PERSONALITY DISORDERS

notb 10/17/26

personality disorders

involves long lasting, pervasive, and inflexible patterns of thinking, mood, perceptions, behaviors, and ways of relating to others. often shows a deviation from expectations, norms, and cultures. these patterns can cause significant distress. most often appear in late adolescence to early adulthood. behaviors may be odd, dramatic, or anxious. tend to not be diagnosed in children, as personality is fluid in kids. older adult dx may also be unreliable; the gerontological personality disorder scale can be used to assess these patients. main treatment is psychotherapy, with meds being used as an adjunct.

personality

the unique blend of traits, thoughts, attitudes, and behaviors that make a person unique. framed by the “big 5” traits.

freud personality development

theorized that one’s personality develops during the five stages of psychos3xual development from 0 to 18 years of age. five stages includes or4l, an4l, phallic, latency, and g3nital stages. one must progress successfully through each stage to become a well-functioning adult. complications during any of these stages, such as repression or fixation, may impact personality development.

erikson personality development

theorized that there are eight stages of development from birth to end of life. each of these stages contain a developmental task and a psychosocial crisis. one either had successful or unsuccessful resolution of the psychosocial crisis in each stage. how each stage is resolved can have positive or negative impacts on personality development.

cluster A

consists of paranoid PD, schizoid PD, and schizotypical PD. clients who experience these kinds of personality disorders often demonstrate odd or eccentric behaviors. these clients can become aware that their behaviors are considered odd by others and, if motivated, can make changes in those behaviors to relate better to family, friends, and other people in their workplace. care plans that focus on finding and maintaining interpersonal relationships should be developed.

cluster B

specific disorders include antisocial PD, borderline PD, histrionic PD, and narcissistic PD. consists of four personality disorders that are characterized by dramatic, erratic, and emotional behavior. care plans should focus on teaching the clients to set limits on these dramatic and inappropriate behaviors. for clients who have BPD, emotional regulation should be a goal. these clients can become aware of how their behaviors are disruptive to others, analyze the emotions behind those behaviors, and make choices to change the behaviors to fit in better within the boundaries of others.

cluster C

includes avoidant PD, dependent PD, and obsessive-compulsive PD. characterized by anxious and fearful behavior. the care plan goal should be to decrease anxiety. schema therapy can be useful in older clients. these clients can also use coping skills to decrease anxiety and increase their self-esteem. pet therapy has also been shown to decrease anxiety.

interpersonal therapy

therapy that analyzes current problems by processing situational roles and tasks and then seeks solutions that are framed in interpersonal terms.

paranoid PD (A)

shows manifestations of distrust and suspicion of others. these clients also often believe that there are others out to deceive or harm them and that they could be harmed at any moment. these clients have difficulty developing and maintaining close relationships, which can lead to isolation and frustration.

schizoid PD (A)

these clients are socially withdrawn and have little to no interest in forming close relationships. these clients often exhibit limited emotional expression, a preference for solitary activities, avoidance of social interaction, and a lack of desire for meaningful close relationships. these clients can function well in jobs that require little to no social interaction, and s3xual activity is of little interest. may describe some “pain” in not being able to have social interactions like their peers.

schizotypal PD (A)

these clients may have peculiar or eccentric thoughts, behaviors, and patterns of speech; disturbances in the perception of events; odd beliefs or fantasies; and trouble with meeting people and maintaining close friendships. these clients may be inspirational leaders, but their disorder can manifest behaviors that make relationships and fitting into the environment difficult. they may incorrectly interpret ordinary events, have magical thinking, or misunderstand speech.

antisocial PD (B)

these clients tend to disregard and violate the rights of other people and dismiss the rules of society. main manifestations include lying, deception, aggression, violating laws, reckless disregard for the safety of self or others, irresponsibility, and a total lack of remorse. can be attributed to a dysregulation of serotonin, which contributes to low arousal, poor fear conditioning, and deficits in decision-making. CBT is the main treatment.

borderline PD (B)

these clients often exhibit poor boundaries between themselves and others, excessive emotional reactions, fear of abandonment, and impulsivity among many other manifestations. most concerning manifestations include self-harm, and suicide attempts or threats. behaviors can seem frantic, dramatic, attention-seeking, and overly expressive. origins can begin with a sensitivity to rejection in childhood. exposure to traumatic events increase the chance of developing this disorder. DBT and CBT can help with this, along with narrative therapy and medications.

histrionic PD (B)

clients demonstrate behaviors that are dramatic, emotion, and attention-seeking, and may even be seductive. attention-seeking behavior may lead to safety issues and even accidental injury.

narcissistic PD (B)

characterized by a pattern of grandiose behaviors centering on self-superiority and the need to be admired, combined with a lack of empathy for others. these clients often overestimate their abilities and accomplishments and are often preoccupied with thoughts of unlimited success, power, brilliance, beauty, or ideal love. these clients may devalue the nurse or over idealize the nurse and other providers. functions as a defense against the client dealing with feelings of low self-esteem.

avoidant PD (C)

client with this disorder may lack close fiends, avoid social activities for fear of criticism, and feel anxious or embarrassed when in front of other people. in most careers and relationships, these traits can hamper successful achievements because the client avoids responsibilities to prevent criticism from others.

dependent PD (C)

these clients have an excessive and often pervasive need to be taken care of, with behaviors described as cloning or having excessive fear of separation. these individuals exhibit very submissive behaviors and often have difficulties making decisions without guidance, need reassurance, and depend on others to assume responsibility for major areas of their lives. may go to excessive lengths to obtain nurturance.

obsessive-compulsive PD (C)

these clients often have intense obsessive thoughts that are then relieved by compulsive, ritualized behaviors. clients who have this disorder are perfectionistic, demand control, lack flexibility, and are reluctant to delegate tasks to others. client feels the need for control but is often unaware of the effects of their PD.

schema therapy

psychoeducation that changes the patterns of thought (schemas).