I’m NOT
beautiful like
YOU.
I’m beautiful like
ME.
Personality
Disorders
Agnes June L. Custodio, MAN, RN
NCM 205 Lecturer
Learning Outcomes
At the end of 2.5 hours discussion, the
students should be able to:
1.
Differentiate between the three major
categories of personality disorders.
2.
Identify specific personality disorders
within each category.
3.
Plan nursing care for each personality
disorder.
4.
Discuss values learned from the topic.
Personality Disorder
• An
enduring pattern of inner
experience and behavior that deviates
markedly from the expectations of the
individual’s culture in at least 2 of the
ff:
 Cognition
 Affectivity
 Interpersonal functioning
 Impulse control
DSM V Definition
• Pattern
is enduring, inflexible, and
pervasive across a broad range of
situations.
• Leads
to clinically significant
distress or impairment in social,
occupational, or other important
areas of functioning.
The Clusters
• Cluster
A
• Odd-eccentric
• Cluster
B
• Dramatic
• Cluster
C
• Fearful
Each of us has a disorder.
Nobody is perfect.
So, be kind.
Self-acceptance
is the first step
towards
embracing
differences in
others.
(J. L.)
Cluster A
Cluster A – PD 1
>4
 Suspicious
 Doubts friends or
associates
 No confidante
 Reads meanings from
remarks
 Bears grudges
 Perceives attacks on self
- quick to react or do
counterattack
 Doubts partner’s fidelity
Pervasive
distrust and
suspiciousness
Cluster A – PD 2
>4
 Not comfortable with close relationships
 Prefers solitary activities
 Has little interest in sex
 Not interested in any
activities
 No confidante
 Indifferent to praise or
criticism
 Emotionally cold
Pervasive detachment from social relationships
Cluster A – PD 3
>5
 Ideas of reference
 Odd beliefs “6th sense”
 Unusual perceptual
experiences
 Odd thinking/speech
 Suspicious
 No confidante
 Inappropriate or
constricted affect
 Odd, eccentric behavior
 Excessive social anxiety
Pervasive
perceptual
distortions &
eccentricities
of behavior
Be kind
for everyone
you meet is
fighting a
hard battle.
(Plato)
Cluster B
Cluster B – PD 1
Pervasive
disregard or
violation of
rights of others
>3
 Failure to conform to
social norms
 Deceitful (lying,
conning)
 Impulsive
 Irritable and
aggressive
 Reckless disregard for
safety of self or others
 Consistent
irresponsibility
 Lack of remorse
Cluster B – PD 2
 Frantic efforts to avoid abandonment
 Unstable/intense intimate relationship
(idealization vs.
devaluation)
 Unstable self
image
 Chronic feelings of
emptiness
 Recurrent suicidal
acts, threats or
self-mutilation
Cluster B – PD 2 > 3
 Impulsivity (at least 2 of the ff):
 spending
 sex
 substance abuse
 binge eating
 reckless driving
 Affective instability
 Inappropriate and intense
anger or difficulty in
controlling anger
Pervasive instability and marked impulsivity
Cluster B – PD 3
Pervasive
attention
seeking
>5
Uncomfortable if not COA
Inappropriately seductive
Unstable emotionally
Uses physical appearance
to draw attention to self
Speech is excessively
impressionistic but lacking
in detail
Self-dramatization
Suggestible
“Feeling close”
Cluster B – PD 4 > 5
 Preoccupied with fantasies
of unlimited success, power,
beauty, or ideal love
 Believes he/she is special or
unique
 Grandiose
 Entitled
 Arrogant, haughty
 Needs excessive admiration
 Interpersonally exploitative
 Lacks empathy
Pervasive
grandiosity
Cluster C
Cluster C – PD 1 > 4
Pervasive
feelings of
inadequacy
 Avoids activities with
interpersonal contact
 Will not get involved (if…)
 Restrained in intimate
relationships
 Preoccupied with being
criticized or rejected
 Inhibited in new
interpersonal situations
 Views self as unappealing
or inferior to others
 Reluctant to take risks
Cluster C – PD 2 > 5
 Difficulty in making everyday decisions
 “Sucker”
 Needs others to assume
responsibility
 Difficulty in expressing
disagreement
 Difficulty initiating projects
 Feels helpless when alone
 Urgently seeks another
Pervasive
relationship
excessive
 Unrealistically preoccupied
need to be
cared for
w/ fears of being left alone
Cluster C – PD 3 > 5
 Preoccupied w/ details/rules/order/scheds
 Perfectionism interferes w/ completion
 Overconscientious & inflexible morality
 Unable to discard worn-out or worthless
objects
 Workaholic
 Reluctant to delegate
tasks
 Miser towards self &
others
 Rigid and stubborn
Pervasive perfectionism
Let’s Review….
Cluster A Disorders
• Paranoid.
• Schizoid.
• Schizotypal.
Cluster B Disorders.
• Antisocial.
• Borderline.
• Histrionic.
• Narcissistic.
Cluster C Disorders.
• Avoidant.
• Dependent.
• Obsessive-compulsive.
Mnemonic
• Cluster
A
• Weird.
• Cluster
B
• Wild.
• Cluster
C
• Worried.
Each of us has a disorder.
Nobody is perfect.
So, be kind.
Assignment
1.
Study about the management
of each personality disorder
(medications, therapies,
nursing approach)
2.
Read about Schizophrenia
3.
Love yourself, but don’t forget
to love others, too….
References.
•
1. (2000). Diagnostic and statistical manual of
mental disorders, dsm-iv-tr.. (IV ed.). Washington,
DC.: Amer Psychiatric Pub Inc.
•
2. Sadock, B. J., H. I. Kaplan, and V. A. Sadock.
Kaplan & sadock\'s synopsis of psychiatry,
behavioral sciences/clinical psychiatry. 10.
Lippincott Williams & Wilkins, 2007. Print.