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PERSONALITY DISORDERS

- LIFELONG BEHAVIORS
- DO NOT SEEK TREATMENT UNLESS A SEVERE CRISIS OR TRAUMA PRECIPITATES OTHER SYMPTOMS
- CODED ON AXIS 2
- IT IS OFTEN DIFFICULT TO CREATE A THERAPEUTIC RELATIONSHIP WITH CLIENTS WITH PD

4 CHARACTERISTICS
- INFLEXIBLE OR MALADAPTIVE RESPONSE TO STRESS
- DISABILITY IN WORKING OR LOVING
- CAPACITY TO “GET UNDER THE SKIN” OF OTHERS – DIFFICULT TO BE ARROUND, IRRITATIVE
- ABILITY TO EVOKE INTERPERSONAL CONFLICT
- MANY USE DRUGS AND COMMIT CRIMES SUCH AS MURDER
SECONDARY PREVENTIONS
- DECREASE STRESS
- CRISIS INTERVENTION
PERSONALITY DISORDERS
• CLIENT IS NOT OUT OF TOUCH WITH REALITY AS WITH SCHIZOPHRENIA
• THEY ARE LIFE LONG DISORDERS. THEIR WAY OF LIFE
• DIFFICULT TO TREAT***
• PEOPLE CAN HAVE A SEVERE OR MILD FORM OF A DISORDER
• THEY ARE CODED ON AXIS II**
• MEDICATIONS ARE ONLY USED TO TREAT SYMPTOMS
• THESE PEOPLE ARE NOT OUT OF TOUCH WITH REALITY; THEY ARE AWARE OF THEIR BEHAVIOR
• SEEN IN ALL HEALTHCARE SETTINGS
• NOT ADMITTED TO PSYCH UNIT. THEY ARE NOT TREATED IN AN ACUTE CARE SETTING??
• BORDERLINE OR ACTING OUT BEHAVIOR IS THE REASON THEY ARE ADMITTED TO THE UNIT
PSYCHOTHERAPY
• GROUP THERAPY
O ANTISOCIAL PERSONALITY WOULD INTERFERE WITH GROUP PROCESS
• ANGER MANAGEMENT
• SOCIAL SKILLS TRAINING
IMPAIRED SOCIAL INTERACTION FOR MANIPULATIVE CLIENTS
• SPELL OUT ACCEPTABLE BEHAVIOR
• WRITTEN CONSEQUENCES OF BREAKING RULES
• WRITTEN COPY OF RULES
• BE FIRM
• SET LIMITS AND ENFORCE THEM
• HOLD THEM ACCOUNTABLE WITH CONSEQUENCES THAT ARE MEANINGFUL TO THEM
Cause Of Personality Disorders
• MAY BE GENETIC
• MAY BE A LEARNED BEHAVIOR – MODELING AFTER PARENTS
• UNHEALTHY INTERPERSONAL RELATIONSHIPS

CLUSTER “A”
BEHAVIORS DESCRIBED AS ODD OR ECCENTRIC
Cluster A
GENETIC LINK
Personalities have
UNHEALTHY INTERPERSONAL RELATIONSHIPS problems with
MANAGEMENT relationships
• TREATMENT
O SUPPORTIVE PSYCHOTHERAPY
O GROUP THERAPY

