1- Personality Disorders - Psychiatric Mental Health for Nursing Students (Level Up RN‬)

Source: https://www.youtube.com/watch?v=s-Du4_yVkiY&rco=1

Correct Answer: B. Schizotypal personality disorder involves brief, less intense psychotic-like symptoms

Explanation:
Schizotypal personality disorder may include perceptual distortions and brief psychotic-like episodes, but these are less intense and less frequent than in schizophrenia. Persistent hallucinations and full psychosis are characteristic of schizophrenia, not schizotypal PD.

Which statement best differentiates schizotypal personality disorder from schizophrenia?

A. Schizotypal personality disorder includes persistent auditory hallucinations
B. Schizotypal personality disorder involves brief, less intense psychotic-like symptoms
C. Schizophrenia does not include bizarre behavior
D. Schizophrenia is characterized by magical thinking only

Correct Answer: C. Schizotypal personality disorder

Explanation:
Schizotypal personality disorder is associated with perceptual distortions or illusions, not true hallucinations. This distinction helps differentiate it from schizophrenia.

A nurse documents that a patient reports seeing shadows or misinterpreting sounds but does not experience true hallucinations. Which personality disorder is most consistent with this finding?

A. Schizoid personality disorder
B. Paranoid personality disorder
C. Schizotypal personality disorder
D. Borderline personality disorder

Correct Answer: C. Behaviors are ego-syntonic and viewed as correct by the patient

Explanation:
In OCPD, behaviors such as perfectionism and rigidity are ego-syntonic, meaning the individual believes they are appropriate. This contrasts with OCD, where thoughts and behaviors are ego-dystonic and distressing.

Which statement about obsessive-compulsive personality disorder (OCPD) is most accurate?

A. Patients recognize their behaviors as unwanted and distressing
B. Anxiety is relieved by performing compulsive rituals
C. Behaviors are ego-syntonic and viewed as correct by the patient
D. Intrusive thoughts are the primary symptom

Correct Answer: C. Disregard for the rights of others

Explanation:
The hallmark of antisocial personality disorder is a persistent disregard for and violation of the rights of others, often including deceitfulness, manipulation, and lack of remorse.

Which feature is more characteristic of antisocial personality disorder than of other Cluster B disorders?

A. Fear of abandonment
B. Grandiose self-image
C. Disregard for the rights of others
D. Emotional exaggeration

Correct Answer: C. Aggression may be present but is not required

Explanation:
While aggression may occur, antisocial personality disorder is defined by manipulation, deceitfulness, and violation of social norms, not aggression alone.

A nursing student states, “All patients with antisocial personality disorder are physically aggressive.” Which response is most accurate?

A. The statement is correct
B. Aggression is required for diagnosis
C. Aggression may be present but is not required
D. Aggression only occurs in childhood

Correct Answer: A. Obsessive-compulsive personality disorder

Explanation:
Individuals with OCPD are rigid, rule-bound, and perfectionistic. They believe their behavior is correct (ego-syntonic), which often leads to relationship difficulties.

Which personality disorder is most strongly associated with ego-syntonic perfectionism that interferes with relationships?

A. Obsessive-compulsive personality disorder
B. Avoidant personality disorder
C. Dependent personality disorder
D. Narcissistic personality disorder

Correct Answer: C. Black-and-white thinking about relationships

Explanation:
Splitting (viewing others as all good or all bad) is a key defense mechanism seen in borderline personality disorder and helps differentiate it from other Cluster B disorders.

Which assessment finding best supports a diagnosis of borderline personality disorder rather than another Cluster B disorder?

A. Grandiose sense of self-importance
B. Manipulation without remorse
C. Black-and-white thinking about relationships
D. Excessive emotional expression to gain attention

Correct Answer: B. Avoidant personality disorder

Explanation:
Avoidant personality disorder is characterized by low self-esteem and avoidance of relationships due to fear of rejection, not lack of desire for connection.

Which personality disorder is most likely to involve fear of rejection despite a desire for relationships?

