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Mary is a 26-year-old female who presents with a history of non-suicidal self-injury, specifically cutting her arms and legs, since she was a teenager. She has made two suicide attempts by overdosing on prescribed medications, one as a teenager and one six months ago; she also reports chronic suicidal ideation, explaining that it gives her relief to think about suicide as a "way out."

When upset, Mary states that she will "zone out," even in conversations or while at work. She states, "I don't know who Mary really is," and describes a longstanding pattern of changing her hobbies, style of clothing, and sometimes even her job based on who is in her social group. At times, she thinks that her partner is "the best thing that's ever happened to me" and will impulsively buy him gifts, send caring text messages, and the like; however, at other times she admits to thinking "I can't stand him," and will ignore or lash out at him, including yelling or throwing things. Immediately after doing so, she reports feeling regret and panic at the thought of him leaving her. Mary reports that before she began dating her current partner she sometimes engaged in sexual activity with multiple people per week, often with partners whom she did not know. 

Which diagnosis best aligns with the symptoms illustrated in the case?

Question 1 options:

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Question 1 (2 points)

Mary is a 26-year-old female who presents with a history of non-suicidal self-injury, specifically cutting her arms and legs, since she was a teenager. She has made two suicide attempts by overdosing on prescribed medications, one as a teenager and one six months ago; she also reports chronic suicidal ideation, explaining that it gives her relief to think about suicide as a "way out."

When upset, Mary states that she will "zone out," even in conversations or while at work. She states, "I don't know who Mary really is," and describes a longstanding pattern of changing her hobbies, style of clothing, and sometimes even her job based on who is in her social group. At times, she thinks that her partner is "the best thing that's ever happened to me" and will impulsively buy him gifts, send caring text messages, and the like; however, at other times she admits to thinking "I can't stand him," and will ignore or lash out at him, including yelling or throwing things. Immediately after doing so, she reports feeling regret and panic at the thought of him leaving her. Mary reports that before she began dating her current partner she sometimes engaged in sexual activity with multiple people per week, often with partners whom she did not know. 

Which diagnosis best aligns with the symptoms illustrated in the case?

Question 1 options:

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Jason and his partner, Juan, presented for couples' therapy to address increasing conflict they are experiencing since moving in together.  Juan described a several-month-long apartment search that was made "agonizing" by Jason's rigid work schedule and his "long" list of apartment demands. They were unable to come to a decision, and eventually they decided to just share Jason's apartment. As Juan concluded, "Jason won."

Jason refused to hire movers for his Juan's belongings, insisting on personally packing and taking an inventory of every item in his Juan's place. What should have taken two days took over a week. Once the items were transported to Jason's apartment, Juan began to complain about his "crazy rules" about where items could be placed on the bookshelf, which direction the hangers in the closet faced, and whether their clothes could be intermingled. Juan also complained that there was hardly any space for his possessions because Jason "never threw anything away. "

Jason often comes home after 9:00 or 10:00 p.m., because he had a personal rule to always have a blank "to-do" list by the end of the day. Juan would often wake early in the morning to find Jason grimly organizing shelves or closets or sorting books alphabetically by author. Throughout this process and the longer they lived together Juan found himself feeling increasingly detached from Jason.

Jason denied symptoms of depression and free-floating anxiety. He said that he had never experimented with cigarettes or alcohol, adding, "I wouldn't want to feel like I was out of control. 

Given the symptoms, what is the best diagnosis for Jason?

Question 3 options:

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Question 3 (2 points)

Jason and his partner, Juan, presented for couples' therapy to address increasing conflict they are experiencing since moving in together.  Juan described a several-month-long apartment search that was made "agonizing" by Jason's rigid work schedule and his "long" list of apartment demands. They were unable to come to a decision, and eventually they decided to just share Jason's apartment. As Juan concluded, "Jason won."

Jason refused to hire movers for his Juan's belongings, insisting on personally packing and taking an inventory of every item in his Juan's place. What should have taken two days took over a week. Once the items were transported to Jason's apartment, Juan began to complain about his "crazy rules" about where items could be placed on the bookshelf, which direction the hangers in the closet faced, and whether their clothes could be intermingled. Juan also complained that there was hardly any space for his possessions because Jason "never threw anything away. "

Jason often comes home after 9:00 or 10:00 p.m., because he had a personal rule to always have a blank "to-do" list by the end of the day. Juan would often wake early in the morning to find Jason grimly organizing shelves or closets or sorting books alphabetically by author. Throughout this process and the longer they lived together Juan found himself feeling increasingly detached from Jason.

