Personality Disorders

PERSONALITY DISORDERS
Tiffany Adrias
Marie Alexandria Azuro
Godfrey Bag-ao
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WHAT IS PERSONALITY?
PERSONALITY can be defined as an
ingrained enduring pattern of behaving
and relating to self, others, and the
environment; personality includes
perceptions, attitudes, and emotions.
PERSONALITY DISORDERS are

diagnosed when personality traits become
inflexible and maladaptive and
significantly interfere with how a person
functions in society or cause the person
emotional distress.
Diagnosis is made when the person
exhibits enduring behavioral patterns
that deviate from cultural expectations
in two or more of the following areas:
● Ways of perceiving and interpreting
self, other people, and events
(cognition)
● Range, intensity, lability, and
appropriateness of emotional
response (affect)
● Interpersonal functioning
● Ability to control impulses or
express behavior at the appropriate
time and place (impulse control)
CATEGORIES OF PERSONALITY DISORDERS
● Cluster A includes people whose behavior appears odd or eccentric and
includes paranoid, schizoid, and schizotypal personality disorders.
● Cluster B includes people who appear dramatic, emotional, or erratic and

includes antisocial, borderline, histrionic, and narcissistic personality
disorders.
● Cluster C includes people who appear anxious or fearful and includes

avoidant, dependent, and obsessive-compulsive personality disorders.
PERSONALITY DISORDERS SYMPTOMS/CHARACTERISTICS
PARANOID- mistrust and suspicious of others;
guarded, restricted affect
SCHIZOID- detached from social relationships;
restricted affect; involved with things more than people
SCHIZOTYPAL- acute discomfort in relationships;
cognitive or perceptual distortions; eccentric behavior
ANTISOCIAL- disregard for rights of others, rules, and
laws
BORDERLINE- unstable relationship, self-image, and
affect; impulsivity, self-mutilation
HISTRIONIC- excessive emotionality and attention seeking
NARCISSISTIC- grandiose; lack of empathy, need for
admiration
AVOIDANT- social inhibitions, feelings of inadequacy,
hypersensitive to negative evaluation,
DEPENDENT- submissive and clinging behavior, excessive
need to be taken care of.
OBSESSIVE-COMPULSIVE- preoccupation with
orderliness, perfectionism and control
DEPRESSIVE- pattern of depressive cognitions and

behavior in a variety of contexts
PASSIVE-AGGRESSIVE- pattern of negative
attitudes and passive resistance to demands for
adequate performance in social and occupational
situations
A. Pervasive distrust and suspiciousness of others such that their
motives are interpreted as malevolent, beginning by early
adulthood and present in a variety of contexts, as indicated by
four or more of the following:
1.Suspects, without sufficient basis, that others are exploiting, harming, or
deceiving him/her.
2. Is preoccupied with unjustified doubts about the loyalty or
trustworthiness of friends or associates.
3. Is reluctant to confide in others because of unwarranted fear that the
information will be used maliciously against him/her.
4. Reads hidden demeaning or threatening meanings into
benign remarks or events.
5. Persistently bears grudges (i.e., is unforgiving of insults,
injuries, or slights)
6. Perceives attack on his/her character or reputation that
are not apparent to others and is quick to react angrily or to
counterattack.
7. Has recurrent suspicions, without justifications, regarding
fidelity of spouse or other partner.
B. Does not occur exclusively during the course of schizophrenia, a bipolar
disorder or depressive disorder with psychotic features, or in another
psychotic disorder and is not attributable to the psychological effects of
another medical condition.
PREVALENCE - 0.5 - 2.5 in general population.

