AssessmentsCluster C personality disorders
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 46-year-old man comes to the office for a psychological evaluation after having repeated fights with his coworkers. When asking the patient about his childhood, he mentions that he is the eldest child in his family and that his father used to work in the army. Currently, the patient claims to enjoy strict workout routines and also adores making lists for his daily activities, asserting that he doesn't go to bed until they're finished. When asking the patient about his current problem, he claims that his coworkers don't ever organize their workspaces, and he finds it very difficult to work in such an environment. In fact, he repeatedly washes his hands immediately after greeting them each day. Looking at his previous workplace evaluations, he has an immaculate profile and an outstanding job performance. Which of the following defense mechanisms is most likely to be associated with his condition?
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People with this disorder can be hypersensitive to rejection and negative feedback, becoming even more withdrawn when that happens.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.