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Varcarolis – Chapter 24: Personality Disorders

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This document contains Chapter 24 of Varcarolis: Foundations of Psychiatric-Mental Health Nursing, focusing on personality disorders, diagnosis, treatment approaches, and patient care strategies. Useful for academic study and clinical preparation.

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A 37-year-old client, referred to the mental health clinic with a suspected personality disorder, is withdrawn and
suspicious and states, "I've always preferred to be alone" and then adds, "I can read your thoughts whenever I want
to." This presentation supports which psychiatric diagnosis?


a. Avoidant personality disorder
b. Obsessive-compulsive personality disorder
c. Schizotypal personality disorder (STPD)
d. Narcissistic personality disorder


Schizotypal personality disorder (STPD)


The main traits that describe STPD are psychoticism such as eccentricity, odd or unusual beliefs and thought
processes, and social detachment by preferring to be socially isolated, as well as being overly suspicious or anxious.
In obsessive-compulsive personality disorder the main pathological personality traits are rigidity and inflexible
standards of self and others, along with persistence of goals long after they are necessary, even if they are self-
defeating or negatively affect relationships. People with narcissistic personality disorder come across as arrogant,
with an inflated view of their self-importance. They have a need for constant admiration, along with a lack of empathy
for others, a factor that strains most relationships over time. Traits of avoidant personality disorder include low self-
esteem, feelings of inferiority compared with peers, and a reluctance to engage in unfamiliar activities involving new
people.

, A 24-year-old client diagnosed with borderline personality disorder (BPD) is admitted to the inclient psychiatric unit
following a suicide attempt. Which client statements illustrate a primary coping style of persons with BPD?


a. "Last night the nurse let me go outside and smoke. I can't believe you aren't letting me. I used to think you were the
best nurse here."
b. "I promise I am not feeling suicidal. I won't hurt myself."
c. "My provider says I might get out of here tomorrow. Do you think I'm ready to go?"
d. "I will never again speak to any of my messed up family members. I know that this will help me to be more
functional."


a. "Last night the nurse let me go outside and smoke. I can't believe you aren't letting me. I used to think you were the
best nurse here."


A primary coping style used by clients with BPD is called splitting. Splitting is the inability to incorporate positive and
negative aspects of oneself or others into a whole image. The individual may tend to idealize another person (friend,
lover, health care professional) at the start of a new relationship and hope that this person will meet all of his or her
needs. At the first disappointment or frustration, however, the individual quickly shifts to devaluation, despising the
other person. The other options do not describe splitting, which is a primary coping style of clients with BPD.

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