CEA Nursing Practice Exam

A young female with recurrent self-harm and unstable relationships is characteristic of which disorder?

1. Severe anxiety disorder

2. Bipolar disorder

3. Borderline personality disorder

4. Major depressive disorder

The correct answer is: Borderline personality disorder

The characteristics of recurrent self-harm and unstable relationships are strongly indicative of borderline personality disorder. This disorder is marked by a pervasive pattern of instability in interpersonal relationships, self-image, and affects, along with significant impulsivity. Individuals with borderline personality disorder often experience intense emotional responses and have difficulties maintaining stable relationships, leading to a cycle of idealization and devaluation of others. Those with this disorder may engage in self-harm as a coping mechanism to deal with emotional distress or to communicate their pain. This behavior typically serves to alleviate feelings of emptiness or to express intense emotions that they may feel unable to articulate otherwise. The instability in relationships is also a hallmark feature, as individuals may oscillate between extreme closeness and extreme distance with loved ones. In contrast, severe anxiety disorder primarily involves excessive worry and fear rather than self-harm or relationship instability. Bipolar disorder involves mood swings that include depressive episodes and manic episodes but does not centrally feature the instability in relationships characteristic of borderline personality disorder. Major depressive disorder includes symptoms of persistent sadness and a lack of interest but does not typically present with recurrent self-harm as a defining symptom or the relational dynamics seen in borderline personality disorder.