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O COGNITIVE-BEHAVIORAL THERAPY
O LOW DOSE ANTIPSYCHOTICS

• NURSING PLAN
O SOCIAL ISOLATION
O IMPAIRED SOCIAL INTERACTION
NURSING INTERVENTIONS
O DON’T BE FRIENDLY & SOCIAL
O BE NEUTRAL & MATTER OF FACT
O EXPLAIN THINGS- IF CHANGES MADE TO ROUTINE
O IF IN HOSPITAL TEACH SIDE EFFECTS OF MEDS SO WILL BE PREPARED FOR
O BE AWARE OF CLIENT ISOLATION, SUSPICIOUSNESS
O AVOID BEING TOO NICE OR OVERLY FRIENDLY
O USE NEUTRAL KIND APPROACH
O CLEAR, STRAIGHTFORWARD EXPLANATIONS
O SIMPLE, CLEAR LANGUAGE
O GIVE WARNING ABOUT CHANGES, REASONS FOR DELAY, SE OF MEDS
PARANOID
• #1 PROJECTION
• SUSPICIOUS AND VERY MISTRUSTFUL
• HYPERSENSITIVE – VERY SENSITIVE
• JEALOUS
O DON’T LIKE IT WHEN GOOD HAPPENS TO SOMEONE ELSE
• TENSE, FIND IT DIFFICULT TO RELAX
• NO TRUE SENSE OF HUMOR
• CANNOT ESTABLISH WARM, LASTING RELATIONSHIPS
O CANNOT TRUST
• USUALLY LACK SOFT, SENTIMENTAL FEELINGS
• USE PROJECTION
O BLAME SOMEONE ELSE
O PLACE UNDESIRED FEELINGS YOU HAVE AND PLACE ON SOMEONE ELSE
O EX. PT SAYS “MY FAMILY HATES ME”, PT MEANS “I HATE THEM”
DESCRIBE CHARACTERISTICS OF THE PARANOID PERSONALITY DISORDER
• BEARS GRUDGES, DISTRUSTFUL, AND SUSPICIOUSNESS
• RELUCTANT TO CONFIDE IN OTHERS. SUSPICIOUS AND DISTRUSTING
• ARGUMENTATIVE, HOSTILE ALOOFNESS, RIGID, CRITICAL, AND CONTROLLING OF OTHERS, GRANDIOSITY.
SCHIZOID
• SON OF SAM
O LONER – NO ONE KNEW HIM, NO CLOSE FRIENDS
• DEFECT IN CAPACITY TO FORM SOCIAL RELATIONSHIPS
• ABSENCE OF WARM AND TENDER FEELINGS FOR OTHERS
• INDIFFERENCE TO PRAISE, CRITICISM, AND THE FEELINGS OF OTHERS
O DON’T CARE IF YOU PRAISE OF CRITICIZE THEM
• LONERS AND HAVE FEW FRIENDS, IF ANY, CLOSE FRIENDS
• PURSUE SOLITARY INTEREST OR HOBBIES
• APPEAR “COLD” AND ALOOF
• APPEAR RESERVED AND WITHDRAWN
• OFTEN UNABLE TO EXPRESS FEELINGS OR HOSTILITY
• EXCESSIVE DAYDREAMING AND FANTASIZING
O AUTISTIC – TRYING TO ESCAPE FROM REALITY (PRE-PSYCHOTIC)
• SELF ABSORBED, ABSENT-MINDED

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• NOT PSYCHOTIC
O ISOLATED AND STAY WITH SELF, AVOID OTHERS AND DO NOT CARE FOR OTHERS. VERY COLD. WORK
WHERE THEY DO NOT HAVE TO BE WITH OTHERS. WORK AT POSTAL OFFICE AT NIGHT.
DESCRIBE CHARACTERISTICS OF THE SCHIZOID PERSONALITY
• FLAT AFFECT, DETACHED FROM SOCIAL RELATIONSHIPS, AND A RESTRICTED RANGE OF EXPRESSIONS IN
INTERPERSONAL SETTINGS.
• SOCIAL DETACHMENT AND LACK OF CLOSE RELATIONSHIPS. INTEREST IN SOLITARY ACTIVITIES, ALOOF AND
INDIFFERENT, RESTRICTED EXPRESSION OF EMOTIONS, LACK OF INTEREST IN OTHERS
SCHIZOTYPAL
• CLOSE AS BEING PSYCHOTIC AS YOU CAN GET
• ODDITIES OF THOUGHT, PERCEPTION, AND BEHAVIOR SUCH AS IDEAS OF REFERENCE, ILLUSIONS,
DEPERSONALIZATION, AND PECULIAR SPEECH. DO NOT HAVE DELUSIONS OR HALLUCINATIONS
• SOCIAL ISOLATION
• SUSPICIOUS
• MAGICAL THINKING
O MAY THINK YOU HAVE A CERTAIN POWER “STEP ON A CRACK” OR “I HAVE A 6 SENSE”
TH

O MAY BE VAGUE OR OVER ELABORATE IN CONVERSATION, CIRCUMSTANTIALITIES

O STILL IN TOUCH WITH REALITY
• SPLITTING- SELF & OTHERS VIEWED AS ALL GOOD OR ALL BAD
• WILL GO IN SEARCH OF SOMEONE ELSE ONCE YOU BEGIN TO ENFORCE RULES
• SELF MUTILATE FOR ATTENTION
DESCRIBE CHARACTERISTICS OF THE SCHIZOTYPAL PERSONALITY
• SOCIAL AND INTERPERSONAL DEFICITS MARKED BY ACUTE DISCOMFORT WITH AND REDUCED CAPACITY FOR
RELATIONSHIPS AS WELL AS BY COGNITIVE OR PERCEPTUAL DISTORTIONS AND ECCENTRICITIES OF BEHAVIOR.
• EXHIBITS ABNORMAL OR HIGHLY UNUSUAL THOUGHTS, PERCEPTIONS, SPEECH, AND BEHAVIOR PATTERNS.
• SUSPICIOUS, PARANOID, MAGICAL THINKING, ODD THINKING AND SPEECH, RELATIONSHIP DEFICITS.

CLUSTER “B”
BEHAVIORS DESCRIBED AS DRAMATIC, EMOTIONAL, OR ERRATIC
UNHEALTHY PERSONAL RELATIONSHIPS
INTERVENTIONS
• UNDERSTAND SEDUCTIVE BEHAVIOR AS A RESPONSE TO STRESS
• KEEP RELATIONSHIP PROFESSIONAL
• ENCOURAGE/MODEL USE OF CONCRETE DESCRIPTIVE LANGUAGE
• TEACH & MODEL ASSERTIVENESS
• BENEFIT FROM ASSERTIVENESS
Histrionic
• LIVELY AND DRAMATIC
• PRONE TO EXAGGERATION
• BEHAVIOR OVERLY REACTIVE AND INTENSELY EXPRESSED
O A PERSON WHO WOULD GO TO A CASUAL PARTY WITH A RED DRESS AND 3” HEELS.
• CRAVE EXCITEMENT AND BECOME BORED WITH NORMAL ROUTINES
• THEY LOVE CRISIS
• SEEN BY OTHERS AS SHALLOW AND LACKING GENUINENESS
• SELF-INDULGENT AND INCONSIDERATE OF OTHERS
• DEMANDING
• DEPENDENT, HELPLESS – WHEN YOU MEET THEM THEY SEEM TO HAVE A WONDERFUL SELF CONCEPT
• PRONE TO MANIPULATIVE SUICIDAL THREATS, GESTURES, OR ATTEMPTS (TAKE SERIOUSLY)
O EVERY TIME I SAY I WILL BREAK UP SHE SAYS SHE WILL KILL HERSELF
O AT FIRST YOU THINK THEY ARE INDEPENDENT BUT THEY ARE NOT
O MORE WITH WOMEN

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O THEY WANT TO BE CENTER OF ATTENTION

