Download - Unit 10 personality disorders 1
NUR 448
Personality Disorders
Definition
Extreme exaggerations of personality traits or styles.
Essential features are: chronicity pervasiveness maladaption
Three clusters
Cluster A (Odd, eccentric) Paranoid, Schizoid, Schizotypal
Cluster B (Dramatic, erratic) Antisocial, Borderline, Histrionic, Narcissistic
Cluster C (Anxious, fearful) Avoidant, Dependent, Obsessive-compulsive
Cluster A - Paranoid
Distrustful, suspiciousBears grudgesJealous, envious, hypersensitiveHypervigilent, ideas of referenceRestricted affect, controllingDefense mechanism—projectionOften racist
Cluster A - Schizoid
LonerOdd thoughts, perceptions & speechAloof, no social involvementIndifferent to praise or criticismBouts of mini psychosisCognitive impairment
Cluster A - Schizotypal
Odd, peculiar speechBizarre fantasies and behaviorMagical thinkingIdeas of referenceUnusual beliefs, clairvoyantFortune tellers, street people
Cluster B - Antisocial
Disregard for the rights of othersInstant gratificationNo remorseLying, stealing, revengefulTruant as children, cruelty to animalsFiresetting, substance abuseRx. Restrictive settings (jail, prison)Qualitative difference to soci0pathic
personality
Cluster B - Borderline
Theory-problems with separation-individuation
Bad mother-good motherUnstable and impulsive on eating, spending,
and sexualityUnstable personal relationshipsClinging, demanding, controlling
Borderline
Difficulty being alone, mood swingsExplosive anger, self-mutilationMini-psychoses, eating disordersSplitting (pitting one person against another)Projection, suicide gesturesCutting, carving or other self abuse actions
(never the face)Rx: Small doses of antipsychotic medication
Cluster B - Histrionic
Needs to be center of attentionSeductive, provocative behaviorShallow emotional expressionDramatic, theatricalSuggestibleFocused on physical appearanceOften show “la belle indifference”- disconcern
for personal problems
Cluster B- Narcissistic
Grandiose self importanceUnlimited fantasies of power, wealth, brilliance, beautyFeels special or unique-associates with
people of high statusDemands admiration, entitlement, special
treatmentAble to break laws-severe cases act as anti-
social personalities
Narcissistic
ExploitiveLacks empathyEnviousHaughty, arrogant
Cluster C - Avoidant
Social inhibitionFear of close relationshipsAnxious, lonely, fearful of criticism or
rejectionViews self as socially inept, reluctant to take
risks
Cluster C - Dependent
Difficulty with decision makingSeeks excessive advice and reassurance Difficulty expressing disagreementFear of having to take care of selfExcessive lengths to obtain nurturanceFeels uncomfortable when alone
Cluster C - Obsessive-compulsive
Preoccupied with details, rules, lists and order
Perfectionism that interferes with task completion
Over-conscientious and inflexibleReluctant to delegateMiserly spendingRigid and stubborn
Obsessive Compulsive Personality
Obsessive Compulsive Personality
Obsessive Compulsive Disorder
Obsessive Compulsive Disorder
FastidiousNeatness and
orderlinessDemanding of othersAble to lead normal
lifeBehaviors: labeling,
measuring, things are the same
HoardingCompulsive actionsSeclusiveDisabling and anxiety
producingBehaviors: checking
the door, hand washing, counting, picking at face
Some Differences Between
Treatment
Symptom specificSome improve with time (borderline and
antisocial)Group therapy helpful for some
Questions
Which personality disorders are more disruptive?
What is the difference between schizoid and avoidant personalities?
What are the differences among obsessive- compulsive behavior, obsessive-compulsive personality, and obsessive-compulsive disorder?
Which axis of the DSMIV includes personality disorders?
What are the culture issues of personality disorders?
What are the gender issues of personality disorders?