Personality Disorders by Elzeany

2. Quality Management OfficerQuality Management Officer
Buraidah Mental Health HospitalBuraidah Mental Health Hospital
Prepared by :Prepared by :

3. Personality Disorder is an enduringPersonality Disorder is an enduring
pattern of inner experience & behaviourpattern of inner experience & behaviour
that differs markedly from thethat differs markedly from the
expectations of the individual’s culture.expectations of the individual’s culture.
Pervasive and inflexible, has an onset inPervasive and inflexible, has an onset in
adolescence or early adulthood, is stableadolescence or early adulthood, is stable
overtime, & leads to distress or impairment .overtime, & leads to distress or impairment .
Personality Disorders are long standing andPersonality Disorders are long standing and
maladaptive pattern of perceiving & respondingmaladaptive pattern of perceiving & responding
to other people and to stressful circumstances .to other people and to stressful circumstances .

5. CLUSTER ACLUSTER A
Odd, eccentricOdd, eccentric
CLUSTER BCLUSTER B
• HistrionicHistrionic
Dramatic, erraticDramatic, erratic
CLUSTER CCLUSTER C
• AvoidantAvoidant
fearfulfearful
• SchizoidSchizoid
• SchizotypalSchizotypal
• NarcissisticNarcissistic
• AntisocialAntisocial
• DependentDependent
• Obsessive-Obsessive-
CompulsiveCompulsive
• ParanoidParanoid
• BorderlineBorderline

7. A pervasive distrust and suspiciousness suchA pervasive distrust and suspiciousness such
that the motives of others are interpreted asthat the motives of others are interpreted as
malevolent (malicious) .malevolent (malicious) .

8. Constantly on guardConstantly on guard
HypervigilantHypervigilant
Ready for any real or imagined threatReady for any real or imagined threat
Trusts no oneTrusts no one
Constantly tests the honesty of othersConstantly tests the honesty of others
Tends to misinterpret minute cuesTends to misinterpret minute cues
Magnifies OversensitiveMagnifies Oversensitive
Distorts cues in the environmentDistorts cues in the environment

9. Failure to respond to others in a meaningfulFailure to respond to others in a meaningful
emotional way .emotional way .
Characterized primarily by a profound defect inCharacterized primarily by a profound defect in
the ability to form personal relationships .the ability to form personal relationships .

10. Indifferent to othersIndifferent to others
Client aloofClient aloof
Client emotionally coldClient emotionally cold
In presence of others, clientsIn presence of others, clients
appear shy, anxious, or uneasyappear shy, anxious, or uneasy
Inappropriately serious aboutInappropriately serious about
everything and have difficulty actingeverything and have difficulty acting
in a light-hearted mannerin a light-hearted manner

11. Peculiarities of thinking , odd beliefs , &Peculiarities of thinking , odd beliefs , &
eccentricities of appearance , behavior,eccentricities of appearance , behavior,
interpersonal style , and thoughts .interpersonal style , and thoughts .
(e.g. belief in psychic phenomena(e.g. belief in psychic phenomena
& having magical powers . )& having magical powers . )

12. Discomfortwith&reduced
Discomfortwith&reduced
capacityforcloserelationships
capacityforcloserelationships
Mostaresociallyisolated
MostaresociallyisolatedHighlysuspicious
Highlysuspicious

14. Lack of regard for the moral or legal standardsLack of regard for the moral or legal standards
in the local culture , marked inability to getin the local culture , marked inability to get
along with others or abide by social rules .along with others or abide by social rules .

15. •Cruel and maliciousCruel and malicious
•Inability to form lastingInability to form lasting
monogamous relationshipmonogamous relationship
•Inconsistent work orInconsistent work or
academic performanceacademic performance
•Cold, callous , intimidatingCold, callous , intimidating
•Failure to conform to societal normsFailure to conform to societal norms

16. Lack of one's own identity, with rapid changesLack of one's own identity, with rapid changes
in mood, intense unstable interpersonalin mood, intense unstable interpersonal
relationships, marked impulsively , instabilityrelationships, marked impulsively , instability
in affect & in self image.in affect & in self image.

17. •Self-mutilation & suicidal gestures are commonSelf-mutilation & suicidal gestures are common
•Patterns of unstable moods & relationshipsPatterns of unstable moods & relationships
•Fear of abandonment , very poor self-imageFear of abandonment , very poor self-image

18. Pervasive attention-seeking behaviorPervasive attention-seeking behavior
including inappropriate sexual seductivenessincluding inappropriate sexual seductiveness
& shallow or exaggerated emotions .& shallow or exaggerated emotions .

19. • Common diagnosis in females flamboyant gayCommon diagnosis in females flamboyant gay
““Drama Queen”Drama Queen”
• Overly dramatic , sensational, & sexual provocativeOverly dramatic , sensational, & sexual provocative
• Impulsive & need to be the center of attentionImpulsive & need to be the center of attention
• Thinking & emotions are perceived as shallowThinking & emotions are perceived as shallow

20. A pervasive patternA pervasive pattern
of grandiosity , needof grandiosity , need
for admiration ,& afor admiration ,& a
lack of empathy.lack of empathy.

21. • Sensitive to criticism , envious & arrogantSensitive to criticism , envious & arrogant
• Exaggerated , unreasonable sense of selfExaggerated , unreasonable sense of self
importanceimportance
• Preoccupation with receiving attentionPreoccupation with receiving attention
• Lack sensitivity and compassion for otherLack sensitivity and compassion for other
peoplepeople

23. Marked social inhibition , feelings of inadequacy ,Marked social inhibition , feelings of inadequacy ,
& extremely sensitive to criticism .& extremely sensitive to criticism .

24. •Interpersonally anxious & fearful of rejectionInterpersonally anxious & fearful of rejection
•Extreme sensitivity to the opinion of othersExtreme sensitivity to the opinion of others
•Highly avoidant of most interpersonal relationshipsHighly avoidant of most interpersonal relationships

25. Characterized by a pervasive and excessive needCharacterized by a pervasive and excessive need
to be taken care of ; that leads to submissive andto be taken care of ; that leads to submissive and
clinging behavior and fears of separationclinging behavior and fears of separation

26. •Unreasonable fear of abandonmentUnreasonable fear of abandonment
•Reliance on others to make major & minor life decisionsReliance on others to make major & minor life decisions
•Assumes passive and submissive roles in relationshipsAssumes passive and submissive roles in relationships
•Avoids positions of responsibility and becomes anxiousAvoids positions of responsibility and becomes anxious
when forced into themwhen forced into them

27. Characterized by perfectionism &Characterized by perfectionism &
inflexibility, preoccupation withinflexibility, preoccupation with
uncontrollable patterns of thought & actionuncontrollable patterns of thought & action

28. •Polite and formalPolite and formal
•Especially concerned with matters ofEspecially concerned with matters of
organization and efficiencyorganization and efficiency
•Tends to be rigid and unbendingTends to be rigid and unbending

29. Personality DisordersPersonality Disorders
SUMMARY Descriptive BehaviorsSUMMARY Descriptive Behaviors

30. CLUSTER ACLUSTER A
Paranoid personality:Paranoid personality:
Suspicious, distrustfulSuspicious, distrustful
Socially distant,
Socially distant,
detacheddetached
Schizoid personality:
Schizoid personality:
Odd, eccentricOdd, eccentric
Schizotypal personality:Schizotypal personality:

31. CLUSTER BCLUSTER B
* Antisocial personality:
* Antisocial personality:
Impulsive, aggressive, manipulative
Impulsive, aggressive, manipulative
*Borderline personality:
*Borderline personality:
Impulsive, self-destructive, unstable
Impulsive, self-destructive, unstable
*Histrionic personality:
*Histrionic personality:
Emotional, dramatic, theatrical
Emotional, dramatic, theatrical
*Narcissistic personality:
*Narcissistic personality:
Boastful, egotistical,
Boastful, egotistical, ““superiority complex
superiority complex””

32. CLUSTER CCLUSTER C
•Avoidant personality:
Avoidant personality:
Dependent,
Dependent,submissive,
submissive,clinging
clinging
Perfectionistic,
Perfectionistic,
rigid,
rigid,
controlling
controlling
Shy,Shy,
timid,
timid,
“inferiority complex”
“inferiority complex”
•Dependent personality:
Dependent personality:
•Obsessive–compulsive
Obsessive–compulsive
personality:
personality:

33. Nursing Interventions :Nursing Interventions :

34. Nursing Interventions

35. Be patient with client’s extreme emotionalBe patient with client’s extreme emotional
behaviors. Provide a consistent andbehaviors. Provide a consistent and
structured milieu to decrease powerstructured milieu to decrease power
struggles.struggles.
Encourage interaction (group), but do not push .Encourage interaction (group), but do not push .
Be as neutral as possible as client perceives others asBe as neutral as possible as client perceives others as
threatening .threatening .
Approach in a gentle, interested but non intrusive way .
Respect client’s need for distance .
Nursing Interventions :

36. Nursing Interventions :
Protect client from suicide and self mutilation .
Set clear limits to maintain impulse control
Teach problem solving and assertiveness training.
Teach expression of feelings .
Help client to recognize distress related to the
need for perfection and control .

37. Nursing Interventions :
• Safety-suicide precautionsSafety-suicide precautions
• Anxiety Reduction
• Focus on behavior, not the reasons for the behavior
• No changing of the rules-be consistent it creates a
feeling of safety .
• Increase their sense of worth and competence by
having them make their own decisions .