GOOD AFTERNOON
PERSONALITY DISORDERS
Hari Krishna G L
Scope of the session
• Discuss about Personality Disorder,
characteristics and classification.
• Nursing management of PD
Definition
• “An enduring pattern of inner experience
and behavior that deviates markedly from
the expectations of the culture of the
individual who exhibits it.” (APA,2000)
• Pervasive and inflexible
• Onset in adolescence and early adulthood
Characteristics
• Denies the maladaptive behavior
• Minor stress is poorly tolerated
• Increased inability to cope with anxiety
• Defective ego functioning
• Person is in contact with reality, although
has difficulty dealing with it
• Anxiety / depression may be present
• Psychiatric help rarely is sought
Prevalence
• 5-10% in general population
Etiology
• Biological factors:
1. Genetic factors
2. Family history
3. Neuro transmitter imbalance
• Psychological factors:
1. Child neglect
2. Childhood trauma
3. Parental rejection
4. Alcoholic parents
5. Excessive parental control
Contd….
• Socio-cultural factors:
1. Broken homes/families
2. Prolonged separation
3. Assault
4. Experience to death and loss
Classification (DSM IV- TR)
1. Cluster A(Odd and eccentric)
-’ Schizophrenic continuum’
a. Paranoid PD
b. Schizoid PD
c. Schizotypal PD
2. Cluster B(Dramatic, emotional and
erratic)
-’Psychopathic continuum’
a. Anti social PD
b. Histrionic PD
c. Narcissistic PD
d. Borderline PD
3. Cluster C (Anxious and fearful)
- ‘Introversion’
a. Avoidant PD
b. Dependant PD
c. Obsessive-compulsive PD(Anankastic)
1. Paranoid PD
• Suspiciousness
• Mistrustful
• Sensitive
• Argumentative
• Stubborn
• Hostile and difficulty maintaining jobs
2. Schizoid PD
• Emotionally cold
• Aloof
• Detached
• Humorless
• Quietness
• Oversensitive and cold
3. Schizo typal PD
• Odd and eccentric behavior
• Poor rapport with others
• Odd beliefs or magical thinking
• Suspiciousness
• Unusual perceptual experiences
4. Antisocial PD
• Failure to sustain relationship
• Disregard for feeling of others
• Impulsive actions
• Aggressive
• Persistent lying
• Low tolerance to frustration
• Lack of guilt
5.Histrionic PD
• Emotional blackmail
• Angry scenes
• Demonstrative suicidal attempts
• Over concern with physical attractiveness
• Attention seeking attitude
6. Narcissistic PD
• Ideas of grandiosity
• Inflated sense of self importance
• Preoccupation with fantasies
• Attention seeking and dramatic behavior
• Sense of inferiority
• Easily depressed by minor events
7. Borderline PD
• Unstable relationship
• Impulsive behavior
• Lack of control of anger
• Recurrent suicidal threats
• Uncertainty about personal identity
• Ambivalent
• Powerlessness
8. Anxious (Avoidant) PD
• Persistent feeling of tension and
apprehension
• Inferiority complex
• Fear of criticism
• Excessive preoccupation
• Lack of close friends
• Low self esteem
9. Dependant PD
• Subordination of one’s own needs
• Avoiding personal responsibility
• Inability to take decisions
• Low self esteem
• Tend to be passive
10. OC (Anankastic) PD
• Feelings of excessive doubt
• Preoccupation with rules and regulations
• Perfectionist
• Inflexible
• Limited interpersonal skills
• Has insight into the difficulties
PASSIVE-AGGRESSIVE
PERSONALITY DISORDER
Passive aggressive PD
• Have negative attitude and seldom do
anything that can be positive
• Gives the impression of being hardworking
and sincere
• Argumentative and criticize others
• Spends more time in verbalizing about
personal misfortunes and blocked
opportunities.
Course and prognosis
• May become permanent and worsen with
time
• May mature and develop more adaptive
coping styles
• May drop out of treatment , preventing
follow up
• May never seek treatment
Treatment
• Psychological treatment:
Psychotherapy
CBT(Cognitive Behavior
Therapy)
Family therapy
• Pharmacotherapy
Antipsychotics
Antidepressants
Mood stabilizers
Nursing management
• Assessment
History
MSE
Nursing problems
• Ineffective individual coping
• Non compliance
• Impaired social interaction
• Ineffective verbal communication
• Disturbed thought process
Nursing interventions
• Good therapeutic relationship
• Convey an attitude of acceptance
• Maintain low level of stimuli in the environment
• Provide safety and security in interactions
• Observe patient’s behaviour frequently
• Help the client to gain insight into his/her behavior
• Limit setting
• Enhance patient’s self esteem
• Give health education
• Administer medications as prescribed
CONCLUSION
• Clients with personality disorder are some
of the most difficult ones to take care of.
• The therapeutic approach is not to change
the characteristics but to decrease the
inflexibility of the maladaptive traits.
QUIZ
1. According to DSM-IV-TR classification,
antisocial personality disorders is
classified under
A. Cluster-A
B. Cluster-B
C. Cluster-C
D. Cluster-D
Contd….
2. Narcissistic personality disorder is
characterized by
A. Callous unconcern for feelings of others
B. Self-dramatization, theatricality
C. Ideas of grandiosity and inflated sense of
self-importance
D. Significant and persistent disturbances of
identity of self.
Contd…
3. Antisocial personality disorders are
characterized by all, except
A. Low frustration tolerance
B. Drug abuse
C. Learning from past experience
D. Criminal activities
4. A client expresses the belief that the
armed force is out to kill him. This is an
example of
A. Hallucinations
B. Delusion of persecution
C. Delusion of reference
D. Depersonalization
GENDER IDENTITY DISORDER 08/07/2025 37