Jason denied symptoms of depression and free-floating anxiety. He said Question 6 (1 point)

Which of the following statements does not represent current evidence and clinical knowledge regarding personality disorders?

Question 6 options:

that he had never experimented with cigarettes or alcohol, adding, "I wouldn't want to feel like I was out of control. 

Given the symptoms, what is the best diagnosis for Jason?

Question 3 options:

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Question 3 (2 points)

Jason and his partner, Juan, presented for couples' therapy to address increasing conflict they are experiencing since moving in together.  Juan described a several-month-long apartment search that was made "agonizing" by Jason's rigid work schedule and his "long" list of apartment demands. They were unable to come to a decision, and eventually they decided to just share Jason's apartment. As Juan concluded, "Jason won."

Jason refused to hire movers for his Juan's belongings, insisting on personally packing and taking an inventory of every item in his Juan's place. What should have taken two days took over a week. Once the items were transported to Jason's apartment, Juan began to complain about his "crazy rules" about where items could be placed on the bookshelf, which direction the hangers in the closet faced, and whether their clothes could be intermingled. Juan also complained that there was hardly any space for his possessions because Jason "never threw anything away. "

Jason often comes home after 9:00 or 10:00 p.m., because he had a personal rule to always have a blank "to-do" list by the end of the day. Juan would often wake early in the morning to find Jason grimly organizing shelves or closets or sorting books alphabetically by author. Throughout this process and the longer they lived together Juan found himself feeling increasingly detached from Jason.

Jason denied symptoms of depression and free-floating anxiety. He said that he had never experimented with cigarettes or alcohol, adding, "I wouldn't want to feel like I was out of control. 

Given the symptoms, what is the best diagnosis for Jason?

Question 3 options:

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Todd is a 32-year-old man referred for a mental health evaluation by the human resources department of a large construction business that had been his employer for 2 weeks. At his initial job interview, Todd presented as very motivated and provided two carpentry school certifications that indicated a high level of skill and training. Since starting his job, his supervisors have noted frequent arguments, absenteeism, poor workmanship, and multiple errors that might pose a safety risk. When confronted, Todd was reportedly dismissive, indicating that the problem was "cheap wood" and "bad management" and added that if someone got hurt, "it's because of their own stupidity."

The head of human resources did a background check during the course of the psychiatric evaluation. Phone calls revealed that Todd had been expelled from two carpentry training programs and that both his graduation certificates had been falsified. He had been fired from his job at one local construction company after a fistfight with his supervisor and from another job after abruptly leaving a job site. A quick review of their records indicated that he had provided them with the same false documentation.

During the mental health evaluation, Todd focused on unfairness at the company and on how he was "a hell of a better carpenter than anyone there could ever be." He claimed that his two marriages had ended because of jealousy. He said that his partners were "always thinking I was with someone else," which is why "they both lied to judges and got restraining orders saying I'd hit them." As "payback for the jail time," he refused to pay child support for his two children.

Mr. Edwards said he "must have been smart" because he had been able to make Cs in school despite showing up only half the time. He spent time in juvenile hall at age 14 for stealing "kid stuff, like tennis shoes and wallets that were practically empty." He left school at age 15 after being "framed for stealing a car" by his principal. Todd pointed out these historical facts as evidence that he was able to overcome injustice and adversity.

In regard to substance use, Todd said he smoked marijuana as a teenager and started drinking alcohol on a "regular basis" after he first got married at age 22. He denied that use of either substance was a problem.

On mental status examination, Todd was a casually dressed man who made reasonable eye contact and was without abnormal movements. His speech was coherent, goal directed, and of normal rate. There was no evidence of any thought disorder or hallucinations. He was preoccupied with blaming others, but these comments appeared to represent overvalued ideas rather than delusions. He was cognitively intact. His insight into his situation was poor.

Which diagnosis best describes the symptoms displayed by Todd:

Question 5 options:

Question 6 (1 point)

Which of the following statements does not represent current evidence and clinical knowledge regarding personality disorders?

Question 6 options: