Psychiatric Nursing: Personality Disorders


Personality Disorder
Symptoms / Characteristics
Nursing Interventions
Paranoid
Mistrust & suspicions of others; guarded, restricted affect
Serious, straightforward approach; teach client to validate ideas before taking action; involve client in treatment planning
Schizoid
Detached from social relationships; restricted affect; involved with things more than people
Improve client’s functioning in the community; assist client to find case manager
Schizotypal
Acute discomfort in relationships; cognitive or perceptual distortions; eccentric behavior
Develop self-care skills; improve community functioning; social skills training
Antisocial
Disregard fro rights of others, rules, and laws
Limit setting; confrontation; teach client to solve problems effectively and manage emotions of anger or frustration
Borderline
Unstable relationships, self-image, and affect; impulsivity; self-mutilation
Promote safety; help client to cope and control emotions; cognitive restructuring techniques; structure time; teach social skills
Histrionic
Excessive emotionality and attention seeking
Teach social skills; provide factual feedback about behavior
Narcissistic
Grandiose; lack of empathy; need for admiration
Matter-of-fact approach; gain cooperation with needed treatment; teach client any needed self-care skills
Avoidant
Social inhibitions; feelings of inadequacy; hypersensitive to negative evaluation
Support and reassurance; cognitive restructuring techniques; promote self-esteem
Dependent
Submissive and clinging behavior; excessive need to be taken care of
Foster client’s self-reliance and autonomy; teach problem-solving and decision-making skills; cognitive restructuring techniques
Obsesive-compulsive
Preoccupation with borderlines; perfectionism, and control
Encourage negotiation with others; assist client to make timely decisions and complete work; cognitive restructuring techniques
Depressive
Pattern of depressive cognitions and behaviors in a variety of contexts
Assess self-harm risk; provide factual feedback; promote self-esteem; increase involvement in activities
Passive-aggresive
Pattern of negative attitudes and passive resistance to demands for adequate performance in social and occupational situations
Help client to identify feelings and express them directly; assist client to examine own feelings and behavior realistically

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