AP Psychology Quiz: Selection Of Categories Of Psychological Disorders
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Selection Of Categories Of Psychological DisordersQuestion 1 of 20

A person has depressed mood, anhedonia, sleep changes, and impaired concentration for three weeks. Which diagnosis best fits?

Major Depressive Disorder, requiring at least two weeks of symptoms including depressed mood or anhedonia with functional impairment.
Persistent Depressive Disorder, requiring at least two years of chronic depressed mood rather than a three-week episode.
Bipolar I Disorder, requiring a manic episode; depressive symptoms alone do not establish bipolar I diagnosis.
Cyclothymic Disorder, requiring two years of fluctuating hypomanic and depressive symptoms without full episodes.
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AP Psychology Quiz

AP Psychology Quiz: Selection Of Categories Of Psychological Disorders

Practice Selection Of Categories Of Psychological Disorders in AP Psychology with focused quiz questions that help you check what you know, review explanations, and build confidence with test-style prompts.

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Question 1

A person has depressed mood, anhedonia, sleep changes, and impaired concentration for three weeks. Which diagnosis best fits?

  1. Major Depressive Disorder, requiring at least two weeks of symptoms including depressed mood or anhedonia with functional impairment. (correct answer)
  2. Persistent Depressive Disorder, requiring at least two years of chronic depressed mood rather than a three-week episode.
  3. Bipolar I Disorder, requiring a manic episode; depressive symptoms alone do not establish bipolar I diagnosis.
  4. Cyclothymic Disorder, requiring two years of fluctuating hypomanic and depressive symptoms without full episodes.

Explanation: This describes Major Depressive Disorder, which requires at least one major depressive episode lasting at least two weeks with five or more symptoms including depressed mood or anhedonia (loss of interest/pleasure), plus additional symptoms like sleep changes, concentration difficulties, and functional impairment. The three-week duration exceeds the minimum two-week requirement. Persistent Depressive Disorder requires chronic depressed mood for at least two years, not a discrete three-week episode. Bipolar I Disorder requires at least one manic episode; depressive symptoms alone don't establish bipolar diagnosis. Cyclothymic Disorder requires two years of fluctuating hypomanic and depressive symptoms without meeting full episode criteria.

Question 2

A person is preoccupied with a slight perceived facial flaw and repeatedly checks mirrors, causing distress. Which diagnosis fits best?

  1. Body Dysmorphic Disorder, involving preoccupation with perceived appearance defects plus repetitive behaviors like mirror checking causing distress. (correct answer)
  2. Anorexia Nervosa, involving restriction and fear of weight gain with low weight, not focal concern about a minor facial flaw.
  3. Obsessive-Compulsive Disorder, involving varied obsessions/compulsions; appearance-focused preoccupation is more specifically Body Dysmorphic Disorder.
  4. Social Anxiety Disorder, involving fear of negative evaluation, not persistent preoccupation with a perceived physical defect and checking behaviors.

Explanation: This describes Body Dysmorphic Disorder (BDD), characterized by preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others, plus repetitive behaviors (like mirror checking) or mental acts (like comparing appearance with others) in response to appearance concerns. The preoccupation causes clinically significant distress or impairment. The focus on a perceived facial flaw with repetitive checking behaviors is classic for BDD. Anorexia Nervosa involves weight-related concerns and restriction leading to low weight. While OCD can involve appearance-related obsessions, BDD is the more specific diagnosis when appearance preoccupation is primary. Social Anxiety Disorder involves fear of negative evaluation in social situations, not persistent preoccupation with physical appearance defects.

Question 3

A child has severe temper outbursts three times weekly and persistently irritable mood between outbursts for 12 months. Diagnosis?

  1. Disruptive Mood Dysregulation Disorder, with frequent severe temper outbursts and persistent irritability for at least 12 months. (correct answer)
  2. Oppositional Defiant Disorder, involving defiance and vindictiveness, not necessarily severe recurrent outbursts with chronic irritability.
  3. Bipolar I Disorder, involving episodic mania; chronic irritability without discrete manic episodes is not sufficient for bipolar I.
  4. Intermittent Explosive Disorder, involving discrete outbursts without persistent irritable mood between episodes in children.

