Personality Disorders MCQs

Psychiatry · 24 free questions with answers & explanations.

1. 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?
2. A 40-year-old man consistently disregards the rights of others, has a history of repeated law violations, deceitfulness, and impulsivity. He shows no remorse after harming others and has a pattern dating back to adolescence. A diagnosis of antisocial personality disorder requires that the individual must be at least which age at the time of diagnosis?
3. A 26-year-old woman with Borderline Personality Disorder repeatedly views her therapist as either 'the best doctor in the world' or 'completely useless and uncaring' across different sessions. This alternation is an example of which defence mechanism?
4. Which of the following personality disorders is in the DSM-5 Cluster A ('Odd/Eccentric') group?
5. Dialectical Behaviour Therapy (DBT), developed by Marsha Linehan, is the evidence-based psychotherapy of choice for Borderline Personality Disorder. Which of the following correctly describes its core theoretical model?
6. A 26-year-old woman presents with a pattern of unstable relationships (alternating idealisation and devaluation), fear of abandonment, identity disturbance, recurrent self-cutting, and affective instability. She meets DSM-5 criteria for Borderline Personality Disorder. The psychotherapy with the strongest evidence base for BPD is:
7. A 38-year-old male lawyer consistently exploits colleagues, shows no remorse for harm caused, lies to clients, and has had two previous convictions for fraud. These traits have been stable since early adulthood. His presentation is most consistent with which DSM-5 personality disorder, and what is a key ICD-11 difference in its classification?
8. A patient with Schizotypal Personality Disorder is MOST likely to respond to which pharmacological intervention for cognitive-perceptual symptoms (ideas of reference, magical thinking, perceptual distortions)?
9. A 24-year-old woman has a history of intense unstable relationships, frantic efforts to avoid abandonment, recurrent self-cutting, a persistent empty feeling, and brief dissociative episodes when stressed. According to DSM-5, her presentation MOST closely fits which personality disorder cluster and specific diagnosis?
10. Which defence mechanism is being used by a patient with alcoholism who attributes his repeated job terminations to 'bad luck' and his wife's departure to 'her own issues,' while stating that his drinking is 'completely under control'?
11. A 30-year-old man is repeatedly fired because he believes he deserves special treatment, takes advantage of colleagues, lacks empathy, and is preoccupied with fantasies of unlimited success. He reacts with rage when criticized. Which personality disorder cluster and SPECIFIC diagnosis fits BEST?
12. A 25-year-old woman has a history of self-harm, intense unstable relationships, chronic emptiness, identity disturbance, and frantic efforts to avoid abandonment. She frequently uses splitting (seeing her therapist as 'perfect' then suddenly 'the worst ever'). What defence mechanism characterises borderline personality disorder, and what is the psychodynamic explanation for its use?
13. ICD-11 fundamentally reconceptualised personality disorders by replacing categorical subtypes with a dimensional model. Which is the correct description of this model?
14. A 28-year-old man with antisocial personality disorder is described by his family as charming, superficial, lacking remorse for hurting others, with a history of juvenile conduct disorder. Which defence mechanisms are most characteristic of antisocial/narcissistic cluster?
15. A 26-year-old woman has a history of unstable relationships, fear of abandonment, identity disturbance, self-cutting, and brief psychotic episodes under stress. She is started on dialectical behaviour therapy (DBT). Which primary mechanism does DBT target in Borderline Personality Disorder?
16. Cluster B personality disorders are characterised by dramatic, emotional, or erratic behaviour. Which personality disorder is most associated with lack of empathy, grandiosity, and exploitative behaviour WITHOUT the pervasive disregard for and violation of others' rights seen in Antisocial PD?
17. A 40-year-old man has a lifelong pattern of odd beliefs, magical thinking, peculiar speech, ideas of reference, and social isolation but maintains contact with reality and has no frank psychosis. He does not meet criteria for schizophrenia. The DSM-5 Cluster A personality disorder best describing this presentation is:
18. A 32-year-old woman has a pattern of intense unstable relationships (idealising then devaluing), chronic emptiness, impulsive spending and binge eating, recurrent self-cutting, rapid mood shifts lasting hours, and an intense fear of abandonment. Her symptoms span multiple areas of life since adolescence. Which cluster does her personality disorder belong to in DSM-5?
19. A 26-year-old woman describes intense unstable relationships alternating between idealisation and devaluation, chronic feelings of emptiness, recurrent self-harm, and frantic efforts to avoid abandonment. She is diagnosed with Borderline Personality Disorder. Which neuroimaging finding is MOST consistently associated with BPD?
20. A 50-year-old man displays a pervasive pattern of grandiosity, need for admiration, and lack of empathy. He exploits colleagues and reacts with rage to any perceived criticism. Under DSM-5 Alternative Model of Personality Disorders (AMPD), which is the CORE pathological trait domain that MOST defines narcissistic personality disorder?
21. A 25-year-old woman presents with intense fear of abandonment, unstable relationships (idealizing then devaluing), identity disturbance, impulsivity, and recurrent self-harm. She describes feeling empty chronically. The DSM-5 Cluster to which this personality disorder belongs is:
22. A patient with Antisocial Personality Disorder (ASPD) is distinct from someone with 'psychopathy' (as measured by the Hare Psychopathy Checklist). The key difference is that ASPD focuses on which domain, while psychopathy adds which interpersonal-affective dimension?
23. A 38-year-old woman with suspected cluster B personality disorder has identity disturbance, chronic emptiness, frantic abandonment avoidance, intense and unstable relationships alternating between idealisation and devaluation, and impulsive self-harm. The operative defence mechanism most associated with this disorder is:
24. A 45-year-old man is suspicious that colleagues at work are exploiting him, questions the loyalty of close friends, reads demeaning meanings into neutral remarks, and holds long-lasting grudges. He has no history of psychosis. The personality disorder cluster and specific diagnosis is: