Personality Disorders — MCQs

A 40-year-old married male exhibits a pattern of distrust and suspicion towards others, including his family and friends. He often interprets their advice as having ulterior motives and is particularly suspicious of his wife. Which of the following personality disorders is most consistent with these behaviors?

Q160

What is the definition of voyeurism in the context of sexual behavior?

Personality Disorders Indian Medical PG Practice Questions and MCQs

Question 151: Which personality disorder is characterized by unstable interpersonal relationships and impulsive behavior?

A. Obsessive-compulsive
B. Borderline (Correct Answer)
C. Histrionic
D. Schizoid

Explanation: **Borderline** - **Borderline personality disorder** is defined by a pervasive pattern of **instability in interpersonal relationships, self-image, and affects**, along with marked impulsivity. - Patients often experience intense, short-lived emotional episodes and may engage in **self-harm** or suicidal behaviors. *Obsessive-compulsive* - This disorder is characterized by a preoccupation with **orderliness, perfectionism**, and mental and interpersonal control, often at the expense of flexibility and efficiency. - Individuals tend to be meticulous, rigid, and resistant to delegating tasks, but generally do not exhibit unstable relationships or impulsivity. *Histrionic* - This personality disorder involves excessive **emotionality and attention-seeking behavior**, often dramatic and theatrical. - While they seek attention in relationships, their relationships are not necessarily unstable in the impulsive and intense way seen in borderline personality disorder; rather, they are often superficial. *Schizoid* - Individuals with **schizoid personality disorder** exhibit a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings. - They tend to be loners and indifferent to praise or criticism, which is contrary to the intense and unstable relationships seen in borderline personality disorder.

Question 152: A 35-year-old woman presents with a pervasive pattern of instability in relationships, self-image, and emotions. She exhibits impulsive behavior and chronic feelings of emptiness. What is the most likely diagnosis?

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

Explanation: ***Borderline personality disorder*** - This disorder is characterized by a pervasive pattern of **instability in interpersonal relationships**, self-image, and affects, along with marked impulsivity. - Key features include **chronic feelings of emptiness**, frantic efforts to avoid abandonment, and impulsive behaviors such as spending, sex, substance abuse, or binge eating. *Narcissistic personality disorder* - Individuals with this disorder exhibit a pervasive pattern of **grandiosity**, need for admiration, and lack of empathy. - Their primary concern is often their own self-importance, rather than relational instability or emotional dysregulation. *Histrionic personality disorder* - This disorder is characterized by **excessive emotionality** and **attention-seeking behavior**. - While they may have unstable relationships, the driving force is usually attention rather than profound identity disturbance or chronic emptiness. *Dependent personality disorder* - Individuals with this disorder have a pervasive and excessive need to be cared for, leading to **submissive and clinging behavior** and fears of separation. - This is distinct from the emotional lability and impulsivity seen in the patient described.

Question 153: Which of the following personality disorders is associated with a lack of empathy, grandiosity, and a need for admiration?

A. Borderline personality disorder
B. Antisocial personality disorder
C. Narcissistic personality disorder (Correct Answer)
D. Histrionic personality disorder

Explanation: ***Narcissistic personality disorder*** - This disorder is characterized by a pervasive pattern of **grandiosity**, a constant **need for admiration**, and a profound **lack of empathy**. - Individuals often have an inflated sense of self-importance and believe they are unique or special. *Borderline personality disorder* - Characterized by **instability in interpersonal relationships**, self-image, and affects, along with marked impulsivity. - While they can struggle with empathy, their primary features are not grandiosity or a constant need for admiration, but rather fears of abandonment and emotional dysregulation. *Antisocial personality disorder* - Defined by a pervasive pattern of **disregard for and violation of the rights of others**, often involving deceit, impulsivity, and a lack of remorse. - While they share a lack of empathy with narcissistic personality disorder, their primary motivation is often personal gain or dominance rather than admiration. *Histrionic personality disorder* - Characterized by **excessive emotionality** and **attention-seeking behavior**, often through theatricality and sexually provocative conduct. - They desire to be the center of attention, but this differs from the grandiose self-importance and specific need for admiration seen in narcissistic personality disorder.

Question 154: A 40-year-old woman reports experiencing mood swings, impulsivity, and unstable relationships. What is the most likely diagnosis?

A. Borderline personality disorder (Correct Answer)
B. Bipolar disorder
C. Histrionic personality disorder
D. Narcissistic personality disorder

Explanation: ***Borderline personality disorder*** - **Mood swings**, **impulsivity**, and **unstable relationships** are core diagnostic criteria for borderline personality disorder (BPD). - Individuals with BPD often experience an intense fear of abandonment, leading to chaotic interpersonal dynamics and a **fluctuating sense of self**. *Bipolar disorder* - Characterized by distinct episodes of **mania or hypomania** alternating with depressive episodes. - While mood swings occur, they are typically episodic and not continuously present with the intensity and relational instability seen in BPD. *Histrionic personality disorder* - Individuals with this disorder exhibit excessive **emotionality** and **attention-seeking behavior**. - While they may have unstable relationships, the primary focus is on being the center of attention rather than the deep-seated fear of abandonment or identity disturbance typical of BPD. *Narcissistic personality disorder* - Marked by a pervasive pattern of **grandiosity**, a need for admiration, and a lack of empathy. - Relationships are often unstable due to exploitation and a sense of entitlement, but they are not driven by impulsivity, fear of abandonment, or chronic feelings of emptiness, as seen in BPD.

