A 25-year-old woman has a history of intense unstable relationships, recurrent self-cutting when feeling abandoned, marked identity disturbance, chronic emptiness, and impulsive spending and bingeing. She has had three brief episodes of transient paranoid ideation during stressful periods. Which personality disorder is most consistent with this presentation?

• A Histrionic personality disorder
• B Antisocial personality disorder
• C Narcissistic personality disorder
• D Borderline personality disorder ✓

Explanation

Borderline personality disorder (BPD) is characterised by a pervasive pattern of instability in interpersonal relationships, self-image, and affect, with marked impulsivity. Key features include frantic efforts to avoid abandonment, unstable intense relationships, identity disturbance, impulsivity, recurrent self-mutilating behaviour, affective instability, chronic emptiness, inappropriate anger, and transient stress-related paranoid ideation. Five of nine criteria are required. Dialectical behaviour therapy (DBT) is the evidence-based psychotherapy of choice for BPD.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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