PSYCHIATRIC

NURSING

PERSONALITY DISORDER
Personality Disorder
 Personality Disorder
• Assessment:
– Inflexible & maladaptive responses to stress.
– Distress & impairment in social, occupational, &
other areas of functioning.
– Stable & long duration
– Ability to evoke interpersonal conflict .
 Personality Disorder :
Clusters
A: Odd or Eccentric
– Paranoid P.D
– Schizoid P.D. • C : Anxious , fearful
– Schizotypal P.D – Dependent P.D
• B:Dramatic, emotional, erratic – Obsessive –
– Antisocial P.D Compulsive P.D
– Borderline P.D. – Avoidant P.D.
– Histrionic P.D.
– Narcissistic P.D.
 Personality Disorder :
Cluster-A
• Interventions:
A. Paranoid P.D.
– Avoid being too
Vigilant & suspicious friendly/nice
Bear grudges, – Give clear simple
unforgiving explanation, language.
Diff. close – Maintain neutral & kind
relationship/work alone affect.
Cold, lack of sense of – Make a written plan of
humor treatment – cooperation.
Very critical – Antipsychotic medications
 Personality Disorder :
Cluster-A
A. Schizoid P.D. • Interventions:
Neither desire nor close
relationships.
Prefer solitary/loners.
Cold, detachment,
flattened affect.
Occupation involves
little interpersonal
contacts.
– Avoid being too nice &
friendly
– Do not try to re-socialize
– Supportive
psychotherapy
– Behavioral-cognitive ty
– Group therapy
– Atypical AntiPsychotic
 Personality Disorder :
Cluster-A
A. Schizotypal P.D. • Interventions:
Similar to schizoid. – Respect C. need for
Ideas of reference, odd beliefs, social isolation.
magical thinking, illusions. – Appropriate
Paranoid fears intervention for
Lack of interpersonal suspiciousness.
relationships.
– Same with schizoid.
Inappropriate affect
Odd, eccentric or peculiar.
 Personality Disorder :
Cluster-B
B. ANTISOCIAL Personality P.D. • Interventions:
Stealing, lying,cruelty to – Prevent manipulative behavior
animals, vandalism, – set clear & realistic limits.
sunbstance abuse. ( known to all)
Deceitful – Document behaviors, physical
Consistent irresponsibility signs.
Impassivity & repeated – Provide clear boundaries &
aggressiveness. consequences
Total lack of remorse – Be aware of guilt &
Manipulative, aggressive, manipulations.
exploiting. – Treatment for substance abuse
Substance abuse – Lithium; carbamazipine, SSRI
– Behavior therapy
 Personality Disorder :
Cluster-B
B. Borderline P.D.
Intense and unstable relationships-
dependence vs. rejections.
Impulsive, self damaging behaviors.
Recurrent suicidal/self mutilating
behaviors/sarcasm
Chronic feeling of emptiness or boredom,
absence of satisfaction
Frantic efforts to avoid abandonment.
Splitting personality-good vs. bad.
• Interventions:
o Set clear/realistic goals.
o Be aware of manipulative
behaviors
o Provide clear and consistent
boundaries & limits.
o Avoid rejecting and rescuing.
o Assess suicidal, aggressive
behaviors.
o Hospitalization possible.
o Behavior- cognitive therapy
o Group therapy.
o SSRI
 Personality Disorder :
Cluster-B
B. Histrionic P.D.
Consistently draw attention to
themselves. Attractive & use
physical appearance.
Show excessive emotionality
and attention getting behavior.
Shallow personality.
Are suggestible
Without instant gratification or
admiration from others –
depression or suicidal
• Interventions:
– Understand seductive
behavior – distress
– Keep professional
communication and
interactions.
– Use concrete and
descriptive language.
– Teach and model
assertiveness.
 Personality Disorder :
Cluster-B
B. Narcissistic P.D. • Interventions:
Exploit others to meet their own – Remain neutral &
needs & desires
Arrogant, persistent entitlement.
avoid power struggles
Demeanor of grandiosity, need for
or becoming defensive.
admiration, lack of empathy – Convey anassuming
Begrudge others their success or self-confidence.
possessions.
Relationships are characterized by
disruption or control.
 Personality Disorder :
Cluster-C
C. Dependent P.D. • Interventions:
Unusual degree of agreeableness &
friendliness. – Try to satisfy c’s
Clinging behavior need, set limits.
Difficulty decision making
Often mistreated, abused, self
– Teach and role
sacrifice. model assertiveness
Have difficulty expressing
disagreements
 Personality Disorder :
Cluster-C
C. Obsessive-Compulsive P.D. • Interventions:
Inflexible, rigid& need to be in
control – Guard against
Perfectionists engaging in power
Overemphasis on work.
struggles.
Preoccupied with details
Highly critical of self & others- – Need for control is
morality, ethics, values.
very high.
Intimacy in relationships is
superficial. – Defense Mech:
Intellectualization,r
ationalization,
reaction formation.
 Personality Disorder :
Cluster-C
C. Avoidant P.D.
Social inhibition- social phobias
Strong feelings of inadequacies.
Avoid interpersonal activities.
Views- socially inept,
personally un appealing
• Interventions:
– A friendly. Gentle
reassuring approach.
– Cognitive-behavioral,
desensitization, social
skills
– May involve in small
group activities.
– MAOI,
benzodiazepines
The end