Phyllis cannot be alone. Her moods and behaviors are unstable, as are her relationships with other people. She often displays inappropriate and intense anger. Recently, Phyllis wrote a suicide note and offered to show it to her husband. Which of the following diagnoses accounts for her personality?Group of answer choicesborderline personality disorderantisocial personality disorderavoidant personality disorderschizotypal personality disorder
Question
Phyllis cannot be alone. Her moods and behaviors are unstable, as are her relationships with other people. She often displays inappropriate and intense anger. Recently, Phyllis wrote a suicide note and offered to show it to her husband. Which of the following diagnoses accounts for her personality?Group of answer choicesborderline personality disorderantisocial personality disorderavoidant personality disorderschizotypal personality disorder
Solution
The symptoms described in the question are characteristic of Borderline Personality Disorder. This disorder is characterized by a pervasive pattern of instability in interpersonal relationships, self-image, and emotion, as well as marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
- Frantic efforts to avoid real or imagined abandonment.
- A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
- Identity disturbance: markedly and persistently unstable self-image or sense of self.
- Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
- Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
- Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
- Chronic feelings of emptiness.
- Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
- Transient, stress-related paranoid ideation or severe dissociative symptoms.
Phyllis's inability to be alone, unstable moods and behaviors, unstable relationships, inappropriate and intense anger, and recent suicidal behavior all point to a diagnosis of Borderline Personality Disorder.
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