:** OCD (Patient vs. Symptoms). * **Ego-syntonic:** OCPD (Symptoms are part of the patient's "self"). * **First-line Treatment for OCD:** Selective Serotonin Reuptake Inhibitors (SSRIs) at high doses and Cognitive Behavioral Therapy (CBT) using **Exposure and Response Prevention (ERP)**. * **Neurobiology:** OCD is associated with structural abnormalities in the **Orbitofrontal cortex, Anterior Cingulate Cortex, and Caudate nucleus**.

Q: What is Folie à deux?

Shared delusional disorder. **Explanation:** **Folie à deux** (literally "madness of two") is a rare clinical syndrome characterized by the transmission of delusional beliefs from one individual to another. In modern psychiatric classification (ICD-10), it is termed **Shared Psychotic Disorder** or **Induced Delusional Disorder**. 1. **Why Option B is Correct:** The disorder typically involves two people (usually family members with a close emotional bond) living in relative isolation. The **"primary" (inducer/dominant)** individual has a genuine psychotic disorder with stable delusions, which are then "passed on" to the **"secondary" (passive/submissive)** individual. A key diagnostic and therapeutic feature is that the secondary person’s delusions often resolve or significantly improve once they are separated from the primary individual. 2. **Why Other Options are Incorrect:** * **A. Obsessive-compulsive disorder:** Characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions), not shared delusions. * **C. Hysteria:** An archaic term for Dissociative or Conversion disorders, involving physical symptoms without organic causes or emotional dissociation. * **D. Neurasthenia:** An older term (ICD-10) for a condition involving chronic fatigue, lassitude, and somatic complaints, often linked to stress. **Clinical Pearls for NEET-PG:** * **Treatment:** The first step in management is **separation** of the two individuals. The primary person usually requires antipsychotics, while the secondary may only need observation after separation. * **Variants:** If three people are involved, it is *Folie à trois*; if an entire family, it is *Folie à famille*. * **ICD-11 Update:** Under the newer ICD-11, this is categorized under "Induced Delusional Disorder."

Q: A man is extremely particular about being on time and consistently shows a strong need for order, control, and perfectionism. Which personality disorder does this behavior most likely suggest?

Obsessive-Compulsive Personality Disorder. ***Obsessive-Compulsive Personality Disorder*** - Core features include a pervasive pattern of preoccupation with **orderliness**, **perfectionism**, and **mental and interpersonal control**. - The extreme need to be on time and the consistent focus on control and order align perfectly with the diagnostic criteria for **OCPD**. *Paranoid Personality Disorder* - Characterized by a pervasive distrust and **suspiciousness** of others, often interpreting their motives as malevolent. - The primary concern is not order or perfectionism, but rather the fear of being **deceived** or **exploited**. *Narcissistic Personality Disorder* - Defined by a pervasive pattern of **grandiosity**, a need for admiration, and a lack of empathy; they believe they are special or unique. - While they may demand perfection from others, their own behavior is motivated by maintaining high **self-esteem** and status, not inherent orderliness or control for its own sake. *Schizoid Personality Disorder* - Involves profound detachment from social relationships and a restricted range of emotional expression; they typically prefer **solitary activities**. - This disorder does not involve the characteristic preoccupation with rules, control, or **perfectionism** seen in the patient described.

Question 1

Which of the following is a temperament type?

Accepted Answer

Novelty seeking

Answer

Histrionic

Answer

Anankastic

Answer

Narcissistic

Question 2

A 16-year-old girl presents with a history of multiple wrist-slashing suicide attempts, primarily related to domestic conflict. She experiences significant mood fluctuations and exhibits a pervasive pattern of unstable interpersonal relationships. What is the most probable diagnosis?

Accepted Answer

Borderline personality disorder

Answer

Major depression

Answer

Histrionic personality disorder

Answer

Adjustment disorder

Question 3

Mentalization-Based Therapy is primarily used in the treatment of which of the following personality disorders?

Accepted Answer

Borderline personality disorder

Answer

Antisocial personality disorder

Answer

Obsessive-compulsive personality disorder

Answer

Avoidant personality disorder

Question 4

Which of the following is a Cluster B personality disorder?

Accepted Answer

Narcissistic personality disorder

Answer

Schizoid personality disorder

Answer

Dependent personality disorder

Answer

Antisocial personality disorder

Question 5

Which DSM-IV personality disorder is not classified as a personality disorder in ICD-10 and is placed with schizophrenia?

Accepted Answer

Schizotypal

Answer

Schizoid

Answer

Paranoid

Answer

Narcissistic

Question 6

A 27-year-old woman presents with sleep difficulty following a breakup one month ago. She also reports difficulties with work, decision-making, and socializing without external support. She has a history of low self-confidence and fears of rejection and abandonment since early adulthood. She appears anxious and sad but brightens easily. What is the most likely diagnosis in this patient?

Accepted Answer

Dependent personality disorder

Answer

Acute stress disorder

Answer

Major depressive disorder

Answer

Borderline personality disorder

Question 7

A 25-year-old gentleman has repeated thoughts that he has not locked his car door properly and frequently checks it while driving. He also repeatedly checks locks in his house. What is the most likely diagnosis?

Accepted Answer

Obsessive-Compulsive Disorder (OCD)

Answer

Obsessive-Compulsive Personality Disorder (OCPD)

Answer

Phobia

Answer

Somatoform disorder

Question 8

Antisocial personality is seen with which of the following conditions?

Accepted Answer

Drug abuse

Answer

Paranoid schizophrenia

Answer

OCD

Answer

None of the above

Question 9

What is Folie à deux?

Accepted Answer

Shared delusional disorder

Answer

Obsessive-compulsive disorder

Answer

Hysteria

Answer

Neurasthenia

Question 10

A man is extremely particular about being on time and consistently shows a strong need for order, control, and perfectionism. Which personality disorder does this behavior most likely suggest?

Accepted Answer

Obsessive-Compulsive Personality Disorder

Answer

Narcissistic Personality Disorder

Answer

Paranoid Personality Disorder

Answer

Schizoid Personality Disorder

Personality Disorders — MCQs

Personality Disorders — MCQs

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