4- Personality Disorders : Everything you need to know - Psychiatry | 𝐃𝐮𝐚𝐥 𝐑𝐨𝐥𝐞

Source: https://www.youtube.com/watch?v=Q0pc9ZaVG2g

Correct Answer: C. A distinctive pattern of thoughts, emotions, and behaviors shaping interaction with the environment

Explanation:
Personality refers to enduring patterns of thinking, feeling, and behaving that characterize an individual’s interaction with their environment. It is relatively stable but not fixed, and influenced by both genetics and environment.

Personality is BEST defined as:

A. A fixed set of behaviors present from birth
B. Temporary emotional reactions to stress
C. A distinctive pattern of thoughts, emotions, and behaviors shaping interaction with the environment
D. A genetic condition causing maladaptive behavior

Correct Answer: C. Inflexible and maladaptive personality traits causing impairment or distress

Explanation:
Personality disorders involve enduring, inflexible patterns that deviate from cultural expectations and cause social or occupational impairment. They are often ego-syntonic, and do not reliably resolve by age 40 (correction).

Which of the following correctly describes a personality disorder?

A. Acute onset with fluctuating symptoms
B. Ego-dystonic symptoms with insight
C. Inflexible and maladaptive personality traits causing impairment or distress
D. Symptoms that resolve spontaneously by age 40

Correct Answer: C. Consistent with the individual’s self-image

Explanation:
Ego-syntonic symptoms feel acceptable or normal to the individual, which explains why patients with personality disorders often do not seek treatment voluntarily.

Ego-syntonic symptoms are BEST described as:

A. Experienced as distressing and unwanted
B. Recognized as abnormal by the individual
C. Consistent with the individual’s self-image
D. Always associated with anxiety disorders

Correct Answer: A. Cluster A

Explanation:
Cluster A includes Paranoid, Schizoid, and Schizotypal Personality Disorders, characterized by odd, eccentric, and socially withdrawn behavior, and conceptualized as part of the schizophrenia spectrum.

Which personality disorder cluster is MOST associated with odd or eccentric behavior?

A. Cluster A
B. Cluster B
C. Cluster C
D. Neurotic disorders

Correct Answer: B. It includes magical thinking and unusual perceptual experiences

Explanation:
Schizotypal Personality Disorder involves magical thinking, odd beliefs, perceptual distortions, and eccentric behavior.
❌ It is NOT reclassified as schizophrenia in ICD-11 (important correction).

Which statement about Schizotypal Personality Disorder is CORRECT?

A. It is reclassified as schizophrenia in ICD-11
B. It includes magical thinking and unusual perceptual experiences
C. It always progresses to schizophrenia
D. It is characterized by emotional coldness without cognitive distortions

Correct Answer: C. Psychotherapy

Explanation:
Psychotherapy is the cornerstone of treatment for all personality disorders. Medications are adjunctive only and used for comorbid symptoms (correction).

Which treatment is considered FIRST-LINE for most personality disorders?

A. Antipsychotics
B. Benzodiazepines
C. Psychotherapy
D. Mood stabilizers

Correct Answer: C. Histrionic Personality Disorder

Explanation:
Histrionic Personality Disorder is characterized by dramatic behavior, emotional exaggeration, attention-seeking, and shallow affect.

A patient who exaggerates emotions, seeks attention, and uses physical appearance to draw attention MOST likely has:

A. Narcissistic Personality Disorder
B. Borderline Personality Disorder
C. Histrionic Personality Disorder
D. Dependent Personality Disorder

Correct Answer: C. Grandiosity with fragile self-esteem

Explanation:
Narcissistic Personality Disorder involves grandiosity, need for admiration, lack of empathy, and hypersensitivity to criticism due to fragile self-esteem.

Which feature BEST distinguishes Narcissistic Personality Disorder?

A. Fear of abandonment
B. Impulsivity and self-harm
C. Grandiosity with fragile self-esteem
D. Emotional detachment

Correct Answer: C. Dialectical Behavior Therapy

Explanation:
Dialectical Behavior Therapy (DBT) is the gold-standard treatment for Borderline Personality Disorder, targeting emotional dysregulation, self-harm, and interpersonal instability.

The MOST evidence-based psychotherapy for Borderline Personality Disorder is:

A. Psychoanalysis
B. Cognitive Processing Therapy
C. Dialectical Behavior Therapy
D. Exposure Therapy

Correct Answer: C. Splitting

Explanation:
Splitting involves viewing people as all good or all bad, leading to unstable relationships.

Which defense mechanism is MOST characteristic of Borderline Personality Disorder?

A. Projection
B. Repression
C. Splitting
D. Sublimation

Correct Answer: C. It is associated with conduct disorder in childhood

Explanation:
Antisocial Personality Disorder is associated with conduct disorder before age 15.
Psychopathy and sociopathy are related but not identical, and medications have limited benefit (correction).

Which statement about Antisocial Personality Disorder is CORRECT?

A. It is identical to psychopathy
B. It always includes psychotic symptoms
C. It is associated with conduct disorder in childhood
D. It responds well to pharmacotherapy

Correct Answer: B. Avoidant Personality Disorder

Explanation:
Avoidant Personality Disorder involves hypersensitivity to rejection, social inhibition, and feelings of inadequacy.