10-30% in PSYCHIATRIC INPATIENTS
2-10% in PYSCHIATRIC OUTPATIENTS.
More common in MEN than in WOMEN.
Hallmarks are excessive suspiciousness and distrust of others
expressed as a pervasive tendency to interpret actions of others as
deliberately demeaning, malevolent, threatening, exploiting, or
deceiving.
OCCUPATIONAL and MARITAL PROBLEMS are common.
COMORBIDITY
● High risk of depression
● Obsessive - Compulsive Disorder, Agoraphobia, and Substance Abuse

or Dependence.
● It postulated to be a premorbid antecedent of Delusional Disorder,

paranoid type.
FAMILIAL PATTERN AND GENETICS
● risk among relatives of probands with chronic

Schizophrenia and Delusional Disorder, paranoid
type.
DIFFERENTIAL DIAGNOSIS
● Delusional disorder
● Paranoid schizophrenia
● Borderline personality disorder
MANAGEMENT
● Psychotherapy is the treatment of choice.
● Pharmacotherapy is useful in dealing with agitation and anxiety.
● In most cases, an antianxiety agent such as diazepam suffices
● Haloperidol to manage severe agitation or quasi-delusional
thinking.
● Pimozide has successfully reduced paranoid ideation in some
patients.
A pervasive pattern of detachment from social relationships and a
restricted range of expression of emotion in interpersonal settings,
beginning by early adulthood and present in a variety of contexts as
indicated by four (or more) of the following:
.
1. Neither desires nor enjoys close relationships, including being part of
the family.
2. Always almost chooses solitary activities.
3. Has little, if any, interest in having sexual experiences with another
person.
4. Takes pleasure in few, if any, activities.
5. Lacks close friends or confidants other than first-degree

relatives.
6. Appears indifferent to the praise or criticism of others.
7. Shows emotional coldness, detachment, or flattened
affectivity.
Does not occur exclusively during the course of
schizophrenia, a bipolar disorder or depressive disorder
with psychotic features, another psychotic disorder, or
autism spectrum disorder and is not attributable to the
physiological effects of another medical condition.
● Prevalence is about uncommon to 7.5 of the general
population.
● More common in MALE.
● Solitary interests and success at noncompetitive, lonely
jobs that others find difficult to tolerate.
● Lifelong inability to express anger directly.
FAMILIAL PATTERN AND GENETICS
● Increased prevalence among the relatives of

probands with Schizophrenia or Schizotypal
Personality Disorder.
A. A pervasive pattern of social and interpersonal deficits
marked by acute discomfort with, and reduced capacity
for, closed relationship as well as by cognitive or
perceptual distortions and eccentricities of behavior,
beginning by early adulthood and present in a variety of
contexts, as indicated by five (or more) of the following :
1. Ideas of reference (excluding delusions of reference).
2.Odd beliefs or magical thinking that influences
behavior and is inconsistent with subcultural norms (e.g.,
superstitiousness, belief in clairvoyance, telepathy, or
‘‘sixth sense’’: in children and adolescents, bizarre
fantasies or preoccupations).
3. Unusual perceptual experiences, including bodily
illusions.
4. Odd
thinking and speech (e.g.,vague, circumstantial,
metaphorical, over elaborate, or stereotyped).
5. Suspiciousness or paranoid ideation.
6. Inappropriate or constricted affect.
7. Behavior or appearance that is odd, eccentric, or peculiar.
8. Lack of close friends or confidants other than first-degree
relatives.
9. Excessive social anxiety that does not diminish with
familiarity and tends to be associated with paranoid fears
rather than negative judgements about self.
B. Does not occur exclusively during the course of
schizophrenia, a bipolar disorder or depressive disorder with
psychotic features, another psychotic disorder, or autism
spectrum disorder.
● Diagnosis on the basis of the patients’ peculiarities of
thinking, behavior, and appearance.
● Increased prevalence of schizotypal features in the
families of schizophrenic patients.
● Frequently diagnosed in females with fragile X
syndrome.
● 10% of schizotypal personality
disorder eventually committed
suicide.
● Occupational and social difficulties.
● Prevalence rate of 3% in the general

