Personality disorders

Definition
 Enduring patterns
 Deviated from expectations

 Pervasive & inflexible

 Onset in adolescent & early

adulthood
 Leads to distress and impairment
 Personality Trait vs.
Personality Disorders
 Has to be inflexible and maladaptive
and cause functional impairment

Personality disorders are organized

into three clusters:
1. CLUSTER A: odd & eccentric
behaviors (e.g., paranoid, schizoid,
schizotypal)
 2. CLUSTER B: dramatic,
emotional behavior ( antisocial,
borderline, histrionic,
narcissistic)
 3. CLUSTER C: anxious, fearful

behavior (avoidant, dependent,

OCD,

 NOT SPECIFIED: if not meeting

criteria for any personality
 Epidemiology
 10 – 20%
 Borderline PD accounts for

30-60% of all diagnosed PD

 75% of borderline PD are

women
 Antisocial PD has to be 18

year
 Etiology
1. Developmental factors:
 Interruption of any task may lead to
PD
2. Environmental factors:
 Some attribution between
developmental and environmental
factors
3. Biogenetic factors:
 Schizotypal ….. MAO
DIAGNISTIC CRITERIA
PARANOID PERSONALITY
 Difficult, Sarcastic, Hostile, and

Suspicious view of the world

SCHIZOID PD:
 inability to perform relationship, low

interest in establishing any

relationship (marriage)
SCHIZOTYPAL PD
 cognitive and perceptual distortion
ANTISOCIAL PD
 Aggression in all manners

 Criminal records and multiple

sexual relationship
BORDERLINE PD
 Fear of abandonment

 Broke away fearing failure

 Acting out
HISTRIONIC PD
 Dramatic emotional expression,

seeking attention, wants to

impress others
NARCISSISTIC PD
 grandiose self-importance, talk

about themselves and neglect

others, overreaction for criticism
AVOIDANT PD
 Low self-esteem, and fear of
 DEPENDENT PD
 Excessive reliance on others

for social support, fear

separation and avoided
responsibilities.
OCD
perfectionism, detailed person,
never throw anything, and
workaholics.
 NURSING DAIGNOSIS
 Cluster A:
2. Anxiety
3. Ineffective coping
4. Social isolation
5. Disturbed thought process
 Cluster B:
7. Disburdened personal identity
8. Risk for suicide
9. Risk for violence toward self, others
10. Chronic low self esteem
11. Impaired social interaction
 NURSING DAIGNOSIS
 Cluster C:
2. Chronic low self esteem
3. Impaired social interaction
4. Anxiety
5. Ineffective coping
 Nursing intervention
 Assess for suicidal ideation
 Establish “no harm” contract
 Encourage client to attend group therapy
 Teach client alternative ways to express anger
and impulsive feelings
 Discuss with the client self-mutilation
 Encourage the client to have a journal of thought
and feeling before self-mutilation
 Assist client to recognize thought patterns that
contribute to impulsive behaviors
 :
 Suggest alternative behaviors to deal with
intense feelings such as:
2. Recognize the feeling and wrote it up
3. Talk about it
4. Identifying healthy options
5. Role playing
6. Using effective problem solving techniques
7. Self-rewarding
 Helping client to recognize community
behaviors (e.g. driving)
 Evaluation of family system and dynamic
 Engage client in short social interactions
 Teaching assertiveness
 Providing client with direct feedback in a
nonjudgmental fashion.