Clusters A
What three disorders fall into Cluster A
1. Paranoid
2. Schizoid
3. Schizotypal
What 4 disorders fall into Cluster B?
1. Antisocial
2. Boarderline
3. Histrionic
4. Narcissistic
What three disorders fall into Cluster C?
1. Avoidant
2. Dependent
3. Obsessive Compulsive
How many Personality Disorders are there?
10
A nurse is caring for a patient diagnosed with Paranoid Personality Disorder. The patient frequently scans the environment, questions the motives of staff, and becomes tense when the nurse attempts casual conversation. The patient states, “I know you’re hiding something from me.” The provider has ordered 1:1 psychotherapy, along with anti‑anxiety medication and a low‑dose antipsychotic.
Which nursing intervention is most appropriate?
A. Use a warm, overly friendly approach to build rapport with the patient.
B. Encourage the patient to join large group therapy sessions to reduce isolation.
C. Communicate using simple, clear, and direct language to reduce misinterpretation.
D. Offer frequent reassurance that the patient’s suspicions are unfounded.
Correct Answer: C.
Simple, direct communication reduces ambiguity and helps counteract mistrust.
Avoiding excessive friendliness is essential because it can increase suspicion.
1:1 psychotherapy is preferred over group settings, which may heighten paranoia.
Anti‑anxiety and antipsychotic medications (e.g., pimozide, haloperidol) may be prescribed to reduce anxiety and agitation.
What are the characteristics of cluster A?
“Odd or Eccentric”
What are the characteristics of cluster B?
“Dramatic or Emotional”
What are the characteristics of cluster C?
“Anxious or Insecure”
This cluster B personality disorder presents as having severe mood swings, impulsive behavior, NSSI behaviors, fear of abandonment and difficulty forming stable personal relationships.
Boarderline Personality Disorder
A 28‑year‑old patient with a long history of arrests, physical fights, and impulsive behavior is admitted to the psychiatric unit after violating probation. The patient shows no remorse for harming others and states, “People are weak. I do what I want.” The provider diagnoses Antisocial Personality Disorder and initiates a treatment plan that includes CBT, DBT, and mentalization‑based therapy (MBT). The provider also prescribes a mood stabilizer to help reduce aggression and considers adding an SSRI.
Which statement by the nurse demonstrates appropriate understanding of treatment for this disorder?
A. “Benzodiazepines are avoided because they increase emotional regulation in these patients.”
B. “Mood stabilizers may help reduce impulsive aggression associated with this disorder.”
C. “Insight‑oriented therapy is the primary treatment because these patients are highly motivated to change.”
D. “Group therapy is preferred because patients with this disorder easily form trusting relationships.”
Correct Answer: B
Mood stabilizers can help reduce aggression and impulsivity, which are common in Antisocial Personality Disorder.
SSRIs and benzodiazepines may be used to target irritability, anxiety, or impulsivity, though benzodiazepines require caution due to misuse potential.
CBT, DBT, and MBT are evidence‑based therapies that focus on improving emotional regulation, impulse control, and the ability to understand one’s own and others’ emotions.
Patients with ASPD typically lack remorse, struggle with trust, and are not highly motivated for insight‑oriented therapy.
Group therapy is not first‑line because these patients often manipulate or dominate peers.
Patient presents with pervasive distrust and suspicion of others.
What is Paranoid Personality Disorder?
The patient presents with the following diagnostic features:
-may be inappropriate sexually seductive & flirtatious.
-overly dramatic, attention seeking behavior.
-uses physical appearance to draw attention to self
-excessive amounts of time, energy and $ on appearance
-considers relationships more intimate than they actually are
Histrionic Personality Disorder
The patient presents with the following diagnostic features:
-Not flexible preoccupied by details or rules.
-Excessive devotion to work
Obsessive Compulsive Personality Disorder
The provider notes that the patient displays features of several different personality disorders, but does not fully meet the diagnostic criteria for any one specific disorder.
Which diagnosis is most appropriate?
A. Cluster B Personality Disorder
B. Borderline Personality Disorder
C. Unspecified Personality Disorder
D. Mixed Anxiety‑Depressive Disorder
C. Unspecified Personality Disorder
Unspecified Personality Disorder is used when a patient exhibits clinically significant personality traits from multiple personality disorders, but the presentation does not clearly fit one specific diagnosis.
A nurse is reviewing the treatment plan for a patient diagnosed with Borderline Personality Disorder. The patient reports intense mood swings, unstable relationships, and chronic feelings of emptiness. The provider explains that treatment will focus on improving emotional regulation and reducing impulsive behaviors.