Question 155: Which of the following personality disorders has been most studied in relation to schizophrenia comorbidity?

A. Schizotypal Personality Disorder (Correct Answer)
B. Paranoid Personality Disorder
C. Borderline Personality Disorder
D. Schizoid Personality Disorder

Explanation: ***Schizotypal Personality Disorder*** - **Schizotypal personality disorder** is the personality disorder most extensively studied in relation to schizophrenia comorbidity. - It is considered part of the **schizophrenia spectrum**, sharing genetic and neurobiological underpinnings with schizophrenia. - Characterized by **cognitive or perceptual distortions**, eccentric behavior, and marked discomfort with close relationships. - Research consistently demonstrates familial aggregation with schizophrenia and overlapping neurocognitive deficits. *Paranoid Personality Disorder* - Characterized by pervasive **distrust** and **suspiciousness** of others. - While it can share some features with paranoid schizophrenia, it is **not the most studied** personality disorder in terms of direct comorbidity with schizophrenia. - Not formally classified within the schizophrenia spectrum disorders. *Borderline Personality Disorder* - Marked by instability in **interpersonal relationships**, **self-image**, and **affect**, along with marked impulsivity. - Although it can co-occur with transient psychotic symptoms, it is **not primarily linked** to schizophrenia in the same way as schizotypal personality disorder. - Belongs to Cluster B personality disorders, not the schizophrenia spectrum. *Schizoid Personality Disorder* - Defined by a pervasive pattern of **detachment from social relationships** and a restricted range of emotional expression. - While it shares features of social withdrawal, it lacks the **cognitive and perceptual distortions** seen in schizotypal personality disorder. - Less extensively studied than schizotypal personality disorder regarding schizophrenia comorbidity.

Question 156: A 35-year-old woman with borderline personality disorder presents with recurrent suicidal behavior and self-harm. What is the most effective psychotherapeutic approach?

A. Cognitive-behavioral therapy
B. Dialectical behavior therapy (Correct Answer)
C. Psychodynamic therapy
D. Supportive therapy

Explanation: ***Dialectical behavior therapy*** - **DBT** is specifically designed for individuals with **borderline personality disorder** to address emotional dysregulation, suicidal ideation, and self-harm behaviors. - It focuses on teaching skills in **mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness**. *Cognitive-behavioral therapy* - While generally effective for many mental health conditions, **CBT** alone is often less specialized for the complex symptom presentation of **borderline personality disorder** compared to DBT. - It primarily addresses maladaptive thought patterns and behaviors but may not fully encompass the severe emotional dysregulation and interpersonal challenges specific to BPD. *Psychodynamic therapy* - This approach explores unconscious conflicts and past experiences, which can be beneficial for insight, but it is not typically the first-line treatment for **acute suicidality** and **self-harm** in BPD. - Its longer-term, less structured nature may not provide the immediate skill-building and crisis management necessary for these high-risk behaviors. *Supportive therapy* - **Supportive therapy** aims to bolster coping mechanisms and provide empathy, but it lacks the structured skill-building components necessary to effectively manage the core symptoms of **borderline personality disorder**, such as chronic suicidality and self-harm. - It is often used as an adjunct or for less severe presentations, but not as the primary, standalone treatment for the complex issues presented.

Question 157: Which of the following is a characteristic feature of borderline personality disorder?

A. Grandiosity
B. Chronic feelings of emptiness (Correct Answer)
C. Compulsive orderliness
D. Excessive attention seeking

Explanation: ***Chronic feelings of emptiness*** - This is a core diagnostic criterion for **borderline personality disorder (BPD)**, reflecting an inner void and lack of self-identity. - It often leads to impulsive behaviors and frantic efforts to avoid real or imagined abandonment as patients try to fill this void. *Grandiosity* - **Grandiosity** is a characteristic feature of **narcissistic personality disorder**, where individuals have an inflated sense of self-importance and superiority. - It does not typically define the emotional landscape of feeling chronically empty, which is central to BPD. *Compulsive orderliness* - **Compulsive orderliness**, perfectionism, and a preoccupation with control are hallmarks of **obsessive-compulsive personality disorder (OCPD)**. - These traits are distinct from the emotional dysregulation and interpersonal instability seen in BPD. *Excessive attention seeking* - **Excessive attention seeking**, theatricality, and rapidly shifting emotions are characteristic features of **histrionic personality disorder**. - While individuals with BPD may seek attention, it is typically in the context of intense fear of abandonment or emotional dysregulation, rather than a pervasive style of dramatic performance.

