A 34-year-old patient describes a history of conflict-ridden interpersonal relationships. This pattern has been present since late adolescence, occurs across all settings, and has resulted in a history of sporadic employment and tumultuous romantic relationships. The symptoms are not due to a medical condition or the use of a substance. Which psychological diagnosis is most likely in this patient?

Question

A 34-year-old patient describes a history of conflict-ridden interpersonal relationships.  This pattern has been present since late adolescence, occurs across all settings, and has resulted in a history of sporadic employment and tumultuous romantic relationships.  The symptoms are not due to a medical condition or the use of a substance.  Which psychological diagnosis is most likely in this patient?

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11ecba2d_0d8e_58c7_a3bf_a988839ce919_MD0008_00 Personality disorders are characterized by inflexible and enduring patterns of thoughts, feelings, and behaviors that differ markedly from social norms and cause functional impairment. Individuals with personality disorders have pathological personal traits (eg, rigidity, greediness) and maladaptive patterns of relating to others (eg, hostility, superficiality) that are stable over time and across situations. For someone with a pattern of conflict-ridden interpersonal relationships in all settings since late adolescence (ie, stable over time), resulting in a history of sporadic employment and tumultuous romantic relationships (ie, significant impairment), the most likely diagnosis is a personality disorder. (Choice A) Mood disorders (eg, depression) are characterized by persistent disruptions in emotional state. Although individuals with mood disorders may experience social dysfunction (eg, lack of interest in socializing), this is a result of their mood symptomology, not an inflexible and enduring pattern of relating to others (ie, personality disorder). (Choice B) Anxiety disorders (eg, generalized anxiety disorder) are characterized by excessive worry. Although individuals with anxiety disorders may experience social dysfunction (eg, declining social invitations due to anxiety), this is a result of their excessive worry, not an inflexible and enduring pattern of relating to others (ie, personality disorder). (Choice C) Dissociative disorders (eg, dissociative identity disorder) are characterized by disruptions in memory and identity. Although individuals with dissociative disorders may experience social dysfunction (eg, through inconsistent interactions with loved ones), this is a result of their disruptions in memory and identity, not an inflexible and enduring pattern of relating to others (ie, personality disorder). Educational objective: Personality disorders are characterized by inflexible and enduring patterns of thoughts, feelings, and behaviors differing markedly from social norms. Personality disorders are stable over time and across environments and cause significant distress or impairment of functioning.

A 34-Year-Old Patient Describes a History of Conflict-Ridden Interpersonal Relationships