Personality Disorders Practice Questions

Q: Systematic desensitization is:

Graded exposure. **Explanation:** **Systematic Desensitization** is a type of behavior therapy based on the principle of **Classical Conditioning**, specifically **Reciprocal Inhibition** (developed by Joseph Wolpe). The core concept is that a person cannot be both anxious and relaxed at the same time. 1. **Why D is correct:** Systematic desensitization involves **Graded Exposure**. The process follows three steps: (1) Training in deep muscle relaxation (e.g., Jacobson’s Progressive Muscle Relaxation), (2) Construction of a hierarchy of anxiety-provoking stimuli, and (3) Gradual exposure to these stimuli (starting from the least frightening) while maintaining a relaxed state. This "step-by-step" approach makes it a graded technique. 2. **Why other options are incorrect:** * **Sudden Exposure (C):** This describes **Flooding** or **Implosion therapy**, where the patient is immediately exposed to the most feared stimulus at maximum intensity without a gradual buildup. * **Passive/Active Avoidance (A & B):** These are behavioral responses to anxiety, not therapeutic techniques. In fact, systematic desensitization aims to *eliminate* avoidance behaviors by encouraging controlled confrontation with the phobic stimulus. **High-Yield Clinical Pearls for NEET-PG:** * **Indications:** It is the treatment of choice for **Phobias** (Specific phobias, Agoraphobia) and certain cases of OCD. * **Reciprocal Inhibition:** The underlying mechanism where a relaxation response is used to inhibit the anxiety response. * **In-vivo vs. Imaginal:** Exposure can be done in real life (*in-vivo*) or through mental imagery (*imaginal*). * **Founder:** Joseph Wolpe is the key figure associated with this technique.

Q: All of the following are cluster B personality disorders except:

Paranoid. **Explanation:** Personality disorders in the DSM-5 are categorized into three clusters (A, B, and C) based on shared descriptive characteristics. **1. Why Paranoid is the correct answer:** **Paranoid Personality Disorder** belongs to **Cluster A**. Cluster A disorders are characterized by **odd or eccentric** behaviors. This cluster includes: * **Paranoid:** Pervasive distrust and suspiciousness. * **Schizoid:** Social isolation and detached emotional expression. * **Schizotypal:** Odd beliefs, magical thinking, and eccentric appearance. **2. Why the other options are incorrect:** Options A, B, and C all belong to **Cluster B**, which is characterized by **dramatic, emotional, or erratic** behaviors. * **Borderline (A):** Marked by instability in relationships, self-image, and affect, along with significant impulsivity. * **Histrionic (B):** Characterized by excessive emotionality and attention-seeking behavior. * **Narcissistic (C):** Defined by grandiosity, a need for admiration, and a lack of empathy. *(Note: Antisocial Personality Disorder is the fourth member of Cluster B).* **High-Yield Clinical Pearls for NEET-PG:** * **Cluster A (Odd/Eccentric):** "Weird" (Paranoid, Schizoid, Schizotypal). * **Cluster B (Dramatic/Erratic):** "Wild" (Antisocial, Borderline, Histrionic, Narcissistic). * **Cluster C (Anxious/Fearful):** "Worried" (Avoidant, Dependent, Obsessive-Compulsive). * **Defense Mechanisms:** Paranoid PD primarily uses **Projection** (attributing one's own unacceptable feelings to others). * **Genetic Link:** Cluster A disorders have a higher prevalence in biological relatives of patients with Schizophrenia.

Q: A child who is reluctant to go to the shop for sugar, spills half of it on the way. This is an example of:

Passive aggression. **Explanation:** The scenario described is a classic clinical presentation of **Passive-Aggressive behavior**. This defense mechanism involves the indirect expression of hostility through acts of omission, procrastination, stubbornness, or intentional inefficiency. **1. Why Passive Aggression is Correct:** In this case, the child is "reluctant" (underlying hostility/resistance) but cannot openly defy the authority figure. Instead of refusing directly (active aggression), the child complies but performs the task poorly by "spilling half of it." This allows the individual to express resentment while maintaining a facade of compliance. In psychiatry, this is often associated with **Passive-Aggressive Personality Disorder** (now categorized under "Other Specified Personality Disorders" in DSM-5, but still high-yield for exams). **2. Why Other Options are Incorrect:** * **Hysteria (Dissociative/Conversion Disorder):** This involves the unconscious conversion of psychological distress into physical symptoms (e.g., sudden blindness or paralysis) without a physiological cause. It does not involve intentional inefficiency. * **Disobedience:** This implies an overt, direct refusal to follow rules. The child in the question actually went to the shop, meaning they were "obedient" on the surface but sabotaged the result. * **Active Aggression:** This would involve direct confrontation, such as shouting, throwing the money away, or flatly refusing to go. **Clinical Pearls for NEET-PG:** * **Defense Mechanism:** Passive aggression is considered an **immature defense mechanism**. * **Key Features:** Look for keywords like *procrastination, "forgetfulness," stubbornness,* and *intentional inefficiency* in vignettes. * **Management:** In a clinical setting, the best approach is to encourage the patient to express their feelings directly and assertively rather than through indirect sabotage.

Q: Which of the following is the best predictor of attempting suicide in the future?

Prior suicide attempt. **Explanation:** The single best predictor of a future suicide attempt or completed suicide is a **prior history of suicide attempts**. Statistically, individuals who have attempted suicide once are at a significantly higher risk (up to 40–100 times higher than the general population) of trying again, especially within the first 6 to 12 months following the initial attempt. This is a critical high-yield fact for psychiatric risk assessment. **Analysis of Options:** * **Prior suicide attempt (Correct):** It is the most potent clinical indicator. While many factors contribute to risk, a past history demonstrates both the intent and the "acquired capability" to enact self-harm. * **Alcohol abuse (Incorrect):** Substance abuse is a major **risk factor** and often acts as a disinhibitor, but it is statistically secondary to a previous attempt in terms of predictive power. * **Unemployment & Divorce (Incorrect):** These are **psychosocial stressors** (sociodemographic factors). While they increase vulnerability and are common in suicidal patients, they are non-specific and less predictive than a patient’s own behavioral history. **High-Yield Clinical Pearls for NEET-PG:** * **Strongest Predictor:** Prior suicide attempt. * **Most Common Method (India):** Poisoning (pesticides) and Hanging. * **Gender Paradox:** Females attempt suicide more frequently, but males complete suicide more often (due to the use of more lethal methods). * **Protective Factor:** Strong social support and family ties (especially having young children) are the strongest protective factors. * **Highest Risk Comorbidity:** Depression (most common), followed by Bipolar Disorder and Schizophrenia.

Q: What is the cardinal feature of antisocial personality disorder?

Violation of rules of society. **Explanation:** **Antisocial Personality Disorder (ASPD)** is a Cluster B personality disorder characterized by a pervasive pattern of disregard for, and violation of, the rights of others. 1. **Why Option A is correct:** The cardinal feature of ASPD is a chronic failure to conform to social norms and legal codes. Individuals with ASPD lack a "moral compass" or conscience, leading to repeated acts that are grounds for arrest, deceitfulness (repeated lying/conning), impulsivity, and a profound **lack of remorse** for their actions. 2. **Why the other options are incorrect:** * **Option B (Attention-seeking behavior):** This is the hallmark of **Histrionic Personality Disorder**. These individuals feel uncomfortable when they are not the center of attention and often use physical appearance or provocative behavior to draw focus. * **Option C (Unstable interpersonal relationships):** This is the defining feature of **Borderline Personality Disorder (BPD)**. BPD is characterized by a "stable instability" in relationships, self-image, and affect, often involving frantic efforts to avoid abandonment. * **Option D (Grandiose behavior):** This is characteristic of **Narcissistic Personality Disorder**. While both ASPD and Narcissism involve a lack of empathy, Narcissists primarily seek admiration and feel entitled, whereas those with ASPD are more focused on exploitation and rule-breaking. **High-Yield Clinical Pearls for NEET-PG:** * **Age Criteria:** A diagnosis of ASPD cannot be made before age **18**. * **Precursor:** There must be evidence of **Conduct Disorder** with onset before age 15. * **Gender:** It is significantly more common in **males**. * **Key Association:** High correlation with substance abuse and "psychopathy" (though psychopathy is a more severe subset).

Q: A characteristic feature of schizoid personality is:

Emotional coldness. **Explanation:** **Schizoid Personality Disorder (SPD)** is characterized by a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings. **Why "Emotional Coldness" is Correct:** The hallmark of SPD is **emotional coldness, detachment, or flattened affectivity**. These individuals are often described as "loners" who neither desire nor enjoy close relationships, including being part of a family. They show little interest in sexual experiences, take pleasure in few (if any) activities, and appear indifferent to the praise or criticism of others. This lack of emotional reactivity is the core diagnostic feature. **Analysis of Incorrect Options:** * **A. Conversion reaction:** This is a feature of **Dissociative (Conversion) Disorder**, where psychological stress manifests as physical neurological symptoms. It is not a personality trait. * **B. Not concerned with disease:** This is often referred to as *la belle indifférence*, classically associated with **Conversion Disorder**, not schizoid personality. * **C. Checks details of all things:** This is a characteristic of **Obsessive-Compulsive Personality Disorder (OCPD)**, where there is a preoccupation with orderliness, perfectionism, and mental/interpersonal control. **High-Yield Clinical Pearls for NEET-PG:** * **The "S" Rule:** Distinguish between **Schizoid** (Socially distant/Solitary) and **Schizotypal** (Socially awkward + Strange/Magical thinking). * **Defense Mechanism:** The primary defense mechanism used in Schizoid Personality Disorder is **Fantasy**. * **Differential:** Unlike Avoidant Personality Disorder (who desire social contact but fear rejection), Schizoid individuals have **no desire** for social interaction. * **ICD-10/DSM-5 Criteria:** Look for keywords like "Anhedonia," "Introspection," and "Indifference to social norms."

