A woman exhibits entitlement and hostility when she feels slighted in a restaurant. What is the most likely diagnosis according to DSM-5?

The presentation of entitlement and hostility in response to feeling slighted is characteristic of narcissistic personality disorder. Individuals with this disorder often have an inflated sense of self-importance and a deep need for admiration, leading them to develop a sense of entitlement. When their expectations are not met, such as being overlooked in a restaurant, they may react with hostility or anger. This reaction stems from their fragile self-esteem and inability to cope with perceived slights or criticism.

In contrast, borderline personality disorder typically involves intense emotional instability and difficulties in interpersonal relationships, but does not exclusively highlight the themes of entitlement and hostility in the same way. Histrionic personality disorder, while characterized by attention-seeking behavior, does not prominently feature entitlement or the same level of hostility in response to being slighted. Paranoid personality disorder involves pervasive distrust and suspiciousness of others, which does not align with the entitlement factor described in the scenario.

Thus, recognizing the specific combination of entitlement and hostility helps to accurately identify narcissistic personality disorder as the most fitting diagnosis in this case.