population.
CLUSTER B: PERSONALITY DISORDERS
1. ANTISOCIAL PERSONALITY DISORDER
2. BORDERLINE PERSONALITY DISORDER
3. HISTRIONIC PERSONALITY DISORDER
4. NARCISSISTIC PERSONALITY DISORDER
ANTISOCIAL PERSONALITY DISORDER
Antisocial personality disorder is characterized by a pervasive pattern
of disregard for and violation of the rights of others– and with the
central characteristics of deceit and manipulation. Also often referred
to as psychopathy, sociopathy, or dyssocial personality disorder.
Three to four times more common in men than in

women.
SYMPTOMS: ● Impulsivity
● Aggressiveness
● Violation of right of others
● Lack of insight
● Lack of remorse for behavior
● Thrill seeking
● Shallow emotions
● Exploitation of people in
● Lying
relationship
● Rationalization of own
● Poor work history
behavior
● Consistent irresponsibility
● Poor judgement
● Onset is in childhood or adolescence, although formal diagnosis is not made until
the client is 18 years of age.
● Childhood histories of enuresis, sleepwalking, and syntonic acts of cruelty are

characteristic predictors.
● In adolescence, lying, truancy, sexual promiscuity, cigarette smoking, substance

use, and illegal activities that brought into contact with police are prevalent.
● Appearance usually is normal, may be quite engaging and charming.
● May exhibit mild or moderate anxiety.
● Often displays false emotions chosen to suit the occasion or to work to their
advantage.
● Often have average or above average IQ

● Clients generally exercise poor judgement for various reasons
● Clients appear confident, self-assured and accomplished, perhaps even flip or

arrogant.
● They feel fearless believing they cannot be caught red handed.

● They view relationships as serving their needs and pursue others only for personal
gain.
● Never think about repercussions
● Unsuccessful as spouses and parents and leaves others abandoned and

disappointed.
ANTISOCIAL PERSONALTY DISORDER
● NURSING INTERVENTION
○ Promoting responsible behavior
■ Limit setting
■ Identify consequences of exceeding limit
■ Identify expected or acceptable behavior
○ Consistent adherence to rules and treatment plan
○ Confrontation
■ Point out problem behavior
■ Keep client focused on self
○ Help client achieve effective problem-solving skills, decrease impulsivity, and
expressing negative emotions
○ Decrease or eliminate use of drugs and alcohol
ANTISOCIAL PERSONALTY DISORDER
● MANAGEMENT
○ Psychotherapy, also called talk therapy, is sometimes used to treat antisocial
personality disorder. Therapy may include, for example, anger and violence
management, treatment for alcohol or substance misuse, and treatment for
other mental health conditions.
But psychotherapy is not always effective, especially if symptoms are severe and the
person can't admit that he or she contributes to serious problems.
BORDERLINE PERSONALITY DISORDER
Borderline personality disorder is characterized by a pervasive pattern
of unstable interpersonal relationships, self-image, and affect as well as
marked impulsivity.
● They may cling and ask for help one minute and then become angry, act out and
reject all offers of help in the next minute.
SYMPTOMS: ● Suicidal threats
● Chronic feelings of emptiness or
● Fear of abandonment boredom
● Unstable and intense ● Irritability
relationships ● Impaired judgement
● Unstable self-image ● Lack of insight
● Impulsivity or reckless ● Transient psychotic symptoms
● Recurrent self-mutilating such as hallucinations
behavior demanding self harm
● The pervasive mood is dysphoric, involving unhappiness, restlessness and malaise.
● Intellectual capacities are intact, and clients are fully oriented to reality. The
exception is transient psychotic symptoms, during such episodes reports of
auditory hallucinations encouraging or demanding self-harm are most common.
● They make decisions impulsively based on emotions rather than facts

