Rosh Psychiatry Board Practice Exam

What is the likely diagnosis for a woman demonstrating entitlement and demanding immediate attention from restaurant staff?

1. Borderline personality disorder

2. Histrionic personality disorder

3. Narcissistic personality disorder

4. Paranoid personality disorder

The correct answer is: Narcissistic personality disorder

The presentation of entitlement and a demand for immediate attention from restaurant staff is indicative of narcissistic personality disorder. Individuals with this disorder often exhibit a pervasive pattern of grandiosity, a need for admiration, and a lack of empathy. They may believe they are special or unique and can often become frustrated or angry when they perceive that their needs or expectations are not being met. In a restaurant context, a person displaying these traits might expect exceptional service or preferential treatment, leading to a sense of entitlement. This demand for attention aligns well with the characteristics of narcissistic personality disorder, as such individuals often seek to be the center of attention and may resort to manipulative or confrontational behaviors to achieve that. While borderline personality disorder is marked by instability in relationships and self-image, and histrionic personality disorder involves excessive emotionality and attention-seeking behavior, neither captures the specific focus on entitlement and demand for special treatment as strongly as narcissistic personality disorder does. Paranoid personality disorder is characterized by pervasive distrust and suspicion of others, which does not align with the entitlement and demands described in this scenario.