Rosh Psychiatry Board Practice Exam

What disorder is characterized by mood swings, feelings of abandonment, and intense but unstable relationships?

1. Borderline personality disorder

2. Generalized anxiety disorder

3. Major depressive disorder

4. Adjustment disorder

The correct answer is: Borderline personality disorder

The disorder characterized by mood swings, feelings of abandonment, and intense but unstable relationships is indeed borderline personality disorder (BPD). This condition is marked by significant emotional instability, which can lead to rapid mood changes and impulsiveness. Individuals with BPD often struggle with a distorted self-image and a profound fear of abandonment, which can cause them to react intensely to perceived rejection or separation. The unstable relationships are a hallmark of BPD, where individuals may idealize someone one moment but devalue them the next, contributing to a cycle of intense yet tumultuous interactions. This pattern often reflects their difficulties in managing emotions and maintaining a stable sense of self. The cognitive and emotional patterns associated with BPD can lead to behavioral issues, including impulsive actions and self-harming behaviors in response to emotional distress. In contrast, generalized anxiety disorder primarily involves excessive worry and anxiety about various aspects of life but does not encompass the self-identity disturbances or relationship patterns seen in BPD. Major depressive disorder is characterized by a pervasive low mood and lack of interest in activities rather than the intense emotional fluctuations typical of borderline personality disorder. Adjustment disorder involves emotional or behavioral responses to a specific stressor and does not typically present with the chronic instability and symptoms associated with borderline personality disorder.