Personality Disorders Practice Questions

Q: Which of the following is a characteristic of Type A personality?

Competitive. ### Explanation **Concept Overview:** The concept of **Type A and Type B personality patterns** was described by Friedman and Rosenman. Type A is not a formal DSM-5 personality disorder but a behavioral pattern significantly associated with an increased risk of **Coronary Artery Disease (CAD)**. **Why "Competitive" is Correct:** Type A personality is characterized by a chronic, incessant struggle to achieve more in less time. Key features include: * **Competitiveness:** A strong desire to excel and outperform others. * **Time Urgency:** A constant sense of "hurrying," impatience, and multitasking. * **Hostility:** Easily provoked anger or irritability (this is the most cardiotoxic component). * **Ambition:** High-achieving and work-oriented nature. **Analysis of Incorrect Options:** * **B. Dependent:** This is the hallmark of **Dependent Personality Disorder** (Cluster C), characterized by a pervasive need to be taken care of, leading to submissive and clinging behavior. * **C. Suspicious:** This is characteristic of **Paranoid Personality Disorder** (Cluster A), where individuals interpret the motives of others as malevolent without sufficient basis. * **D. Odd and Eccentric:** This describes the general category of **Cluster A Personality Disorders** (Paranoid, Schizoid, and Schizotypal), often referred to as the "Mad" cluster. **NEET-PG High-Yield Pearls:** * **Type B Personality:** The opposite of Type A; characterized by being relaxed, easy-going, and less stressed by achievement. * **Type C Personality:** Associated with **Cancer**; characterized by being cooperative, unassertive, and suppressing negative emotions. * **Type D Personality:** "Distressed" personality; characterized by social inhibition and negative affectivity, also linked to poor cardiac outcomes. * **Key Association:** If a question asks which component of Type A is most strongly linked to Myocardial Infarction, the answer is **Hostility/Anger**.

Q: A 43-year-old principal of a medical college presents for psychiatric evaluation. He reports that throughout his life he has worked hard and lived a disciplined life. He always follows all the rules and does the 'right thing', however, no one really likes him. The principal appears to have which of the following personality traits?

Anankastic. **Explanation:** The clinical vignette describes a classic presentation of **Anankastic Personality Disorder**, also known as **Obsessive-Compulsive Personality Disorder (OCPD)** in the DSM-5. **1. Why Anankastic is correct:** The core features of this disorder include a pervasive pattern of **perfectionism, rigidity, and preoccupation with rules, order, and discipline**. The patient’s history of living a "disciplined life" and strictly following "all the rules" to do the "right thing" aligns with the ego-syntonic nature of OCPD. These individuals are often high achievers (e.g., a college principal) but struggle with interpersonal relationships because their inflexibility and moral rigidity make them appear cold or demanding to others, explaining why "no one really likes him." **2. Why other options are incorrect:** * **Schizoid:** Characterized by social detachment and a restricted range of emotional expression. While they may be loners, they lack the drive for perfectionism and rule-following seen here. * **Paranoid:** Defined by pervasive distrust and suspiciousness of others. There is no evidence of the patient feeling exploited or bearing grudges. * **Borderline:** Characterized by instability in relationships, self-image, and affect, along with impulsivity. This patient’s rigid, disciplined lifestyle is the opposite of the chaotic pattern seen in Borderline PD. **Clinical Pearls for NEET-PG:** * **Ego-syntonic vs. Ego-dystonic:** OCPD is *ego-syntonic* (the person views their traits as desirable), whereas OCD (the anxiety disorder) is *ego-dystonic* (the person is distressed by their obsessions). * **Key Mnemonic:** Remember the **"Four Ps"** of Anankastic PD: **P**erfectionism, **P**reoccupation with rules, **P**unctuality, and **P**leasureless (work over play). * **ICD-10 Terminology:** NEET-PG often uses the term **Anankastic**, which is the ICD-10 nomenclature for OCPD.

Q: Which of the following is NOT characteristic of a Type A personality?

Relaxed attitude. **Explanation:** The concept of **Type A and Type B personality patterns** was originally described by cardiologists Friedman and Rosenman. It is a high-yield topic in Psychiatry and Behavioral Sciences due to its established association with an increased risk of **Coronary Artery Disease (CAD)**. **Why "Relaxed attitude" is the correct answer:** A relaxed attitude is the hallmark of a **Type B personality**. Individuals with Type B patterns are generally easy-going, patient, and less prone to stress. They lack the frantic drive and urgency seen in Type A individuals. Therefore, it is NOT a characteristic of Type A. **Analysis of incorrect options (Characteristics of Type A):** * **Hostility:** This is considered the most "toxic" component of Type A behavior and is the strongest predictor of cardiovascular morbidity. It involves frequent anger and cynicism. * **Sense of time urgency:** Also known as "hurry sickness," these individuals are constantly racing against the clock, multitasking, and becoming impatient with delays. * **Competitiveness:** Type A individuals possess a high achievement drive and a persistent desire to surpass others, often at the expense of their own well-being. **NEET-PG Clinical Pearls:** * **Type A:** High risk for CAD, hypertension, and stress-related disorders. * **Type B:** Low stress, "laid back," and lower risk of heart disease. * **Type C:** Characterized by emotional suppression (especially anger) and compliance; traditionally associated with a higher risk of **Cancer**. * **Type D:** "Distressed" personality, characterized by negative affectivity and social inhibition; also linked to poor cardiac outcomes.

Q: Which of the following is characteristic of a Type D personality disorder?

Self-pessimism. **Explanation:** **Type D Personality** (the "D" stands for **Distressed**) is a psychological construct characterized by two stable traits: **Negative Affectivity** and **Social Inhibition**. 1. **Why Option B is Correct:** Individuals with Type D personality frequently experience negative emotions across time and situations. This includes **self-pessimism**, worry, irritability, and a gloomy outlook on life. They tend to suppress these emotions in social situations due to a fear of rejection or disapproval (social inhibition), leading to significant internal distress. 2. **Analysis of Incorrect Options:** * **Option A (Odd and eccentric behavior):** This describes **Cluster A** personality disorders (Paranoid, Schizoid, and Schizotypal), particularly Schizotypal personality. * **Option C (Reward dependence):** This is one of the dimensions of **Cloninger’s Temperament and Character Inventory**. High reward dependence is seen in individuals who are sensitive to social cues and seek approval, whereas Type D individuals are socially inhibited. * **Option D (Achievement-oriented):** This is a hallmark of **Type A Personality**, which is characterized by competitiveness, time urgency, and hostility. **High-Yield Clinical Pearls for NEET-PG:** * **Cardiovascular Link:** Type D personality is a significant independent predictor of poor prognosis, increased mortality, and reduced quality of life in patients with **Coronary Artery Disease (CAD)**. * **Type A vs. Type D:** While Type A is linked to the *onset* of heart disease (due to hostility), Type D is more strongly linked to *prognosis and mortality* after a cardiac event. * **Type B:** Characterized by a relaxed, patient, and easy-going nature (the opposite of Type A). * **Type C:** Characterized by being cooperative, unassertive, and suppressing emotions; historically linked (though controversially) to **Cancer** proneness.

Q: A 28-year-old male presents with a history of vague pains and multiple surgical scars. He is persistently curious about his diagnosis, requesting various diagnostic procedures and a biopsy. He reports a past history of gallstone and appendicitis pain, but the history is vague and appears manipulative, with no supporting previous records. What is the probable diagnosis?

Factitious disorder. ### **Explanation** **Correct Answer: D. Factitious Disorder** The clinical presentation describes a patient who intentionally produces or feigns physical symptoms (vague pains, requesting biopsies) to assume the **"sick role."** Key indicators in this case include the presence of multiple surgical scars (the "gridiron abdomen"), a vague and manipulative history, and a lack of medical records to support past surgeries. Unlike other disorders, the primary motivation in Factitious Disorder (formerly known as Munchausen syndrome) is internal—the psychological need to be a patient—rather than external gain (like money or avoiding work). **Why Incorrect Options are Wrong:** * **A. Hypochondriasis (Illness Anxiety Disorder):** Patients have a genuine, distressing fear of having a serious disease based on misinterpretation of bodily sensations. They do not intentionally produce symptoms or manipulate history. * **B. Somatization Disorder:** Characterized by multiple, chronic physical complaints across different organ systems. However, these symptoms are **not** intentionally produced; the patient truly feels the distress. * **C. Conversion Disorder:** Involves sudden loss of neurological function (e.g., paralysis, blindness) triggered by psychological stress. The symptoms are involuntary and not consciously faked. **NEET-PG High-Yield Pearls:** * **Factitious Disorder vs. Malingering:** In Factitious Disorder, the goal is the **sick role** (internal incentive). In Malingering, the goal is **secondary gain** (external incentive like disability benefits or avoiding jail). * **Gridiron Abdomen:** A classic sign of Factitious Disorder where the patient has multiple crisscrossing surgical scars from unnecessary exploratory surgeries. * **Management:** The best approach is a non-confrontational alliance, focusing on psychiatric management while avoiding unnecessary invasive procedures.

