• Is defined as the totality of a person’s unique biopsychosocial and spiritual traits that consistently influence behavior.
• The following traits are likely in individuals with a personality disorder:
  1. Interpersonal relations that ranges from distant to overprotective.
  2. Suspiciousness
  3. Social anxiety
  4. Failure to conform to social norms
  5. Self-destructive behaviors
  6. Manipulation and splitting

• Prognosis is poor, and clients experience long term disability and may have other psychiatric disorders.

Cluster A: The Eccentric and Mad group

1. Paranoid – suspicious, jealous, short tempered.
2. Schizotypal – superstitious, believes in magic, ideas of reference.
3. Schizoid – doesn’t want to socialize, prefers to be alone, detached.

Cluster B: The Erratic and Bad group

1. Antisocial – irresponsible, display lack of guilt, good at manipulation.
2. Borderline – intense relationship, self-mutilation, impulsiveness.
3. Histrionic – attention-seeking, self-centered, seductive, dramatic.
4. Narcissistic – grandiose view of self lacks empathy for others.

Cluster C: The anxious and Sad group

1. Obsessive compulsive – preoccupied with perfection, conscious of rules, self-critical, controlling.
2. Avoidant – fearful of criticism and rejection, negative self-esteem, few social interactions.
3. Dependent – submissive, clinging to others, unable to make decision by self.

Signs and Symptoms

1. Inappropriate response to stress and inflexible approach to problem solving.
2. Long term difficulties in relating to others, in school and in work situations.
3. Demanding and manipulative.
4. Ability to cause others to react with extreme annoyance or irritability.
5. Poor interpersonal skills.
6. Anxiety
7. Depression
8. Anger and aggression
9. Difficulty with adherence to treatment.
10. Harm to self or others.

Nursing Diagnoses

• Ineffective individual coping
• Social isolation
• Impaired social interaction
• High risk for violence to self or others
• Anxiety

Nursing Interventions

1. Work with the client to increase coping skills and identify need for improvement coping.
2. Respond to the client’s specific symptoms and needs.
3. Keep communication clear and consistent.
4. Client may require physical restraints, seclusion/observation room, one to one supervision.
5. Keep the client involved in treatment planning.
6. Avoid becoming victim to the client’s involvement in appropriate self-help groups.
7. Require the client take responsibility for his/her own behavior and the consequences for actions.
8. Discuss with the client and family the possible environment and situational causes, contributing factors, and triggers.