Q: Which of the following is a Cluster C personality disorder?

Obsessive compulsive. **Explanation:** Personality disorders are categorized into three clusters (A, B, and C) based on shared descriptive characteristics. **Cluster C** is known as the **"Anxious or Fearful"** cluster. It includes: 1. **Obsessive-Compulsive Personality Disorder (OCPD):** Characterized by a pervasive pattern of preoccupation with orderliness, perfectionism, and control. 2. **Avoidant Personality Disorder:** Characterized by social inhibition and feelings of inadequacy. 3. **Dependent Personality Disorder:** Characterized by an excessive need to be taken care of. **Analysis of Options:** * **Option A (Correct):** OCPD is a classic Cluster C disorder. Unlike OCD (an anxiety disorder), OCPD is **ego-syntonic** (the individual believes their way is correct and feels no distress about their traits). * **Option B (Incorrect):** **Paranoid** personality disorder belongs to **Cluster A** (the "Odd or Eccentric" cluster), along with Schizoid and Schizotypal disorders. * **Option C (Incorrect):** **Schizoid** personality disorder belongs to **Cluster A**. It is characterized by social detachment and a restricted range of emotional expression. * **Option D (Incorrect):** **Borderline** personality disorder belongs to **Cluster B** (the "Dramatic, Emotional, or Erratic" cluster), along with Antisocial, Histrionic, and Narcissistic disorders. **High-Yield Clinical Pearls for NEET-PG:** * **Mnemonic for Clusters:** * **A:** Weird (Odd/Eccentric) * **B:** Wild (Dramatic/Erratic) * **C:** Worried (Anxious/Fearful) * **OCPD vs. OCD:** OCPD is about a lifestyle of perfectionism (ego-syntonic), while OCD involves specific intrusive thoughts and rituals (ego-dystonic). * **Most Common Personality Disorder:** Generally cited as Obsessive-Compulsive Personality Disorder in the general population.

Question 1

Systematic desensitization is:

Accepted Answer

Graded exposure

Answer

Passive avoidance

Answer

Active avoidance

Answer

Sudden exposure

Question 2

A 20-year-old female presents with a history of frequent breakups, past suicide attempts, and mood swings. What is the most likely diagnosis?

Accepted Answer

Borderline personality disorder

Answer

Histrionic personality disorder

Answer

Antisocial personality disorder

Answer

Dependent personality disorder

Question 3

All of the following are cluster B personality disorders except:

Accepted Answer

Paranoid

Answer

Borderline

Answer

Histrionic

Answer

Narcissistic

Question 4

A child who is reluctant to go to the shop for sugar, spills half of it on the way. This is an example of:

Accepted Answer

Passive aggression

Answer

Hysteria

Answer

Disobedience

Answer

Active aggression

Question 5

Which of the following is the best predictor of attempting suicide in the future?

Accepted Answer

Prior suicide attempt

Answer

Alcohol abuse

Answer

Unemployment

Answer

Divorce

Question 6

A young lady was admitted after an overdose of diazepam following a broken affair. She has a history of slitting her wrist previously. What is the most likely diagnosis?

Accepted Answer

Borderline Personality Disorder

Answer

Narcissistic Personality Disorder

Answer

Dependent Personality Disorder

Answer

Histrionic Personality Disorder

Question 7

What is the cardinal feature of antisocial personality disorder?

Accepted Answer

Violation of rules of society

Answer

Attention-seeking behavior

Answer

Unstable interpersonal relationships

Answer

Grandiose behavior

Question 8

A characteristic feature of schizoid personality is:

Accepted Answer

Emotional coldness

Answer

Conversion reaction

Answer

Not concerned with disease

Answer

Checks details of all things

Question 9

Type D personality has been found to be a risk factor for which of the following conditions?

Accepted Answer

Coronary artery disease

Answer

Depression

Answer

Personality disorder

Answer

Schizophrenia

Question 10

Which of the following is a Cluster C personality disorder?

Accepted Answer

Obsessive compulsive

Answer

Paranoid

Answer

Schizoid

Answer

Borderline

Personality Disorders — MCQs

Personality Disorders — MCQs

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