Transcript Chapter 12*Personality Disorders

Chapter 12Personality
Disorders
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Characteristics of Personality
Disorders
Deeply ingrained, inflexible, maladaptive
patterns of behavior
 Most apparent in interpersonal and social
relationships
 Capacity to cause extreme irritation and
annoyance in others
 Consistent and constant symptoms
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Descriptive Adjectives
Egocentric
 Self-indulgent
 Manipulative
 Impulsive
 Lacks awareness of problem
 Dependent
 Passive-aggressive tendency
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Cluster A Personality Disorders
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Tend to demonstrate odd or eccentric
behavior
◦ Paranoid disorder
◦ Schizoid disorder
◦ Schizotypal disorder
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Paranoid Personality Disorder
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Persistent pattern of suspicion or mistrust
Signs and symptoms
◦ Suspicious nature
◦ Angry or hostile outbursts
◦ Rigid, inflexible nature
◦ Self-mutilating acts
◦ Inability to achieve closeness in
interpersonal relationships
◦ Unable to take constructive criticism, but
critical of others
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Paranoid Personality Disorder
Exact cause is unknown
 No-harm contracts, journals, and behavior
logs can help clients who self-mutilate or
engage in cutting to track their thoughts
and behavior patterns.
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Schizoid Personality Disorder
Self-absorbed in own feelings; emotional
indifference
 Loners, avoid close relationships and
intimacy
 Bland facial expression
 Avoid positive emotion in others
 Characteristics seen in most aspects of
life by adult years
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Schizotypal Personality Disorder
Strange and unusual patterns of thinking
and communicating
 Withdrawn from social situations
 Magical thinking
 Ideas of reference
 Little ability to respond to feelings of
others
 Psychotic behavior may occur in brief
episodes
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Cluster B Personality Disorders
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Dramatic, emotional, erratic behavior
◦ Antisocial disorder
◦ Borderline disorder
◦ Narcissistic disorder
◦ Histrionic disorder
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Antisocial Personality Disorder
Persistent pattern of disregard and
infringement on the rights of others
 Indifference to laws of society and
humanity
 Sociopath
 Chronic disorder
 Difficult to treat
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Antisocial Personality Disorder
(cont.)
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Suspicious, feels betrayed
Violates rights of others without remorse
Hostile, punitive scheming
Easily bored, restless
Impulsive
Sexually aggressive
Compulsive self-indulgence
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Borderline Personality Disorder
Persistent pattern of unstable
relationships, insecurity, mood swings
 Insecure, irritable, dependent
 Mood swings (self-admiration/self-dislike)
 Chronic sense of emptiness and
abandonment, anxiety
 Quick change from clingy behavior to
angry outbursts (Jekyll and Hyde)
 Splitting
 Self-mutilation
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Narcissistic Personality Disorder
Narcissism: excessive love and attention
given to one’s own self-image
 Grandiose sense of self-importance, with
underlying feelings of inferiority
 Exploitation of others for own needs
 Little regard for feelings of others
 Fantasies of power, beauty, success
(p. 178)
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Narcissistic Personality Disorder
Arrogance
 Claims of Entitlement
 Demand for the best of everything
 Hypersensitivity to criticism
 Poor insight into behavior
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Histrionic Personality Disorder
Overly dramatic emotional behavior to
attract the attention of others
 Extreme egocentricity
 Unmet dependency needs
 Melodramatic, vague speech
 Manipulative
 Attention-seeking behavior
 Shallow, superficial relationships
 Provocative sexual behavior
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Cluster C Personality Disorders
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Anxious and fearful types of behavior
◦ Avoidant disorder
◦ Dependent disorder
◦ Obsessive-compulsive disorder
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Avoidant Personality Disorder
Sensitive to rejection
 Social inadequacy with intense anxiety
 Lack of trust
 Fear of criticism
 Embarrassment in intimate relationships
 Self-doubt, low self-esteem
 Extreme shyness, social withdrawal
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Dependent Personality Disorder
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Insecurity, self-doubt
Extreme fear of being alone
Extreme reliance on others
Inability to make decisions
Constant need for reassurance
Feelings of incompetence
Self-sacrificing, submissive
Extremely anxious
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Obsessive-Compulsive Personality
Disorder
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Unrealistic expectations
Excessive attention to orderliness, details
Inability to relax
Rigid and controlling
Missed deadlines
Rigid morals and ethics
Hoarding
Shallow
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Treatment of Personality Disorders
Clients must gain perspective about
underlying problem
 Difficult to form therapeutic relationships
◦ Most lack insight, resist attempts to
impose change
◦ Most have trouble trusting others
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Treatment of Personality Disorders
(cont.)
No-harm contracts, journals, behavior
logs
 Psychotherapy
 Cognitive-behavioral therapy
 Occupational therapy
 Preferred methodcombination of
psychotherapy and medication
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Nursing Process Applied
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Assessment
◦ What events or behaviors led to
admission
◦ Nonverbal behaviors and symptoms
◦ Thought processes
◦ Inconsistencies between words and
behavior
◦ Anxiety level, emotional state
◦ Coping mechanisms
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Nursing Process Applied (cont.)
Nursing diagnoses
 Expected outcomes
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Nursing Process Applied (cont.)
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Interventions
◦ Identify personal feelings about the
client’s behavior
◦ Separate the person from the behavior
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Nursing Process Applied (cont.)
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Evaluation
◦ Your ability to set boundaries and
maintain therapeutic approach
◦ Interaction with other clients
◦ Impulse control
◦ The client’s behavior following discharge
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Question
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Tell whether the following statement is
true or false.
Three cluster groups of personality
traits have been identified.
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Answer
True
 Rationale: According to the DSM-IV-TR,
there are three clusters of personality
disorders. Commonalities exist between the
groups.
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Question
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Which personality disorder involves a
continued need for lavish attention and
admiration?
A. Avoidant personality disorder
B. Obsessive-compulsive personality
disorder
C. Narcissistic personality disorder
D. Paranoid personality disorder
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Answer
C. Narcissistic personality disorder
 Rationale: A person with narcissistic
personality disorder has a grandiose
sense of self-importance with little care
for the feelings of others.
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Question
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Which personality disorder involves
extreme shyness and social withdrawal?
A. Obsessive-compulsive personality
disorder
B. Avoidant personality disorder
C. Histrionic personality disorder
D. Schizotypal personality disorder
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Answer
B. Avoidant personality disorder
 Rationale: A person with avoidant
personality disorder is sensitive to
rejection, intensely anxious, and extremely
shy in social situations.
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