Looking back behind a self and

emotions

PERSONALITY
DISORDERS
PERSONALITY

It is an ingrained enduring pattern

of behaving and relating to self,
others, and the environment; it
includes perceptions, attitudes and
emotions.
 4 TEMPERAMENT TRAITS:
1. Harm avoidance
 High- harm avoidance exhibit fear of uncertainty, inhibition,
shyness with strangers, rapid fatigability, and pessimistic
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 oor outburst,and
fickle in relationship.
 Low- novelty seeking are slow tempered, stoic, reflective,
frugal, reserved, orderly, and tolerant, of monotomy; adhere
routine activities.
3. Reward dependence
 High-reward dependence are tender hearted, sensitive,
sociable, and socially dependent which lead to overly
dependent to others.
 Low- reward dependence are practical, tough minded, cold,
socially insensitive, irresolute, and indifferent to being alone.
Social withdrawal, detachment, aloofness, and disinterest in
others.
4. Persistence
 High- persistent people are hardworking and ambitious
overachievers who respond to fatigue or frustration as a
personal challenge.
 Low persistent people are inactive, indolent, unstable, and
erratic. They tend to give easily when frustrated and rarely
strive for higher accomplishments.
PERSONALITY DISORDER
These are traits which becomes
inflexible and maladaptive and
significantly interfere with how a
person functions in society or cause
the person emotional distress. It is
often described as “treatment
resistant”
10-13% general population
15% psychiatric inpatients
45% mental illness
30-50% outpatient

60-70% alcoholism
70-80% criminals
70-90% drug abuse
CATEGORIES OF PERSONALITY DISORDER :

Cluster B Cluster
Cluster A
(Dramatic,Emotional, (Depressive,Passive-
(Odd or Eccentric)
or Erratic) aggressive, or Fearful)
Cluster A
PARANOID PERSONALITY DISORDER
 Mistrust and suspicious of others; guarded, restricted
affect.
H-holds grudges towards others
I- interpret remarks as demeaning or threatening
D-doubt trustworthiness of others
S- suspicious of others
F-fear of confiding in others
F- fear of personal information will be used against them.
B- become angry and threatening when they perceived
they are attacked by others.
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 the
reaction 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. Help client to validate ideas before taking actions.
 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 friends
L- lack of sexual experience
Etiology: orderly and formal without warmth,play or
spontaneous social interactions.
Diagnosis;
 Impaired social interaction
 Risk for loneliness
 Ineffective coping

Intervention:
1. Focus improve functioning in the community
2. Referrals that will accommodate the client’s desire
and 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 to
respond like others do.
SCHIZOTYPAL PERSONALITY DISORDER
 Acute discomfort in relationships; cognitive or
perceptual 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 relationship
U-uncomfortable in social situations
M- magical thinking oroddsbelief
E- eccentric appearance or behavior
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 request
to obtain services or to conduct personal business.
4. Social Skills training may help client to talk
clearly with others and reduce bizarre beliefs such
as social working family members.
Cluster B
 ANTISOCIAL PERSONALITY DISORDER
 Pervasive action of disregard for and violation of
the right of others and with the central
characteristics of deceit and manipulative.
E- engages in illegal activity
V- violates rights of others
I-irresponsible in work and with finances
L- lack of guilt or remorse
I- impulsiveness
A- aggressive behavior
R- recklessness
Etiology: familial history; frequent alcoholism and
neglect; Child abuse and adolescent conduct
disorder.a
Others: bullying, cruelty to people and animals,
stealing, etc.
Diagnosis:
 Risk for other directed violence
 Ineffective denial
 Impaired social interaction

Intervention;
1. Forming therapeutic relationship and promoting
responsible behaviors
2. Limit- setting is an effective technique that
involves 3 Steps:
i. Stating the behavioral limit (describing the
unacceptable 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 client
problematic behavior while remaining neutral and
matter- of- fact).
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 of frustration.
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 the
source of their problems realistically because they
tend to blame others for their failures and
difficulties.
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 hopeless
or use other techniques to avoid responsibility.
12. Avoid any decision or debate why? The rules or
requirement exist. So, state the requirement or rule
in matter of facts.
 BORDERLINE PERSONALITY DISORDER
 Pervasive pattern of unstable interpersonal relationships, self-
image and affect as well as marked impulsivity. It is three
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- impulsivity
P- problems with anger
T- transient dissociative and paranoid symptoms
S- suicidal behavior
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 safety

2. Promoting the therapeutic relationships

3. Establishing boundaries in relationship

4. Teach effective communication skills
5. Reshaping thinking patterns
 Cognitive structuring- changing pattern of thinking
 Thought stopping- alter the process of negative or
self critical thought.
6. Decatastrophizing- involves learning to assess
situations realistically rather than always assuming
a catastrophe.
7. Structuring the clients daily activities involves
minimizing unstructured time
 HISTRIONIC PERSONALITY DISORDER
Excessive emotion and attraction seeking.
N- needs to be center of attention
U- uses physical appearance to become center of
attention
U- uses speech to impress others but is lacking in
depth
D- displace sexually seductive or proviolation
behaviors
D- dramatic expression and emotion
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.
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 and modeling

social skills including establishing eye contact,
activity, listening, and respecting personal space.
4. Encouraging clients to use assistive communication
such as “I” statement.
 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 entitlement
T-takes advantage of others own benefits
N-needs to be admired
F- fantasies of unlimited power, success or brilliance
L- lacks of empathy
A- arrogant
G- grandiose self importance
Etiology: Selfless love and adoration from signifcant
others.
Diagnosis;
 Impaired social interaction
 Ineffective coping
 Ineffective denial

Intervention;
1. Use self awareness
 AVOIDANT PERSONALITY DISORDER
A- avoid occupations involving interpersonal contact sue to
fears of disapproval/ rejection
U- uninvolved with others unless certain of being liked
V- very reluctant to take risks or engage in new activities due
to possibility of being embarrassed
I- inhibited and feels inadequate in new interpersonal situations
P- preoccupied with being criticized or rejected in social
situations
B- believes self to be socially inept, unappealing or inferior to
others
F- fears intimate relationship due to fear of shame and ridicule
 DEPENDENT PERSONALITY DISORDER
P- performs unpleasant tasks to obtain support from others
P- preoccupied with fear of being alone to care for self
P- 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 self
N-needs others to be responsible for important areas of life
U-unable to make decisions without much advice and reassurance
U- urgently needs another relationship for support and care after a
close relationship ends
S- seldom disagrees with others because of fear of loss of support or
approval
Etiology: certain cultures dictate that females should maintain a
dependent role.
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- or task-
related activity
T- too busy working to have friends or leisure
activities
Every personality need not to be afraid/
be ashamed of; for it can be manage
through your own simple way
THANK YOU