Rosh Psychiatry Board Practice Exam

What psychological condition is characterized by a pattern of intense but unstable interpersonal relationships and self-image?

1. Narcissistic personality disorder

2. Borderline personality disorder

3. Antisocial personality disorder

4. Histrionic personality disorder

The correct answer is: Borderline personality disorder

Borderline personality disorder is characterized by a pervasive pattern of instability in interpersonal relationships, self-image, and affects, along with marked impulsivity. Individuals with this disorder often experience intense emotions and may have difficulty maintaining stable relationships, swinging between idealization and devaluation of others. This instability is largely due to a fear of abandonment and a chronic feeling of emptiness. People with borderline personality disorder may exhibit impulsive behaviors, such as reckless spending or substance abuse, which further complicate their relationships. Their self-image is often erratic, leading to frequent changes in goals, values, and career aspirations. These features make borderline personality disorder distinct in how it manifests through unstable emotions and relationships, drawing attention to the underlying struggles with identity and fear of being alone. In contrast, other personality disorders listed do not share this specific pattern of instability in relationships and self-image. For instance, narcissistic personality disorder primarily involves a grandiose sense of self-importance and a lack of empathy rather than instability. Antisocial personality disorder is characterized by a disregard for the rights of others and is often associated with deceitful and manipulative behaviors without the same intensity of relational instability. Histrionic personality disorder features excessive emotionality and attention-seeking, but lacks the profound