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3. personality Disorder

  1. 1. Sub: MHN Topic: personality disorders Prepared by:- Parmar Monal.
  2. 2. • The term personality refers to enduring qualities of an individual that are shown in his ways of behaving in a wide variety of circumstances
  3. 3. • “An abnormal personality is one in which there are deeply ingrained maladaptive patterns of behavior recognizable by the time of adolescence or earlier and continuing through most of adult life. Because of this, the patient suffers or others have to suffer, and there is an adverse affect on the individual or on society.” Definition
  4. 4. Classification ICD10 DSMIV
  5. 5. ICD 10 CLASSIFICATION: • F60-F69 Disorders of adult personality and behavior • F60 Specific personality disorders • F60.0 Paranoid personality disorder • F60.1 Schizoid personality disorder • F60.2 Dissocial personality disorder • F60.3 Emotionally unstable personality disorder
  6. 6. CONTINU… • F60.4 Histrionic personality disorder • F60.5 Anankastic personality disorder • F60.6 Anxious personality disorder • F60.7 Dependent personality disorder • F61 Mixed and other personality disorders
  7. 7. CONTI… • F62 Enduring personality changes, not attributable to brain damage and Disease • F63 Habit and impulse disorders • F64 Gender identity disorders • F65 Disorders of sexual preference
  8. 8. DSMIV Classification: • Cluster A (odd and eccentric): paranoid schizoid, schizotypal personality disorder • Cluster B (dramatic, emotional and erratic antisocial, boarderline, histrionic, narcissistic personality disorders • Cluster C (anxious and fearful): avoidant, dependent and obsessive-compulsive personality disorders
  9. 9. DSMIV Classification Cluster A • Paranoid • Schizoid, • Schizotypal (odd and eccentric) Cluster B Antisocial, Borderline, Histrionic, NArcissistic (dramatic, emotional and erratic) Cluster C Avoidant, Dependent Obsessive- compulsive personality disorders (anxious and fearful)
  10. 10. Etiology:
  11. 11. Genetic factor : Biological factors Psychodynamic
  12. 12. Other Factors: Maternal deprivation antisocial personality abuse in childhood. Borderline personalities
  13. 13. CONTI… failure to resolve oedipal complex Histrionic personality fixation in the oral stage of development. Dependent personality
  14. 14. 1. Paranoid Personality Disorder
  15. 15. This disorder is marked by a distrust of other people and constant unwarranted suspicion that other have sinister motives.
  16. 16. The signs and symptoms are: • Suspicious • Mistrustful • Sensitive • Argumentative • Stubborn • Self-important • Hypersensitive • Jealous and irritable
  17. 17. 2. Schizoid Personality Disorder
  18. 18. Schizoid personality disorder is characterized by • detachment • social withdrawal. People with this disorder are commonly described as • loners, • with solitary interests and occupations and • no close friends; • typically they maintain a social distance even from family members and seem unconcerned about other’s praise or criticism.
  19. 19. The signs and symptoms are: • Emotionally cold • Aloof • Detached • Humorless • Introspective : • No desire for or enjoyment of close relationship • Inability to experience pleasure
  20. 20. • Emotionally cold : That person shows very little emotions They have been told and conditioned to hide their emotions
  21. 21. • Introspective : self examination Analyzing yourself Looking at your own personality Ex when you meditate to try to understand your feelings
  22. 22. 3. Schizotypal Disorder
  23. 23. This disorder is marked by odd thinking and behaviour, a pervasive pattern of social and interpersonal deficit and acute discomfort with others.
  24. 24. The signs and symptoms are • Inappropriate affect • Odd beliefs or magical thinking • Social withdrawal • Odd, eccentric or peculiar behavior • Lack of close relationships • Social isolation • Not fitting easily with others
  25. 25. 4. Antisocial (Dissocial) Personality Disorder (Sociopath, Psychopath):
  26. 26. Antisocial personality disorder is characterized by Chronic antisocial behaviour that violates other right’s or social norms which predisposes the affected person to criminal behaviour. The person is unable to maintain consistent, responsible functioning at work, school or as a parent.
