Categories of Personality Disorders
Cluster A (odd, eccentric)
• paranoid, schizoid, schizotypal
Cluster B (dramatic, emotional, erratic)
• antisocial, borderline personality disorder, narcissistic personality disorder
Cluster C (anxious, fearful)
• avoidant, dependent, obsessive compulsive
4 Permanent Traits Character Trait
-Harm avoidance -Self directedness
-Novelty seeking -Cooperative
-Reward dependence -Self transcendence
-Persistence
Cluster A
1. Paranoid Personality Disorder
• Mistrust, suspiciousness, jealousy, observant for signs of threat
• Secretive, hypersensitive, excessive feeling of self-importance
• Aloof, withdrawn, hypervigilant, restricted affect, labile mood
• Projection, fantasy of retribution
Nursing Intervention
• Approach in formal business-like manner, refrain chitchat and jokes
• Involve client in formulation plan of care
• Teach to validate ideas before taking action
2. Schizoid Personality Disorder
• Pervasive pattern of detachment from social relationships, restricted range of
emotional expression
• Constricted affect, prefers solitary activities, aloof, lack future goals or direction,
indifferent, unfeeling, uncaring
Nursing Intervention
• Improve client functioning in community
• Presence of identified family member as primary relationship
3. Schizotypal Personality Disorder
• Social and interpersonal deficits, acute discomfort and reduced capacity for close
relationship as well as by cognitive or perceptual distortions and behavioral
eccentricities
• May experience psychotic symptoms in response to extreme stress
• Odd, strange, unusual appearance, ill-fitting clothes, disheveled hair
• Speech may be divertive, lose or vague, often flat, restricted emotions sometimes
silly or inappropriate
• Cognitive distortions, magical thinking, ideas of reference, odd beliefs,
extrasensory perception, clairvoyance
• May express great anxiety around other people, can’t respond to normal social
cues
Nursing Intervention
1
, • Development of self-care, social skills, improved community functioning
• Daily routine for hygiene and grooming
• Contact practice by role playing
• May use written requests, telephone for business, not face to face
Cluster B
1. Anti-social Personality Disorder
• Disregards violation of rights, central characteristic of deceit and manipulation
• Lack of remorse for behavior
• Shallow emotions
• Lying rationalization of own behavior
• Poor judgement, impulsive
• Irritable and aggressive, lack of insight, thrill seeking behavior
• Exploitation of people in relationships
• Poor working history
• Consistently irresponsible
History in childhood:
• Enuresis (bed wetting), sleepwalking, cruelty (from abusive parents)
General appearance:
• Usually normal
Mood and affect:
• Actual emotion is quite shallow, can’t emphasize with feelings of others, only feel
remorse when caught by authorities/law enforcers.
Thought process and content:
• No disordered thoughts, but views the world as narrow and distorted
Judgement and insight:
• Impulsive, poor judgment, lacks insight
Self-concept:
• Egocentric, feel fearless, believes they can’t be caught in lies, deceit or illegal
activities
Roles and relationships:
• Manipulative and exploits others, can’t sustain long term commitments
Diagnosis: Ineffective coping
Ineffective role performance
Risk for violence directed to others
Nursing Intervention:
• Limit setting- stating behavioral limit
• Consistent adherence to rules and treatment plans
• Confront- point out problem behavior, keep client focus on self
• Help client solve problems and control emotions
• Express negative emotions such as anger and frustrations, take a time out to a
stressful situation
• Enhance role performance- identify barriers to role fulfilment, decrease or
eliminate use of drugs
2. Borderline Personality Disorder
• Unstable interpersonal relationships, self-image, affect, marked impulsivity
• Common in women
• Fears abandonment
2
Cluster A (odd, eccentric)
• paranoid, schizoid, schizotypal
Cluster B (dramatic, emotional, erratic)
• antisocial, borderline personality disorder, narcissistic personality disorder
Cluster C (anxious, fearful)
• avoidant, dependent, obsessive compulsive
4 Permanent Traits Character Trait
-Harm avoidance -Self directedness
-Novelty seeking -Cooperative
-Reward dependence -Self transcendence
-Persistence
Cluster A
1. Paranoid Personality Disorder
• Mistrust, suspiciousness, jealousy, observant for signs of threat
• Secretive, hypersensitive, excessive feeling of self-importance
• Aloof, withdrawn, hypervigilant, restricted affect, labile mood
• Projection, fantasy of retribution
Nursing Intervention
• Approach in formal business-like manner, refrain chitchat and jokes
• Involve client in formulation plan of care
• Teach to validate ideas before taking action
2. Schizoid Personality Disorder
• Pervasive pattern of detachment from social relationships, restricted range of
emotional expression
• Constricted affect, prefers solitary activities, aloof, lack future goals or direction,
indifferent, unfeeling, uncaring
Nursing Intervention
• Improve client functioning in community
• Presence of identified family member as primary relationship
3. Schizotypal Personality Disorder
• Social and interpersonal deficits, acute discomfort and reduced capacity for close
relationship as well as by cognitive or perceptual distortions and behavioral
eccentricities
• May experience psychotic symptoms in response to extreme stress
• Odd, strange, unusual appearance, ill-fitting clothes, disheveled hair
• Speech may be divertive, lose or vague, often flat, restricted emotions sometimes
silly or inappropriate
• Cognitive distortions, magical thinking, ideas of reference, odd beliefs,
extrasensory perception, clairvoyance
• May express great anxiety around other people, can’t respond to normal social
cues
Nursing Intervention
1
, • Development of self-care, social skills, improved community functioning
• Daily routine for hygiene and grooming
• Contact practice by role playing
• May use written requests, telephone for business, not face to face
Cluster B
1. Anti-social Personality Disorder
• Disregards violation of rights, central characteristic of deceit and manipulation
• Lack of remorse for behavior
• Shallow emotions
• Lying rationalization of own behavior
• Poor judgement, impulsive
• Irritable and aggressive, lack of insight, thrill seeking behavior
• Exploitation of people in relationships
• Poor working history
• Consistently irresponsible
History in childhood:
• Enuresis (bed wetting), sleepwalking, cruelty (from abusive parents)
General appearance:
• Usually normal
Mood and affect:
• Actual emotion is quite shallow, can’t emphasize with feelings of others, only feel
remorse when caught by authorities/law enforcers.
Thought process and content:
• No disordered thoughts, but views the world as narrow and distorted
Judgement and insight:
• Impulsive, poor judgment, lacks insight
Self-concept:
• Egocentric, feel fearless, believes they can’t be caught in lies, deceit or illegal
activities
Roles and relationships:
• Manipulative and exploits others, can’t sustain long term commitments
Diagnosis: Ineffective coping
Ineffective role performance
Risk for violence directed to others
Nursing Intervention:
• Limit setting- stating behavioral limit
• Consistent adherence to rules and treatment plans
• Confront- point out problem behavior, keep client focus on self
• Help client solve problems and control emotions
• Express negative emotions such as anger and frustrations, take a time out to a
stressful situation
• Enhance role performance- identify barriers to role fulfilment, decrease or
eliminate use of drugs
2. Borderline Personality Disorder
• Unstable interpersonal relationships, self-image, affect, marked impulsivity
• Common in women
• Fears abandonment
2
