5- Cluster C (Dependent, Obsessive-Compulsive, and Avoidant) Personality Disorders

Source: https://www.youtube.com/watch?v=OpXLUTp2PwA

Correct answer: C. Disorders associated with anxiety, fearfulness, and behavioral inhibition

Explanation:
Cluster C personality disorders (Dependent, Obsessive-Compulsive, Avoidant) are often called the “anxious” or “worried” cluster, characterized by fearfulness and anxiety. Cluster A resembles psychosis, and Cluster B resembles mood and impulse dysregulation.

Which of the following best describes Cluster C personality disorders?

A. Disorders characterized primarily by psychotic symptoms
B. Disorders marked by emotional instability and impulsivity
C. Disorders associated with anxiety, fearfulness, and behavioral inhibition
D. Disorders defined by detachment and eccentric behavior

Correct answer: C. They share a common theme of anxiety and fearfulness

Explanation:
Cluster C disorders are grouped due to shared anxious and fearful themes, not because they have identical causes or treatments. Their similarities are meaningful but not based on a single shared pathology.

Which statement best explains why Cluster C disorders are grouped together?

A. They share identical biological mechanisms
B. They respond to the same medications
C. They share a common theme of anxiety and fearfulness
D. They have the same prognosis and treatment outcomes

Correct answer: B. Dependent personality disorder

Explanation:
Dependent personality disorder is characterized by excessive reliance on others, fear of being alone, submissiveness, and desperate efforts to maintain relationships.

A patient who relies excessively on others for decision-making, fears abandonment, and urgently seeks new relationships after breakups most likely has:

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

Correct answer: C. Extremely high agreeableness

Explanation:
Dependent PD is best understood as pathologically high agreeableness, where cooperation becomes subservience, trust becomes gullibility, and conflict avoidance becomes maladaptive.

In the OCEAN personality trait model, Dependent Personality Disorder most strongly maps onto which trait?

A. High neuroticism
B. Low openness
C. Extremely high agreeableness
D. Low conscientiousness

Correct answer: C. “I am ineffective and cannot function on my own”

Explanation:
A core feature of Dependent PD is the belief that one is incapable of independent functioning, which drives reliance on others and reassurance-seeking behavior.

Which of the following cognitive patterns is MOST characteristic of Dependent Personality Disorder?

A. “Others are untrustworthy”
B. “Rules must always be followed exactly”
C. “I am ineffective and cannot function on my own”
D. “People are out to harm me”

Correct answer: C. Rigidity that becomes maladaptive

Explanation:
OCPD is defined by rigid, inflexible perfectionism that interferes with task completion, delegation, and relationships, making it maladaptive rather than merely meticulous.

Which feature best distinguishes Obsessive-Compulsive Personality Disorder (OCPD) from normal perfectionism?

A. Anxiety about making mistakes
B. Desire for order and organization
C. Rigidity that becomes maladaptive
D. Attention to detail

Correct answer: D. OCPD traits are ego-syntonic

Explanation:
OCPD traits are ego-syntonic, meaning individuals believe their behavior is correct. OCD symptoms are ego-dystonic and distressing to the individual.

Which statement about OCPD vs OCD is correct?

A. OCPD involves intrusive obsessions and compulsions
B. OCPD symptoms are ego-dystonic
C. OCD and OCPD are variants of the same disorder
D. OCPD traits are ego-syntonic

Correct answer: B. Extreme high conscientiousness with low openness

Explanation:
OCPD reflects excessive conscientiousness combined with low openness, explaining rigidity, rule-bound behavior, and resistance to flexibility.

Obsessive-Compulsive Personality Disorder is best conceptualized in the OCEAN model as:

A. High neuroticism and low agreeableness
B. Extreme high conscientiousness with low openness
C. Low extraversion and high neuroticism
D. Extreme agreeableness and dependence

Correct answer: C. Ego-syntonic nature of symptoms

Explanation:
Because OCPD traits feel correct and justified, patients often do not see a need for treatment, reducing help-seeking behavior.

Which factor most commonly limits treatment engagement in patients with OCPD?

A. Severe cognitive impairment
B. Psychotic symptoms
C. Ego-syntonic nature of symptoms
D. Lack of effective treatments

Correct answer: C. Desire for interpersonal relationships

Explanation:
Individuals with AvPD desire relationships but avoid them due to fear of rejection. Schizoid PD involves genuine indifference to social relationships.

Which feature distinguishes Avoidant Personality Disorder (AvPD) from Schizoid Personality Disorder?

