Personality Disorder Clusters
These personality disorders are described as odd or eccentric and include paranoid, schizoid, and schizotypal.
What is Cluster A?
Rationale:
Cluster A includes paranoid, schizoid, and schizotypal disorders, characterized by odd or eccentric behavior.
This PD is commonly misunderstood; it does not mean avoiding others but instead involves exploiting others and violating rights.
What is antisocial personality disorder?
Rationale:
Antisocial PD features disregard for social norms, impulsivity, and exploitation—not social withdrawal.
Hearing voices is an example of this type of perception disturbance.
What are auditory hallucinations?
Rationale:
Auditory hallucinations are the most common hallucination type in schizophrenia.
A lack of outward facial expression is known as this.
What is flat affect?
Rationale:
Flat affect is a hallmark negative symptom.
For patients with schizophrenia, the nurse should avoid this unless permission is clearly asked and received.
What is touching the patient?
Rationale:
Touch may be misinterpreted due to paranoia or hallucinations.
People with this personality disorder display pervasive mistrust, constantly testing others’ honesty.
What is paranoid personality disorder?
Rationale:
Paranoid PD involves inappropriate mistrust and suspicion of others’ motives.
These patients frequently engage in self-harm to elicit a rescue response and may split the staff.
What is borderline personality disorder?
Rationale:
Borderline PD includes impulsive self-harm, fear of abandonment, and manipulation via staff splitting.
These false fixed beliefs can include being controlled by the government or believing a TV host speaks directly to you.
What are delusions?
Rationale:
Schizophrenia includes persecutory, grandiose, and referential delusions.
This negative symptom involves loss of interest in previously enjoyed activities.
What is apathy?
Rationale:
Apathy is a common negative symptom and resembles depression.
This approach is essential for borderline patients to prevent staff splitting.
What is maintaining consistent limits?
Rationale:
Consistency across staff prevents manipulation and maintains safety.
These individuals prefer to be alone, appear cold and aloof, and have a bland affect.
What is schizoid personality disorder?
Rationale:
Schizoid PD is marked by emotional coldness, preference for solitary work, and lack of spontaneity.
These dramatic and attention-seeking patients may dress provocatively or use objects as makeup.
What is histrionic personality disorder?
Rationale:
Histrionic PD presents with extreme attention-seeking and theatrical behaviors, requiring gentle redirection.
Speech that includes loosely related topics such as “The wind blew my candle… the candle flew away… the wind took me to space.”
What are loose associations?
Rationale:
Loose associations are a disorganized thought pattern common in schizophrenia.
When a client loses motivation to perform activities such as showering or eating.
What is avolition?
Rationale:
Avolition = loss of motivation and goal-directed activity.
When a patient reports hallucinations, the nurse should first do this.
What is acknowledge the hallucination as real to the patient?
Rationale:
Validation builds trust before providing reality orientation.
This PD involves magical thinking and odd beliefs but does not include psychosis.
What is schizotypal personality disorder?
Rationale:
Schizotypal PD involves magical thinking and eccentric behavior without psychotic features.
These individuals have extremely high self-esteem and become hostile when things don’t go their way.
What is narcissistic personality disorder?
Rationale:
Narcissistic PD features exaggerated self-worth and a sense of entitlement.
This rare symptom involves making up new words that only the patient understands.
What are neologisms?
Rationale:
Neologisms are invented words with personal meaning.
This term describes the inability to understand slang, jokes, or idioms.
What is loss of abstract thinking?
Rationale:
Loss of abstract thinking is a documented negative symptom.
For antisocial PD, nurses should focus on this rather than criticizing the patient.
What is focusing on the behavior, not the person?
Rationale:
Promotes therapeutic communication and reduces defensiveness.
This personality disorder cluster includes anxious or fearful traits such as avoidant, dependent, and obsessive-compulsive personality disorders.
What is Cluster C?
Rationale:
Cluster C includes avoidant, dependent, and OCPD disorders, all defined by anxiety and fearfulness.
This PD involves impulsivity, unstable relationships, chronic feelings of emptiness, and frantic efforts to avoid abandonment.
What is borderline personality disorder?
Rationale:
Borderline PD centers around emotional instability and fear of abandonment.
A chaotic mix of unrelated words—“purple fish candle highway rain”—is an example of this.
What is word salad?
Rationale:
Word salad reflects severely disorganized thinking in schizophrenia.
Patients lack insight into their illness and do not believe they need treatment.
What is anosognosia?
Rationale:
Anosognosia is the inability to recognize one’s mental illness.
These long-acting medications help improve compliance in people with schizophrenia.
What are long-acting injectable antipsychotics?
Rationale:
Injectable antipsychotics improve adherence and address chronic symptoms.