Review Question - QID 109016

A 69-year-old male presents to his primary care physician for a checkup. He has not seen a doctor in 15 years and thought he may need an exam. The patient’s past medical history is unknown and he is not currently taking any medications. The patient lives on a rural farm alone and has since he was 27 years of age. The patient works as a farmer and never comes into town as he has all his supplies delivered to him. The patient is oddly adorned in an all-denim ensemble, rarely makes eye contact with the physician, and his responses are very curt. Hi temperature is 98.6°F (37°C), blood pressure is 155/92 mmHg, pulse is 62/min, and respirations are 15/min. A physical exam is performed and is notable for an obese man with an S3 heart sound on a cardiac exam. The patient is informed that further diagnostic testing may be necessary and that it is recommended that he begin taking lisinopril and hydrochlorothiazide. Which of the following is the most likely personality disorder that this patient suffers from?