● Suicidal threats, gestures, and attemps are common.
● Self harm and mutilation, unching, burning, are common.
● Hates being alone, but their erratic labile sometimes dangerous behaviors often isolate
them.
● May often binge eat and purge, drive under the influence, unprotected sex and substance
abuse
NURSING INTERVENTION:
● Promoting client’s safety
○ No self harm contract
○ Safe expression of feelings and emotions
● Helping client to cope and control emotion
○ Identifying feelings, journal entries, moderating emotional responses, decreasing
impulsivity, delaying gratification
● Cognitive restructuring techniques
○ Thought stopping
○ Decatastrophizing
● Structuring time, teaching social skills, teaching effective
communication skills, therapeutic relationship; limit setting
confrontation
MANAGEMENT:
Psychotherapy — also called talk therapy — is a fundamental
treatment approach for borderline personality disorder. Your
therapist may adapt the type of therapy to best meet your needs.
The goals of psychotherapy are to help you:
● Focus on your current ability to function
● Learn to manage emotions that feel uncomfortable
● Reduce your impulsiveness by helping you observe feelings rather than acting on them
● Work on improving relationships by being aware of your feelings and those of others
● Learn about borderline personality disorder
Types of psychotherapy that have been found to be effective include:
● Dialectical behavior therapy (DBT). DBT includes group and individual therapy
designed specifically to treat borderline personality disorder. DBT uses a skills-based
approach to teach you how to manage your emotions, tolerate distress and improve
relationships.
● Schema-focused therapy. Schema-focused therapy can be done individually or in a group.

It can help you identify unmet needs that have led to negative life patterns, which at
some time may have been helpful for survival, but as an adult are hurtful in many areas
of your life. Therapy focuses on helping you get your needs met in a healthy manner to
promote positive life patterns.
● Mentalization-based therapy (MBT). MBT is a type of talk therapy that helps you
identify your own thoughts and feelings at any given moment and create an
alternate perspective on the situation. MBT emphasizes thinking before reacting.
● Systems training for emotional predictability and problem-solving (STEPPS).

STEPPS is a 20-week treatment that involves working in groups that incorporate
your family members, caregivers, friends or significant others into treatment.
STEPPS is used in addition to other types of psychotherapy.
● Transference-focused psychotherapy (TFP). Also called psychodynamic
psychotherapy, TFP aims to help you understand your emotions and
interpersonal difficulties through the developing relationship between you and
your therapist. You then apply these insights to ongoing situations.
● Good psychiatric management. This treatment approach relies on case

management, anchoring treatment in an expectation of work or school
participation. It focuses on making sense of emotionally difficult moments by
considering the interpersonal context for feelings. It may integrate medications,
groups, family education and individual therapy.
HISTRIONIC PERSONALITY DISORDER
● Histrionic personality disorder is characterized by a pervasive pattern of excessive
emotionality and attention seeking.
● Usually occurs and seen more in women than in men.
● Speech is usually colorful and theatrical, full of superlative adjectives.
● There is a tendency to overdress.

● The nurse may feel these clients are charming or even seducing him/her.
● Often exaggerate emotions inappropriately.
● Although they express emotions strongly, most often these are insincere and shallow.
● Rapid shifts in moods and emotions
● Self-absorbed and always think about themselves before others

● They are not comfortable when they are not the center of attention
● They fish for compliments, fabricate unbelievable stories, or create public
scenes to attract attention
● Tend to ignore old relationships when making new ones.
● Have a wide variety of vague physical complaints or exaggerate illness
● Nursing intervention: give feedback about social interactions with othrs, teach
social skills such as appropriate eye contact, engaging in active listening, and
respecting personal space. Explore personal strengths and assets .
● Nursing intervention:
● give feedback about social interactions with others
● teach social skills
○ appropriate eye contact
○ engaging in active listening
○ respecting personal space
● Explore personal strengths and assets.
MANAGEMENT
In general, people with histrionic personality disorder do not believe they need
therapy. They also tend to exaggerate their feelings and to dislike routine, which makes
following a treatment plan difficult.
Psychotherapy is generally the treatment of choice for histrionic personality disorder.