Question 158: A 22-year-old female presents with a pattern of unstable relationships, impulsivity, and an intense fear of abandonment. What is the most likely diagnosis?

A. Borderline personality disorder (Correct Answer)
B. Histrionic personality disorder
C. Narcissistic personality disorder
D. Avoidant personality disorder

Explanation: ***Borderline personality disorder*** - Patients with **borderline personality disorder** often exhibit a pervasive pattern of **unstable relationships**, impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating), and an intense fear of abandonment. - Other common features include **affective instability**, chronic feelings of emptiness, and recurrent suicidal behavior or gestures. *Histrionic personality disorder* - Characterized by **excessive emotionality** and **attention-seeking behavior**, often sexually provocative, but typically without the intense fear of abandonment or self-destructive impulsivity seen in BPD. - Individuals may use their physical appearance to draw attention to themselves and consider relationships to be more intimate than they actually are. *Narcissistic personality disorder* - Involves a pervasive pattern of **grandiosity**, a need for admiration, and a lack of empathy; they would typically not fear abandonment but rather expect others to cater to their needs. - While they may exploit others and have difficulties in relationships, their core issue is often a sense of entitlement rather than an intense fear of being left. *Avoidant personality disorder* - Characterized by **social inhibition**, feelings of inadequacy, and hypersensitivity to negative evaluation, leading to avoidance of social interaction. - Individuals desire relationships but avoid them due to fear of rejection, which is distinct from the chaotic and intense fear of abandonment in BPD, where relationships are actively sought but are unstable.

Question 159: A 40-year-old married male exhibits a pattern of distrust and suspicion towards others, including his family and friends. He often interprets their advice as having ulterior motives and is particularly suspicious of his wife. Which of the following personality disorders is most consistent with these behaviors?

A. Borderline personality disorder
B. Schizoid personality disorder
C. Paranoid personality disorder (Correct Answer)
D. Histrionic personality disorder

Explanation: ***Paranoid personality disorder*** - This disorder is characterized by a pervasive **distrust and suspiciousness of others**, interpreting their motives as malevolent, which perfectly aligns with the patient's behaviors towards family, friends, and his wife. - Individuals with paranoid personality disorder often perceive benign remarks or events as demeaning or threatening, and they tend to bear **grudges** and be reluctant to confide in others. *Borderline personality disorder* - This disorder is marked by a pattern of **instability in interpersonal relationships**, self-image, and affects, along with marked impulsivity, none of which are specifically described in the patient's presentation. - Key features include **fear of abandonment**, intense anger, recurrent suicidal behavior, and chronic feelings of emptiness. *Schizoid personality disorder* - This disorder is characterized by a pattern of **detachment from social relationships** and a restricted range of expression of emotions in interpersonal settings. - Individuals with schizoid personality disorder typically show **little interest in intimacy** and prefer solitary activities, which contrasts with the patient's engagement in relationships, albeit with suspicion. *Histrionic personality disorder* - This disorder is characterized by a pattern of **excessive emotionality** and **attention-seeking behavior**. - Individuals with histrionic personality disorder are often uncomfortable when not the center of attention, use physical appearance to draw attention, and have rapidly shifting and shallow expressions of emotion, which are not depicted in the given scenario.

Question 160: What is the definition of voyeurism in the context of sexual behavior?

A. Gaining sexual pleasure from observing others engaged in sexual activity. (Correct Answer)
B. Using objects for sexual gratification.
C. Deriving sexual pleasure from self-inflicted pain.
D. Achieving sexual gratification through self-stimulation.

Explanation: ***Gaining sexual pleasure from observing others engaged in sexual activity.*** - **Voyeurism** specifically refers to **sexual arousal** derived from secretly watching unsuspecting individuals who are naked, disrobing, or engaging in sexual acts. - The key element is **unconsenting observation** for sexual gratification. *Using objects for sexual gratification.* - This definition describes **fetishism**, where individuals achieve sexual arousal from inanimate objects or specific body parts. - Voyeurism focuses on the act of **observing** rather than the use of objects. *Deriving sexual pleasure from self-inflicted pain.* - This describes **sexual masochism**, a paraphilia characterized by sexual arousal from being subjected to humiliation, bondage, or suffering. - This is distinct from voyeurism, which involves observing others without their knowledge. *Achieving sexual gratification through self-stimulation.* - This is the definition of **masturbation**, a common form of sexual behavior that does not involve observing others. - Voyeurism specifically requires an **external object of observation** for arousal.

Practice by Chapter

Classification of Personality Disorders

Practice Questions

Cluster A Personality Disorders

Practice Questions

Cluster B Personality Disorders

Practice Questions

Cluster C Personality Disorders

Practice Questions

Borderline Personality Disorder

Practice Questions

Antisocial Personality Disorder

Practice Questions

Narcissistic Personality Disorder

Practice Questions

Psychotherapy for Personality Disorders

Practice Questions

Dialectical Behavior Therapy

Practice Questions

Mentalization-Based Therapy

Practice Questions

Pharmacological Approaches

Practice Questions

Outcome and Prognosis

Practice Questions

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