Personality Disorders “..love of self, in contrast to love of humanity…”

COMMON CHARACTERISTICS Deeply ingrained, inflexible, maladaptive patterns of behavior Most apparent in interpersonal and social relationships Capacity to cause extreme irritation and annoyance in others Consistent and constant symptoms

DESCRIPTIVE ADJECTIVES Egocentric Splitting Self-indulgent Manipulative Impulsive Aggressive Hostile Pessimistic Lacks insight or awareness of problem Unable to delay satisfaction of needs Narcissistic Dependent –Demanding unrealistic manner –Denies dependent nature of requests No-win relationships

Cluster “A” Disorders Tend to demonstrate odd or eccentric behaviors –Paranoid disorder –Schizoid disorder –Schizotypal disorder

Cluster “B” Disorders Dramatic, emotional, erratic behavior –Antisocial disorder –Borderline disorder –Histrionic disorder –Narcissistic disorder

Cluster “C” Disorders Exhibit anxious and fearful types of behavior –Avoidant disorder –Dependent disorder –Obsessive-compulsive disorder

Paranoid Personality Disorder Perception –intense and narrowly focused to “real” intent behind actions, see others as dishonest Thinking –misinterpret events and injustices as threats Affect –lack of trust, guardedness

Schizoid Personality Disorder Perception –Self-absorbed in own feelings; emotional barrenness and indifference Thinking –Loners, avoid close relationships and intimacy Affect –Bland facial expression –Avoid positive emotions in others

Schizotypal Personality Disorder Perception –Paranoia, distort reality Thinking –Bizarre, paranoid –Propose to forecast future or read minds –Ideas of reference – everyday events “special” Affect –Rigid –Inflexible –Indifferent –Emotionally aloof –Inappropriate response to situations –Blank expression –Social withdrawal

Antisocial Personality Disorder Perception –Suspicious, feels betrayed Thinking –Humans are basically evil, deceitful, dishonest –Violate rights of others without remorse or guilt –Projection of blame Affect –Hostile, punitive, scheming –Cold, insensitive –Easily bored, restless –Impulsive –Sexually aggressive –Explosive anger –Verbally insulting –Compulsive self- indulgence

Borderline Personality Disorder Perception –Insecure, irritable, dependent Thinking –Persistent pattern of unstable interpersonal relationships –Splitting –Self-mutilation –Dissociation Affect –Mood swings (self- admiration/self-dislike) –Chronic sense of emptiness and abandonment, anxiety –Quick change from clingy, dependent, needy behavior to angry outbursts (Jekyll and Hyde) –Impulsive/intense anger outbursts

Narcissistic Personality Disorder Perception –Grandiose sense of self-importance, with underlying feelings of inferiority Thinking –Lack of insight into unrealistic thinking and behavior –Little regard for feelings of others –Claims of “entitlement” –Fantasies Affect –Arrogant

Histrionic Personality Disorder Perception –Extreme egocentricity –Unmet dependency needs Thinking –Melodramatic, vague speech –Manipulative –Attention-seeking behavior Affect –Overly dramatic, exaggerated –Shallow, superficial relationships –Provocative sexual behavior

Avoidant Personality Disorder Perception –Sensitive to rejection –Social inadequacy with intense anxiety –Lack of trust Thinking –Fear of criticism –Embarrassment in intimate relationships –Self-doubt, low self- esteem Affect –Extreme shyness –Social withdrawal

Dependent Personality Disorder Perception –Insecurity, self-doubt –Extreme fear of being alone Thinking –Extreme reliance on others –Inability to make decisions –Constant need for reassurance –Feelings of incompetence –Self-sacrificing, submissive Affect –Extremely anxious

Obsessive-Compulsive Personality Disorder Perception –Unrealistic expectations –Excessive attention to orderliness, details –Inability to relax Thinking –Rigid and controlling –Missed deadlines –Rigid morals and ethics –Hoarding –Inability to delegate Affect –Stubborn –Shallow

NURSING PROCESS APPLIED Assessment Nursing Diagnosis Expected Outcomes Interventions Evaluation