Personality Disorders Flashcards
Cluster A
Paranoid
Schizoid
Schizotypal
Paranoid
Characterized by distrust and suspiciousness towards others based on unfounded beliefs that others want to harm, exploit, or deceive the person.
Jealousy, controlling behaviors, unwillingness to forgive
May precede a schizophrenia diagnosis
Defense mechanism: Projection
Schizoid Personality Disorder
Characterized by emotional detachment, disinterest in close relationships, and indifference to praise or criticism; often uncooperative.
Lifelong pattern of social withdrawal, expressionless, restricted range of emotional expression
Often marginalized, “loners”
Ridiculed by peers for odd behavior
Does not seek out or enjoy relationships
Schizotypal Personality Disorder
Both a personality disorder and schizophrenia spectrum disorder
Characterized by odd beliefs leading to interpersonal difficulties, an eccentric appearance, and magical thinking or perceptual distortions that are not clear delusions or hallucinations.
Strikingly strange and unusual beliefs, speech patterns, inappropriate affect
Severe anxiety in social situations
Magical thinking
Psychotic symptoms
Can be made aware of suspiciousness and magical thinking
High degree of mistrust – adhere to promises, appointments, and schedules
Cluster A: Nursing Considerations
Being too nice may be met with suspicion – Give straightforward explanations
Cluster A: Nursing Considerations
Simple language
Cluster A: Nursing Considerations
Limit setting
Cluster A: Nursing Considerations
Do not try to increase socialization
Respect need for social isolation
Cluster A: Nursing Considerations
Protect against ridicule
Cluster A: Nursing Considerations
Employ interventions appropriate for suspicion
Cluster A: Nursing Considerations
Strange beliefs and activities may be part of their life
Cluster A: Nursing Considerations
Cluster B
Antisocial
Borderline
Histrionic
Narsisstic
Antisocial Personality Disorder
Disregard for others with exploitation, lack of empathy, repeated unlawful actions, deceit, failure to accept personal responsibility
Evidence of conduct disorder before age 15
Sense of entitlement, manipulative, impulsive, and seductive behaviors
Nonadherence to traditional morals and values
Verbally charming and engaging
Histrionic Personality Disorder
Characterized by:
Emotional attention‑seeking behavior, in which the person needs to be the center of attention
“Dramatic”
Often seductive and flirtatious
Extroverted, colorful personalities, excitable
Struggle with developing meaningful relationships
Do not have insight into their role in impaired relationships
Behaviors stemming from distress
Narcissistic Personality Disorder
Characterized by:
Arrogance
Grandiose views of self‑importance
The need for consistent admiration
A lack of empathy for others that strains most relationships
Often sensitive to criticism
Behaviors stemming from weak self-esteem, shame, and fear of abandonment
Limit settings, clear and consistent boundaries
Cluster B: Nursing Interventions
Document behaviors objectively (i.e. provide times, dates, circumstances) of manipulative behaviors
Cluster B: Nursing Interventions
Know that having desires prevented may result in aggression
Cluster B: Nursing Interventions
All staff need to be consistent
Cluster B: Nursing Interventions
Understand seductive behavior is a response to distress
Cluster B: Nursing Interventions
Keep communication and interactions professional
Cluster B: Nursing Interventions
Clients may exaggerate symptoms
Cluster B: Nursing Interventions
Assess for SI, may make suicidal gestures and inadvertently result in death
Cluster B: Nursing Interventions
Remain neutral, remember behaviors come from fear and abandonment
Cluster B: Nursing Interventions
Avoid engaging in power struggles, becoming defensive
Cluster B: Nursing Interventions
Role model empathy.
Cluster B: Nursing Interventions
Provide the client exercises to enhance new social skills but use with caution because any failure can increase feelings of poor self-worth.
Cluster B: Nursing Interventions
Borderline
Characterized by instability of affect, identity, and relationships, as well as splitting behaviors, manipulation, impulsiveness, and fear of abandonment; often self-injurious and potentially suicidal; ideas of reference are common; often accompanied by impulsivity
Cluster C
Obsessive-Compulsive
Dependent
Avoidant
Avoidant Personality Disorder
Characterized by:
Social inhibition and avoidance of all situations that require interpersonal contact, despite wanting close relationships, due to extreme fear of rejection
Have feelings of inadequacy and are anxious in social situations
Avoid interpersonal contact due to fears of rejection, criticism, or humiliation
Low self-esteem, feelings of inferiority, reluctance to engage in unfamiliar activates with new people
Dependent Personality Disorder
Characterized by:
Extreme dependency in a close relationship with an urgent search to find a replacement when one relationship ends
Submissive and clinging behavior
Overwhelming need to be cared for
Intense fear of separation and abandonment
Intense anxiety when left alone
May manipulate others to assume their responsibilities
Stemming from a lack of confidence in their own abilities or judgment
Vulnerable to exploitation
Obsessive-Compulsive Personality Disorder
Characterized by:
Indecisiveness and perfectionism with a focus on orderliness and control to the extent that the individual might not be able to accomplish a given task
Limited emotional expression
Stubbornness
Indecisiveness
Preoccupation with orderliness, perfectionism, and control
Rigid, inflexible standard of self and others
Nurses should use a friendly, accepting, and reassuring approach.
Cluster C: Nursing Interventions
Remember that being pushed into social situations can cause severe anxiety for these clients
Cluster C: Nursing Interventions
Convey an attitude of acceptance toward fears
Cluster C: Nursing Interventions
Provide the patient exercises to enhance new social skills but use with caution because any failure can increase feelings of poor self-worth.
Cluster C: Nursing Interventions
Assertiveness training can assist the person to learn to express needs
Cluster C: Nursing Interventions
Avoid power struggles, need for control is high
Cluster C: Nursing Interventions
Be aware clients may struggle with sudden changes in routines
Cluster C: Nursing Interventions
Assist clients to identify ineffective coping and to develop effective coping techniques.
Cluster C: Nursing Interventions
Borderline Personality Disorder
Goals of Care
Self-restraint of self-harm, suicide, abusive behavior, aggression Impulse self-control Self-awareness Social interaction Coping Decreased stress
