Comprehensive exams for Mental Health Q 191
Which statement about an individual with a personality disorder is true?
A. Psychotic behavior is common during acute episodes.
B. Prognosis for recovery is good with therapeutic intervention.
C. The individual typically remains in the mainstream of society, although he has problems in social and occupational roles.
D. The individual usually seeks treatment willingly for symptoms that are personally distressful.
Correct Answer: C. The individual typically remains in the mainstream of society, although he has problems in social and occupational roles
An individual with personality disorder usually is not hospitalized unless a coexisting Axis I psychiatric disorder is present. Generally, these individuals make marginal adjustments and remain in society, although they typically experience relationship and occupational problems related to their inflexible behaviors. Personality disorders are chronic lifelong patterns of behavior; acute episodes do not occur.
Option A: Psychotic behavior is usually not common, although it can occur in either schizotypal personality disorder or borderline personality disorder. A thorough personal and social history accompanied by collateral information will lead the clinician towards accurate diagnosis and treatment. Collateral information is paramount in the deduction of an accurate diagnosis, as those closest to the patient will have significant insight into the person afflicted behavioral patterns. Families of individuals with personality disorders will often be the reasons that they present to providers. A common statement heard in the clinic for a patient with personality disorders would be, “My family says they have had enough, and I should get help.” Families and spouses would often present the most significant information pertinent to the diagnoses of personality disorders.
Option B: Because these disorders are enduring and evasive and the individual is inflexible, prognosis for recovery is unfavorable. Personality disorders are not only distressing for the individual, but also a burden to society. Studies have revealed that personality disorders have strong correlations with disability benefits. Because they lack insight, and will not seek proper medical attention, the overall prognosis is grim. Symptomatology tends to wax and wane over time. Luckily, certain disorders experience “burnout” as the individual ages. Symptoms become less severe and debilitating, with age.
Option D: Generally, the individual does not seek treatment because he does not perceive problems with his own behavior. Distress can occur based on other people’s reactions to the individual’s behavior. Most patients with personality disorders often have little to no insight in regards to their maladaptive behavior. They rarely voluntarily present with “personality disorder” or “personality issues” as their chief complaint. More often than not, the patient will present secondarily to psychiatric sequelae of personality disorders. Such sequelae include chronic depression, interpersonal relationship hardships, unsatisfactory academic history, and poor vocational performance.