Q: Which of the following is characteristic of schizoid personality disorder?

Odd and eccentric behavior. **Explanation:** **Schizoid Personality Disorder (SPD)** belongs to **Cluster A** (the "odd or eccentric" cluster) of personality disorders. The hallmark of SPD is a pervasive pattern of detachment from social relationships and a restricted range of emotional expression. These individuals are often described as "loners" who prefer solitary activities, lack interest in sexual experiences, and appear indifferent to praise or criticism. Because they deviate significantly from social norms regarding interpersonal engagement, their behavior is clinically categorized as **odd and eccentric**. **Analysis of Options:** * **Option A (Suspiciousness):** While also a Cluster A trait, pervasive suspiciousness and mistrust of others are specifically characteristic of **Paranoid Personality Disorder**, not Schizoid. * **Option B (Novelty seeking):** This is a temperamental trait often associated with **Cluster B** disorders, particularly Borderline or Histrionic Personality Disorders, where individuals seek stimulation. Schizoid individuals are typically characterized by low novelty seeking. * **Option C (Correct):** As a member of Cluster A (alongside Paranoid and Schizotypal), the defining descriptive umbrella for Schizoid PD is odd/eccentric behavior. * **Option D (Reward dependence):** Schizoid individuals typically show **low reward dependence**. They do not seek social approval or emotional closeness, which are the primary drivers in high reward-dependent individuals. **High-Yield Clinical Pearls for NEET-PG:** * **The "S" Rule:** **S**chizoid = **S**olitary/Seclusive (prefers being alone); **S**chizotypal = **S**trange (magical thinking/odd beliefs). * **Defense Mechanism:** The primary defense mechanism used by individuals with Schizoid PD is **Fantasy**. * **Differential:** Unlike Avoidant PD (who desire social contact but fear rejection), Schizoid individuals have **no desire** for social intimacy.

Q: Which is the treatment of choice for Obsessive-Compulsive Disorder (OCD)?

Exposure and response prevention. **Explanation:** **Obsessive-Compulsive Disorder (OCD)** is characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). The gold-standard psychological treatment is **Exposure and Response Prevention (ERP)**, a specific form of Cognitive Behavioral Therapy (CBT). 1. **Why Option A is correct:** ERP works on the principle of **habituation**. Patients are deliberately exposed to anxiety-provoking stimuli (Exposure) and instructed to refrain from performing the ritualistic behavior (Response Prevention). Over time, the patient learns that the anxiety dissipates naturally without the compulsion, breaking the negative reinforcement cycle. 2. **Why other options are incorrect:** * **Psychoanalysis (B):** Focuses on unconscious conflicts and childhood experiences; it has been found largely ineffective for the core symptoms of OCD. * **Flooding (C):** A form of behavior therapy involving prolonged, intense exposure to a feared stimulus to extinguish the fear response. While related to exposure, it is generally too distressing for OCD patients and lacks the specific "response prevention" component essential for OCD. * **Modeling (D):** Involves observing others interact with the feared object. While helpful in simple phobias, it is not the primary treatment for OCD. **High-Yield Clinical Pearls for NEET-PG:** * **First-line Pharmacotherapy:** Selective Serotonin Reuptake Inhibitors (SSRIs) are the drugs of choice (e.g., Fluoxetine, Fluvoxamine, Sertraline). Note that OCD requires **higher doses** and **longer duration** (10–12 weeks) for a response compared to depression. * **Most Effective Combination:** ERP + SSRIs. * **TCA of Choice:** Clomipramine (most serotonin-specific TCA) is highly effective but usually second-line due to its side-effect profile. * **Neurosurgery (Refractory cases):** Anterior Cingulotomy or Gamma Knife Capsulotomy.

Q: Which of the following personality disorders is characterized by a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation?

