Personality Disorders — MCQs

Personality Disorders Indian Medical PG Practice Questions and MCQs

Question 161: What is the medical definition of transvestism?

A. Cross-dressing for sexual arousal or gratification (Correct Answer)
B. Engaging in sexual acts with oneself in public
C. A desire for sexual relations with deceased individuals
D. Arousal from visual stimuli of the opposite gender

Explanation: ***Cross-dressing for sexual arousal or gratification*** - **Transvestic disorder** (formerly called transvestism) is medically defined as **recurrent and intense sexual arousal from cross-dressing**, manifested by fantasies, urges, or behaviors - The key diagnostic feature is that the cross-dressing is **specifically for sexual excitement**, not merely for comfort or gender expression - Persons with transvestic disorder typically **identify with their birth-assigned sex** and do not have gender dysphoria - According to **DSM-5**, the behavior must persist for at least **6 months** and cause clinically significant distress or impairment *Engaging in sexual acts with oneself in public* - This describes **exhibitionistic disorder** or public indecency, which involves exposing one's genitals to unsuspecting strangers or masturbating in public - While distinct from transvestic disorder, though some individuals may have multiple paraphilic disorders *A desire for sexual relations with deceased individuals* - This refers to **necrophilic disorder**, a rare paraphilia involving sexual attraction to corpses - Completely unrelated to transvestic disorder, which involves cross-dressing behavior *Arousal from visual stimuli of the opposite gender* - This is too broad and could describe typical heterosexual attraction or **voyeuristic disorder** (observing unsuspecting people who are naked or engaged in sexual activity) - Does not capture the specific defining feature of transvestic disorder: **sexual arousal from the act of cross-dressing itself**

Question 162: Patients who are grandiose and require admiration from others have which type of personality?

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

Explanation: ***Narcissistic*** - **Narcissistic Personality Disorder** is characterized by a pervasive pattern of grandiosity, a constant need for admiration, and a lack of empathy for others. - Individuals often have an inflated sense of self-importance and believe they are special and unique. *Histrionic* - **Histrionic Personality Disorder** is marked by excessive emotionality and attention-seeking behavior. - These individuals are often dramatic, seductive, and uncomfortable when not the center of attention, but their grandiosity is not the primary feature. *Borderline* - **Borderline Personality Disorder** is characterized by instability in relationships, self-image, affects, and impulsivity. - While they may seek attention, it is typically driven by a fear of abandonment or identity disturbance, rather than grandiosity. *Antisocial* - **Antisocial Personality Disorder** involves a pervasive pattern of disregard for and violation of the rights of others. - Key features include deceitfulness, impulsivity, irritability, and a lack of remorse, rather than a primary need for admiration or grandiosity.

Question 163: What term describes obsessive attention by an individual towards another person?

A. Harassment
B. Following
C. Stalking (Correct Answer)
D. Coercing

Explanation: ***Stalking*** - This term specifically describes **obsessive and repeated unwanted attention** directed towards another person. - It involves a pattern of behavior including **surveillance, following, and persistent contact** that is fixated and intrusive. - In psychiatric context, stalking is associated with **erotomania, obsessive love disorder**, and certain personality disorders. - Stalking behavior reflects the **obsessive preoccupation** that characterizes the attention described in the question. *Harassment* - Harassment is a **broader term** that encompasses various unwanted behaviors including threats, intimidation, and offensive conduct. - While stalking is a form of harassment, **not all harassment involves obsessive attention** toward a specific person. - Harassment can be situational or sporadic, whereas the question specifically asks about **obsessive attention**. *Following* - Following simply refers to the physical act of **moving behind someone** or tracking their movements. - It is a behavior that may be **part of stalking** but does not capture the obsessive psychological component. - Following alone lacks the connotation of **persistent, unwanted, and obsessive attention** that defines the phenomenon in question. *Coercing* - Coercing involves **forcing someone to do something against their will** through threats, pressure, or intimidation. - This term focuses on **manipulation and control of behavior** rather than obsessive attention. - Coercion is about achieving compliance, not about the **fixated preoccupation** with another person.