Explanation: This describes Disruptive Mood Dysregulation Disorder (DMDD), characterized by severe recurrent temper outbursts (verbal or behavioral) that are grossly out of proportion to the situation, occurring three or more times per week for at least 12 months with no more than three consecutive months without symptoms. The mood between outbursts is persistently irritable or angry most of the day, nearly every day. Onset must be before age 10. ODD involves defiance and vindictiveness but not necessarily the severe recurrent outbursts with chronic irritability. Bipolar I requires discrete manic episodes with elevated mood and increased activity; chronic irritability alone isn't sufficient. Intermittent Explosive Disorder doesn't typically involve persistent irritable mood between episodes in children.

Question 4

A person has chronic worry about many topics, restlessness, muscle tension, and sleep problems for over six months. Diagnosis?

  1. Generalized Anxiety Disorder, defined by excessive anxiety and worry across domains with associated symptoms for at least six months. (correct answer)
  2. Panic Disorder, defined by unexpected panic attacks and concern about attacks, not persistent broad worry across topics.
  3. Obsessive-Compulsive Disorder, involving obsessions and compulsions, not primarily generalized worry with tension and insomnia.
  4. Posttraumatic Stress Disorder, requiring trauma exposure and intrusion/avoidance symptoms, not generalized worry without a trauma trigger.

Explanation: This describes Generalized Anxiety Disorder (GAD), characterized by excessive anxiety and worry about multiple events or activities occurring more days than not for at least six months. The worry is difficult to control and associated with at least three additional symptoms (restlessness, fatigue, concentration problems, irritability, muscle tension, sleep disturbance). The key features are the generalized nature across multiple domains, chronicity (six months), and associated physical/cognitive symptoms. Panic Disorder involves discrete panic attacks and worry about future attacks. OCD involves specific obsessions and compulsions. PTSD requires trauma exposure and specific trauma-related symptom clusters including intrusion and avoidance symptoms.

Question 5

A person repeatedly violates others' rights, lies, is impulsive, and shows lack of remorse since age 15. Which diagnosis fits?

  1. Antisocial Personality Disorder, requiring pervasive disregard for others' rights since age 15 and evidence of Conduct Disorder before age 15. (correct answer)
  2. Narcissistic Personality Disorder, involving grandiosity and need for admiration, not a consistent pattern of unlawful behavior and remorse deficits.
  3. Borderline Personality Disorder, involving abandonment fears and affective instability, not primarily chronic rights violations and deceitfulness.
  4. Intermittent Explosive Disorder, involving discrete aggressive outbursts, not pervasive deceit, exploitation, and longstanding violation of rights.

Explanation: This describes Antisocial Personality Disorder, which requires a pervasive pattern of disregard for and violation of others' rights occurring since age 15, evidence of Conduct Disorder before age 15, and the individual must be at least 18 years old. Key features include repeated unlawful acts, deceitfulness, impulsivity, irritability and aggressiveness, disregard for safety, consistent irresponsibility, and lack of remorse. The pattern must be pervasive and longstanding, not limited to discrete episodes. Narcissistic Personality Disorder involves grandiosity but not necessarily criminal behavior or lack of remorse. Borderline Personality Disorder involves emotional instability and abandonment fears. Intermittent Explosive Disorder involves discrete aggressive outbursts, not a pervasive pattern of rights violations.

Question 6

A teen has inattention and hyperactivity across home and school for 8 months, impairing grades. Which disorder fits best?

  1. Oppositional Defiant Disorder, characterized by angry/irritable mood and defiant behavior toward authority, without primary attention and hyperactivity symptoms.
  2. Attention-Deficit/Hyperactivity Disorder, Combined Presentation, with persistent inattention and hyperactivity-impulsivity across settings causing functional impairment. (correct answer)
  3. Autism Spectrum Disorder, defined by social-communication deficits and restricted, repetitive behaviors, not primarily by cross-setting hyperactivity and distractibility.
  4. Generalized Anxiety Disorder, involving excessive worry and tension; concentration problems may occur but hyperactivity across settings is not central.

Explanation: This case presents classic symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD), Combined Presentation. The key diagnostic features include persistent inattention and hyperactivity occurring across multiple settings (both home and school) for at least 6 months, causing functional impairment in academic performance. ADHD requires symptoms to be present before age 12 and to interfere with functioning in two or more settings. While Oppositional Defiant Disorder involves defiant behavior, it lacks the core attention and hyperactivity symptoms. Autism Spectrum Disorder is characterized by social-communication deficits and repetitive behaviors rather than hyperactivity as the primary concern. Generalized Anxiety Disorder may include concentration difficulties but does not feature the pervasive hyperactivity across settings that defines ADHD.

