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A psychiatric disorder where projection is the major defense mechanism
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A psychiatric disorder which rarely coexists with mood disorders or substance abuse
A psychiatric disorder that has a genetic association with schizophrenia
A psychiatric disorder associated with the belief that people are either all good or all bad at different times
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A psychiatric disorder associated with anxiety disorders
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The patient presents with signs of borderline personality disorder. Borderline personality disorder is associated with splitting, that is, believing people to either be all good or all bad. Borderline personality disorder is characterized by an unstable mood and interpersonal relationships, impulsiveness, self-mutilation, boredom, and a sense of emptiness. Females are more commonly affected than males. Splitting is a major defense mechanism. Be able to distinguish it from other Cluster B personality disorder which are also dramatic, emotional, and erratic (antisocial, histrionic, and narcissistic). Antisocial personality disorder is associated with criminality and disregard for the rights of others. Histrionic is associated with attention seeking and sexual provocation, and narcissistic is associated with grandiosity and a sense of entitlement. Angstman and Rasmussen discuss personality disorders. Personality disorders are present in 9% of the U.S. population. Psychotherapy, pharmacotherapy, and brief interventions by family physicians can improve the health of patients with these disorders. Patients with borderline personality disorder may benefit from the use of omega-3 fatty acids, second-generation antipsychotics, and mood stabilizers. Allilaire discusses diagnosis and treatment of borderline personality disorder. The prevalence is about 2% with female to male ratio of 2-3:1. Adolescents and adults may be affected. There is a high risk of suicide, addictive behaviors, eating disorders, and criminality. These individuals frequently have a history of trauma in early childhood such as separation, loss, physical or sexual abuse, and affective deprivation. The clinical course is often lengthy and complex, but outcome may be favorable as long as the principal risk, suicide, is correctly managed. Incorrect Answers: Answer 1: Paranoid personality disorder is associated with projection as a major defense mechanism. Answer 2: Cluster B personality disorders such as antisocial, borderline, and histrionic are associated with mood disorders and substance abuse. Answer 3: Cluster A personality disorders such as paranoid, schizoid, and schizotypal have an association with schizophrenia. Answer 5: Anxiety disorders are associated with Cluster C personality disorders: avoidant, obsessive-compulsive, and dependent.
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