O TAMMY FAYE BAKER
DESCRIBE CHARACTERISTICS OF THE HISTRIONIC PERSONALITY
• A PERVASIVE PATTERN OF EXCESSIVE EMOTIONALITY AND ATTENTION SEEKING, BEGINNING IN EARLY ADULTHOOD
AND PRESENT IN A VARIETY OF CONTEXTS. ATTENTION SEEKING, NEEDS TO BE THE CENTER OF ATTENTION
• SEXUALLY SEDUCTIVE OR PROVOCATIVE, SELF-DRAMATIZING AND THEATRICAL, OVERLY CONCERNED WITH
APPEARANCE, HAS ROMANTIC FANTASIES AND CONTROLS PARTNERS, BORES EASILY, DISPLAYS DEPENDENCY.
BORDERLINE
• ON BORDER OF BEING PSYCHOTIC May Be Caused By
• UNPREDICTABLE IN AREAS THAT ARE POTENTIALLY SELF-DAMAGING -Learned behavior
O SPENDING
-See violence everyday
O GAMBLING and become numb to
O SEX it.
O OVEREATING
O SHOPLIFTING, ETC. -Child who has no
restraints
• VERY IMPULSIVE – MOST LIKELY TO COMMIT SUICIDE
• CONSTANTLY WANT TO BE AROUND OTHER PEOPLE -Inconsistent discipline
O TAKE ON CHARACTERISTICS OF THE PEOPLE THEY ARE AROUND
• PROBLEMS WITH RELATIONSHIPS
O PATTERN OF UNSTABLE AND INTENSE INTERPERSONAL RELATIONSHIPS
O LOVE ONE DAY AND HATE THE NEXT DAY
• CONSTANT ANGER AND FREQUENT DISPLAYS OF TEMPER
• IDENTITY DISTURBANCE
• MARKED SHIFTS IN MOOD - LABILE
• DEPRESSED WHEN ALONE
• CHRONIC FEELINGS OF EMPTINESS AND BOREDOM
• PHYSICALLY SELF-DAMAGING ACTS
• HAVE A PROBLEM CONTROLLING ANGER
• VERY MANIPULATIVE
• LOVE TO HATE
• SEES SOMEONE AS ALL GOOD OR ALL BAD – “SPLITTING”
• “FATAL ATTRACTION”
DESCRIBE THE CHARACTERISTICS OF THE BORDERLINE PERSONALITY
• A PERVASIVE PATTERN OF INSTABILITY OF INTERPERSONAL RELATIONSHIPS, SELF IMAGE, AND AFFECTS AND
MARKED IMPASSIVITY BEGINNING IN EARLY ADULTHOOD AND PRESENT IN A VARIETY OF CONTEXTS.
• UNCLEAR IDENTITY, UNSTABLE AND INTENSE, EXTREME SHIFTS IN MOOD, EASILY ANGERED, EASILY BORED,
ARGUMENTATIVE, DEPRESSION, SELF-DESTRUCTIVE BEHAVIOR, MANIPULATIONS, UNABLE TO TOLERATE ANXIETY,
CHRONIC FEELINGS OF EMPTINESS AND FEAR OF BEING ALONE. SPLITTING
MANAGEMENT
• MEDS
O SSRI
O TEGRETOL
O LOW DOSE ANTIPSYCHOTICS

• BEHAVIOR THERAPY
• IMPULSIVE BEHAVIOR INTERVENTIONS
O IDENTIFY ANTECEDENT NEEDS & FEELINGS
O DISCUSS CURRENT/PREVIOUS IMPULSIVE ACTS
O EXPLORE IMPACT ON SELF & OTHERS
O RECOGNIZE CUES TO IMPULSIVE BEHAVIOR
O REFER OR TEACH NEEDED COPING
O DISCUSS ALTERNATIVES TO IMPULSIVE BEHAVIOR

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O ROLE PLAY NEW SKILLS & PROVIDE FEEDBACK

• INTERVENTIONS
O SET CLEAR, REALISTIC GOALS
O BE AWARE OF MANIPULATIVE BEHAVIORS
O CLEAR, CONSISTENT BOUNDARIES/LIMITS
O FOR BEHAVIOR PROBLEM REVIEW THERAPEUTIC GOALS & TREATMENT BOUNDARIES
O AVOID REJECTING, RESCUING
O ASSESS FOR SUICIDAL OR SELF MUTILATING BEHAVIOR

• NURSING DIAGNOSIS
O IMPAIRED SOCIAL INTERACTION

 THIS DIAGNOSIS APPLIES TO DISORDERS THAT CAN MANIPULATE

 THINGS YOU MUST DO:
• RECOGNIZE YOU ARE BEING MANIPULATED
• WHEN THE PATIENT COMES TO THE UNIT YOU NEED TO TELL THEM WHAT IS
ACCEPTABLE AND WHAT IS NOT ACCEPTABLE.
• GIVE THEM A WRITTEN COPY OF THE RULES AND GO OVER WITH THEM WHEN 1 ST