Question 7

A child has multiple motor and vocal tics for over one year, starting before age 18. Which diagnosis fits best?

  1. Tourette's Disorder, defined by multiple motor tics and at least one vocal tic persisting over one year with onset before 18. (correct answer)
  2. Persistent (Chronic) Motor Tic Disorder, involving motor tics only without vocal tics, persisting over one year.
  3. Stereotypic Movement Disorder, involving repetitive nonfunctional movements, not sudden, rapid, recurrent tics with vocal components.
  4. Obsessive-Compulsive Disorder, involving compulsions driven by obsessions, not involuntary motor and vocal tics.

Explanation: This describes Tourette's Disorder, which requires both multiple motor tics and one or more vocal tics present at some time during the illness, occurring many times a day nearly every day or intermittently for more than one year, with onset before age 18. Tics are sudden, rapid, recurrent, nonrhythmic motor movements or vocalizations. The combination of multiple motor tics AND vocal tics persisting over one year distinguishes Tourette's from other tic disorders. Persistent Motor Tic Disorder involves only motor tics without vocal tics. Stereotypic Movement Disorder involves repetitive nonfunctional movements that are more rhythmic and purposeless than tics. OCD involves obsessions and compulsions, not involuntary tics.

Question 8

A person persistently believes they are severely overweight despite being underweight and restricts intake intensely. Which disorder fits?

  1. Anorexia Nervosa, involving restriction leading to significantly low weight plus intense fear of weight gain and body image disturbance. (correct answer)
  2. Bulimia Nervosa, involving recurrent binge eating with compensatory behaviors, typically without significantly low body weight.
  3. Binge-Eating Disorder, involving binge episodes without compensatory behaviors, not persistent restriction leading to low weight.
  4. Avoidant/Restrictive Food Intake Disorder, involving restriction without body image disturbance or fear of gaining weight.

Explanation: This case describes Anorexia Nervosa, which has three core features: restriction of energy intake leading to significantly low body weight, intense fear of gaining weight or becoming fat (or persistent behavior that interferes with weight gain), and disturbance in the way body weight or shape is experienced. The persistent belief of being severely overweight despite being underweight demonstrates the required body image disturbance. Bulimia Nervosa involves binge eating with compensatory behaviors and typically occurs at normal or above-normal weight. Binge-Eating Disorder involves recurrent binges without restriction leading to low weight. ARFID involves food restriction but without the body image disturbance or fear of weight gain.

Question 9

A child shows limited eye contact, social reciprocity difficulties, and repetitive behaviors beginning in early development. Best category?

  1. Personality Disorders, because enduring maladaptive traits begin by early adulthood and are stable across many contexts.
  2. Neurodevelopmental Disorders, because early-onset social communication differences and restricted, repetitive behaviors define this category. (correct answer)
  3. Anxiety Disorders, because social avoidance is driven by fear of judgment rather than developmental social-communication differences.
  4. Disruptive, Impulse-Control, and Conduct Disorders, because aggression and rule violations are required for diagnosis.

Explanation: Limited eye contact, difficulties with social reciprocity, and repetitive behaviors beginning in early development are core features of Autism Spectrum Disorder, which falls under Neurodevelopmental Disorders. ASD is characterized by persistent deficits in social communication and social interaction across contexts, plus restricted, repetitive patterns of behavior, interests, or activities, with symptoms present in early developmental period. Personality Disorders don't typically begin until adolescence or early adulthood. Anxiety Disorders might cause social avoidance but don't include the developmental social-communication deficits or repetitive behaviors. Disruptive disorders focus on aggression and rule-breaking rather than social-communication differences.

Question 10

An adult has 3 weeks of elevated mood, decreased need for sleep, grandiosity, and risky spending causing hospitalization. Which diagnosis fits best?

  1. Cyclothymic Disorder, involving numerous hypomanic and depressive symptoms for at least 2 years without full manic episodes or hospitalization.
  2. Bipolar I Disorder, defined by at least one manic episode with marked impairment, possible hospitalization, and elevated or irritable mood. (correct answer)
  3. Major Depressive Disorder, requiring at least 2 weeks of depressed mood or anhedonia, not sustained elevated mood with grandiosity.
  4. Schizoaffective Disorder, requiring mood episodes plus psychotic symptoms persisting independently; mania alone with hospitalization is insufficient.

