q25 - raji_321

[ArchivalUser]

A 24-year-old female is brought to the emergency room after threatening to kill herself by cutting her wrists. She has multiple scars on her wrists, which she admits were caused by prior suicide attempts. She states she is very angry at her boyfriend, who left her for another woman. She previously thought her boyfriend was an angel and now she thinks he is a monster. She feels very empty inside. While smiling, she states that she is depressed. During the interview, she drops
to the ground, but continues to talk while lying on the floor. She believes nobody understands her. What is her underlying personality disorder?
A. Antisocial
B. Borderline
C. Histrionic
D. Narcissistic
E. Schizoid

[ArchivalUser]

B?

[ArchivalUser]

The correct answer is B. Characteristics of borderline personality disorder include frantic behavior to avoid abandonment, unstable interpersonal relationships, alternating between idealization and devaluation (splitting), recurrent suicidal gestures or other types of self-mutilatory behavior, feelings of emptiness, and inappropriate intense anger.
An antisocial patient (choice A) does not confirm to social norms, is deceitful, impulsive, reckless, irresponsible, and lacks remorse for wrongdoings.

One symptom that would suggest histrionic personality disorder (choice C) in this patient is her theatrical exaggeration of her emotions by talking while lying on the floor. A histrionic patient might present with attention-seeking and/or seductive and provocative behavior, but the presence of splitting, recurrent suicidal gestures and anger argue strongly for the diagnosis of borderline personality disorder.