ADMITTED
• TELL THEM WHAT THE CONSEQUENCES WILL BE WHEN THEY BREAK THE RULES
• YOU MUST ENFORCE THE RULES
• MUST BE CONSISTENT BY ALL NURSES INVOLVED
• THE PATIENT MUST BE HELD RESPONSIBLE FOR BEHAVIOR
• TALK WITH OTHER STAFF MEMBERS RE: BEHAVIOR “SPLITS STAFF” GROUP MEETINGS
O R/F OTHER DIRECTED VIOLENCE
O INEFFECTIVE COPING
NARCISSISTIC
• LOVE OF SELF
• IN CHILDREN IT IS OK
• GRANDIOSE SENSE OF OWN IMPORTANCE
• PREOCCUPIED WITH FANTASIES OF UNLIMITED SUCCESS
• REQUIRES CONSTANT ATTENTION AND ADMIRATION
• LACK OF EMPATHY
• INTENSE ENVY OF OTHERS
• GETS JEALOUS IF SOMETHING GOOD HAPPENS TO SOMEONE ELSE
DESCRIBE THE CHARACTERISTICS OF THE NARCISSISTIC PERSONALITY
• A PERVASIVE PATTERN OF GRANDIOSITY (IN FANTASY AND BEHAVIOR), NEED FOR ADMIRATION AND LACK OF
EMPATHY.
• BEGINNING IN EARLY ADULTHOOD AND PRESENT IN A VARIETY OF CONTEXTS
• GRANDIOSITY, REQUIRES ADMIRATION AND INFLATED ACCOMPLISHMENTS, OVERESTIMATES ABILITIES AND
UNDERESTIMATES CONTRIBUTIONS OF OTHERS, LACKS EMPATHY AND SENSITIVITY TO NEEDS OF OTHERS.
MANAGEMENT
NURSING DIAGNOSIS
IMPAIRED SOCIAL INTERACTION
• INTERVENTIONS
O STAY NEUTRAL, AVOID POWER STRUGGLES
O DON’T BE DEFENSIVE WHEN DISPARAGED
O CONVEY UNASSUMING SELF-CONFIDENCE
ANTISOCIAL
• WEAK SUPEREGO - HAVE NO CONSCIOUS***
• HARDEST ONE TO DEAL WITH
• DOES NOT FEEL BAD IF THEY DO SOMETHING WRONG
• VIEW PEOPLE AS OBJECTS
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• WHAT CAN YOU DO FOR ME. FEELS NO GUILT

• NO CAPACITY FOR FORMING CLOSE RELATIONSHIPS
• SELF-CENTERED AND SELFISH
• INSENSITIVE TO FEELINGS OF OTHERS
• LACK OF GUILT AND SHAME
• UNABLE TO TOLERATE FRUSTRATION OF HIS WISHES
• DOES NOT ASSUME RESPONSIBILITY FOR BEHAVIOR
• DOES NOT LEARN FROM EXPERIENCE
• GET UPSET IF THINGS DON’T GO THEIR WAY
• SUPERFICIAL CHARM AND GOOD INTELLIGENCE
O VERY IMPRESSED WHEN YOU FIRST MEET THEM
• NO CAPACITY FOR LOVE
• LACK OF INSIGHT
• PUNISHMENT DOES NOT ALTER BEHAVIOR
• DEMANDING AND UNGRATEFUL
• LIVE FOR PLEASURE AND GRATIFICATION
• OFTEN UNFAITHFUL IN MARRIAGE AND DIVORCE IS COMMON
• LIE, CHEAT, AND STEAL
• MANIPULATIVE
• NOTHING IS HIS FAULT
• CRIMINALS THAT ARE ANTISOCIAL SHOULD NOT BE PAROLED
O BECAUSE THEY DON’T FEEL GUILTY ABOUT WHAT THEY HAVE DONE. WILL NOT BE REHABILITATED.
• NOT ALL ANTISOCIAL ARE CRIMINALS
O VERY SUCCESSFUL BUSINESSMEN
• CAN SPLIT STAFF
• TREATED BY THE LAW
• DECREASES WITH AGE
DESCRIBE THE CHARACTERISTICS OF THE ANTISOCIAL PERSONALITY
• A PERVASIVE PATTERN OF DISREGARD FOR AND VIOLATION OF THE RIGHTS OF OTHERS OCCURRING SINCE AGE
15.
• A PATTERN OF IRRESPONSIBLE AND ANTISOCIAL BEHAVIOR, CHARACTERIZED BY SELFISHNESS, INABILITY TO
MAINTAIN LASTING RELATIONSHIPS, POOR SEXUAL ADJUSTMENT, FAILURE TO ACCEPT SOCIAL NORMAL, IRRITABILITY
AND AGGRESSIVENESS.
• PERCEIVES THE WORLD AS HOSTILE, SUPERFICIAL CHARM AND HOSTILITY, NO SHAME OR GUILT, SELF CENTERED,
UNRELIABLE, EASILY BORED, POOR WORK HISTORY, UNABLE TO TOLERATE FRUSTRATION
• VIEWS OTHERS AS OBJECTS TO BE MANIPULATED, POOR JUDGMENT, IMPULSIVE.
MANAGEMENT
• MEDS
O LITHIUM
O ANTICONVULSANTS
O SSRI
• STAFF MUST BE UNITED IN TREATMENT PLAN REGARDING
O BEHAVIOR THERAPY
O LIMIT SETTING- CLEAR, CONSISTENT, ENFORCEABLE
O TEAM MUST BE AWARE OF LIMITS, NEED OF CONSISTENCY