A. Avoidance of social situations
B. Emotional detachment
C. Desire for interpersonal relationships
D. Fear of criticism

Correct answer: B. They share symptoms, genetics, and treatment response

Explanation:
AvPD and SAD have substantial overlap, including symptoms, genetic risk, and response to SSRIs and CBT. However, they are still distinct diagnoses in DSM-5.

Which statement best reflects the relationship between Avoidant Personality Disorder and Social Anxiety Disorder (SAD)?

A. They are completely unrelated disorders
B. They share symptoms, genetics, and treatment response
C. AvPD has no effective treatment
D. SAD always progresses into AvPD

Correct answer: D. It is not truly a personality disorder

Explanation:
The idea that AvPD is merely a severe form of social anxiety is a debated viewpoint, not accepted as DSM consensus.

Which claim about Avoidant Personality Disorder is controversial rather than established consensus?

A. It involves fear of rejection
B. It overlaps significantly with social anxiety disorder
C. It responds to CBT and SSRIs
D. It is not truly a personality disorder

Correct answer: C. High neuroticism and low extraversion

Explanation:
Research shows AvPD is associated with high neuroticism and low extraversion, even though it does not map as cleanly as other PDs.

Contrary to some claims, Avoidant Personality Disorder most commonly correlates with which OCEAN traits?

A. High agreeableness and high conscientiousness
B. Low neuroticism and high extraversion
C. High neuroticism and low extraversion
D. Low openness and high conscientiousness

Correct answer: C. Traits help deepen understanding beyond categorical labels

Explanation:
While DSM categories have limitations, trait-based models (like OCEAN) provide valuable insight into patient behavior, functioning, and treatment planning.

Which statement best summarizes the clinical utility of personality traits in diagnosis?

A. Personality traits replace DSM diagnoses
B. Personality traits are irrelevant to diagnosis
C. Traits help deepen understanding beyond categorical labels
D. Traits only apply to Cluster B disorders

Correct answer: C. Sometimes come to clinical attention due to distress

Explanation:
Cluster C disorders cause significant subjective distress, leading them to sometimes present clinically—more often than Cluster A, but generally less dramatically than Cluster B.

Compared with Cluster A and Cluster B personality disorders, Cluster C disorders most commonly:

A. Never come to clinical attention
B. Always require inpatient treatment
C. Sometimes come to clinical attention due to distress
D. Present primarily during psychotic episodes

Correct answer: C. Desperate efforts to establish a new relationship

Explanation:
Individuals with Dependent PD experience intense fear of being alone and may urgently seek new relationships to avoid perceived helplessness.

Which behavior is MOST characteristic of Dependent Personality Disorder following the end of a close relationship?

A. Emotional detachment
B. Immediate withdrawal from social contact
C. Desperate efforts to establish a new relationship
D. Increased rule-following behavior

Correct answer: C. Inflexible conscientiousness

Explanation:
OCPD involves rigid adherence to rules and procedures, often without evaluating whether the underlying goal still makes sense.

A patient who rigidly follows a checklist despite evidence that the task itself is unnecessary is demonstrating which core feature of OCPD?

A. Obsessive rumination
B. Ego-dystonic anxiety
C. Inflexible conscientiousness
D. Impulsivity

Correct answer: C. Overvaluation of order and correctness

Explanation:
In OCPD, difficulty discarding items stems from rigidity and perfectionism, not obsessions (OCD) or emotional attachment (hoarding disorder).

Difficulty discarding worn-out or worthless objects in OCPD is best explained by:

A. Psychotic beliefs about objects
B. Obsessions and compulsions
C. Overvaluation of order and correctness
D. Emotional attachment to possessions

Correct answer: C. Reluctance to spend money on oneself or others

Explanation:
OCPD often includes miserliness, driven by an excessive need for control and fear of waste.

Which financial behavior is MOST characteristic of Obsessive-Compulsive Personality Disorder?

A. Impulsive spending
B. Excessive charitable donations
C. Reluctance to spend money on oneself or others
D. Financial irresponsibility

Correct answer: C. Avoidance due to fear of embarrassment

Explanation:
Avoidant PD involves active avoidance driven by fear of criticism or embarrassment, not indifference to relationships (as in schizoid PD).

Which feature is MOST likely to be seen in Avoidant Personality Disorder but NOT explained solely by lack of interest in relationships?

A. Emotional coldness
B. Risk-taking behavior
C. Avoidance due to fear of embarrassment
D. Preference for solitary activities

Correct answer: B. Inhibited and restrained behavior

Explanation:
AvPD is characterized by behavioral inhibition, social reticence, and withdrawal due to fear of rejection.

In interpersonal situations, individuals with Avoidant Personality Disorder are most likely to display:

A. Dominant and controlling behavior
B. Inhibited and restrained behavior
C. Rapid emotional shifts
D. Disorganized speech