PERSONALITY DISORDER

• Personality refers to an individual's characteristic and relatively permanent patterns of thoughts, feelings, and behaviors that define their experiences and relationships.

Personality Disorder

• Involves impairment of personality functioning and maladaptive personality traits.
• Behavior often does not conform to cultural, social, or legal norms.
• Individuals find it difficult to recognize or acknowledge that their problems stem from their personalities.
• They stand among the most challenging and complex disorders to treat.

Personality Disorder Clusters

• Cluster A: Characterized by odd or eccentric behaviors, including paranoid, schizoid, and schizotypal personality disorders.
• Cluster B: Characterized by erratic or dramatic behaviors, including antisocial, borderline, histrionic, and narcissistic personality disorders.
• Cluster C: Characterized by anxious or fearful behaviors, including avoidant, dependent, and obsessive personality disorders.

Paranoid Personality Disorder

• A clinical picture marked by long-standing distrust and suspiciousness of others.
• Individuals believe that others intend to exploit, harm, or deceive them, often using projection as a defense mechanism.
• Nursing interventions include maintaining commitments, using a formal approach, setting limits on threatening behavior, and using simple language.
• Psychotherapy as a treatment modality focuses on building trusting relationships through individual therapy and improving social skills via group therapy.
• Medications used in treatment include antianxiety drugs to reduce anxiety and antipsychotics for severe agitation and delusions.

Schizoid Personality Disorder

• Characterized by a lifelong pattern of social withdrawal and emotional detachment.
• Individuals neither seek nor enjoy close relationships and tend to be loners.
• Nursing actions include improving functioning in the community, avoiding being overly friendly, and protecting against ridicule.
• Psychotherapy as a treatment involves individual and group therapy.
• Medications used may include antidepressants for depressive symptoms and antipsychotics to improve emotional expressiveness.

Schizotypal Personality Disorder

• It's clinical picture is Hallmarked by magical thinking, odd beliefs, strange speech, and inappropriate affect.
• Do not blend in with the crowd
• Individuals experience extreme anxiety in social situations and may exhibit hallucinations, paranoia and delusions.
• Focus includes self-care and social skills through grooming and social training.
• The encouragement of daily routines and respect for the need for social isolation are key nursing interventions.

Antisocial Personality Disorder

• Characterized by disregarding the rights of others, deceit, and manipulation for personal gain.
• Individuals often lack empathy and remorse, displaying callousness. Do not abide by the law.
• Manipulative behavior has clear limits, stating the undesirable behavior, identifying consequences, and defining expected behavior and possible confrontation.
• Treatment may involve mood-stabilizing drugs like lithium or depakote.

Borderline Personality Disorder

• Characterized by unstable interpersonal relationships, self-image, and mood.
• Experiences emotional lability and impulsivity, leading to quick reactions without considering consequences and potential suicide attempts.
• Safety involving self-harm is paramount, and structured setting of limits is important, including duration of meeting and boundaries must be put in place.
• Treatment includes dialectical and cognitive behavioral therapy.

Histrionic Personality Disorder

• Involves excessive attention-seeking behavior and discomfort when not the center of attention.
• Exaggerated closeness within relationships with insincere and shallow emotions.
• Nursing interventions include feedback about social interactions and role-playing.

Narcissistic Personality Disorder

• The presentation features feelings of entitlement, grandiosity, a need for admiration, a lack of empathy, and a sense of superiority.
• Individuals view their problems as the fault of others and possess fragile, vulnerable self-esteem, being hypersensitive to criticism.
• At work, they may be successful due to ambition but struggle with teamwork and accepting criticism. Actions include self-awareness skills to avoid anger, a matter-of-fact approach, and limit setting on inappropriate behavior.

Avoidant Personality Disorder

• Affected individuals are extremely sensitive to rejection, feel inferior, and experience social discomfort, leading to avoidance of interpersonal contact and unfamiliar environments or activities.
• They may reject promotions due to fears of failure, shyness, or unfamiliarity.
• Nursing interventions involve self-affirmations, positive self-talk, and social skills training.

Dependent Personality Disorder

• Marked by a pattern of submissive and clinging behavior to elicit caretaking from others.
• Individuals have intense fears of separation and abandonment, lacking confidence in their ability or judgement.
• Nursing interventions include assistance with grief and teaching problem-solving skills.

Obsessive-Compulsive Personality Disorder

• Characterized by a preoccupation with perfectionism, mental and interpersonal control, and orderliness, sacrificing flexibility, openness, and efficiency.
• They can be preoccupied with details and rules, potentially missing the bigger picture.
• Emotions appear rigid, stiff and formal, and can sound insincere.
• Nursing actions include offering different perspectives on decision-making, helping clients tolerate less-than-perfect work, and cognitive restructuring.