Personality Disorders

Question 1

Cluster A

Answer 1

Paranoid
Schizoid
Schizotypal

Question 2

Paranoid

Answer 2

Characterized by distrust and suspiciousness towards others based on unfounded beliefs that others want to harm, exploit, or deceive the person.
Jealousy, controlling behaviors, unwillingness to forgive

May precede a schizophrenia diagnosis

Defense mechanism: Projection

Question 3

Schizoid Personality Disorder

Answer 3

Characterized by emotional detachment, disinterest in close relationships, and indifference to praise or criticism; often uncooperative.
Lifelong pattern of social withdrawal, expressionless, restricted range of emotional expression
Often marginalized, “loners”
Ridiculed by peers for odd behavior
Does not seek out or enjoy relationships

Question 4

Schizotypal Personality Disorder

Answer 4

Both a personality disorder and schizophrenia spectrum disorder
Characterized by odd beliefs leading to interpersonal difficulties, an eccentric appearance, and magical thinking or perceptual distortions that are not clear delusions or hallucinations.
Strikingly strange and unusual beliefs, speech patterns, inappropriate affect
Severe anxiety in social situations
Magical thinking
Psychotic symptoms
Can be made aware of suspiciousness and magical thinking

Question 5

High degree of mistrust – adhere to promises, appointments, and schedules

Answer 5

Cluster A: Nursing Considerations

Question 6

Being too nice may be met with suspicion – Give straightforward explanations

Answer 6

Cluster A: Nursing Considerations

Question 7

Simple language

Answer 7

Cluster A: Nursing Considerations

Question 8

Limit setting

Answer 8

Cluster A: Nursing Considerations

Question 9

Do not try to increase socialization

Respect need for social isolation

Answer 9

Cluster A: Nursing Considerations

Question 10

Protect against ridicule

Answer 10

Cluster A: Nursing Considerations

Question 11

Employ interventions appropriate for suspicion

Answer 11

Cluster A: Nursing Considerations

Question 12

Strange beliefs and activities may be part of their life

Answer 12

Cluster A: Nursing Considerations

Question 13

Cluster B

Answer 13

Antisocial
Borderline
Histrionic
Narsisstic

Question 14

Antisocial Personality Disorder

Answer 14

Disregard for others with exploitation, lack of empathy, repeated unlawful actions, deceit, failure to accept personal responsibility
Evidence of conduct disorder before age 15
Sense of entitlement, manipulative, impulsive, and seductive behaviors
Nonadherence to traditional morals and values
Verbally charming and engaging

Question 15

Histrionic Personality Disorder

Answer 15

Characterized by:
Emotional attention‑seeking behavior, in which the person needs to be the center of attention
“Dramatic”
Often seductive and flirtatious
Extroverted, colorful personalities, excitable
Struggle with developing meaningful relationships
Do not have insight into their role in impaired relationships
Behaviors stemming from distress

Question 16

Narcissistic Personality Disorder

Answer 16

Characterized by:
Arrogance
Grandiose views of self‑importance
The need for consistent admiration
A lack of empathy for others that strains most relationships
Often sensitive to criticism
Behaviors stemming from weak self-esteem, shame, and fear of abandonment

Question 17

Limit settings, clear and consistent boundaries

Answer 17

Cluster B: Nursing Interventions

Question 18

Document behaviors objectively (i.e. provide times, dates, circumstances) of manipulative behaviors

Answer 18

Cluster B: Nursing Interventions

Question 19

Know that having desires prevented may result in aggression

Answer 19

Cluster B: Nursing Interventions

Question 20

All staff need to be consistent

Answer 20

Cluster B: Nursing Interventions

Question 21

Understand seductive behavior is a response to distress

Answer 21

Cluster B: Nursing Interventions

Question 22

Keep communication and interactions professional

Answer 22

Cluster B: Nursing Interventions

Question 23

Clients may exaggerate symptoms

Answer 23

Cluster B: Nursing Interventions

Question 24

Assess for SI, may make suicidal gestures and inadvertently result in death

Answer 24

Cluster B: Nursing Interventions

Question 25

Remain neutral, remember behaviors come from fear and abandonment

Answer 25

Cluster B: Nursing Interventions

Question 26

Avoid engaging in power struggles, becoming defensive

Answer 26

Cluster B: Nursing Interventions

Question 27

Role model empathy.

Answer 27

Cluster B: Nursing Interventions

Question 28

Provide the client exercises to enhance new social skills but use with caution because any failure can increase feelings of poor self-worth.

Answer 28

Cluster B: Nursing Interventions

Question 29

Borderline

Answer 29

Characterized by instability of affect, identity, and relationships, as well as splitting behaviors, manipulation, impulsiveness, and fear of abandonment; often self-injurious and potentially suicidal; ideas of reference are common; often accompanied by impulsivity

Question 30

Cluster C

Answer 30

Obsessive-Compulsive Dependent Avoidant

Question 31

Avoidant Personality Disorder

Answer 31

Characterized by: Social inhibition and avoidance of all situations that require interpersonal contact, despite wanting close relationships, due to extreme fear of rejection Have feelings of inadequacy and are anxious in social situations Avoid interpersonal contact due to fears of rejection, criticism, or humiliation Low self-esteem, feelings of inferiority, reluctance to engage in unfamiliar activates with new people

Question 32

Dependent Personality Disorder

Answer 32

Characterized by: Extreme dependency in a close relationship with an urgent search to find a replacement when one relationship ends Submissive and clinging behavior Overwhelming need to be cared for Intense fear of separation and abandonment Intense anxiety when left alone May manipulate others to assume their responsibilities Stemming from a lack of confidence in their own abilities or judgment Vulnerable to exploitation

Question 33

Obsessive-Compulsive Personality Disorder

Answer 33

Characterized by: Indecisiveness and perfectionism with a focus on orderliness and control to the extent that the individual might not be able to accomplish a given task Limited emotional expression Stubbornness Indecisiveness Preoccupation with orderliness, perfectionism, and control Rigid, inflexible standard of self and others

Question 34

Nurses should use a friendly, accepting, and reassuring approach.

Answer 34

Cluster C: Nursing Interventions

Question 35

Remember that being pushed into social situations can cause severe anxiety for these clients

Answer 35

Cluster C: Nursing Interventions

Question 36

Convey an attitude of acceptance toward fears

Answer 36

Cluster C: Nursing Interventions

Question 37

Provide the patient exercises to enhance new social skills but use with caution because any failure can increase feelings of poor self-worth.

Answer 37

Cluster C: Nursing Interventions

Question 38

Assertiveness training can assist the person to learn to express needs

Answer 38

Cluster C: Nursing Interventions

Question 39

Avoid power struggles, need for control is high

Answer 39

Cluster C: Nursing Interventions

Question 40

Be aware clients may struggle with sudden changes in routines

Answer 40

Cluster C: Nursing Interventions

Question 41

Assist clients to identify ineffective coping and to develop effective coping techniques.

Answer 41

Cluster C: Nursing Interventions

Question 42

Borderline Personality Disorder | Goals of Care

Answer 42

``` Self-restraint of self-harm, suicide, abusive behavior, aggression Impulse self-control Self-awareness Social interaction Coping Decreased stress ```