WBR0588

Author	[[PageAuthor::Serge Korjian M.D. (Reviewed by Serge Korjian)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Behavioral Science/Psychiatry
Sub Category	SubCategory::General Principles
Prompt	[[Prompt::A 35-year-old woman has lived alone most of her adult life. She has no friends and does not like leaving the house much. She has never had an intimate relationship and prefers being alone. She spends her days drawing and collecting random objects which she fashions into dolls. What is the most likely personality disorder present in this patient?]]
Answer A	AnswerA::Schizotypal
Answer A Explanation	[[AnswerAExp::Schizotypal personality disorder is characterized by weird and eccentric appearance, magical beliefs, bizarre fantasies or preoccupations, and odd thinking and speech. Patients can usually have some form of withdrawal but not as prominent as in schizoid personality.]]
Answer B	AnswerB::Schizoid
Answer B Explanation	[[AnswerBExp::This patient exhibits the typical features of schizoid personality disorder. The patient neither desires nor enjoys close relationships, and almost always chooses solitary activities. Other features include anhedonia, intimacy avoidance, and restricted affectivity.]]
Answer C	AnswerC::Avoidant
Answer C Explanation	[[AnswerCExp::Avoidant personality disorder is characterized by avoidance of activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection. The patient usually desires relationships but is afraid of possible consequences.]]
Answer D	AnswerD::Dependent
Answer D Explanation	AnswerDExp::Dependent personality disorder is characterized by a submissive personality often with very low self esteem. Patients usually have a constant need to be taken care of.
Answer E	AnswerE::Borderline
Answer E Explanation	[[AnswerEExp::Borderline personality disorder is characterized by a pervasive pattern of instability of interpersonal relationships and self-image. Patients are usually impulsive, have a pattern of intense unstable relationships, and recurrent suicidal behavior or threats.]]
Right Answer	RightAnswer::B
Explanation	[[Explanation::Schizoid personality disorder is characterized by voluntary social withdrawal and indifference. Patients with schizoid personality disorder express little emotion and are content with being socially isolated and not having relationships. They usually feel little if any desire for sexual relationships. Patients typically have hobbies and daily work activities that require as little social contact as possible. On the other hand, avoidant personality disorder describes a pattern of hypersensitivity and social inhibition in patients who are usually very shy. These patients desire social relationships but are very timid, often feel inadequate, and are afraid of rejection. Five features are usually seen in schizoid personality disorder: Social withdrawal, social detachement, intimacy avoidance, restricted affectivity, and anhedonia. Educational Objective: Schizoid personality disorder is characterized by voluntary social withdrawal with no desire for social contact or relationships. References: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA:American Psychiatric Publishing.]]
Approved	Approved::Yes
Keyword	WBRKeyword::Schizoid personality disorder, WBRKeyword::Avoidant personality disorder, WBRKeyword::Personality disorders, WBRKeyword::Cluster A
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::