The goal of treatment is to help the individual uncover the motivations and fears
associated with their thoughts and behavior, and to help the person learn to relate to
others in a more positive way.
NARCISSISTIC PERSONALITY DISORDER
● Narcissistic personality disorder is characterized by pervasive pattern of
grandiosity (in fantasy or behavior), need for admiration, and lack of empathy.
● 50% to 75% of people with this diagnosis are men.
● Clients may display arrogant or haughty attitude
● Lack the ability to recognize or empathize with others

● Often preoccupied with fantasies of unlimited success, power, brilliance, beauty,
or ideal love.
● Tend to belittle the feelings of others
● They view their problems as fault of others
● Underlying self-esteem is almost always fragile and vulnerable

● Hypersensitive to criticism and needs constant attention and admiration
● They often display sense of entitlement
● Only privileged people can appreciate and are worthy of their friendship
● They expect special treatment and often get angry when they do not receive it
● May experience some success in work because they are ambitious and confident
● Nursing intervention: nurse must use self awareness skills to avoid anger and
frustration.
● Nurse must not internalize criticism from clients when they become rude and
arrogant
● The goal is to gain cooperation and teaching about comorbid medical or
psychiatric conditions, medication regimen, and any needed self-care skills in a
matter-of-fact manner. He or she limits on rude or verbally abusive behavior and
explains his or her expectations to client.
● The goal is to gain cooperation and teaching about comorbid medical or
psychiatric conditions, medication regimen, and any needed self-care skills in a
matter-of-fact manner. He or she limits on rude or verbally abusive behavior and
explains his or her expectations to client.
MANAGEMENT
Treatment for narcissistic personality disorder is talk therapy (psychotherapy).
Medications may be included in your treatment if you have other mental health
conditions.
Psychotherapy can help in:
● Learn to relate better with others so your relationships are more intimate,
enjoyable and rewarding
● Understand the causes of your emotions and what drives you to compete, to
distrust others, and perhaps to despise yourself and others
MANAGEMENT
Areas of change are directed at helping you accept responsibility and learning to:
● Accept and maintain real personal relationships and collaboration with
co-workers
● Recognize and accept your actual competence and potential so you can tolerate
criticisms or failures
● Increase your ability to understand and regulate your feelings
● Understand and tolerate the impact of issues related to your self-esteem
● Release your desire for unattainable goals and ideal conditions and gain an
acceptance of what's attainable and what you can accomplish
Cluster C : Personality Disorders
❖ Avoidant Personality Disorder

❖ Dependent Personality Disorder
❖ Obsessive-Compulsive Personality Disorder.
Avoidant Personality Disorder
- is characterized by feelings of extreme social inhibition, inadequacy, and

sensitivity to negative criticism and rejection. Yet the symptoms involve more
than simply being shy or socially awkward. Avoidant personality disorder
causes significant problems that affect the ability to interact with others and
maintain relationships in day-to-day life.
Avoidant Personality Disorder Symptoms
➢ Avoiding work, social, or school activities for fear of criticism or rejection. It may
feel as if you are frequently unwelcome in social situations, even when that is not
the case. This is because people with avoidant personality disorder have a low
threshold for criticism and often imagines themselves to be inferior to others.
➢ Low self-esteem
➢ Self-isolation
What causes avoidant personality disorder?
The exact cause of avoidant personality disorder is not known.