Question 164: Schizotypal personality disorder is classified under which cluster of personality disorders?

A. Cluster A (Odd, eccentric behavior) (Correct Answer)
B. Cluster B (Dramatic, emotional, or erratic behavior)
C. Cluster C (Anxious, fearful behavior)
D. Cluster D (Not a valid cluster)

Explanation: ***Cluster A (Odd, eccentric behavior)*** - **Schizotypal personality disorder** involves symptoms like **peculiar thinking**, odd beliefs, and discomfort in social interactions, which align with the eccentric behaviors characteristic of Cluster A. - This cluster also includes **paranoid** and **schizoid** personality disorders, all sharing features of detachment and unusual thought patterns. *Cluster B (Dramatic, emotional, or erratic behavior)* - Cluster B includes disorders like **antisocial**, **borderline**, **histrionic**, and **narcissistic** personality disorders, which are characterized by impulsivity, emotional volatility, and often a disregard for others' feelings. - Schizotypal personality disorder's primary features are *not* dramatic emotional outbursts or erratic behavior in the sense of these disorders. *Cluster C (Anxious, fearful behavior)* - This cluster encompasses **avoidant**, **dependent**, and **obsessive-compulsive** personality disorders, all marked by anxiety, fearfulness, and a strong need for control or reassurance. - Schizotypal personality disorder's core features are closer to *cognitive distortions* and *social detachment* rather than pervasive anxiety or fear. *Cluster D (Not a valid cluster)* - The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes personality disorders into three main clusters: **A, B, and C**. - There is no recognized "Cluster D" in the official classification system for personality disorders.

Question 165: Which personality disorder shows the most phenomenological overlap with autism spectrum disorder in terms of social interaction difficulties?

A. Schizoid Personality Disorder (Correct Answer)
B. Borderline Personality Disorder
C. Schizotypal Personality Disorder
D. None of the options

Explanation: ***Schizoid Personality Disorder*** - Shows the **most phenomenological overlap** with autism spectrum disorder (ASD) in terms of social withdrawal and detachment from social relationships - Both conditions feature **reduced social engagement** and preference for solitary activities - However, the mechanisms differ: schizoid PD involves **lack of desire** for social relationships, while ASD involves **impaired social cognition** and communication skills - Diagnostic distinction is important but can be challenging due to overlapping presentations *Schizotypal Personality Disorder* - Features **eccentric behaviors**, peculiar thought patterns, and **magical thinking** that are not characteristic of ASD - While social difficulties exist, they stem from odd beliefs and perceptual distortions rather than core social communication deficits - The cognitive-perceptual abnormalities distinguish it from ASD *Borderline Personality Disorder* - Characterized by **emotional instability**, intense and chaotic relationships, and fear of abandonment - While some individuals with ASD may have emotional dysregulation, the pervasive relationship instability and identity disturbance of BPD are distinct from ASD core features - BPD involves **intense engagement** in relationships (though unstable), contrasting with ASD social difficulties *None of the options* - Incorrect, as schizoid personality disorder does show significant phenomenological overlap with ASD in the domain of social interaction patterns

Question 166: Markedly inappropriate sensitivity, self importance and suspiciousness are clinical features of

A. Antisocial
B. Histrionic
C. Schizoid
D. Paranoid (Correct Answer)

Explanation: ***Paranoid*** - **Paranoid personality disorder (PPD)** is characterized by a pervasive distrust and suspicion of others and their motives, leading to misinterpretation of their actions as malevolent. - Individuals with PPD often display heightened **sensitivity to criticism**, a sense of **self-importance**, and are prone to unwarranted suspiciousness about the loyalty or trustworthiness of friends and associates. *Antisocial* - **Antisocial personality disorder** is primarily characterized by a disregard for and violation of the rights of others, often involving deception, manipulation, and a lack of remorse. - While they may be manipulative, their core features do not typically include hypersensitivity or suspiciousness as primary characteristics. *Historic* - This term is likely a misspelling of **histrionic personality disorder**, which is characterized by excessive emotionality and attention-seeking behavior. - Individuals with histrionic personality disorder crave attention and are often inappropriately seductive, but they do not typically exhibit the marked suspiciousness or hypersensitivity described in the question. *Schizoid* - **Schizoid personality disorder** is characterized by a pervasive pattern of detachment from social relationships and a restricted range of emotional expression. - People with schizoid personality disorder tend to be introverted, solitary, and indifferent to social interactions, rather than suspicious or self-important in a negative way.

