If you are preparing for the California MFT Clinical Exam or the National MFT exam, a topic that could very well be tested on your exam is personality disorders. We constantly hear people casually labeling others as narcissistic, borderline, or antisocial, to name a few. However, when working as a mental health professional, these personality disorders have specific criteria we must be familiar with before considering this cluster of diagnoses. So what are the distinguishing features of personality disorders?
Personality disorders are:
- Generally egosyntonic
- Characterized by unhealthy and rigid patterns of thoughts and behaviors
- Frequently linked to dysfunctional relationships, problems in employment, and academic challenges, and general challenges in social settings.
Let’s test your knowledge of personality disorders in this week’s FREE practice question!
Free Practice Question:
A 50-year-old man seeks individual therapy on the advice of his lawyer. The man is quick to share that he is the owner of a very successful company that he built from the ground up and that revolutionized how people function. He explains that he and his wife are going through a divorce. He states, “she never showed me the respect, love or attention I deserved. And even though she wants custody of the kids, she has no right to ask for any of my hard-earned mon
ey.” He explains that he is “revered” at work, and while he is always working hard, it’s worth the sacrifices because his staff and professional community recognize his talents and importance. Which of the following diagnoses should the therapist consider for this client?
A. Histrionic Personality Disorder
B. Narcissistic Personality Disorder
C. Bipolar Disorder
D. Antisocial Personality Disorder
(scroll down for the correct answer and rationale...)
The correct answer is B.
According to the DSM 5, Narcissistic Personality Disorder is characterized by an ongoing pattern of grandiosity, continual need for admiration, and lack of empathy for others. We see this very clearly in the vignette. The client is divorcing his wife for her failure to see him as he sees himself. He seems to need respect, attention and love. In addition, his description of his company and it's effect on society are illustrative of a sense of self-importance. Finally, the client’s description of how he is perceived by others at work and within his professional community.
Answer A is incorrect. For Histrionic Personality Disorder you need to see the client engaging in attention-seeking behaviors--cute or overly sexualized.
Bipolar Disorder is a differential diagnosis for Narcissistic Personality Disorder. Grandiosity is also present with mania and depressive symptoms are likely when a person’s ego is injured. The grandiosity can be seen in the vignette, but there are no depressive symptoms.
Finally, answer D, Antisocial Personality Disorder is incorrect. We do not see behaviors that indicate a pervasive disregard for rules, or the rights of others. There is a disregard for his wife and children (not wanting to give money). However, it is very specific, not pervasive, and is a response to her harming his ego.
Exam Preparation
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