A 16 year old girls is diagnosed with borderline personality disorder (BPD) , which of the following is a typ… - NORCET 9 Prelims-2025

NORCET 9 Prelims-2025

Mental Health Nursing

Easy

Appeared in: NORCET 9 Prelims-2025

Explanation

The defining features of Borderline Personality Disorder (BPD) are instability in emotions, self-image, and interpersonal relationships, along with marked impulsivity.
A core characteristic is a frantic effort to avoid real or imagined abandonment, which leads to significant distress and relationship turmoil.
Interpersonal relationships are often intense and unstable, marked by a pattern of alternating between extremes of idealization (seeing someone as perfect) and devaluation (seeing them as completely bad or worthless), a defense mechanism known as 'splitting'.
This pattern of chaotic relationships and fear of being left alone is central to the diagnosis of BPD.

Option B: Social withdrawal and a lack of emotional expression are hallmark features of Schizoid Personality Disorder, not BPD. Individuals with BPD often have very intense, albeit unstable, emotional expressions and relationships.
Option C: A preoccupation with orderliness and perfectionism is characteristic of Obsessive-Compulsive Personality Disorder (OCPD). This is distinct from BPD, which is characterized by impulsivity and chaos rather than rigid control.
Option D: Excessive suspiciousness and distrust of others are the primary features of Paranoid Personality Disorder. While individuals with BPD can experience transient, stress-related paranoia, pervasive distrust is the hallmark of Paranoid Personality Disorder.

Visual 1: Infographic: A chart comparing the key features of Cluster B personality disorders (Antisocial, Borderline, Histrionic, Narcissistic) to highlight the unique instability in relationships seen in BPD.
Visual 2: Flowchart: A diagram illustrating the cycle of idealization, perceived abandonment, and devaluation in BPD relationships.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Characteristics of Borderline Personality Disorder (BPD) as background academic context rather than a clinical decision trigger.
Nurses caring for patients with BPD must establish clear, consistent boundaries to manage manipulative or splitting behaviors and ensure a safe therapeutic environment.
It is crucial to assess for self-harm behaviors and suicidal ideation, as these are common and high-risk features of BPD. A non-judgmental and validating approach can help build trust.
What if? If the 16-year-old girl also reported engaging in reckless driving and binge eating, it would further support the BPD diagnosis by confirming the criterion of 'impulsivity in at least two potentially self-damaging areas'.

How to Approach the Question

First, identify the core concept in the question, which is 'borderline personality disorder (BPD)'.
Recall the key diagnostic criteria for BPD from the DSM-5. Focus on the acronym 'AM SUICIDE': Abandonment fears, Mood instability, Suicidal/self-harm behavior, Unstable relationships, Impulsivity, Control of anger issues, Identity disturbance, Dissociative/paranoid symptoms, Emptiness (chronic).
Evaluate each option against these core features.
Option A directly mentions 'unstable interpersonal relationship' and 'fear of abandonment,' which are two of the most prominent criteria for BPD.
Eliminate the other options by recognizing them as hallmark features of other personality disorders: Schizoid (B), OCPD (C), and Paranoid (D).

Concept Tested & Keywords

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