A young woman presents with a history of emotional instability, dependent behavior, impulsive aggression, and unstable interpersonal relationships. Which of the following is the most likely diagnosis?

1. A

   Dependent personality disorder

2. B

   Antisocial personality disorder

3. C

   Histrionic personality disorder

4. D

   Borderline personality disorder

Appeared in: AIIMS M.Sc. Nsg Entrance exam-2026

Explanation

• The correct diagnosis is Borderline Personality Disorder (BPD).
• This is because the patient's symptoms—emotional instability (affective lability), impulsive aggression, and unstable interpersonal relationships—are hallmark features of BPD.
• The dependent behavior described is often a manifestation of the frantic efforts to avoid abandonment, a core criterion for BPD.
• BPD is defined by a pervasive pattern of instability across moods, relationships, self-image, and behavior, which perfectly matches the case description.

Why Other Options Were Wrong

• Option A: Dependent Personality Disorder (Cluster C) is primarily characterized by an excessive need to be taken care of, leading to submissive and clinging behavior. It does not typically involve the intense anger, impulsive aggression, and affective instability seen in this patient.
• Option B: Antisocial Personality Disorder is characterized by a disregard for and violation of the rights of others, deceitfulness, and a lack of remorse. While impulsivity and aggression can be present, the core features of emotional instability and fear of abandonment described here are more indicative of BPD.
• Option C: Histrionic Personality Disorder is defined by excessive emotionality and attention-seeking behavior. Individuals with this disorder feel uncomfortable when they are not the center of attention. The patient's symptoms are driven more by instability and fear of abandonment rather than a need for attention.

Related Visual

• Visual 1: Infographic - A diagram illustrating the nine diagnostic criteria for Borderline Personality Disorder, highlighting the symptoms presented in the question (instability, impulsivity, unstable relationships).
• Visual 2: Table - A comparative table of Cluster B personality disorders (Antisocial, Borderline, Histrionic, Narcissistic) showing the key differences in core features, interpersonal style, and affect.

Clinical Relevance

• Nursing practice connection: Use the key finding related to Diagnosis of Cluster B personality disorders based on clinical presentation to guide bedside assessment, documentation, and the next nursing action.
• Nurses frequently encounter patients with BPD in various settings. Understanding the core features is crucial for providing effective, non-judgmental care and managing challenging behaviors like splitting.
• A key nursing priority is safety, as individuals with BPD have a high risk of self-harm and suicide attempts. A thorough risk assessment is mandatory.
• What if? If the patient's primary features were grandiosity, a need for admiration, and a lack of empathy, the diagnosis would shift towards Narcissistic Personality Disorder, another Cluster B disorder.

How to Approach the Question

• First, identify the key symptoms presented in the clinical vignette: emotional instability, dependent behavior, impulsive aggression, and unstable relationships.
• Recognize that this constellation of symptoms points towards a significant personality dysfunction, likely within Cluster B (dramatic, emotional, erratic).
• Systematically evaluate each option. Note that Dependent PD is a Cluster C (anxious, fearful) disorder, making it a less likely fit for the described aggression and instability.
• Compare the remaining Cluster B options. Antisocial PD is defined by violating others' rights, and Histrionic PD by attention-seeking. Neither is the primary driver in the vignette.
• Conclude that the pattern of pervasive instability in mood, relationships, and self-image, combined with impulsivity, is the classic presentation of Borderline Personality Disorder.

Concept Tested & Keywords

• Concept Tested: Diagnosis of Cluster B personality disorders based on clinical presentation.
• Stem keywords: emotional instability, dependent behavior, impulsive aggression, unstable interpersonal relationships
• Lead-in keywords: most likely diagnosis
• Clinical cues: The combination of instability in mood, relationships, and behavior is a key diagnostic clue.

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QlCrEBhU8TdAPFhVTshtEE

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