Personality Disorders

• Personality


  • The habitual patterns and qualities of behavior of an individual as expressed by physical and mental activities and attitudes
  • The distinctive individual qualities of a person
  • The total of the person's internal and external patterns of adjustment to life, determined in part by genetically transmitted organic endowment and by life's experience
• Personality Traits


  • Qualities of behavior that make a person unique
  • Reflect the person's characteristic patterns of thoughts, feelings, and behaviors
• Personality Disorders


  • Non-psychotic illness characterized by maladaptive behavior, which the person uses to fulfill his or her needs and brings satisfaction to self
  • Pervasive and inflexible pattern of behavior demonstrating unhealthy characteristics that limit the individual's ability to function in society
  • A type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving
  • A person with a personality disorder has trouble perceiving and relating to situations and people, causing significant problems and limitations in relationships, social activities, work and school
• Characteristics of Personality Disorders

  • The person denies the maladaptive behaviors he or she exhibits; they have become a way of life
  • The maladaptive behaviors are inflexible
  • Minor stress is poorly tolerated, resulting in increased inability to cope with anxiety
  • The person is in contact with reality, although he or she has difficulty dealing with it
  • Disturbance of mood, such as anxiety or depression, may be present
  • Psychiatric help is rarely sought because the person is unaware or denies that his or her behavior is maladaptive
• Risk Factors for Personality Disorders


  • Family history of personality disorders or other mental illness
  • Abusive, unstable or chaotic family life during childhood
  • Being diagnosed with childhood conduct disorder
  • Variations in brain chemistry and structure
• Types of Personality Disorders

  • Cluster A: Odd, eccentric thinking or behavior
  • Cluster B: Dramatic, overly emotional or unpredictable thinking or behavior
  • Cluster C: Anxious, fearful thinking or behavior
• Paranoid Personality Disorder


  • Pervasive distrust and suspicion of others and their motives
  • Unjustified belief that others are trying to harm or deceive you
  • Unjustified suspicion of the loyalty or trustworthiness of others
  • Hesitancy to confide in others due to unreasonable fear that others will use the information against you
  • Perception of innocent remarks or nonthreatening situations as personal insults or attacks
  • Angry or hostile reaction to perceived slights or insults
  • Tendency to hold grudges
  • Unjustified, recurrent suspicion that spouse or sexual partner is unfaithful
  • Cold and aloof manner
  • Rigid and inflexible
  • Resentful, accusing and argumentative
  • Inability to tolerate criticisms
  • Controlling relationships
  • Extreme jealousy
  • Projection of faults to others
  • Inability to perceive self as a problem
  • Angry or hostile outbursts
  • No friends
  • No sense of humor
• Schizoid Personality Disorder


  • Lack of interest in social or personal relationships, preferring to be alone
  • Limited range of emotional expression
  • Inability to take pleasure in most activities
  • Inability to pick up normal social cues
  • Appearance of being cold or indifferent to others
  • Little or no interest in having sex with another person
  • Withdrawal and seclusion
  • Emotional indifference
  • Self-absorbed attitude
  • Avoidance of close relationships and intimacy
  • Loners
  • Preference in solitary activities
  • Decreased pleasure experience
  • Bland facial expression
  • Daydreaming
  • Social avoidance
  • Functions well in vocation that requires them to work alone
• Schizotypal Personality Disorder


  • Peculiar dress, thinking, beliefs, speech or behaviour
  • Odd perceptual experiences, such as hearing a voice whisper your name
  • Flat emotions or inappropriate emotional responses
  • Social anxiety and a lack of or discomfort with close relationships
  • Indifferent, inappropriate or suspicious response to others
  • "Magical thinking" — believing you can influence people and events with your thoughts
  • Belief that certain casual incidents or events have hidden messages meant only for you
  • Social isolation
  • Common in childhood and adolescence
  • 1% develops psychotic disorders or schizophrenia
  • Suspiciousness or paranoid ideation
  • Excessive social anxiety
  • Suspiciousness or paranoid ideation
  • Ideas of reference
• Antisocial Personality Disorder


