A patient with grandiose accomplishments, lack of empathy, and arrogance most likely has which personality disorder?

The description of a patient exhibiting grandiose accomplishments, a lack of empathy, and arrogance aligns with the characteristics of narcissistic personality disorder. This disorder is marked by an inflated sense of self-importance, a strong need for admiration, and a lack of consideration for others’ feelings. Individuals with this condition often see themselves as superior and may have fantasies of unlimited success, power, or brilliance, which reflects the grandiosity mentioned.

In contrast, the other options represent different personality disorders with distinct features. For example, individuals with schizoid personality disorder typically display social detachment and a limited range of emotional expression, which does not align with the traits described. Obsessive-compulsive personality disorder is characterized by perfectionism and a preoccupation with orderliness, rather than the grandiosity noted in the question. Lastly, borderline personality disorder involves instability in relationships, self-image, and emotions but does not specifically highlight the grandiosity and arrogance that are pivotal to narcissistic personality disorder.

Thus, the most accurate match for the symptoms presented is narcissistic personality disorder.