However, it is believed that both genetics and environment play a role.
Social Impact of Avoidant Personality Disorder
Avoidant personality disorder causes a fear of rejection that often makes it

difficult to connect with other people. You may be hesitant to seek out
friendships, unless you are certain that the other person will like you.
When you are involved in a relationship, you may be afraid to share
personal information or talk about your feelings. This can make it difficult
to maintain intimate relationships or close friendships.
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental
Disorders (DSM-5), a person diagnosed with avoidant personality disorder needs to show at least
four of the following criteria:
● Avoids occupational activities that involve significant interpersonal contact, because of fears of
criticism, disapproval, or rejection.
● Is unwilling to get involved with people unless they are certain of being liked.
● Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.
● Is preoccupied with being criticized or rejected in social situations.
● Is inhibited in new interpersonal situations because of feelings of inadequacy.
● Views self as socially inept, personally unappealing, or inferior to others.
● Is unusually reluctant to take personal risks or to engage in any new activities because they may
prove embarrassing.
Nursing Interventions
● Promoting client’s safety

● Promoting therapeutic relationship
● Establishing boundaries in relationships.
● Teaching effective communication skills.
● Helping clients to cope and to control emotions.
● Reshaping thinking patterns
● Structuring the client’s daily activities.
Medical Management
● Psychotherapy.
Psychotherapy is at the core of care for personality disorders; because personality disorders produce symptoms as a result
of poor or limited coping skills, psychotherapy aims to improve perceptions of and responses to social and environmental
stressors.
● Inpatient care
Because the underlying disorder remains basically unchanged by inpatient interventions, length of stay should be
minimized to avoid dependency that subverts recovery from the circumstances prompting the hospitalization.
● Transfers
Some patients hospitalized in the psychiatric units of general hospitals, where stays are generally shorter than 2 weeks, may
require transfer to psychiatric hospitals that can provide long-term care.
Pharmacologic Management
➢ Antidepressants. The selective serotonin reuptake inhibitors (SSRIs) and newer antidepressants are
safe and reasonable effective; however, because the depression of most patients with personality
disorders stems from their limited range of coping capacities, antidepressants are usually less effective
than in patients with uncomplicated major depression
➢ Anticonvulsants, These agents are useful for stabilizing the affective extremes in patients with bipolar
disorder, but they are less effective in doing so in patients with personality disorders; they have some
demonstrated efficacy in suppressing impulsive and particularly aggressive behavior in patients with
personality disorder.
➢ Antipsychotics. Response to antipsychotics in patients with a personality disorder is less dramatic

than it is in true psychotic axis I disorders, but symptoms such as anxiety, hostility, and sensitivity to
rejection may be reduced.
Assessment and Diagnostic Findings
➢ Toxicology screen.
➢ Screening for HIV and other sexually transmitted diseases.
➢ CT scanning
➢ Radiography
Dependent Personality Disorder
Dependent personality disorder (DPD) is a type of anxious personality

disorder. People with DPD often feel helpless, submissive or incapable of
taking care of themselves. They may have trouble making simple decisions.
But, with help, someone with a dependent personality can learn
self-confidence and self-reliance.
● Mental health experts describe personality as a person’s way of thinking, feeling and behaving.
● A personality disorder affects the way people think or act, making them behave differently over
time.
● Dependent personality disorder (DPD) is one of 10 types of personality disorders.
● Other types include antisocial personality disorder, narcissistic personality disorder and
paranoid personality disorder.
● Dependent personality disorder usually starts during childhood or by the age of 29.
CAUSES:
➢ Abusive relationships
➢ Childhood trauma
➢ Family history
➢ Certain cultural and religious or family behaviors

Symptoms of dependent personality disorder
● Avoidance of personal responsibility.