  • Impulsive, aggressive, manipulative
  • A pervasive pattern of disregard for and violation of the rights of others
  • Common in men
  • Patients with these disorders are those with conduct disorders in childhood
  • 80% to 90% of all crimes are committed by these people
  • Fails to follow rules and regulations
  • Desire for pleasure and need gratification
  • Repeated acts that are grounds for arrest
  • Repeated lying, use of aliases, or conning others
  • Impulsivity or failure to plan ahead
  • Repeated physical fights or assaults
  • Reckless disregard for safety of self and others
  • Failure to sustain consistent work behavior or honor financial obligations
  • Lack of remorse at having hurt, mistreated or stolen form another
  • Poor work history
  • Lack of concern about right and wrong, socially accepted morals and values, sexual promiscuity
  • Aggressive, often violent behaviour
  • Charming and scheming
• Borderline Personality Disorder


  • Impulsive and risky behavior, such as having unsafe sex, gambling or binge eating
  • Unstable or fragile self-image
  • Unstable and intense relationships
  • Up and down moods, often as a reaction to interpersonal stress
  • Suicidal behavior or threats of self-injury
  • Intense fear of being alone or abandoned
  • Ongoing feelings of emptiness
  • Frequent, intense displays of anger
  • Stress-related paranoia that comes and goes
  • Frantic effort to avoid real or imagined abandonment
  • Pattern of unstable interpersonal relationships
  • Unstable self-image or sense of self
  • Chronic feelings of emptiness and boredom
  • Inappropriate anger or difficulty controlling anger
  • Unable to experience pleasure and unable to maintain employment
  • Prone to commit suicide
  • Coexistence of depression
  • People with this disorder are prone to constant mood swings and bouts of anger
  • "Jekyll and Hyde" characteristic
  • Clingy, dependent and manipulative behaviour
• Histrionic Personality Disorder


  • Constantly seeking attention
  • Excessively emotional, dramatic or sexually provocative to gain attention
  • Speaks dramatically with strong opinions, but few facts or details to back them up
  • Easily influenced by others
  • Shallow, rapidly changing emotions
  • Excessive concern with physical appearance
  • Thinks relationships with others are closer than they really are
  • Is uncomfortable in situation where he or she is not the center of attention
  • Displays inappropriate sexually seductive or provocative behaviour
  • Has rapid shifts of emotion
  • Uses physical appearance to draw attention to self
  • Shows dramatization or exaggerated expression of emotion
  • Is suggestible
  • Pre occupied with fantasies of unlimited success and beauty
  • Envious of others and believes that others are envious of her
  • Common in women
  • Considers relationship to be more intimate than they really are
  • They need to be the center of attention all the time, often interrupting others in order to dominate the conversation
  • They use grandiose language to describe everyday events and seek constant praise
  • Histrionics also tend to exaggerate friendships and relationships, believing that everyone loves them
• Narcissistic Personality Disorder


  • Belief that you're special and more important than others
  • Fantasies about power, success and attractiveness
  • Failure to recognize others' needs and feelings
  • Exaggeration of achievements or talents
  • Expectation of constant praise and admiration
  • Arrogance
  • Unreasonable expectations of favors and advantages, often taking advantage of others
  • Envious of others or believes that others are envious of them
  • Boastful, egotistical, "superiority complex"
  • Has a grandiose sense of self- importance and uniqueness
  • Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  • Believes he or she is unique and special and should only associate with others who are special or high-status people
  • Has sense of entitlement
  • Is interpersonally exploitative/ exploits other people/ takes advantage
  • Lacks empathy
  • Shows arrogance
  • Excessive drive for success and power
  • Obsessively Taking Selfies is Now a Real Mental Disorder Called 'Selfitis'
• Avoidant Personality Disorder


