A 24-year-old single woman presents to the PMHNP for a psychiatric evaluation after discharge from an inpatient psychiatric unit, where she had been admitted for a suicide attempt. She cut her wrists after her boyfriend of one month broke up with her. She reports a long history of self-mutilation, impulsiveness, and no relationship lasting longer than three months. Which is the most likely diagnosis?

Choice A reason: Histrionic personality disorder involves attention-seeking behavior and excessive emotionality. While unstable relationships may occur, self-harm and impulsivity are not core features. Choice B reason: Narcissistic personality disorder is characterized by grandiosity, need for admiration, and lack of empathy. It does not typically involve self-mutilation or intense fear of abandonment. Choice C reason: Dependent personality disorder involves excessive reliance on others and difficulty making decisions independently. While fear of abandonment is present, impulsivity and self-harm are not hallmark features. Choice D reason: Borderline personality disorder is marked by emotional instability, impulsivity, intense fear of abandonment, and recurrent self-harming behaviors. The client’s history of unstable relationships, suicide attempt, and self-mutilation strongly align with this diagnosis.