• COMMUNICATE EXPECTATIONS TO CLIENT

• BE REALISTIC REGARDING WHAT BEHAVIORS TO LIMIT
• CLEAR CONSEQUENCES OF EXCEEDING LIMITS
• FOLLOW THROUGH WITH CONSEQUENCES IN NONPUNITIVE MANNER
INTERVENTIONS

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• SET, CLEAR, REALISTIC LIMITS ON SPECIFIC MANNER

• ALL LIMITS ADHERED TO BY ALL STAFF
• DOCUMENT SIGNS OF MANIPULATION OR AGGRESSION
• PROVIDE CLEAR BOUNDARIES, CONSEQUENCES
• GUARD AGAINST LETTING CLIENT MAKE YOU FEEL GUILTY
• GUARD AGAINST BEING MANIPULATED

CLUSTER C
BEHAVIOR DESCRIBED AS ANXIOUS OR FEARFUL
AVOIDANT
• SHY, INTROVERTED, LACKS SELF-CONFIDENCE, AND IS EXTREMELY SENSITIVE TO REJECTION
• TEND TO AVOID RELATIONSHIPS WITH OTHERS
• AVOIDS SOCIAL SITUATIONS
• USUALLY BECAUSE OF PARENTAL AVOIDANCE & REJECTION
• POSSIBLE GENETIC LINK
DESCRIBE CHARACTERISTICS OF THE AVOIDANCE PERSONALITY
• SHYNESS AND AVOIDANCE OF CONFLICT, RISK AND NEW SITUATIONS, LITTLE TOLERANCE FOR GROUP PROCESS.
• CHARACTERIZED BY SOCIAL WITHDRAWAL AND EXTREME SENSITIVITY TO POTENTIAL REJECTION. FEELINGS OF
INADEQUACY, HYPERSENSITIVE TO REACTIONS OF OTHERS AND REACTS POORLY TO CRITICISM, SOCIAL INHIBITION,
LACK OF SUPPORT SYSTEM.
MANAGEMENT
• INTERVENTIONS
O SUPPORTIVE PSYCHOTHERAPY
O COGNITIVE-BEHAVIORAL THERAPY
 SOCIAL SKILLS TRAINING
 ASSERTIVENESS TRAINING
• MEDS
O ANAFRANIL
O SSRI
O ANTI ANXIETY
O MAOI’S
• NURSING DIAGNOSIS
O IMPAIRED SOCIAL INTERACTION
NURSING PLAN
O ANXIETY
O INEFFECTIVE COPING
O FRIENDLY REASSURING APPROACH
DEPENDENT
• CLINGING VINE
• HELPLESS
• A LOT OF SECONDARY GAIN
• LACKS SELF-CONFIDENCE, ALLOWS OTHER TO ASSUME RESPONSIBILITY FOR MAJOR AREAS OF HIS OR HER LIFE.
• CANNOT FUNCTION INDEPENDENTLY, AND BELITTLES SELF
O EX. A WOMAN WHO LETS HUSBAND DECIDE IF SHE CAN WORK, WHAT THEY WILL WEAR, CAN SHE
DRIVE.
O A LOT OF SECONDARY GAIN
DESCRIBE THE DEPENDENT PERSONALITY
• SELF-SACRIFICE OR TOLERATION OF PHYSICAL, SEXUAL OR EMOTIONAL ABUSE.
• THE INDIVIDUAL LACKS SELF CONFIDENCE AND THE ABILITY TO FUNCTION INDEPENDENTLY
• PASSIVELY ALLOWS OTHERS TO MAKE DECISIONS AND ASSUME RESPONSIBILITY FOR MAJOR AREAS IN THEIR LIFE.