A. Schizoid personality disorder
B. Avoidant personality disorder
C. Paranoid personality disorder
D. Dependent personality disorder

Correct Answer: B. Suspiciousness without loss of reality testing

Explanation:
Paranoid personality disorder involves chronic distrust and suspicion, but the individual maintains reality testing. Fixed delusions and hallucinations indicate a psychotic disorder.

Which finding best differentiates paranoid personality disorder from a psychotic disorder?

A. Persistent fixed delusions
B. Suspiciousness without loss of reality testing
C. Auditory hallucinations
D. Disorganized speech

Correct Answer: C. Schizoid personality disorder

Explanation:
Schizoid personality disorder is characterized by emotional detachment and lack of desire for social relationships, not fear of rejection.

A patient states, “I don’t feel lonely. I just don’t need close relationships.” Which personality disorder is most consistent with this statement?

A. Avoidant personality disorder
B. Dependent personality disorder
C. Schizoid personality disorder
D. Schizotypal personality disorder

Correct Answer: C. Desire for relationships with fear of rejection

Explanation:
Avoidant personality disorder involves a strong desire for relationships, but fear of rejection prevents engagement. Schizoid individuals lack this desire.

Which feature is most characteristic of avoidant personality disorder rather than schizoid personality disorder?

A. Preference for solitude
B. Flat affect
C. Desire for relationships with fear of rejection
D. Emotional detachment

Correct Answer: C. Rage or shame

Explanation:
Although narcissistic individuals appear confident, they often have fragile self-esteem and respond to criticism with rage, shame, or humiliation.

Which response is most typical of an individual with narcissistic personality disorder when faced with criticism?

A. Indifference
B. Withdrawal due to fear of rejection
C. Rage or shame
D. Increased dependency

Correct Answer: C. Dependent personality disorder

Explanation:
Dependent personality disorder is marked by fear of separation and inability to function independently, leading individuals to tolerate poor treatment to maintain relationships.

A patient remains in unhealthy relationships and becomes distressed when alone, even when support is available. Which personality disorder is most likely?

A. Avoidant personality disorder
B. Borderline personality disorder
C. Dependent personality disorder
D. Histrionic personality disorder

Correct Answer: C. Fear-driven avoidance and dependence

Explanation:
Cluster C personality disorders are characterized by anxiety and fear, including avoidance, dependence, and rigidity.

Which behavior pattern best represents a Cluster C personality disorder?

A. Emotional manipulation and impulsivity
B. Bizarre beliefs and eccentric behavior
C. Fear-driven avoidance and dependence
D. Grandiosity and lack of empathy

• Cluster A (odd/eccentric): Paranoid, Schizoid, Schizotypal → correctly described

• Cluster B (dramatic/impulsive): Antisocial, Borderline, Histrionic, Narcissistic → correct

• Cluster C (anxious/fearful): Avoidant, Dependent, Obsessive-Compulsive → correct

Personality Disorder Clusters:

• Paranoid PD: distrustful, suspicious ✔

• Schizoid PD: blunt/flat affect, reclusive, difficulty forming relationships ✔

• Schizotypal PD: bizarre speech/behavior, magical thinking, perceptual disturbances ✔

  • Correctly distinguished from schizophrenia as less intense and less frequent psychotic episodes

Personality Disorder - Cluster A:

• Antisocial PD: violates social norms, aggression, manipulation, recklessness, history of violence/animal cruelty ✔

• Borderline PD:

  • Intense mood swings ✔

  • Splitting defense mechanism ✔

  • Unstable relationships ✔

  • Increased risk of self-harm and suicide ✔

• Histrionic PD: center of attention, seductive, exaggerated emotions ✔

• Narcissistic PD: grandiosity, entitlement, lack of empathy, exploiting others ✔

Personality Disorder - Cluster B:

• Avoidant PD: low self-esteem, avoids relationships due to fear of rejection ✔

• Dependent PD: excessive reliance on others for decisions, needs, self-worth; people-pleasing ✔

• Obsessive-Compulsive PD (OCPD): inflexible, perfectionistic, rule-oriented, difficulty with relationships ✔

Personality Disorder - Cluster C: