Comprehensive Overview of Personality Disorders: Susan Stocks PowerPoint Presentation

Define personality disorder

- Inflexible, rigid personality traits - result in maladaptive patterns of behavior/impairment in functioning

- Some personality behaviors considered normal-only if significant distress/impairment occurs=disorder

What is the criteria for a personality disorder?

- Impairment of personality functioning/maladaptive traits

- Significant functional impairment/distress

- Behavior fails to conform to cultural, social or legal norms

- Diagnosed in young adulthood, after personality develops

- Relatively common

- Long standing

What are the traits of a PD?

•Anger

•Lack of guilt/remorse

•Impulsivity

•Irresponsible

•Risk taking

•Manipulative, dishonest, deceitful, lying behaviors

•Labile moods

What are the biologic theories related to the etiology of PD?

heredity/genetics/biochemical changes affecting development of personality

What are the psychodynamic theories related to the etiology of PD?

social learning, culture, random life events affecting development of personality (trauma)

What are the Cluster A behaviors and associated disorders?

odd/eccentric

paranoid PD

schizoid PD

schizotypal PD

What are the Cluster B behaviors and associated disorders?

dramatic, emotional, eccentric

antisocial

borderline

histrionic

narcissistic

What are the cluster C behaviors and associated disorders?

anxious/fearful

avoidant PD

Dependent PD

Obsessive-compulsive PD

What are two common PD seen in Psychiatric Settings?

Antisocial

Borderline

Define Antisocial

disregard for rights of others/rules/laws; lack of remorse/empathy

Define Borderline

unstable relationships, self-image, impulsivity, self-mutilation

What are the S/S of BPD

- Pattern unstable/intense personal relationships

- Unstable self-image

- Impulsivity

- Recurrent suicidal behavior

- Chronic feelings of emptiness

- Intense anger/difficulty controlling anger

- Manipulative

- Defense Mechanism-Splitting

Name three Nursing Diagnoses for BPD

- risk for self-harm

- impaired social interaction

- chronic low self-esteem

What are Interventions related to BPD

- safety-client, environment

- encourage client to express anger appropriately

- encourage expression of client feelings

- do not offer attention/sympathy to maladaptive behaviors

What are the S/S of Antisocial PD

- Disregard/violate rights of others

- Cannot empathize with others

- Rationalize their behavior

- Deceitful

- Charming, engaging

- Do not consider moral/ethics in decision making

- Use Projection as defense mechanism

- *occurs in approximately 3% of population, however in prison populations around 50% are diagnosed with ASPD

Name 4 Nursing Diangoses related to Antisocial PD

- Risk for Other-directed violence

- Impaired Social Interaction

- Defensive Coping

- Chronic low self-esteem

What are some nursing interventions related to Antisocial PD?

- Safety-client, environment, etc

- Facilitate a low-stimuli environment

- Encourage client to express anger appropriately

- Encourage expression of client feelings/hostility

- Utilize therapeutic communication to encourage trust; non-judgmental attitude

- Tranquilizing medications as ordered

What are treatments for antisocial PD

•Psychotropic medication-based on type/severity of symptoms (mood dysregulation, anxiety, psychosis, aggression/ impulsivity)

•Therapeutic strategies –group/individual therapies: CBT, self-help and coping skills

•Therapeutic communication –provide appropriate interactions, facilitate positive behaviors, help clients identify dysfunctional behavior

•Difficult to treat

What are treatment challenges for someone with Antisocial PD?

•As rapid/substantial changes in personality unlikely, treatment progress is slow/erratic. Many behaviors and aspects of personality are long-standing and deep rooted

•Lack of steady, notable progress leads to frustration for client, family, and those providing care

What is the nurses role when caring for someone with antisocial PD?

•Assessment

•Maintain physical safety of client

•Avoid being manipulated/frustrated

•Utilize therapeutic communication with clear boundaries