Question 167: 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.

Question 168: Which of the following conditions is most commonly associated with self-mutilation?

A. Catatonic schizophrenia
B. Paranoid schizophrenia
C. Borderline personality disorder (Correct Answer)
D. None of the options

Explanation: **_Borderline personality disorder_** - **Self-mutilation** (e.g., cutting, burning) is a common coping mechanism in **borderline personality disorder (BPD)**, used to relieve intense emotional pain or a sense of emptiness. - This behavior is often associated with the characteristic **emotional dysregulation**, **impulsivity**, and unstable interpersonal relationships seen in BPD. - Self-mutilation is included as a diagnostic criterion in DSM-5 for BPD. *Catatonic schizophrenia* - This subtype of schizophrenia is characterized by profound disturbances in psychomotor behavior, such as **immobility**, **mutism**, **posturing**, or **excessive, purposeless motor activity**. - While individuals with catatonia may injure themselves during periods of extreme agitation or impulsivity, **self-mutilation** is not a primary or defining feature of catatonic schizophrenia. *Paranoid schizophrenia* - This type of schizophrenia is dominated by **delusions** (often persecutory or grandiose) and **auditory hallucinations**. - While individuals with paranoid schizophrenia may engage in self-harm if driven by delusional beliefs or command hallucinations, **self-mutilation** as a primary coping mechanism is not a hallmark characteristic of this disorder. *None of the options* - This option is incorrect because **borderline personality disorder** is strongly and specifically associated with self-mutilation.

Question 169: What is the term for sexual attraction to corpses?

A. Necrophilia (Correct Answer)
B. Exhibitionism
C. Undinism
D. Voyeurism

Explanation: ***Necrophilia*** - Necrophilia is a paraphilia defined by a **sexual attraction to or sexual acts with corpses**. - The term is derived from Greek words "nekros" (corpse) and "philia" (love). *Exhibitionism* - **Exhibitionism** is a paraphilia characterized by obtaining sexual arousal from exposing one's genitals to an unsuspecting stranger. - There is no involvement with corpses in exhibitionism. *Voyeurism* - **Voyeurism** is a paraphilia where sexual arousal is obtained from observing unsuspecting individuals who are naked, undressing, or engaging in sexual activity. - This paraphilia focuses on secretly watching live people, not corpses. *Undinism* - **Undinism** (also known as urolagnia) is a paraphilia characterized by sexual gratification from urine or urination. - This paraphilia is completely unrelated to sexual attraction to corpses.

Question 170: What term describes deriving sexual pleasure from inflicting or receiving pain, humiliation, or bondage?

A. Sodomy
B. Sadomasochism (Correct Answer)
C. Necrophilia
D. Bestiality

Explanation: ***Sadomasochism*** - This term specifically encompasses deriving **sexual pleasure** from activities involving either **inflicting pain (sadism)** or **receiving pain (masochism)**, including humiliation or bondage. - Sadomasochism is recognized in psychiatric classification as a paraphilic disorder when it causes distress or impairment. - The term covers the **spectrum of both dominant and submissive roles** in consensual pain-related sexual activities. *Sodomy* - This term traditionally refers to **anal or oral intercourse**, and in some legal contexts, to non-procreative sexual acts. - It does **not** describe deriving pleasure from pain or power dynamics. - This is a legal/cultural term, not a psychiatric paraphilia classification. *Necrophilia* - This is the psychiatric term for **sexual attraction to corpses** or sexual acts with dead bodies. - It is a distinct paraphilia that does **not** involve consensual pain dynamics with living partners. *Bestiality/Zoophilia* - This refers to **sexual contact between humans and animals**. - This paraphilia is completely distinct from pain-based sexual practices between humans.

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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