● Difficulty being alone.
● Fear of abandonment and a sense of helplessness when relationships end.
● Oversensitivity to criticism.
● Pessimism and lack of self-confidence.
● Trouble making everyday decisions.
RISK FACTORS
● having a history of neglect

● Having an abusive upbringing
● being in a long-term, abusive relationship
● having overprotective or authoritarian parents
● having a family history of anxiety disorders
MEDICAL MANAGEMENT
A mental health provider can help you manage DPD. You may have psychotherapy (talk therapy)
such as cognitive-behavioral therapy. This care teaches you new ways to handle difficult situations.
Psychotherapy and CBT can take time before you start to feel better.
With psychotherapy and CBT, your provider guides you to improve your self-confidence. You’ll work
to become more active and self-reliant. Your provider will also talk to you about finding more
positive relationships. A positive, meaningful relationship can build self-confidence and help you
overcome some of the symptoms of DPD.
PHARMACOLOGIC MANAGEMENT
If DPD causes depression or anxiety, your provider might prescribe medication. You may take
depression medicines , such as fluoxetine (Prozac). Or your provider might recommend sedatives,
such as alprazolam (Xanax).
OBSESSIVE- COMPULSIVE PERSONALITY DISORDER
DESCRIPTION:
Obsessive-compulsive personality disorder (OCPD) is a personality disorder

that’s characterized by extreme perfectionism, order, and neatness. People with
OCPD will also feel a severe need to impose their own standards on their
outside environment.
People with OCPD have the following characteristics:
● They find it hard to express their feelings.

● They have difficulty forming and maintaining close relationships with others.
● They’re hardworking, but their obsession with perfection can make them
inefficient.
● They often feel righteous, indignant, and angry.
● They often face social isolation.
● They can experience anxiety that occurs with depression.
CAUSES
● OCPD may be caused by a combination of genetics and childhood experiences ;

● adults can recall experiencing OCPD from a very early age. They may have felt that
they needed to be a perfect or perfectly obedient child. This need to follow the rules
then carries over into adulthood.
SIGNS AND SYMPTOMS OF OCPD
● perfectionism to the point that it ● hoarding worn or useless items
impairs the ability to finish tasks ● an inability to share or delegate work
because of a fear it won’t be done right
● stiff, formal, or rigid mannerisms
● a fixation with lists
● being extremely frugal with money
● a rigid adherence to rules and
● an overwhelming need to be
regulations
punctual ● an overwhelming need for order
● extreme attention to detail ● a sense of righteousness about the way
● excessive devotion to work at the things should be done
expense of family or social ● a rigid adherence to moral and ethical
relationships codes
TREATMENT
● Psychodynamic therapy
● Cognitive behavioral therapy
● Schema therapy
● Radically Open Dialectical Behavior Therapy (RO DBT)
● Family and couples therapy
PHARMACOLOGIC MANAGEMENT
The Food and Drug Administration has not approved any medications for the
treatment of OCPD. While some people with OCPD obtain relief from anxiety,
hoarding, or depression by taking medications, medications are usually not
considered to be a primary treatment for OCPD. Those seeking
psychopharmacological treatment should consult a psychiatrist or
psychopharmacologist about their options, and clarify the possible side effects of any
medication they consider taking.
MANAGEMENT
● Align your values and actions
● Engage in community service
● Develop healthy coping strategies

OTHER RELATED DISORDERS
● DEPRESSIVE PERSONALITY DISORDER
● PASSIVE-AGGRESSIVE PERSONALITY DISORDER
● Researchers are still studying the following two disorders for inclusion aas
personality disorders
DEPRESSIVE PERSONALITY DISORDER
Depressive personality disorder is characterized by a pervasive pattern of depressive
cognitions and behaviors in a various context.
● Almost the same signs and symptoms with major depression but less severe and
short durations
● These clients have sad, gloomy affect

● Inability to experience joy or pleasure
● Cannot relax and no sense of humor
● Brood and worry over all things in life
● They have a pessimistic view of the world

● Self-esteem is quite low, with feelings of worthlessness and inadequacy
● They need and want the approval of others but tend to push them away
● Assess whether there is risk of self harm

● Explain that client must take action, rather than wait to feel better.
● Encourage to become active or engage with other people
● Give factual feedback rather than general praise.
PASSIVE-AGGRESSIVE PERSONALITY DISORDER
Passive aggressive personality disorder is characterized by a negative attitude and a
pervasive pattern of passive resistance to demands for adequate social and
occupational performance.
● May appear cooperative but withdrawn

