NSG 2271, PSYCHOSOCIAL NURSING, CHAPTER 22, PERSONALITY AND IMPULSE CONTROL
DISORDERS| QUESTIONS WITH 100% CORRECT ANSWERS| LATEST UPDATE 100% VERIFIED
Obsessive-Compulsive Personality Disorder (Cluster C) bears resemblance to obsessive-
compulsive disorder (OCD) and is closely related to anxiety disorder. Although the disorders
have similar names, the clinical manifestations are quite different.
1. Patients with OCD tend to use obsessive thoughts and compulsions when anxious but less so
wen anxiety decreases, whereas those with OCPD do not demonstrate obsessions and
compulsions but a pervasive pattern of preoccupation with orderliness, perfectionism and
control.
2. Patients with OCPD have the capacity to delay rewards and those with OCD do not.
Individuals with the disorder attempt to maintain control by careful attention to rules, trivial
details, procedures and lists. They may be completely devoted to work. They are uncomfortable
with unstructured leisure time, especially vacations. Behaviorally, they are perfectionists,
maintaining a regulated, highly structured, strictly organized life. A need to control others and
situation is common in their personal and work lives. They are prone to repetition and have
difficulty making decisions and completing tasks because they become so involved in the
details. They can be overly conscientious about morality and ethics and value polite, formal,
and correct interpersonal relationships. They can be rigid, stubborn, and indecisive and are
unable to accept new ideas and customs. Their mood is tense and joyless. Warm feelings are
restrained and they tightly control the expression of emotions.
oppositional defiant disorder is characterized by a persistent pattern of disobedience,
argumentativeness, angry outbursts, low tolerance for frustration, and tendency to blame
others for misfortunes, large and small. Children with this disorder have trouble making friends
and often find themselves in conflict with adults.
Paranoid Personality Disorder (Cluster A) is characterized by a long-standing suspiciousness
and mistrust of people; refuse to assume personal responsibility for their own feelings, assign
responsibility to others and avoid relationships they cannot control. They are suspicious,
guarded, and hostile; mistrustful, even of relatives and friends. They misinterpret actions of
,others as deception, deprecation, and betrayal, especially regarding loyalty or trustworthiness
of friends and associates. They are unforgiving and hold grudges. Their typical emotional
response are anger and hostility. They distance themselves from others and are outwardly
argumentative and abrasive. Internally they feel powerless, fearful and vulnerable. Blind to
their own unattractive behaviors and characteristics they often attribute these traits to others.
Outward demeanor seems cold, sullen and humorless. They want to appear controlled and
objective but react emotionally, displaying signs of nervousness, anger, envy and jealousy.
Orderly by nature. Occupational problems are common. They do not seek mental health care
until they decompensate into psychosis.
The prevalence estimate for paranoid personality disorder is ___%, whereas the National
Epidemiologic Survey on Alcohol and Related Conditions data suggests a prevalence of ___%.
2.3% according to NESARC 4.4%
Etiologic factors of paranoid personality disorder etiologic factors remain unclear, but a
genetic predisposition for an irregular maturation may be involved.
Nursing diagnosis of patients with paranoid personality disorder Patients are normally seen
for other conditions and diagnosis is based on the patient's underlying suspiciousness. The
assessment reveals disturbed or illogical thoughts that demonstrate misinterpretation of
environmental stimuli. A nursing diagnosis of Disturbed Though Process is usually supported by
the assessment data. A social isolation diagnosis is not appropriate because the person does
not meet the defining characteristics of feelings of aloneness, rejection, desire for contact with
people and insecurity in social situations.
Nursing interventions for patients with paranoid personality disorder Nursing interventions
are difficult to implement because of the patient's mistrust. If a trusting relationship is
established the nurse helps the patient identify problem areas (such as getting alone with
others) through therapeutic techniques and help the patient develop small changes in thinking
and behavior over time.
parasuicidal behavior Deliberate self-injury with intent to harm oneself. (The most serious
consequence in self-harm behavior; BPD)
, personality traits prominent aspects of personality exhibited in a wide range of social and
personal contexts
projective identification a defense mechanism by which people with BPD protect their
fragile self-image. They project their feelings onto a significant other with the unconscious hope
that this person knows how to deal with it. It becomes a defensive way of interacting with the
world and leads to more rejection.
pyromania Irresistible impulse to start fires; repeated fire setting with tension or arousal
before setting fires, fascination or attraction to the fires and gratification when setting,
witnessing or participating in the aftermath of fires. They are often fire watcher or even
firefighters. They are not motivated by aggression, anger, suicidal ideation or political ideology.
Schizoid Personality Disorder (Cluster A) characterized as being expressively impassive and
interpersonally disengaged. They tend to be unable to experience joy and pleasure. Introverted,
reclusive and clinically they seem distant, aloof, apathetic and emotionally detached. Life-long
loners, who have difficulty making friends, seem uninterested in social activities and appear to
gain little satisfaction in personal relationships. They appear to be incapable of forming
relationships. Their interests are directed at objects, things and abstractions. They may do well
at solitary jobs other people may find difficulty to tolerate. May daydream excessively and
become attached to animals. Frequently do not marry or form long-lasting relationships. As
children they engage in solitary activities. They seem to have cognitive deficit characterized by
obscure thought processes. Communication is confused and lacks focus. They reveal minimum
introspection and self awareness, and interpersonal experiences are described in a very
mechanical way.
