personality disorder 2

8/7/2019 Personality Disorder 2

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PERSONALITY

It is an ingrained enduring pattern

of behaving and relating to self,

others, and the environment; it

includes perceptions, attitudes and

emotions.


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4 TEMPERAMENT TRAITS:

1. Harm avoidance High- harm avoidance exhibit fear of uncertainty,

inhibition, shyness with strangers, rapid fatigability, andpessimistic worry in anticipation of problems.

Low- harm avoidance are carefree, energetic, outgoing,and optimistic.

2. Novelty seeking

High-novelty seeking are quick tempered,curious, easily

bored, impulsive, extravagant, and disorderly ooroutburst,and fickle in relationship.

Low- novelty seeking are slow tempered, stoic, reflective,frugal, reserved, orderly, and tolerant, of monotomy;

adhere routine activities.


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3. Reward dependence

High-reward dependence are tender hearted, sensitive,

sociable, and socially dependent which lead to overlydependent to others.

Low- reward dependence are practical, tough minded,cold, socially insensitive, irresolute, and indifferent tobeing alone. Social withdrawal, detachment, aloofness,and disinterest in others.

4. Persistence

High- persistent people are hardworking and ambitiousoverachievers who respond to fatigue or frustration as apersonal challenge.

Low persistent people are inactive, indolent, unstable,and erratic. They tend to give easily when frustrated andrarely strive for higher accomplishments.


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PERSONALITY DISORDER

These are traits which becomesinflexible and maladaptive and

significantly interfere with how aperson functions in society or cause

the person emotional distress. It is

often described as treatment

resistant


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10-13% general population

15% psychiatric inpatients

45% mental illness

30-50% outpatient

60-70% alcoholism

70-80% criminals

70-90% drug abuse


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CATEGORIES OF PERSONALITY DISORDER :

Cluster A

(Odd or Eccentric)

Cluster B

(Dramatic,Emotional,or

Erratic)

Cluster

(Depressive,Passive-

aggressive, or Fearful)


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PARANOID PERSONALITY DISORDER

Mistrust and suspicious of others; guarded, restrictedaffect.

H-holds grudges towards others

I- interpret remarks as demeaning or threateningD-doubt trustworthiness of others

S- suspicious of others

F-fear of confiding in others

F- fear of personal information will be used againstthem.

B- become angry and threatening when they perceived

they are attacked by others.


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Etiology: abusive, cruel, and/or sadistic

Diagnosis: Fear and anxiety

Intervention:

1. Formal- businesslike manner and refrain from

social chitchat or jokes. Clients take everything

seriously and are particularly sensitive with thereaction and motivation of others.

2. Being on time keeping commitments and being

particularly straight forward are essential.3. Involve them in formulating their plans of care

because this client needs to feel in control.

4. H

elp client to validate ideas before taking actions.


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SCHIZOID PERSONALITY DISORDER

Detached from social relationships; restricted affect;involved with things more than people. More

common in men than woman.

C- chooses to become alone

A- avoids activities

A- appears cold and detached or uncaring

L- lack desire for close relationship or friendsL- lack of sexual experience

Etiology: orderly and formal without warmth,play or

spontaneous social interactions.


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Diagnosis; Impaired social interaction Risk for loneliness Ineffective coping

Intervention:

1. Focus improve functioning in the community

2. Referrals that will accommodate the clients desireand used for solitude

3. Facilitates designed to promote socialization

through group activities would be less desirable.4. Offer time and support to the client

unconditionally. Because the client is unable torespond like others do.


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SCHIZOTYPAL PERSONALITY DISORDER

Acute discomfort in relationships; cognitive orperceptual distortions; eccentric behavior

B- blunted or inappropriate affect

V- vague, stereotypical, overelaborate speech

I-ideas of reference

P- peculiar thinking

S- suspiciousness

F- few close relationshipU-uncomfortable in social situations

M- magical thinking oroddsbelief

E- eccentric appearance or behavior


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Etiology: Unknown; familial history

Intervention:

1. Development of self-care and social skills.

2. Encourages clients for a daily hygiene and

grooming.

3. Allow client to practice clear and logical requestto obtain services or to conduct personal business.

4. Social Skills training may help client to talk

clearly with others and reduce bizarre beliefs suchas social working family members.


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ANTISOCIAL PERSONALITY DISORDER

Pervasive action of disregard for and violation ofthe right of others and with the central

characteristics of deceit and manipulative.

E- engages in illegal activityV- violates rights of others

I-irresponsible in work and with finances

L- lack of guilt or remorseI- impulsiveness

A- aggressive behavior

R- recklessness


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Etiology: familial history; frequent alcoholism and

neglect; Child abuse and adolescent conduct

disorder.aOthers: bullying, cruelty to people and animals,

stealing, etc.

Diagnosis:3 Risk for other directed violence

3 Ineffective denial

3 Impaired social interaction

Intervention;

1. Forming therapeutic relationship and promoting

responsible behaviors


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2. Limit- setting is an effective technique that

involves 3 Steps:

i. Stating the behavioral limit (describing theunacceptable behavior)

ii. Identifying the consequences of the limit is

exceeded.iii. Identifying the expected or desired behavior

3. Confrontation- manage manipulative or deceptive

behavior (e.g. The nurse points out clientproblematic behavior while remaining neutral and

matter- of- fact).