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• DIFFICULTY MAKING DECISIONS, LACKS AUTONOMY, CANNOT TOLERATE BEING ALONE AND MUST ALWAYS HAVE A
CLOSE RELATIONSHIP, NEEDS OTHERS TO ASSUME RESPONSIBILITY AND MAKE DECISIONS.
• THIS DISORDER COMMONLY OCCURS IN INDIVIDUALS WHO HAVE A GENERAL MEDICAL CONDITION OR A DISABILITY
THAT REQUIRES THEM TO BE DEPENDENT ON OTHERS
• LONG-TERM INABILITY TO CARE INDEPENDENTLY FOR THE SELF ERODES CONFIDENCE, AUTONOMY, AND PERSONAL
INTEGRITY.
OBSESSIVE – COMPULSIVE
• JUST PERSONALITY
• EXCESSIVE DEVOTION TO WORK, PERFECTIONIST, RESTRICTED ABILITY TO EXPRESS WARM, TENDER EMOTIONS,
INDECISIVE, PRONE TO SELF-DOUBT, MORE AT EASE WITH THINGS THAN PEOPLE.
• LOVE TO WORK
• CANNOT MAKE DECISIONS BECAUSE THEY ARE A PERFECTIONIST, THEY WANT TO MAKE A PERFECT DECISION
• DEVELOP TO AVOID BEING CRITICIZED BY PARENTS & PREVENTS PUNISHMENTS
• DON’T GET IN A POWER STRUGGEL
DESCRIBE THE OBSESSIVE COMPULSIVE PERSONALITY TYPE
• PREOCCUPATION WITH ORDERLINESS, PERFECTIONISM, AND MENTAL AND INTERPERSONAL CONTROL, AT THE
EXPENSE OF FLEXIBILITY, OPENNESS, AND EFFICIENCY, BEGINNING BY EARLY ADULTHOOD.
• THIS CLIENT HAS DIFFICULTY EXPRESSING WARM AND TENDER EMOTIONS AND REFLECTS PERFECTIONISM,
STUBBORNNESS, THE NEED TO CONTROL OTHERS, AND A DEVOTION TO WORK. ORDERLINESS AND
PERFECTIONISM, OVERLY CONSCIENTIOUS, INFLEXIBLE AND PREOCCUPIED WITH DETAILS AND RULES, DEVOTED TO
WORK AND LACKS LEISURE ACTIVITIES AND FRIENDSHIPS, MISERLY AND STUBBORN, HOARDS WORTHLESS OBJECTS.
MANAGEMENT
• NURSING DIAGNOSIS
O INEFFECTIVE INDIVIDUAL COPING
• MED IS ANAFRANIL
PERSONALITY DISORDER, NOT OTHERWISE SPECIFIED
• MEETS GENERAL CRITERIA BUT DOES NOT MEET SPECIFIC CRITERIA OF ANY OF THE SUBTYPES

Treatment For Personality Disorders

• NOT EASY TO TREAT
• LIFELONG DISORDER “THIS IS THE WAY I AM”
• EARLY TREATMENT IS NECESSARY
• MOST OF THE TIME THESE PEOPLE DON’T THINK ANYTHING IS WRONG WITH THEM.
• 2 TYPES SEEN ON WARDS MOST OFTEN BORDERLINE AND ANTISOCIAL
Therapy
• INDIVIDUAL PSYCHOTHERAPY
• GROUP THERAPY
O IF ANTISOCIAL THEY WILL CONTROL THE GROUP AND COMPLETELY DESTROY THE GROUP PROCESS
• PSYCHOANALYTIC
O VERY EXPENSIVE
• BEHAVIOR THERAPY
O REWARDS FOR APPROPRIATE BEHAVIOR
O IMPOSING CONSEQUENCES FOR INAPPROPRIATE BEHAVIOR
• ASSERTIVENESS TRAINING
O USED FOR DEPENDENT INDIVIDUAL
• SOCIAL SKILLS TRAINING
O ALL OF THEM (HOW TO RELATE TO OTHERS)
• ANGER MANAGEMENT
O FOR BORDERLINE
• DRUGS MAY BE USED
O WILL ONLY BE USED TO TREAT THE SYMPTOMS

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