Avoidant personality disorder. ### Explanation **Correct Answer: A. Avoidant personality disorder** Avoidant Personality Disorder (APD) is a **Cluster C** ("Anxious/Fearful") disorder. The core psychopathology involves a pervasive pattern of **social inhibition**, intense **feelings of inadequacy**, and extreme **hypersensitivity to criticism** or rejection. Unlike schizoid individuals who prefer solitude, patients with APD actually desire social relationships but avoid them due to a paralyzing fear of being shamed, ridiculed, or rejected. **Analysis of Incorrect Options:** * **B. Histrionic personality disorder (Cluster B):** Characterized by excessive emotionality and **attention-seeking** behavior. These individuals are uncomfortable when they are not the center of attention, which is the opposite of the social withdrawal seen in APD. * **C. Paranoid personality disorder (Cluster A):** Defined by pervasive **distrust and suspiciousness** of others. While they may avoid others, it is due to the belief that others have malevolent motives, not due to feelings of personal inadequacy. * **D. Narcissistic personality disorder (Cluster B):** Characterized by **grandiosity**, a need for admiration, and a lack of empathy. While they are sensitive to "narcissistic injury" (criticism), their baseline is an inflated sense of self-importance, not inadequacy. **High-Yield Clinical Pearls for NEET-PG:** * **The "Social Desire" Rule:** Differentiate APD from Schizoid PD—Schizoid patients have **no desire** for relationships (loners by choice), whereas Avoidant patients **desire** relationships but are too afraid to pursue them (loners by fear). * **Defense Mechanism:** The primary defense mechanism used in APD is **Fantasy** (imagining idealized relationships to compensate for real-world isolation). * **Treatment:** Social skills training and Cognitive Behavioral Therapy (CBT) are first-line; Beta-blockers or SSRIs may be used to manage associated anxiety.

Question 1

Which of the following is a characteristic of Type A personality?

Accepted Answer

Competitive

Answer

Dependent

Answer

Suspicious

Answer

Odd and eccentric

Question 2

A 43-year-old principal of a medical college presents for psychiatric evaluation. He reports that throughout his life he has worked hard and lived a disciplined life. He always follows all the rules and does the 'right thing', however, no one really likes him. The principal appears to have which of the following personality traits?

Accepted Answer

Anankastic

Answer

Schizoid

Answer

Paranoid

Answer

Borderline

Question 3

Which of the following is NOT characteristic of a Type A personality?

Accepted Answer

Relaxed attitude

Answer

Hostility

Answer

Sense of time urgency

Answer

Competitiveness

Question 4

Which of the following is characteristic of a Type D personality disorder?

Accepted Answer

Self-pessimism

Answer

Odd and eccentric behavior

Answer

Reward dependence

Answer

Achievement-oriented

Question 5

A 28-year-old male presents with a history of vague pains and multiple surgical scars. He is persistently curious about his diagnosis, requesting various diagnostic procedures and a biopsy. He reports a past history of gallstone and appendicitis pain, but the history is vague and appears manipulative, with no supporting previous records. What is the probable diagnosis?

Accepted Answer

Factitious disorder

Answer

Hypochondriasis

Answer

Somatization disorder

Answer

Conversion disorder

Question 6

Which of the following is characteristic of schizoid personality disorder?

Accepted Answer

Odd and eccentric behavior

Answer

Suspiciousness

Answer

Novelty seeking

Answer

Reward dependence

Question 7

A 27-year-old female presents with social withdrawal and significant reluctance to socialize with colleagues. She has no friends and declined a date with a male colleague she liked, stating, "Nobody would like me, and I don't want to hurt myself." What is the most likely diagnosis?

Accepted Answer

Avoidant personality disorder

Answer

Histrionic personality disorder

Answer

Schizoid personality disorder

Answer

Anankastic personality disorder

Question 8

Which is the treatment of choice for Obsessive-Compulsive Disorder (OCD)?

Accepted Answer

Exposure and response prevention

Answer

Psychoanalysis

Answer

Flooding

Answer

Modeling

Question 9

Which of the following personality disorders is characterized by a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation?

Accepted Answer

Avoidant personality disorder

Answer

Histrionic personality disorder

Answer

Paranoid personality disorder

Answer

Narcissistic personality disorder

Question 10

Which of the following statements is false with respect to Borderline personality disorder?

Accepted Answer

Individuals remain in a stable relationship for a long time.

Answer

It is also called emotionally unstable personality disorder.

Answer

Parasuicide risk is high.

Answer

Suicide risk is high.

Personality Disorders — MCQs

Personality Disorders — MCQs

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