Explanation: This presentation clearly describes a manic episode characteristic of Bipolar I Disorder. The patient exhibits the classic triad of mania: elevated mood, decreased need for sleep, and grandiosity, along with risky behavior (excessive spending) severe enough to require hospitalization. A single manic episode lasting at least one week (or any duration if hospitalization is required) is sufficient for a Bipolar I diagnosis. Cyclothymic Disorder involves milder hypomanic symptoms without full manic episodes or hospitalization. Major Depressive Disorder involves depressed mood and anhedonia, not the elevated mood and grandiosity seen here. Schizoaffective Disorder requires both mood episodes and psychotic symptoms that occur independently of mood episodes, which is not described in this case.

Question 11

A person has multiple distinct identities and recurrent gaps in recall for everyday events. Which diagnosis is most consistent?

  1. Schizophrenia, because hallucinations and delusions are required and best explain identity changes and memory problems.
  2. Depersonalization/Derealization Disorder, because identity remains intact while experiences of unreality or detachment are primary.
  3. Dissociative Identity Disorder, because distinct identity states plus recurrent amnesia for daily events are defining features. (correct answer)
  4. Delusional Disorder, because fixed false beliefs occur without prominent identity disruption or recurrent amnesia.

Explanation: Multiple distinct identity states (previously called personalities) combined with recurrent gaps in recall for everyday events are the two required features for Dissociative Identity Disorder (DID). This disorder involves disruption of identity characterized by two or more distinct personality states, with recurrent gaps in recall that are inconsistent with ordinary forgetting. Depersonalization/Derealization Disorder involves feelings of detachment or unreality but maintains a single, intact identity. Schizophrenia might involve identity confusion but centers on psychotic symptoms like hallucinations and delusions. Delusional Disorder involves fixed false beliefs without the identity fragmentation seen in DID.

Question 12

After a car crash, an adult has nightmares, avoidance, hypervigilance, and guilt for 2 months. Which disorder category applies?

  1. Trauma- and Stressor-Related Disorders, defined by exposure to trauma and subsequent intrusion, avoidance, negative mood/cognition, and arousal symptoms. (correct answer)
  2. Anxiety Disorders, centered on fear and worry without requiring trauma exposure or a specific intrusion-avoidance symptom cluster.
  3. Dissociative Disorders, involving depersonalization, derealization, or amnesia as primary symptoms rather than trauma-linked intrusion and avoidance.
  4. Schizophrenia Spectrum and Other Psychotic Disorders, characterized by delusions, hallucinations, and disorganized thinking, not trauma-triggered reexperiencing.

Explanation: This scenario describes Post-Traumatic Stress Disorder (PTSD), which falls under Trauma- and Stressor-Related Disorders. The patient experienced a traumatic event (car crash) followed by the characteristic symptom clusters of PTSD: intrusion symptoms (nightmares), avoidance behaviors, negative alterations in mood and cognition (guilt), and alterations in arousal and reactivity (hypervigilance). These symptoms have persisted for more than one month, meeting the duration criterion for PTSD. Anxiety Disorders do not require trauma exposure as a precipitating event. Dissociative Disorders primarily involve disruptions in consciousness, memory, or identity rather than the trauma-linked symptom constellation seen here. Schizophrenia Spectrum Disorders involve psychotic symptoms like hallucinations and delusions, not trauma-triggered reexperiencing and avoidance.

Question 13

A teen restricts food, has intense fear of weight gain, and is significantly underweight. Which diagnosis best matches?

  1. Bulimia Nervosa, involving recurrent binge eating with compensatory behaviors; body weight is often within or above normal range.
  2. Avoidant/Restrictive Food Intake Disorder, involving inadequate intake without fear of weight gain or body image disturbance.
  3. Anorexia Nervosa, characterized by restriction leading to significantly low weight, intense fear of gaining weight, and body image disturbance. (correct answer)
  4. Binge-Eating Disorder, involving recurrent binges without compensatory behaviors and without the requirement of significantly low body weight.

Explanation: This case clearly describes Anorexia Nervosa, characterized by the three core features: restriction of food intake leading to significantly low body weight, intense fear of gaining weight despite being underweight, and disturbance in body image perception. The combination of food restriction, weight phobia, and significantly low weight is pathognomonic for Anorexia Nervosa. Bulimia Nervosa involves binge-purge cycles and typically maintains normal or above-normal weight. Avoidant/Restrictive Food Intake Disorder involves food restriction without the weight and body image concerns central to anorexia. Binge-Eating Disorder features recurrent binge episodes without the severe restriction and low body weight seen in anorexia.

