Personality Disorders ANS: typically hard to diagnose because they don't really cause you to end up in
the hospital
- usually secondary and often co-occur with other mental health diagnoses such as depression, anxiety,
and eating and substance use disorders
- *must be 18 years old or older to get a diagnosis*
Cluster A Personality Disorders ANS: possess odd or eccentric traits; includes: Paranoid, Schizoid, and
Schizotypal
- social isolation
- defensive coping
- ineffective individual coping
biological roots
Interventions: Emphasize client skill & resource development in finding & maintaining interpersonal
relationships
Paranoid ANS: Characterized by distrust and suspiciousness toward others based on unfounded beliefs
that others want to harm, exploit, or deceive the person
Schizoid ANS: Characterized by emotional detachment, disinterest in close relationships and indifference
to praise or criticism; often uncooperative
- show little emotion
,Schizotypal ANS: Characterized by *odd beliefs* leading to interpersonal difficulties, an eccentric
appearance, and *magical thinking* or perceptual distortions that are not clear delusions or
hallucinations
- avoid close relationships
Cluster B Personality Disorders ANS: possess dramatic, emotional, or erratic traits; includes: Antisocial,
Borderline, Histrionic, and Narcissistic
- self-mutilation (ex: cutting yourself)
- risk for violence
- powerlessness
- altered family processes
psychodynamic roots
Interventions: Develop skills to limit dramatic & inappropriate behaviors
Antisocial ANS: Characterized by 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; non-adherence to
traditional morals and values; verbally charming and engaging
- psychopaths, physically unable to show empathy
Borderline ANS: Characterized by instability of affect, identity, and relationships, as well as splitting
behaviors, manipulation, impulsiveness, and fear of abandonment
- often tries self-injury and may be suicidal; ideas of reference are common; often accompanied by
impulsivity
- altered self image
- ALL IN ALL the time
- splitting is a defense mechanism
,Splitting ANS: commonly associated with *borderline* personality disorder; the inability to incorporate
positive and negative aspects of oneself or others into a whole image
EX: "You are the worst person in the world" ...a few hours later... "You are the best, but the nurse from
the last shift is absolutely terrible"
Histrionic ANS: Characterized by emotional *attention-seeking behavior*, in which the person needs to
be the center of attention; often seductive and flirtatious
- display emotions outwardly
Narcissistic ANS: Characterized by arrogance, grandiose views of self-importance, the need for
consistent admiration, and a lack of empathy for others that strains most relationships; often sensitive
to criticism
- HUGE egos, truly believe they are better
- can feel empathy, it's just suuuuper hard
Cluster C Personality Disorders ANS: possess anxious or fearful traits; insecurity and inadequacy;
includes: Avoidant, Dependent, and Obsessive-Compulsive
- anxiety
- self-esteem disturbance
- hopelessness
chronic trauma roots
Intervention: Provide education & therapies to learn how to best manage feelings of anxiety
, Avoidant ANS: 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 criticism
Dependent ANS: Characterized by extreme dependency in a close relationship with an urgent search to
find a replacement when one relationship ends
- clingy
Obsessive-Compulsive ANS: 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
Nursing Care for Personality Disorders ANS: - perform a self-assessment prior to caring for clients
- *safety is always a priority* concern because clients are at a risk for self-injury or violence
- set *clear, strict boundaries*
- plan for how to respond to impulsive, aggressive, or manipulative behaviors
- prepare for transference and protect from countertransference
- trustworthy, genuine, and respectful care
- case management
Personality disorders treatment ANS: - Antidepressant
- Anxiolytic
- Antipsychotic
- mood stabilizer (Lithium)
Standardized Screening Tools for Eating Disorders ANS: - Eating Disorders Inventory
- Body Attitude Test