Week 11: Personality Disorders

What are the cluster A (eccentric) personality disorders?

Paranoid, schizoid, and schizotypal

What are the cluster B (erratic) personality disorders?

Borderline, Narcissistic, histrionic, and antisocial

What are the cluster C (anxious) personality disorders?

Avoidant, dependent, and obsessive-compulsive

What is personality?

The characteristics and behavior that comprise a persons unique adjustment to life, including major traits, interests, drives, values, self-concept, abilities, and emotional patterns

What is personality developed?

Around 9-18 months of age

What is personality disorder?

A pattern of inflexible inner experiences and extrernal behaviors that differ from cultural expectations and impairs daily life

What are the most common symptoms that occur in all of the types of personality disorders?

Impairment in interpersonal relationships, dysfunction in cognition, dysfunction in affect, and dysfunction in impulse control

What is the general treatment for personality disorders?

Psychopharmacology, individual therapy, DBT, family education and therapy, social skills training, and group therapy

What is the prognosis like for personality disorder?

Depends on the degree of impairment and the persons motrivation

What is schizotypal personality disorder?

Magical thinking, odd ideas, eccentricity, superstition, sometimes wants relationships, brief episodes of hallucination or delusion, rambling during conversation

What are nursing interventions for schizotypal Personality Disorder?

Respect the patients need for social isolation, encourage interaction but don’t force it, reinforce socially appropriate behavior

What is schizoid personality disorder?

Social withdrawal, uninterested in others, unaffected by praise and criticism, does not want relationships, loners by choice, avoid close relationships, depersonalization, cold/detached/distant

What are nursing interventions for schizoid personality disorder?

Avoid being too nice, do not try to increase socialization, protect against group ridicule, respect personal space and time

What is paranoid personality disorder?

Paranoia, distrustful, doubts loyalty, easily offended, does not take criticism well, quick to anger, anxious, 

What are nursing interventions for paranoid personality disorder?

Counteracting mistrust, adhere to schedules and boundaries, avoid being overfriendly, use simple/direct language

What is the mood/affect of people with paranoid personality disorder?

Guarded

What is borderline personality disorder?

Intense erratic behavior, push/pull, black/white, no grey areas, splitting, suicidal behavior typically for attention but should take it seriously just incase, mood swings throughout the day, feelings of emptiness and boredom, intense anger, efforts to avoid abandonment, unstable relationships, impulsivity

What is splitting?

A defense mechanism in which they are unable to accept both positive and negative feelings (all good or all bad; no grey areas)

What are nursing interventions for borderline personality disorder?

Risk assessment, identify triggers, building trust, teach coping strategies, setting boundaries and conflict resolution, promoting safety

What is antisocial personality disorder?

Antagonistic behaviors (opposing), lack of empathy/remorse/guilt, violation of others rights, believe that rules don’t apply to them, aggressive, superficially charming but deceitful

What are nursing interventions for antisocial personality disorder?

Identify dysfunctional thinking, assist with anger control, help build a new support system, enhance self-awareness

What is histrionic personality disorder?

Self-centered, attention-seeking, dramatic, bold, low-frustration level, excessive emotions, considers relationships to be more intimate than they actually are

What are nursing interventions for histrionic personality disorder?

Keep interactions professional, ignore flirtations, help patient clarify feelings, assess for SI, set firm boundaries

What is narcissistic personality disorder?

Feelings of entitlement, lack of empathy, low self-esteem, hypersensitivity, constant need for admiration, are not trying for attention because they know that the already have the attention

What are nursing interventions for narcissistic personality disorder?

Stop giving attention and they will leave you alone, remain neutral, promote patient self-identity, avoid power struggles, role-model empathy

What is avoidant personality disorder?

Inferiority, social withdrawal, prolonged shyness, avoidance, avoids group settings and work, lots of anxiety, preoccupied with rejection, humiliation, and failure

What are nursing interventions for avoidant personality disorder?

Friendly and reassuring approach, acceptance of patient fears, exercises to enhance new social skills, assertiveness training

What dependent personality disorder?

Indecisive, clinginess, requires constant reassurance, fear of aloneness, needs someone to tell them exactly what to do, intense anxiety when left alone

What are nursing interventions for dependent personality disorder?

Help address current stressors, set limits, encourage independence

What is obsessive-compulsive personality disorder?

Needs rules, organization, perfectionistic, constantly productive, inflexible standards, very hard to work with, excessive goal-seeking, so busy preparing for things that they don’t get to the end result or product

What are nursing interventions for obsessive-compulsive personality disorder?

Avoid power struggle, remember the patient has difficulty with unexpected changes, provide structure, promote calm and supportive energy

What are things that people with personality disorders have an increased risk of?

Depression, anxiety, and anger