Question 14

A person avoids relationships due to fear of rejection and feelings of inadequacy, despite wanting connection. Which disorder fits?

  1. Avoidant Personality Disorder, marked by social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation across contexts. (correct answer)
  2. Schizoid Personality Disorder, involving lack of desire for close relationships, not avoidance driven by fear of rejection.
  3. Social Anxiety Disorder, typically situation-specific fear of scrutiny, not a pervasive personality pattern of inadequacy and avoidance.
  4. Dependent Personality Disorder, involving submissive clinging and difficulty being alone, not avoidance of closeness due to rejection fears.

Explanation: This describes Avoidant Personality Disorder, characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation beginning by early adulthood. Key features include avoidance of occupational activities involving interpersonal contact, unwillingness to get involved unless certain of being liked, restraint in relationships due to fear of ridicule, preoccupation with criticism or rejection, inhibition in new situations, view of self as inadequate, and reluctance to take risks. The desire for connection despite avoidance due to rejection fears distinguishes it from Schizoid Personality Disorder. Social Anxiety Disorder is more situation-specific, while Avoidant PD represents a pervasive personality pattern. Dependent PD involves clinging rather than avoidance.

Question 15

A person often feels detached from their body, like watching themselves from outside, while reality testing remains intact. Diagnosis?

  1. Depersonalization/Derealization Disorder, involving persistent or recurrent detachment experiences with intact reality testing and significant distress. (correct answer)
  2. Delusional Disorder, involving fixed false beliefs despite evidence, not episodic detachment sensations with preserved reality testing.
  3. Schizophrenia, involving psychotic symptoms such as hallucinations and disorganized thought, not primarily depersonalization with insight.
  4. Conversion Disorder (Functional Neurological Symptom Disorder), involving motor or sensory symptoms incompatible with neurological disease, not detachment.

Explanation: This case describes Depersonalization/Derealization Disorder, characterized by persistent or recurrent depersonalization (feeling detached from oneself) and/or derealization (feeling that surroundings are unreal or dreamlike). The key feature is that reality testing remains intact - the person knows the experiences are not real but continues to have them. This preserved insight distinguishes it from psychotic disorders. Delusional Disorder involves fixed false beliefs held with conviction despite evidence. Schizophrenia involves frank psychotic symptoms without preserved reality testing. Conversion Disorder involves neurological-type symptoms like motor or sensory deficits, not subjective experiences of detachment.

Question 16

After a serious accident, a person has nightmares, avoidance, hypervigilance, and negative mood for over one month. Diagnosis?

  1. Adjustment Disorder, because stress reactions are brief and do not require trauma exposure or specific symptom clusters.
  2. Acute Stress Disorder, because symptoms must resolve within one month after the traumatic event.
  3. Posttraumatic Stress Disorder, because trauma exposure plus intrusion, avoidance, arousal, and mood/cognition changes persist beyond one month. (correct answer)
  4. Panic Disorder, because recurrent unexpected panic attacks with concern about future attacks best explains hypervigilance and nightmares.

Explanation: This scenario describes Posttraumatic Stress Disorder (PTSD), which requires exposure to a traumatic event followed by four symptom clusters: intrusion symptoms (nightmares), avoidance of trauma-related stimuli, negative alterations in mood and cognition, and alterations in arousal and reactivity (hypervigilance). The key distinguishing factor is that symptoms persist for more than one month after the trauma. Acute Stress Disorder has similar symptoms but resolves within one month. Adjustment Disorder involves less severe stress reactions without the specific PTSD symptom clusters. Panic Disorder involves recurrent panic attacks but doesn't require trauma exposure or include nightmares and avoidance of trauma reminders.

Question 17

A person has persistently depressed mood and low energy most days for two years, without symptom-free periods over two months. Diagnosis?

  1. Bipolar II Disorder, requiring hypomanic episodes, not chronic low mood and low energy without elevated or expansive mood periods.
  2. Persistent Depressive Disorder (Dysthymia), defined by chronic depressed mood for at least two years with limited symptom-free intervals. (correct answer)
  3. Major Depressive Disorder, requiring discrete episodes lasting at least two weeks, not necessarily chronic symptoms for two years.
  4. Cyclothymic Disorder, involving fluctuating hypomanic and depressive symptoms, not continuous depressed mood without hypomanic features.