A person who avoids social interaction due to fear of criticism and feelings of inferiority MOST likely has:

A. Schizoid Personality Disorder
B. Avoidant Personality Disorder
C. Dependent Personality Disorder
D. Social Anxiety Disorder

Correct Answer: C. Psychotherapy

Explanation:
Psychotherapy is primary. Benzodiazepines are generally avoided due to risk of dependence (correction).

Which is the PRIMARY treatment for Dependent Personality Disorder?

A. Benzodiazepines
B. Antidepressants
C. Psychotherapy
D. Beta blockers

Correct Answer: C. OCPD traits are experienced as acceptable

Explanation:
OCPD is ego-syntonic, while OCD is ego-dystonic. They are distinct disorders with different treatment approaches (important clarification).

Which statement BEST differentiates Obsessive-Compulsive Personality Disorder (OCPD) from OCD?

A. OCPD is ego-dystonic
B. OCD is ego-syntonic
C. OCPD traits are experienced as acceptable
D. Both are treated identically

Correct Answer: C. Obsessive-Compulsive Personality Disorder

Explanation:
OCPD involves preoccupation with orderliness, control, perfectionism, and rigidity, often at the expense of flexibility and leisure.

Which Cluster C personality disorder is characterized by perfectionism and rigidity?

A. Avoidant
B. Dependent
C. Obsessive-Compulsive Personality Disorder
D. Paranoid

Correct Answer: C. Extreme, maladaptive variants of normal personality traits

Explanation:
Personality disorders are dimensional, arising from exaggerated or rigid forms of normal personality traits, not separate from normal personality (important conceptual clarification).

Personality disorders are BEST conceptualized as:

A. Discrete disease entities unrelated to normal personality
B. Acute psychiatric illnesses with episodic course
C. Extreme, maladaptive variants of normal personality traits
D. Neurodegenerative disorders

Correct Answer: C. 10–20%

Explanation:
Epidemiological studies estimate prevalence up to 10–20%, making personality disorders relatively common (previously stated but not tested).

The estimated prevalence of personality disorders in the general population is approximately:

A. 1–2%
B. 5%
C. 10–20%
D. >30%

Correct Answer: C. Core traits persist, but behavioral expression may soften

Explanation:
Personality disorders do not “cure”, but impulsivity, aggression, or emotional intensity may decrease with age (correction to the “resolution by 40” claim).

Which statement BEST describes the course of personality disorders across the lifespan?

A. They resolve completely by age 40
B. They worsen progressively with age
C. Core traits persist, but behavioral expression may soften
D. They convert into mood disorders

Correct Answer: C. Ego-syntonic nature of traits

Explanation:
Traits are ego-syntonic, meaning individuals experience them as normal or justified, leading to low help-seeking behavior.

Poor insight in personality disorders is PRIMARILY due to:

A. Cognitive impairment
B. Ego-dystonic symptom experience
C. Ego-syntonic nature of traits
D. Presence of psychosis

Correct Answer: C. Interpersonal and/or occupational dysfunction

Explanation:
Diagnosis requires clinically significant impairment or distress, especially in interpersonal functioning.

Which feature is REQUIRED for diagnosing a personality disorder?

A. Presence of anxiety symptoms
B. Childhood trauma
C. Interpersonal and/or occupational dysfunction
D. Psychotic symptoms

Correct Answer: C. Pervasive pattern affecting self-concept and relationships

Explanation:
Avoidant Personality Disorder is pervasive and trait-based, affecting identity and relationships, whereas social anxiety disorder is situational and symptom-based.

Which feature BEST distinguishes Avoidant Personality Disorder from Social Anxiety Disorder?

A. Fear of criticism
B. Avoidance of social situations
C. Pervasive pattern affecting self-concept and relationships
D. Physiological anxiety symptoms

Correct Answer: C. Mood disorders

Explanation:
Cluster B disorders (especially Borderline) show affective instability, which may mimic mood disorders but lacks clear episodicity.

Patients with Cluster B personality disorders are MOST likely to be misdiagnosed as having:

A. Schizophrenia
B. Anxiety disorders
C. Mood disorders
D. Neurocognitive disorders

Correct Answer: C. Symptom-targeted adjunctive treatment

Explanation:
Medications do not treat personality pathology itself, but are used to manage specific symptoms (e.g., mood instability, anxiety, impulsivity).

The role of pharmacotherapy in personality disorders is BEST described as:

A. Curative treatment
B. First-line monotherapy
C. Symptom-targeted adjunctive treatment
D. Ineffective and contraindicated

Correct Answer: C. History of conduct disorder before age 15

Explanation:
A history of conduct disorder before age 15 is a diagnostic requirement, not just adult antisocial behavior.

Which factor MOST strongly supports the diagnosis of Antisocial Personality Disorder?

A. Adult criminal behavior alone
B. Substance use disorder
C. History of conduct disorder before age 15
D. Lack of empathy in adulthood

Correct Answer: C. Help is often sought due to comorbid conditions

Explanation:
Patients often seek help for depression, anxiety, or interpersonal crises, not for the personality disorder itself.

Which of the following is TRUE regarding personality disorders and treatment engagement?

A. Most patients actively seek psychiatric help
B. Treatment is usually court-mandated
C. Help is often sought due to comorbid conditions
D. Insight improves rapidly with medication