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