Psyche report on personality disorder

CLUSTER C: ANXIOUS-FEARFUL

CLUSTER C: ANXIOUS-FEARFUL

DEPENDENT PERSONALITY DISORDER

AVOIDANT PERSONALITY DISORDER

OBSESSIVE COMPULSIVE PERSONALITY DISORDER

DEPENDENT PERSONALITY DISORDERA “pervasive and excessive need to be taken care of that leads to submissive and clinging behaviors and fears of separation”

(APA. 2000)

Dependent individuals want others to make daily decision for them.

They need direction and reassurance. These individuals feel inferior and cling

to others excessively. Avoiding responsibility and expressing

helplessness.


Dependent individuals also expect that if they perform good deeds for others, they will be rewarded by someone doing something for them.

Passivity and concealing of sexual feelings and anger are a means of avoiding conflict.


UNIQUE CAUSE:CultureCommon in women



PSYCHOTHERAPEUTIC MANAGEMENTNURSE-PATIENT RELATIONSHIP

The nurse slowly works on decision making with the patient to increase responsibility for self in daily living.The patient needs assistance with managing anxiety because it will increase as the patient assumes more responsibility for self. Assertiveness is an important area of the nurse’s teaching.Verbalization of feelings and ways to cope with them are essential



Helping clients to identify their strengths and needs.Cognitive restructuring is a useful technique for understanding what lies behind negative moodsThe nurse may also need to teach problem solving and decision making and help clients apply them to daily life.

AVOIDANT PERSONALITY DISORDERPatients with the avoidant personality disorder are timid, socially uncomfortable and withdrawn. They feel inadequate and are hypersensitive to criticism.Desire relationship but need to be certain of being liked before making social contacts.To keep their anxiety at a minimal level, these individuals avoid situations in which they might be disappointed or rejected.

AVOIDANT PERSONALITY DISORDERWhen interacting with someone, this person sounds uncertain and lacks self confidence and also is afraid to ask questions or speak up in public, withdraws from social support, and conveys helplessness.

AVOIDANT PERSONALITY DISORDERPSYCHOTHERAPEUTIC MANAGEMENTNURSE-PATIENT RELATIONSHIP

The nurse helps the patient gradually confront his or her fears. Discussing the patient’s feelings and fears before nad after doing something that he or she is afraid to do is an essential part of the relationship. The nurse supports and directs the patient in accomplishing small goals. Helping the patient to be assertive and develop social skills is necessary.

AVOIDANT PERSONALITY DISORDERPSYCHOTHERAPEUTIC MANAGEMENTNURSE-PATIENT RELATIONSHIP

Because of the patient’s anxiety, relaxation techniques are taught to enable the person to be successful in interactions.The nurse will give positive feedback to the patient for any real success and for any attempts to engage in interactions with others to promote self esteem.

OBSESSIVE COMPULSIVE PERSONALITY DISORDERThey are perfectionist and inflexible.

They are strict and often set standards for themselves that are too high; thus their work is never good enough.

They are preoccupied with rules, trivial details, and procedures.

They find it difficult to express warmth or tender emotions.

There is little give-and-take in their interactions with others, and they are rigid, controlling and cold.

They are serious about all of their activities, so having fun or experiencing pleasure is difficult.

They are afraid of making mistakes, they can be indecisive or will put off decisions until all the facts have been obtained.


UNIQUE CAUSES:

HereditaryEarly parent-child relationship around issues of autonomy, control and authority.



The nurse needs to support the patients in exploring his or her feelings and in attempting new experiences and situations. The nurse helps the patient with decision making and encourage follow -through behavior. At times, there’s a need to confront the patient’s procrastination and intellectualization.



The nurse teaches the patient the importance of leisure activities and exploring interests in the area. Teaching the patient that he or she is human and that it is all right to make mistakes helps decrease irrational beliefs about the necessity to be perfect.


OTHER RELATED

DISORDERS

DEPRESSIVE PERSONALITY DISORDER

Depressive personality disorder is characterized by pervasive pattern of depressive cognitions and behaviors in various contexts. They often seek treatment for their distress and generally have a favorable response to anti-depressant medications.

APA, 2000

DEPRESSIVE (Masochistic) PERSONALITY DISORDER

Similar behavior characteristics as clients with major depression (e.g. moodiness, brooding, joylessness, pessimism)

They view the pessimism as being “realistic” regardless of positive outcome in a given situation.

They express persistent unhappiness, cheerlessness, and hopeless regardless of the situation.

They consider pleasure and enjoyment a sin.


They use their misery to gain the love and admiration of others.

Clients may repress or not express angerSelf criticismSelf esteem is quite lowThey prefer to follow others rather than be

a leaders in any work or social situations.


PSYCHOTHERAPEUTIC MANAGEMENTNURSE-PATIENT

RELATIONSHIPAssess whether there is risk from self harmEncouraging the client to become involved in activities or engaged with others provides opportunities to interrupt the cyclical, negative thought patterns.Giving factual feedback rather than general praise.

PASSIVE-AGGRESSIVE PERSONALITY DISORDERPassive-aggressive personality disorder is characterized by a negative attitude and a pervasive pattern of passive resistance to demands for adequate social and occupational performance.

APA, 2000

PASSIVE-AGGRESSIVE (negativistic) PERSONALITY DISORDER

These clients may appear cooperative, even ingratiating, or sullen and withdrawn depending on the circumstances

Changing of moods (easily upset or offended)There is a pervasive attitude that is negative, sullen,

and defeatistClients perceive and anticipate difficulties and

disappointments where none exist Impaired in making judgment and decisions Insight is also limited; blaming others for their own

feeling & misfortune


May complain they are misunderstood by others and may report feeling of cheated, victimized and exploitedAvoiding responsibilitiesThey show the following traits:

PessimisticProcrastinationStubbornnessIntentional inefficiencyForgetfulnessDependency


CAUSES:DOMINANT rigid fatherOral Character Fear of rejection when exhibiting aggressive behavior

TAKE NOTE: This individuals harbor feelings of hostility but are afraid to express them due to fear of rejection and retaliation. Thus, they express hostility passively. Frequently, they agree to perform tasks they do not want to perform and subtly undermine completion of the tasks.


PSYCHOTHERAPEUTIC MANAGEMENT


NURSE-PATIENT RELATIONSHIP

Encourage to express feelings directly especially angerHelp them examine the relationship between feelings and subsequent actionsMethods such as having the client write about the feelings or role play are effective

CYCLOTHYMIC PERSONALITYPersons with this personality has rapidly changing moods that alternate between high-spirited buoyancy alternates, and gloom and pessimism.Each mood tend to last for a week or longer and occur for no apparent reason or identifiable cause.They manifest sign and symptoms of bipolar disorder but in subtle form.Considered a temperament that characterizes many gifted and creative people

If you wake up at a different time, in a

different place, could you wake up

as a different person?

Psyche report on personality disorder

Education

dependent individuals

patients feelings

patients anxiety

excessive need

negative moodsthe nurse

makedaily decision

self esteem

orher fears