Which of the following has the highest risk of metabolic syndrome?

A. Fear of abandonment. Individuals with borderline personality disorder (BPD) have an intense fear of abandonment, leading to frantic efforts to avoid real or imagined rejection. This fear often results in unstable relationships, clingy behavior, or extreme emotional reactions to perceived neglect.

B. No remorse. Lack of remorse is characteristic of antisocial personality disorder (ASPD), not BPD. People with BPD may experience guilt, regret, and self-loathing, particularly after impulsive actions or relationship conflicts. Unlike ASPD, they do not engage in manipulative or harmful behavior without concern for others' feelings.

C. Mood swings. Rapid and intense mood swings are a hallmark of BPD. Affected individuals may shift from euphoria to despair within hours, often triggered by interpersonal stressors. This emotional instability contributes to self-destructive behaviors and difficulty maintaining relationships.

D. Impulsivity. People with BPD frequently engage in impulsive and reckless behaviors, such as substance abuse, binge eating, reckless driving, or self-harm. These behaviors are often driven by emotional dysregulation and difficulty coping with distress.

A. Adderall (amphetamine/dextroamphetamine) is a stimulant that increases dopamine and norepinephrine levels in the brain, improving focus and impulse control in individuals with ADHD. It is a Schedule II controlled substance due to its potential for abuse and dependence.

B. Strattera (atomoxetine) is a non-stimulant medication used for ADHD. It is a selective norepinephrine reuptake inhibitor (NRI) that helps with attention and impulse control but has a lower risk of abuse compared to stimulant medications. Unlike stimulants, it may take several weeks to show full effects.

C. Vyvanse (lisdexamfetamine) is a stimulant that is a prodrug of dextroamphetamine, meaning it must be metabolized in the body before becoming active. This mechanism provides a longer, smoother effect with a lower potential for abuse compared to immediate-release stimulants.

D. Ritalin (methylphenidate) is a stimulant that increases dopamine and norepinephrine activity in the brain, improving focus and impulse control. It is commonly used in both children and adults with ADHD and has short-acting, intermediate, and long-acting formulations.