MIDTERMS: Topic 7
b) Range, intensity, lability, and
o Can be defined as an ingrained enduring
pattern of behaving and relating to self,
others, and the environment.
o It includes perceptions, attitudes, and
emotions.
o These behaviors and characteristics are
consistent across a broad range of
situations and do not change easily.
o A person usually is not consciously
aware of his/her personality.
o 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.
o They are not usually diagnosed until
adulthood, when personality is more
completely formed.
o Diagnosis is made when the person exhibits
enduring behavioral patterns that deviate
from cultural expectations in two or more of
the following areas:
a) Ways of perceiving and
interpreting self, other people,
and events (Cognition)
appropriateness of emotional
response (Affect)
c) Interpersonal functioning
d) Ability to control impulses or
express behavior at the
appropriate time and place
(Impulse Control)
[CLUSTER A]
ECCENTRIC/MAD GROUP
Includes people whose behavior appears odd or
eccentric and includes: PARANOID, SCHIZOID and
SCHIZOTYPAL PERSONALITY DISORDERS.
 PARANOID - Suspicious, jealous, short
tempered
 SCHIZOID - Doesn’t want to socialize,
prefers to be alone, detached
 SCHIZOTYPAL - Superstitious, believes in
magic, ideas of reference

[CLUSTER B]
ERRATIC AND BAD GROUP
Individuals who appear dramatic, emotional, or
erratic (Antisocial, Borderline, Histrionic, and
Narcissistic).
 ANTISOCIAL -Irresponsible, display lack
of guilt, good at manipulation
 BORDERLINE - Intense relationship, self-
mutilation, impulsiveness
 HISTRIONIC - Attention seeking, self-
centered, seductive, and dramatic
 NARCISSISTIC - Grandiose view of self;
lack of empathy for others
[CLUSTER C]
ANXIOUS AND SAD GROUP
Individuals who appear anxious or fearful
(AVOIDANT, DEPENDENT, AND OBSESSIVE-
COMPULSIVE)
 AVOIDANT - Fearful of criticism and
rejection, negative self-esteem, few
social interactions.
 DEPENDENT - Submissive, clinging to
others, unable to make decision by self
 OBSESSIVE COMPULSIVE- Preoccupied with
perfection, conscious of rules, self- critical,
controlling
RISK FACTORS
1. Family Genetics: links are implicated in
the disorder
2. Environmental Factors: Personality
disorders have been linked to childhood
experiences or early family dysfunction
3. Altered social interactions patterns:
social interactions may modify feelings of
self-esteem or ideas of worth
4. Personality Characteristics:
tendencies toward aloofness that make
social settings and interactions difficult.
Clients tend to avoid social gatherings.
SIGNS AND SYMPTOMS
OF PERSONALITY
DISORDERS
1) Inappropriate response to stress and
inflexible approach to problem solving
2) Long term difficulties in relating to
others, in school, and in work
situations
3) Demanding and manipulative
4) Ability to cause others to react with
extreme annoyance or irritability
5) Poor interpersonal skills
6) Anxiety
7) Depression
8) Anger and aggression
9) Difficulty with adherence to
treatment
10)Harm to self or others (suicidal
ideation, self-mutilation, violence
toward others, or threats)
11)Egocentric
12)Overwhelming fears of abandonment
13)Pessimistic, immature, lonely,
impulsive, hostile and suspicious
NURSING INTERVENTIONS
1. Work with client to increase coping skills
and identify need for improved coping.
2. Respond to client’s specific symptoms
and needs.
3. Keep communication clear and
consistent.
4. Client may require physical restraints,
seclusion/observation room, one-to-one
supervision. Follow policies and
procedures.
5. Keep client involved in treatment
planning.
6. Behavior contract may be used for anger
and aggression, suicidal ideation,
manipulation, or isolation
7. Do not become victim to the client’s
involvement in appropriate self-help
groups
8. Require the patient to take responsibility for
her own behavior and consequences for
actions.

CLIENT AND FAMILY EDUCATION

1) Discuss with the client and family the
possible environment and situational
causes, contributing factors, and
triggers.
2) Help the client and family to identify the
internal and external indicators of
personality disorders.
3) Educate the client and family about the
following issues.
Teach:
a) Coping Skills
b) Anger Management
c) Problem Solving
d) Medication Adherence