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4. Helping clients solve problem and control

emotions.

Problem solving includes: Identify the problem

Exploresolutions

Choose and implement alterations

Evaluate results

5. Managing emotions, especially anger and

emotion by letting them identify sources offrustration.


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6. Taking a time- out on leaving the area and taking

a neutral place to regain internal conscience.

7. Enhancing role performance helps client to

identify specific problems at work or home that

are barriers to success un fulfilling roles.

8. Assessing use of alcohol and other drugs is

essential when examining role performance

because clients use or abuse the substances.

9. The nurse must redirect them to examine thesource of their problems realistically because

they tend to blame others for their failures and

difficulties.


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10. Encourage the client to identify the actions that

precipitated hospitalized of the client to deny

responsibilities and consequences for their own

actions.

11. GIVE POSITIVE FEEDBACK FOR HONESTY.The

client may try to act he/ she is sick or hopelessor use other techniques to avoid responsibility.

12. Avoid any decision or debate why? The rules or

requirement exist. So, state the requirement orrule in matter of facts.


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BORDERLINE PERSONALITY DISORDER

Pervasive pattern of unstable interpersonal relationships,self-image and affect as well as marked impulsivity. It isthree times more common in woman than men.

U- unstable and intense interpersonal relationship

E- erratic avoidance of abandonment; real or emerged

S- self mutilating behavior

C- chronic feelings of emptiness

R- rapid mood shifts

I- impulsivityP- problems with anger

T- transient dissociative and paranoid symptoms

S- suicidal behavior


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Etiology: Experiences a chaotic or violent family

Diagnosis:

Risk for suicide

Risk for self mutility behavior

Risk for other directed violence

Ineffective coping Social isolation

Intervention:

1.

Promoting clients safety2. Promoting the therapeutic relationships

3. Establishing boundaries in relationship


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4. Teach effective communication skills

5. Reshaping thinking patterns

Cognitive structuring- changing pattern of

thinking

Thought stopping- alter the process of negativeor self critical thought.

6. Decatastrophizing- involves learning to assess

situations realistically rather than alwaysassuming a catastrophe.

7. Structuring the clients daily activities involves

minimizing unstructured time


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HISTRIONIC PERSONALITY DISORDER

Excessive emotion and attraction seeking.

N- needs to be center of attention

U- uses physical appearance to become center of

attentionU- uses speech to impress others but is lacking in

depth

D- displace sexually seductive or proviolation

behaviors

D- dramatic expression and emotion


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E- easily influenced by others

E- exaggerated degree of intimacy with others

S- shallow rapidly changing emotions

Etiology: valuing self

Diagnosis:

Impaired social interaction Ineffective coping

Intervention:

1. Give clients feedback about the social interaction

with others including manner.


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2. Discuss social situations to explore the clients

perceptions of others reaction and behavior.

Teaching those skills and a role playing in a safe,non threatening, environment can help clients to

gain confidence in their ability to interact socially.

3. Nurse must be specific in describing andmodeling social skills including establishing eyecontact, activity, listening, and respecting personal

space.

4. Encouraging clients to use assistive

communication such as I statement.


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Narcissistic personality disorder

Pattern of grandiosity (in fantasy behavior)need of admiration.

B- believes he/she is special

E- envious of others/ unto him or her

S- sense of entitlementT-takes advantage of others own benefits

N-needs to be admired

F- fantasies of unlimited power, success or

brillianceL- lacks of empathy

A- arrogant

G- grandiose self importance


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Etiology: Selfless love and adoration from signifcant

others.

Diagnosis; Impaired social interaction

Ineffective coping

Ineffective denial

Intervention;

1. Use self awareness


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AVOIDANT PERSONALITY DISORDER

A- avoid occupations involving interpersonal contact

sue to fears of disapproval/ rejectionU- uninvolved with others unless certain of being liked

V- very reluctant to take risks or engage in newactivities due to possibility of being embarrassed

I- inhibited and feels inadequate in new interpersonalsituations

P- preoccupied with being criticized or rejected in socialsituations

B- believes self to be socially inept, unappealing orinferior to others

F- fears intimate relationship due to fear of shame andridicule


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DEPENDENT PERSONALITY DISORDER

P- performs unpleasant tasks to obtain support from others

P- preoccupied with fear of being alone to care for selfP- problem with initiating projects or doing things on own

because of little self- confidence

A- anxious or helpless when alone because of fear of being

unable to care for selfN-needs others to be responsible for important areas of life

U-unable to make decisions without much advice andreassurance

U- urgently needs another relationship for support and careafter a close relationship ends

S- seldom disagrees with others because of fear of loss ofsupport or approval

Etiology: certain cultures dictate that females should

maintain a dependent role.


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OBSESSIVE COMPULSIVE PERSONALITY

DISORDER

O- over consciousness and inflexible

U- unable to discard worthless or worn-out objects

R-rigid and stubborn

R- reluctant to spend and hoards money

P- preoccupied with details, rules, list, organization

P- perfectionism that interferes with task completion

O- others must do things his/her way in work- ortask- related activity

T- too busy working to have friends or leisure

activities


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Every personality need not to beafraid/ be ashamed of; for it can be

manage through your own simple way


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THANK YOU

personality disorder 2

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