Match each patient's clinical presentation with the most accurate personality disorder diagnosis.
- A collegiate athlete with no history of hallucinations describes communicating with spirits through her crystals; she exhibits circumstantial speech and mentions she desires friendships, but her severe social anxiety—which stems from paranoid fears about others' intentions rather than negative self-evaluation—prevents her from forming close bonds.Schizotypal personality disorder
- A retired architect strongly opposes providing his medical history for the electronic health record, citing a rigid belief that his data will be weaponized by former colleagues; he lacks fixed delusions of control but persistently interprets neutral clinic policies as personal attacks and holds enduring grudges.Paranoid personality disorder
- Following a superficial scrape in the waiting room, a personal trainer displays rapidly shifting, shallow emotional expression and theatrical sobbing; she actively uses her physical appearance to draw attention, flirts overtly with the triage nurse, and acts as though the on-call physician is a lifelong companion.Histrionic personality disorder
- An office manager who recently experienced a breakup immediately began dating a new partner to secure emotional support; she frequently calls the clinic to request that the physician make mundane lifestyle decisions on her behalf, and she goes to excessive lengths to obtain nurturance, even volunteering for highly unpleasant tasks.Dependent personality disorder
Answer
Vignette 1 matches Schizotypal personality disorder; Vignette 2 matches Paranoid personality disorder; Vignette 3 matches Histrionic personality disorder; Vignette 4 matches Dependent personality disorder.
Each patient's presentation precisely aligns with the DSM-5 diagnostic criteria for a distinct personality disorder. The athlete displays Cluster A schizotypal traits (eccentricity, magical thinking, paranoid anxiety). The architect displays Cluster A paranoid traits (distrust, unjustified suspicion). The personal trainer displays Cluster B histrionic traits (theatricality, superficial intimacy, shallow shifting emotions). The office manager displays Cluster C dependent traits (submissive clinginess, indecisiveness, urgent relationship seeking).
Step-by-Step Solution
Key Concept
Distinguishing personality disorders across Clusters A, B, and C by identifying their defining diagnostic criteria and differentiating them from overlapping psychiatric conditions.