AssessmentsCluster C personality disorders
Cluster C personality disorders
USMLE® Step 1 style questions USMLE
A 29-year-old woman comes to the office for a routine check-up at the prompting of her parent. The patient’s parent reports that the patient has endured emotional abuse by her partner. The patient refuses to end the relationship with her partner and feels uneasy when the partner is not around. She adds, “I'm worried that if I leave the relationship, my life will only get worse.” She has not been employed since she started dating and living with her partner, and she is convinced that nobody would hire her. A review of her medical record indicates that she has endured several episodes of verbal abuse from prior relationships, which she suggested “were all her fault.” She has had four prior serious relationships and reports that she has not been single for more than a few weeks in the last 10 years. The patient’s parent states that they manage most of her finances and that the patient is “unable to handle it on her own.” She does not have any friends outside of her romantic relationship. Vitals are within normal limits. Physical examination is unremarkable. Which of the following best describes the underlying cause of this patient’s behavior?
Content Reviewers:Rishi Desai, MD, MPH
Contributors:Tanner Marshall, MS
If you were asked to describe a friend’s personality, you might describe them as a creative type, or easy-going but nervous in groups.
Basically, you’re trying to summarize the personality traits that make them who they are—either how they think or how they act.
Sometimes these thought patterns or behaviors which make up a person’s personality can actually be harmful in the sense that they interfere with their day-to-day functioning in their personal life, at work, or in social settings.
If this were the case, we would say that the individual has a personality disorder.
The DSM-5 lists ten personality disorders that are split into three different “clusters”: A, B, and C.
These used to be under the umbrella of “Axis 2” but that way of organizing isn’t really used anymore.
As you can probably guess, they all have a genetic association with anxiety disorders.
Let’s start with avoidant personality disorder.
Individuals with this disorder tend to be shy, timid, and socially inhibited, with extremely low self-esteem, seeing themselves as incapable, inadequate, and undesirable.
These individuals often want close relationships with others, but rarely take social risks, and avoid social situations, which makes it hard for them to meet new people.
People with this disorder can be hypersensitive to rejection and negative feedback, becoming even more withdrawn when that happens.
There is overlap between avoidant personality disorders and social phobias, but one key difference is that social phobias tend to be focused on anxiety of specific situations like public speaking or dancing in public, while avoidant personality disorder is defined by an anxiety of social situations more generally.
Next we’ve got obsessive compulsive personality disorder (OCPD), which is where individuals are obsessed with orderliness, perfectionism, and having complete control, as well as rules, details, and schedules.
While OCPD might sound like a great set of attributes, people with this disorder can often be inflexible and easily stressed, as well as surprisingly inefficient because they spend so much extra time planning and worrying about tasks, rather than simply getting on with them.