Personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment (DSM-V). Show
DescriptionPersonality can be defined as an ingrained enduring pattern of behaving and relating to self, others, and the environment; personality includes perceptions, attitudes, and emotions. • Personality disorders are diagnosed when personality traits become inflexible and maladaptive and significantly interfere with how a person functions in society or cause the person emotional distress. CategoriesThe DSM-V lists personality disorders as a separate and distinct category from other major mental illness; they are on axis II of the multiaxial classification system. •
Cluster A. Cluster A includes people whose behavior appears odd or eccentric and includes paranoid, schizotypal, and schizoid personality disorders. Cluster A: Personality Disorders• Paranoid Personality Disorder. This personality is characterized by pervasive mistrust and suspiciousness of others; clients with this disorder interpret others actions as potentially harmful. Cluster B: Personality Disorders• Antisocial Personality Disorder. This disorder is characterized by a pervasive pattern of disregard for and violation of the rights of others- and with the central characteristics of deceit and manipulation. Cluster C: Personality Disorders•
Avoidant Personality Disorder. This disorder is characterized by a pervasive pattern of social discomfort and reticence, low self-esteem, and hypersensitivity to negative evaluation. Statistics and IncidencesPersonality disorders are relatively common, occurring in 10% to 13% of the general population. • 15% of all psychiatric inpatients have a primary diagnosis of a personality disorder. Clinical ManifestationsThe clinical manifestations of a person with personality disorder include: • Paranoid. Mistrusts and is suspicious of others; has guarded, restricted affect. Assessment and Diagnostic FindingsThe following tests can be used in the diagnosis of personality disorders:
Medical ManagementCaregivers should be vigilant about suicidal potential and should document their assessments in the medical record at each visit.
Pharmacologic ManagementMedications are in no way curative for any personality disorder; they should be viewed as an adjunct to psychotherapy so that the patient may productively engage in psychotherapy.
The nursing management of a patient with personality disorder include the following: Nursing AssessmentAssessment of the
patient include: Nursing DiagnosisNursing diagnoses for clients with personality disorder include the following: • Risk for suicide related to low frustration tolerance. Nursing Care Planning and GoalsMain Article: 4 Personality Disorders Nursing Care Plans Nursing care plan goals for personality disorders may include: • The client will be safe and free of significant injury. Nursing InterventionsClients with personality disorder often are involved in long-term psychotherapy to address issues of family dysfunction and abuse.
EvaluationGoals are met as evidenced by:
Documentation GuidelinesDocumentation in a client with personality disorder include:
Practice Quiz: Personality DisordersNursing practice questions for Personality Disorders. Please visit our nursing test bank page for more NCLEX practice questions. 1. Clients with personality disorders have difficulties in their social and occupational functions. Clients with a personality disorder will most likely: A.
Responsd to anti anxiety medication 1. Answer: D. Manifest enduring patterns of inflexible behaviors.
2. A client tends to be insensitive to others, engages in abusive behaviors and does not have a sense of remorse. Which personality disorder is he likely to have? A. Antisocial 2. Answer: A. Antisocial
3. A teenage girl is diagnosed to have a borderline personality disorder. Which manifestations support the diagnosis? A. Social withdrawal, inadequacy, sensitivity to rejection and criticism 3. Answer: B. Lack of self-esteem, strong dependency needs, and impulsive behavior.
4. The plan of care for clients with borderline personality should include: A. Restricting her from other clients 4. Answer: B. Ensuring she adheres to certain restrictions.
5. A hospitalized client, diagnosed with a borderline personality disorder, consistently breaks the unit’s rules. This behavior should be confronted because it will help the client: A. Set realistic goals 5. Answer: C. Become more self-aware.
What assessment is used for personality disorders?Personality disorder can be assessed in a number of ways, including self-report, checklists and structured clinical interview. Numerous instruments are available to aid the clinician in making a diagnosis. These differ in terms of both reliability and validity.
What are the three main risk factors identified with personality disorders?Risk factors
Family history of personality disorders or other mental illness. Abusive, unstable or chaotic family life during childhood. Being diagnosed with childhood conduct disorder.
How do you know if a client has a personality disorder?PD affects three key areas, she reveals: "your inability to manage your emotions either by being easily overwhelmed or by switching off from your emotions; distorted beliefs such as a pronounced fear of rejection or belief that others can't be trusted; and difficulties in forming and maintaining relationships because ...
How do you work with patients with personality disorders?Key principles for working with people with personality disorders. Be compassionate.. Demonstrate empathy.. Listen to the person's current experience.. Validate the person's current emotional state.. Take the person's experience seriously, noting verbal and non-verbal communications.. Maintain a non-judgemental approach.. Stay calm.. |