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Psychiatric-Mental Health Nursing

Summary

Psychiatric-Mental Health NursingSummary

Summary

18.1 Identification and Diagnosis

There are multiple types of personality disorders, but they tend to have certain symptoms in common that lead to diagnosis. A personality disorder may exist when a personality exhibits enduring patterns of thoughts, emotions, and behaviors that deviate significantly from cultural norms and cause significant distress and impairment in functioning. While everyone has unique personality traits, a personality disorder is diagnosed when these traits cause significant distress, disrupt daily life, and lead to difficulties in relationships, work, or other areas of functioning. A personality disorder is diagnosed through a thorough assessment by a trained professional, such as a psychiatrist. It requires a history, behavioral observations, and meeting certain criteria specific to each disorder.

18.2 Cluster Disorders (A, B, C)

Cluster A personality disorders include paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. Cluster A is characterized by eccentric, odd, or peculiar behavior, thinking, and beliefs. Individuals with these disorders often struggle socially. They can often appear distrustful and detached to others.

Cluster B personality disorders include antisocial, borderline, histrionic, and narcissistic personality disorders. Cluster B personality disorders are characterized by dramatic, overly emotional, or unpredictable thinking or behavior. They may also have a history of unstable relationships.

Cluster C personality disorders share a common theme of anxious and fearful behaviors. They are characterized by a chronic pattern of thoughts, feelings, and behaviors that are driven by a sense of fear, insecurity, and a desire for safety. The three personality disorders within cluster C are avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder (OCPD).

18.3 Nursing Care and Treatment Approaches

Treating personality disorders can be a difficult process. Psychotherapy is the top recommended modality for all personality disorders. Cognitive behavioral therapy can be very helpful, as can dialectical behavioral therapy, which was developed specifically for borderline personality disorder. There are no medications specifically approved to treat personality disorders, but they may be prescribed for other related symptoms, such as anxiety or depression.

Clients living with personality disorders often struggle with interpersonal relationships and work challenges. Increasing self-awareness, learning to set personal boundaries, and regulating emotional responses can help with these challenges. Educating family members on the nature of these disorders can also help encourage empathy.

Nursing care for clients with personality disorders begins with safety, empathy, and understanding. Nurses must approach the client with a consideration for the whole person, and not just as a diagnosis. Setting goals and limits for the client early when creating the treatment plan will help the nurse-client relationship. There are various skills to help people with personality disorders learn how to cope. Nurses must also remember that self-care is an important part of caring for these clients in order to minimize stress and ensure that they maintain their ability to provide the best care possible to clients.

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