  27. 27. The signs and symptoms are • Failure to sustain relationships • Disregard for the feelings of others • Impulsive actions • Low tolerance to frustration • Tendency to cause violence • Lack of guilt
  28. 28. CONTI… • Failure to learn from experience • Reckless disregard for own or others safety • Impulsivity and failure to plan ahead • Manipulative behavior for self-gratification • Inability to maintain close personal or sexual relationship
  29. 29. Nursing intervention • convey the message that it is not him but his behavior which is unacceptable. • Maintain low level of stimuli • Help the patient to identify the true objects of his hostility • Explore with patient alternative ways of handling frustration • Have sufficient staff available to present a show of strength to patient if necessary
  30. 30. Conti.. • Administer tranquilizing medications • Mechanical restraints may be necessary if the patient is not calmed by 'talking down’ or by medication. • Explain consequences if limits are violated • Provide positive feedback for acceptable behavior • He must understand that certain behaviors will not be tolerated within the society and that severe consequences will be imposed upon those individuals
  31. 31. 5.Borderline Personality Disorder
  32. 32. • Borderline personality disorder is marked by • a pattern of instability in interpersonal relationships, mood, behaviour and self- image.
  33. 33. The four main categories of signs and symptoms are • Unstable relationships • Unstable self image • Unstable emotions • Impulsivity
  34. 34. Nursing intervention • Observe patient’s behavior frequently • avoid appearing watchful and suspicious • Secure a verbal contract from patient that he will seek out staff members for help when urge for self-mutilation is felt • Encourage patient to talk about feelings he was having just prior to this behavior • Rotate staff who works with the
  35. 35. 6. Histrionic Personality Disorder
  36. 36. Patients with this disorder characteristically have a pervasive pattern of excessive emotionality and attention seeking behaviour and are drawn to momentary excitements and fleeting adventures.
  37. 37. The signs and symptoms are • Dramatic emotionality (Emotional blackmail, angry scenes, demonstrative suicide attempts, etc.) • Craving for novelty and excitement • Shallow and labile affectivity • Attention-seeking behavior • Over concern with physical attractiveness
  38. 38. CONTI.. • Exaggerated, vague speech • Self dramatization • Impulsivity • Suggestibility • Ego-centricity, self-indulgence and lack of consideration for others
  39. 39. 7.Narcissistic Personality Disorder
  40. 40. Patient with narcissistic personality disorder is • Self centred, • self-absorbed and • lacking in empathy for others. • He typically takes advantage of people to achieve his own ends, and uses them without regard to their feelings.
  41. 41. The signs and symptoms are • Attention-seeking, dramatic behavior • Unable to face criticism • Lack of empathy • Exploitative behavior • Arrogance • Preoccupation with fantasies of success, power, beauty, brilliance or ideal love
  42. 42. 8. Anxious (Avoidant) Personality Disorder
  43. 43. Anxious (Avoidant) Personality Disorder is marked by • feelings of inadequacy, • extreme social anxiety, • social withdrawal and • hypersensitivity to others opinions. • low self-esteem and • poor self-confidence; • have difficulty viewing situations and interactions objectively.
  44. 44. The signs and symptoms are • Persistent feeling of tension and appre- hension • Inferiority complex • Fear of criticism, disapproval or rejection • Unwillingness to become involved with people • Excessive preoccupation with being criticized or rejected in social situations
  45. 45. 9.Dependent Personality
  46. 46. Dependent Personality disorder is characterized by an • Extreme need to be taken care of, • which leads to submissive, • Clinging behaviour and • fear of separation or rejection. • People with this disorder let others make important decisions for them and have a • strong need for constant reassurance and support.
  47. 47. The signs and symptoms are • Subordination of one's own needs • Unwillingness to make even reasonable demands on other people • Inability to take decision • Feeling uncomfortable or helpless when alone • Low self-esteem and lack of self-confidence • Hypersensitivity to criticism
  48. 48. 10.Obsessive- compulsive (Anankastic ) Personality Disorder
  49. 49. • This disorder is marked by a pervasive desire for perfection and order at the expense of openness, • flexibility and efficiency. • The individual places a great deal of pressure on himself and others not to make mistakes.
  50. 50. The signs and symptoms are • Feeling of excessive doubt and caution. • Preoccupation with details, rules, lists, order or schedule • Perfectionism • Rigidity and stubbornness • High standards
  52. 52. • Individual therapy • Group therapy • Therapeutic community • Behaviour • Occupational • Recreational
  53. 53. NURSING INTERVENTIONS FOR PATIENTS WITH PERSONALITY DISORDERS • Show acceptance of the person at all times by separating the person from the behaviors. • Provide a safe environment • Explain all unit rules and enforce them fairly and consistently. • Explain all unit rules and enforce them fairly and consistently. • Identify inappropriate behavior and discuss possible alternative behavior
  54. 54. Conti.. • Encourage the patient to openly express feelings and thoughts • Identify triggers of acting-out behaviors • Communicate problems with manipulative patients to other team members • Monitor medication. • Assess for suicidal ideation • Develop a no-harm contract with the patient with self-destructive tendencies • Encourage the patient to keep a private journal of thoughts and feelings.
  55. 55. summary