  • Too sensitive to criticism or rejection
  • Feeling inadequate, inferior or unattractive
  • Avoidance of work activities that require interpersonal contact
  • Socially inhibited, timid and isolated, avoiding new activities or meeting strangers
  • Extreme shyness in social situations and personal relationships
  • Fear of disapproval, embarrassment or ridicule
  • Shy, timid, "inferiority complex
  • Is willing to get involved with people unless certain of being liked
  • Overly serious, blunted emotional expression
  • Fears criticism and rejection
  • Shows restraint in intimate relationships for fear of being shamed or ridiculed
  • Is inhibited in interpersonal relationships because of feelings of inadequacy
  • Views self as socially inept and inferior to others
  • Is unusually reluctant to take personal risks
  • Devaluation of personal abilities and achievements
• Dependent Personality Disorder


  • Excessive dependence on others and feeling the need to be taken care of
  • Submissive or clingy behavior toward others
  • Fear of having to provide self-care or fend for yourself if left alone
  • Lack of self-confidence, requiring excessive advice and reassurance from others to make even small decisions
  • Difficulty starting or doing projects on your own due to lack of self-confidence
  • Difficulty disagreeing with others, fearing disapproval
  • Tolerance of poor or abusive treatment, even when other options are available
  • Urgent need to start a new relationship when a close one has ended
  • Submissive, clinging
  • Has difficulty making everyday decisions
  • Needs others to assume responsibility for major areas of his life
  • Has difficulty expressing disagreement
  • Has difficulty initiating projects
  • Seldom disagrees for fear of loss of support and approval
  • Lack of self- confidence, poor self- esteem, indecisiveness
  • Goes to excessive lengths to obtain nurturance from others
  • Feels uncomfortable or helpless when alone
  • Urgently seeks relationships as source of care and support
  • Is unrealistically reoccupied with fears of being left to take care of self
• Obsessive-Compulsive Personality Disorder


  • Preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility
  • Preoccupation with details, orderliness and rules
  • Extreme perfectionism, resulting in dysfunction and distress when perfection is not achieved, such as feeling unable to finish a project because you don't meet your own strict standards
  • Desire to be in control of people, tasks and situations, and inability to delegate tasks
  • Neglect of friends and enjoyable activities because of excessive commitment to work or a project
  • Inability to discard broken or worthless objects
  • Rigid and stubborn
  • Inflexible about morality, ethics or values
  • Tight, miserly control over budgeting and spending money
  • Is preoccupied with details, lists, rules, organization or schedules
  • Excessive dedication to work/ too busy to have friends and leisure activities
  • Aspires to perfectionism that interferes with task completion
  • Is excessively devoted to work and productivity
  • Is over conscientious, scrupulous, and flexible about matters of morality, ethics or values
  • Moralistic judgmental attitude toward others
  • Is unable to discard worn-out and worthless objects
  • Is reluctant to delegate tasks
  • Adopts a miserly spending style/ reluctant to spend/ hoards money
  • Is rigid and stubborn
• Managing Personality Disorders


  • Psychotherapy: Short term psychotherapy focusing on solutions for specific life problems, group therapy
  • Medications: Antidepressants, mood stabilizers, antipsychotics, anti-anxiety medications
• Nursing Interventions for Clients with Personality Disorders

  • For odd, eccentric PD: Adopt objective, matter-of-fact manner, provide daily structure, maintain focus on reality, help with problem solving
  • For dramatic, emotional, erratic PD: Prevent self-harm, give immediate feedback on inappropriate behavior, act as role model, avoid rescuing or rejecting, set limits
  • For anxious, fearful PD: Establish caring, consistent relationship, encourage decision making and assertiveness, provide positive feedback, teach stress management
• Nursing Interventions for Families of Clients with Personality Disorders

  • Help define and maintain generational boundaries, provide positive feedback, encourage clear definitions of acceptable behavior, encourage parents to work on conflicts, teach stress reduction