Question at position 4 When Sarah's boyfriend broke up with her, she became extremely distressed and angry. She began to drink heavily and use illicit substances in order to cope with her emotions. On several occasions, Sarah has even threatened to kill herself if her boyfriend didn't answer her calls. Sarah is most likely to be diagnosed with which of the following disorders?borderline personality disorder (BPD)schizotypal personality disorderantisocial personality disorder (APD)obsessive-compulsive personality disorderSingle choice
A
borderline personality disorder (BPD)
B
schizotypal personality disorder
C
antisocial personality disorder (APD)
D
obsessive-compulsive personality disorder

Question

Question at position 4 When Sarah's boyfriend broke up with her, she became extremely distressed and angry. She began to drink heavily and use illicit substances in order to cope with her emotions. On several occasions, Sarah has even threatened to kill herself if her boyfriend didn't answer her calls. Sarah is most likely to be diagnosed with which of the following disorders?borderline personality disorder (BPD)schizotypal personality disorderantisocial personality disorder (APD)obsessive-compulsive personality disorderSingle choice

A

borderline personality disorder (BPD)

B

schizotypal personality disorder

C

antisocial personality disorder (APD)

D

obsessive-compulsive personality disorder

BlackTom AI · Accepted Answer

Borderline Personality Disorder is characterized by unstable interpersonal relationships, intense fear of abandonment, emotional dysregulation, impulsive self‑damaging behaviors (e.g., substance abuse), and recurrent suicidal threats or gestures.

1. Relevant knowledge points and concepts
- DSM‑5 criteria for BPD include: frantic efforts to avoid real or imagined abandonment; unstable and intense interpersonal relationships; identity disturbance; impulsivity in potentially self‑damaging areas (e.g., substance use); recurrent suicidal behavior, gestures, or threats; affective instability; inappropriate, intense anger; and transient stress‑related paranoid ideation or dissociation.  
- Other personality disorders differ: schizotypal involves odd beliefs and social anxiety; antisocial involves disregard for rights, deceit, and criminal behavior; OCPD involves perfectionism and rigidity.

2. Step‑by‑step reasoning
- Sarah’s boyfriend broke up with her; she became extremely distressed and angry — demonstrates intense affective instability and anger.  
- She began drinking heavily and using illicit substances to cope — indicates impulsivity in self‑damaging behaviors.  
- She has threatened to kill herself if her boyfriend didn’t answer her calls — is a recurrent suicidal threat and suggests frantic efforts to avoid abandonment/manipulative attempts to prevent separation.

3. Intermediate “checks” against diagnostic criteria
- Frantic efforts to avoid abandonment: present (threatening suicide to get responses).  
- Impulsivity in self‑damaging areas: present (heavy drinking and illicit substance use).  
- Recurrent suicidal behavior/gestures: present (threats of killing herself).  
- Intense anger/affective instability: present. These meet multiple BPD criteria.

4. Why the correct answer is correct
- The combination of fear of abandonment, extreme emotional reactions (anger, distress), impulsive substance use, and suicidal threats aligns strongly with BPD and DSM‑5 diagnostic features.

5. Why the other options are incorrect
- Schizotypal: would show eccentric beliefs, odd thinking, not primarily abandonment crises or suicidal threats.  
- Antisocial PD: centers on disregard for others, deceit, criminality, and lack of remorse rather than panic over abandonment or suicidal gestures.  
- OCPD: involves perfectionism and control, not impulsive substance use or suicidal threats.

6. Conclusion
- Therefore, the most likely diagnosis is borderline personality disorder (BPD), which matches the provided answer.

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The following patterns of affect, cognition, and behaviour are noted in those diagnosed with Borderline Personality Disorder, EXCEPT:

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