Prevalence of schizoid personality disorder is estimated to be 3.1%
Etiology of schizoid personality disorder the etiology of schizoid personality disorder is
speculative: (1) There may be defects in either the limbic or reticular regions of the brain that
may result in its development. (2) Defects may stem from an adrenergic-cholinergic imbalance
DISORDERS| QUESTIONS WITH 100% CORRECT ANSWERS| LATEST UPDATE 100% VERIFIED
Obsessive-Compulsive Personality Disorder (Cluster C) bears resemblance to obsessive-
compulsive disorder (OCD) and is closely related to anxiety disorder. Although the disorders
have similar names, the clinical manifestations are quite different.
1. Patients with OCD tend to use obsessive thoughts and compulsions when anxious but less so
wen anxiety decreases, whereas those with OCPD do not demonstrate obsessions and
compulsions but a pervasive pattern of preoccupation with orderliness, perfectionism and
control.
2. Patients with OCPD have the capacity to delay rewards and those with OCD do not.
Individuals with the disorder attempt to maintain control by careful attention to rules, trivial
details, procedures and lists. They may be completely devoted to work. They are uncomfortable
with unstructured leisure time, especially vacations. Behaviorally, they are perfectionists,
maintaining a regulated, highly structured, strictly organized life. A need to control others and
situation is common in their personal and work lives. They are prone to repetition and have
difficulty making decisions and completing tasks because they become so involved in the
details. They can be overly conscientious about morality and ethics and value polite, formal,
and correct interpersonal relationships. They can be rigid, stubborn, and indecisive and are
unable to accept new ideas and customs. Their mood is tense and joyless. Warm feelings are
restrained and they tightly control the expression of emotions.
oppositional defiant disorder is characterized by a persistent pattern of disobedience,
argumentativeness, angry outbursts, low tolerance for frustration, and tendency to blame
others for misfortunes, large and small. Children with this disorder have trouble making friends
and often find themselves in conflict with adults.
Paranoid Personality Disorder (Cluster A) is characterized by a long-standing suspiciousness
and mistrust of people; refuse to assume personal responsibility for their own feelings, assign
responsibility to others and avoid relationships they cannot control. They are suspicious,
guarded, and hostile; mistrustful, even of relatives and friends. They misinterpret actions of
,others as deception, deprecation, and betrayal, especially regarding loyalty or trustworthiness
of friends and associates. They are unforgiving and hold grudges. Their typical emotional
response are anger and hostility. They distance themselves from others and are outwardly
argumentative and abrasive. Internally they feel powerless, fearful and vulnerable. Blind to
their own unattractive behaviors and characteristics they often attribute these traits to others.
Outward demeanor seems cold, sullen and humorless. They want to appear controlled and
objective but react emotionally, displaying signs of nervousness, anger, envy and jealousy.
Orderly by nature. Occupational problems are common. They do not seek mental health care
until they decompensate into psychosis.
The prevalence estimate for paranoid personality disorder is ___%, whereas the National
Epidemiologic Survey on Alcohol and Related Conditions data suggests a prevalence of ___%.
2.3% according to NESARC 4.4%
Etiologic factors of paranoid personality disorder etiologic factors remain unclear, but a
genetic predisposition for an irregular maturation may be involved.
Nursing diagnosis of patients with paranoid personality disorder Patients are normally seen
for other conditions and diagnosis is based on the patient's underlying suspiciousness. The
assessment reveals disturbed or illogical thoughts that demonstrate misinterpretation of
environmental stimuli. A nursing diagnosis of Disturbed Though Process is usually supported by
the assessment data. A social isolation diagnosis is not appropriate because the person does
not meet the defining characteristics of feelings of aloneness, rejection, desire for contact with
people and insecurity in social situations.
Nursing interventions for patients with paranoid personality disorder Nursing interventions
are difficult to implement because of the patient's mistrust. If a trusting relationship is
established the nurse helps the patient identify problem areas (such as getting alone with
others) through therapeutic techniques and help the patient develop small changes in thinking
and behavior over time.
parasuicidal behavior Deliberate self-injury with intent to harm oneself. (The most serious
consequence in self-harm behavior; BPD)
, personality traits prominent aspects of personality exhibited in a wide range of social and
personal contexts
projective identification a defense mechanism by which people with BPD protect their
fragile self-image. They project their feelings onto a significant other with the unconscious hope
that this person knows how to deal with it. It becomes a defensive way of interacting with the
world and leads to more rejection.
pyromania Irresistible impulse to start fires; repeated fire setting with tension or arousal
before setting fires, fascination or attraction to the fires and gratification when setting,
witnessing or participating in the aftermath of fires. They are often fire watcher or even
firefighters. They are not motivated by aggression, anger, suicidal ideation or political ideology.
Schizoid Personality Disorder (Cluster A) characterized as being expressively impassive and
interpersonally disengaged. They tend to be unable to experience joy and pleasure. Introverted,
reclusive and clinically they seem distant, aloof, apathetic and emotionally detached. Life-long
loners, who have difficulty making friends, seem uninterested in social activities and appear to
gain little satisfaction in personal relationships. They appear to be incapable of forming
relationships. Their interests are directed at objects, things and abstractions. They may do well
at solitary jobs other people may find difficulty to tolerate. May daydream excessively and
become attached to animals. Frequently do not marry or form long-lasting relationships. As
children they engage in solitary activities. They seem to have cognitive deficit characterized by
obscure thought processes. Communication is confused and lacks focus. They reveal minimum
introspection and self awareness, and interpersonal experiences are described in a very
mechanical way.
Prevalence of schizoid personality disorder is estimated to be 3.1%
Etiology of schizoid personality disorder the etiology of schizoid personality disorder is
speculative: (1) There may be defects in either the limbic or reticular regions of the brain that
may result in its development. (2) Defects may stem from an adrenergic-cholinergic imbalance