Explanation: This case describes Persistent Depressive Disorder (Dysthymia), which requires chronically depressed mood for at least two years in adults (one year in children) with no symptom-free periods longer than two months. The key distinguishing features are the chronic nature and the requirement that the person has not been without symptoms for more than two months at a time during the two-year period. Bipolar II requires hypomanic episodes, which involve elevated or irritable mood, not chronic depression. Major Depressive Disorder involves discrete episodes but doesn't require the two-year chronicity without significant symptom-free periods. Cyclothymic Disorder involves alternating periods of hypomanic and depressive symptoms, not continuous depressed mood.

Question 18

Someone has intrusive contamination thoughts and repetitive handwashing to reduce anxiety, consuming hours daily. Which disorder is most likely?

  1. Obsessive-Compulsive Disorder, involving intrusive obsessions and time‑consuming compulsions performed to reduce distress or prevent feared outcomes. (correct answer)
  2. Generalized Anxiety Disorder, involving broad worries across domains without specific ritualized compulsions tied to obsessions.
  3. Specific Phobia, involving fear of a particular object or situation, not intrusive obsessions and repetitive neutralizing rituals.
  4. Somatic Symptom Disorder, involving excessive focus on physical symptoms rather than contamination obsessions and washing compulsions.

Explanation: This describes classic Obsessive-Compulsive Disorder (OCD), characterized by obsessions (intrusive contamination thoughts) and compulsions (repetitive handwashing) that are time-consuming and cause significant distress or impairment. The key features include intrusive, unwanted thoughts that cause anxiety (obsessions) and repetitive behaviors performed to reduce distress or prevent feared outcomes (compulsions). The time-consuming nature (hours daily) and functional impact are important diagnostic criteria. GAD involves broad worries across multiple domains without specific ritualized behaviors. Specific phobias involve fear of particular objects or situations, not intrusive thoughts with compulsive neutralizing behaviors. Somatic Symptom Disorder focuses on physical symptoms and health concerns, not contamination obsessions with washing rituals.

Question 19

A student has recurrent panic attacks and avoids buses due to fear of being unable to escape. Which disorder best matches?

  1. Agoraphobia, involving fear and avoidance of situations where escape may be difficult, often associated with panic-like symptoms. (correct answer)
  2. Social Anxiety Disorder, focused on fear of scrutiny and embarrassment in social performance situations, not primarily escape concerns.
  3. Specific Phobia, limited to a particular object or situation without the broader escape-related avoidance across multiple settings.
  4. Obsessive-Compulsive Disorder, characterized by obsessions and compulsions; avoidance is driven by rituals rather than fear of escape difficulty.

Explanation: This case describes Agoraphobia, characterized by fear and avoidance of situations where escape might be difficult or help unavailable if panic-like symptoms occur. The student's avoidance of buses specifically due to fear of being unable to escape is a classic agoraphobic concern. Agoraphobia often develops following panic attacks and involves avoidance of multiple situations like public transportation, open spaces, or crowds. Social Anxiety Disorder focuses on fear of negative evaluation in social situations rather than escape concerns. Specific Phobia would involve fear of buses themselves rather than the escape-related anxiety. Obsessive-Compulsive Disorder involves ritualistic behaviors driven by obsessions, not situational avoidance based on escape fears.

Question 20

An adult has unstable relationships, intense fear of abandonment, impulsivity, and recurrent self-harm for years. Which diagnosis best fits?

  1. Borderline Personality Disorder, involving pervasive instability in relationships, self-image, and affect with marked impulsivity and self-harm risk. (correct answer)
  2. Bipolar I Disorder, defined by manic episodes; chronic interpersonal instability and abandonment fears are not core diagnostic requirements.
  3. Posttraumatic Stress Disorder, requiring trauma exposure with intrusion and avoidance; self-harm may occur but is not defining alone.
  4. Antisocial Personality Disorder, involving disregard for others' rights and deceitfulness; abandonment fears and affective instability are not central.

Explanation: This case exemplifies Borderline Personality Disorder (BPD), characterized by pervasive instability in interpersonal relationships, self-image, and affect, along with marked impulsivity. The intense fear of abandonment, unstable relationships, impulsivity, and recurrent self-harm are core features of BPD that must be present by early adulthood and occur across various contexts. The chronic nature (lasting years) distinguishes this from episodic mood disorders. Bipolar I Disorder involves discrete manic episodes rather than the chronic interpersonal instability and abandonment fears central to BPD. PTSD requires trauma exposure with specific symptom clusters not described here. Antisocial Personality Disorder involves violation of others' rights and lack of remorse, not the emotional dysregulation and abandonment fears characteristic of BPD.