Personality Disorders A personality disorder is an enduring pattern of inner experience and behavior that: Deviates markedly from the expectation of…

Question Answered step-by-step Personality Disorders A personality disorder is an enduring pattern of inner experience and behavior that: Deviates markedly from the expectation of one’s culture.Is pervasive, maladaptive, and inflexible.Has an onset in adolescence or early adulthood.Is stable over time. Leads to distress or impairment NSG 350 Mental health PowerPoint All personality disorders share four common characteristics. ·      Inflexibility/maladaptive responses to stress·      Disability in social and professional relationships·      Tendency to provoke interpersonal conflict·      Capacity to cause irritation or distress in others·       Personality disorders are predisposing factors for many other psychiatric disorders and often co-occur with depression and anxiety. Personality disorders have a significant effect on the course of treatment for other psychiatric disorders. A client with a personality disorder demonstrates long-term maladaptive behaviorthat prevents accomplishment of desired goals in relationships and other efforts. The maladaptive behaviors of a personality disorder are not experienced asuncomfortable by the individual and some areas of personal functioning may bevery adequate. The medical diagnosis of a personality disorder is found under Axis II of theDSM-V. Personality disorders are divided into three groups, called clusters.Cluster A – generally described as odd or eccentricCluster B – generally described as dramatic, emotional, or erraticCluster C – generally described as anxious or fearful Key FactorsDefense mechanisms used by clients with personality disorders includerepression, suppression, regression, undoing, and splitting. Of these, splitting, the inability to incorporate positive and negative aspectsof oneself or others into a whole image, is frequently seen in the inpatientsetting. Splitting is commonly associated with borderline personality disorder. In splitting, the client tends to characterize people or things as all good or allbad at any particular moment. For example, the client might say, “You are theworst person in the world.” Later that day she might say, “You are the best,but the nurse from the last shift is absolutely terrible.” Cluster A(Odd or eccentric traits) Paranoid personality Characterized by distrust and suspiciousness towardothers based on unfounded beliefs that others wantto harm, exploit, or deceive the person Schizoid personality Characterized by emotional detachment, disinterestin close relationships, and indifference to praise orcriticism; often uncooperative Schizotypal personality Characterized by odd beliefs leading to interpersonal difficulties, an eccentric appearance, and magicalthinking or perceptual distortions that are not cleardelusions or hallucinationsCluster B(Dramatic, emotional, or erratic traits) Antisocial personality Characterized by disregard for others withexploitation, repeated unlawful actions, deceit, andfailure to accept personal responsibility Borderline personalityCharacterized by instability of affect, identity,and relationships; fear of abandonment, splittingbehaviors, manipulation, and impulsiveness; oftentries self-mutilation and may be suicidal Histrionic personality Characterized by emotional attention-seekingbehavior, in which the person needs to be the centerof attention; often seductive and flirtatious Narcissistic personality Characterized by arrogance, grandiose views ofself-importance, the need for consistent admiration,and a lack of empathy for others that strains mostrelationships; often sensitive to criticism   Cluster C(Anxious or fearful traits; insecurity and inadequacy) Avoidant personality Characterized by social inhibition and avoidanceof all situations that require interpersonal contact,despite wanting close relationships, due to extremefear of rejection; often very anxious in socialsituations Dependent personality Characterized by extreme dependency in a closerelationship with an urgent search to find areplacement when one relationship ends; the mostfrequently-seen personality disorder in the clinicalsetting Obsessive-compulsive personalityCharacterized by perfectionism with a focus on orderliness and control to the extent that theindividual may not be able to accomplish a giventaskNursing InterventionsSafety is always a priority concern, since some clients with a personality disorder are at risk for self- or other-directed violence. Developing a therapeutic relationship is often challenging due to the client’s distrust or hostility toward others. A firm, yet supportive approach and consistent care will help build atherapeutic nurse-client relationship. Limit-setting is important when working with the client who is manipulative or who acts out. Feelings of being threatened or having no control may cause a client to act out toward the nurse. Offering the client realistic choices may enhance the client’s sense of control. Communication strategies, client outcomes, and therapies should be aimed at the specific personality disorder. Communication StrategiesLimit-setting and consistency are essential with clients who are manipulative, especially those with borderline or antisocial personality disorders. Assertiveness training and modeling can be important for clients withdependent and histrionic personality disorders. For clients with histrionic personality disorder, who may be very flirtatious, it is important to maintain professional boundaries and communication. Clients with schizoid or schizotypal personality disorders tend to isolate themselves, and this need for social isolation should be respected. For very dependent clients, self-assess frequently for countertransference reactions to client’s clinging and frequent requests for help. 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