● May alternate between stubbornness or fault finding.
● They view the future negatively.
● Often indecisive allowing other to make decisions for themselves
● Experience conflict between dependence and self-assertion
● They habitually resent, oppose, and resist demands to function at a level expected
by others.
● They procrastinate, often forget, stubborn, and intentionally produces inefficient

works.
● Often have somatic complaints and may even adopt a sick role.
● Then nurse can help in examining the relationship between feelings and
subsequent actions
● Teach the client about actions and repercussions
● Methods such as having the client write about their feelings are effective
● The nurse can help the client express negative emotions suh as anger in a positive
way.

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PERSONALITY DISORDERS

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TURN OFF YOUR MIC AT ALL TIMES

PERSONALITY DISORDERS are

● Cluster B includes people who appear dramatic, emotional, or erratic and

● Cluster C includes people who appear anxious or fearful and includes

DEPRESSIVE- pattern of depressive cognitions and

PREVALENCE - 0.5 - 2.5 in general population.

● Obsessive - Compulsive Disorder, Agoraphobia, and Substance Abuse

● It postulated to be a premorbid antecedent of Delusional Disorder,

● risk among relatives of probands with chronic

5. Lacks close friends or confidants other than first-degree

● Increased prevalence among the relatives of

● Occupational and social difficulties.

● Prevalence rate of 3% in the general

Three to four times more common in men than in

● Childhood histories of enuresis, sleepwalking, and syntonic acts of cruelty are

● In adolescence, lying, truancy, sexual promiscuity, cigarette smoking, substance

● May exhibit mild or moderate anxiety.

● Often have average or above average IQ

● Clients appear conﬁdent, self-assured and accomplished, perhaps even ﬂip or

● They feel fearless believing they cannot be caught red handed.

● Never think about repercussions

● Unsuccessful as spouses and parents and leaves others abandoned and

● They make decisions impulsively based on emotions rather than facts

● Self harm and mutilation, unching, burning, are common.

● Schema-focused therapy. Schema-focused therapy can be done individually or in a group.

● Systems training for emotional predictability and problem-solving (STEPPS).

● Good psychiatric management. This treatment approach relies on case

● Usually occurs and seen more in women than in men.

● Speech is usually colorful and theatrical, full of superlative adjectives.

● There is a tendency to overdress.

● Often exaggerate emotions inappropriately.

● Rapid shifts in moods and emotions

● Self-absorbed and always think about themselves before others

Psychotherapy is generally the treatment of choice for histrionic personality disorder.

● 50% to 75% of people with this diagnosis are men.

● Clients may display arrogant or haughty attitude

● Lack the ability to recognize or empathize with others

● Tend to belittle the feelings of others

● They view their problems as fault of others

● Underlying self-esteem is almost always fragile and vulnerable

● They often display sense of entitlement

❖ Avoidant Personality Disorder

- is characterized by feelings of extreme social inhibition, inadequacy, and

The exact cause of avoidant personality disorder is not known.

Avoidant personality disorder causes a fear of rejection that often makes it

● Promoting client’s safety

➢ Antipsychotics. Response to antipsychotics in patients with a personality disorder is less dramatic

Dependent personality disorder (DPD) is a type of anxious personality

➢ Certain cultural and religious or family behaviors

● Avoidance of personal responsibility.

● having a history of neglect

Obsessive-compulsive personality disorder (OCPD) is a personality disorder

● They ﬁnd it hard to express their feelings.

● OCPD may be caused by a combination of genetics and childhood experiences ;

● Engage in community service

● Develop healthy coping strategies

● These clients have sad, gloomy aﬀect

● Cannot relax and no sense of humor

● Brood and worry over all things in life

● They have a pessimistic view of the world

● Assess whether there is risk of self harm

● May appear cooperative but withdrawn