Which interventions should the nurse expect to see included in the treatment plan? Select all that apply.
A. Cognitive‑behavioral therapy (CBT) to address maladaptive thoughts and behaviors
B. Medications prescribed to target specific symptoms such as mood instability or anxiety
C. Schema‑focused therapy to help the patient understand how early unmet needs influence current patterns
D. Dialectical behavior therapy (DBT) to build distress‑tolerance and emotional‑regulation skills
E. Long‑term benzodiazepine therapy as the primary treatment for emotional instability
F. Avoidance of psychotherapy because it increases emotional sensitivity in these patients
Correct Answers: A, B, C, D
CBT helps challenge distorted thinking and reduce impulsive or self‑damaging behaviors.
Medications are used to treat symptoms, not the disorder itself—commonly mood instability, anxiety, or impulsivity.
Schema‑focused therapy helps patients explore how early childhood experiences and unmet needs shape current emotional and relational patterns.
DBT is one of the most effective treatments for BPD, improving emotional regulation, distress tolerance, and interpersonal effectiveness.
Benzodiazepines are not first‑line and carry risks of dependence and disinhibition.
Psychotherapy is essential; structured therapies are the cornerstone of treatment.
The patient presents with the following diagnostic features:
-Described as a loner
-Socially withdrawn or detached
-Avoids close relationships even being part of the family
Schizoid
Previously known as psychopaths or sociopaths. Have a general disregard for the rights of others and often accompanied by criminal behavior. Resent authority.
Antisocial Personality Disorder
The patient presents with the following diagnostic features:
-begins in early childhood
-a pattern of withdrawing socially, feelings of inadequacy and hypersensitivity to negative evaluation
-social isolation
-fears criticism, disapproval and rejection
Avoidant Personality Disorder
A nurse is teaching a group of students about mental health disorders. The nurse explains that some conditions involve long‑standing, rigid patterns of thinking, feeling, and behaving that deviate significantly from cultural expectations and cause distress or impairment in relationships, work, or self‑identity. These patterns are stable over time and difficult to change.
Which term best describes this type of disorder?
A. Mood disorder
B. Personality disorder
C. Psychotic disorder
D. Adjustment disorder
B. Personality Disorder
A personality disorder involves deeply ingrained, inflexible patterns of behavior and inner experience that are maladaptive and culturally incongruent.
These patterns begin in adolescence or early adulthood and remain stable over time.
Mood disorders (A) involve disturbances in emotional regulation, not pervasive personality traits.
Psychotic disorders (C) involve hallucinations, delusions, or disorganized thinking.
Adjustment disorders (D) are short‑term responses to identifiable stressors, not lifelong patterns.
A patient with a long history of rigid perfectionism, excessive devotion to work, difficulty delegating tasks, and persistent preoccupation with rules is diagnosed with a Cluster C personality disorder. The patient reports distress related to intrusive, repetitive thoughts about making mistakes and becomes anxious when tasks are not completed “perfectly.” The provider explains that medication may help reduce obsessive thinking patterns associated with this disorder.
Which medication would the nurse expect to see prescribed?
A. Lithium
B. Clomipramine
C. Risperidone
D. Alprazolam
Correct Answer: B. Clomipramine (Anafranil)
Clomipramine (Anafranil) is a tricyclic antidepressant commonly used to reduce obsessive thoughts and compulsive‑like behaviors seen in Obsessive‑Compulsive Personality Disorder (OCPD).
Fluoxetine, an SSRI, is also commonly used for similar symptom relief.
Lithium is used for mood stabilization, not for OCPD.
Risperidone is an antipsychotic used for psychotic disorders or severe agitation.
Alprazolam is a benzodiazepine and is not first‑line for OCPD due to dependence risk.
The patient presents with the following diagnostic features:
-odd beliefs: mind reading, special powers, six sense, bizarre fantasies, disorganized thinking, episodes of Hallucinations/delusions but can be made aware
-vulnerable to cults
- Severe discomfort with close relationships
Schizotypal
The patient presents with the following diagnostic features:
-Have a need for excessive admiration
-Grandiose sense of self importance. Exaggerates achievements and talents
-preoccupied with fantasies of unlimited success & power
-lacks empathy
Narcissistic Personality Disorder
-A pattern of submissiveness & clingy to others and an excessive need to be taken care of.
-begins early adulthood
-unrealistic fear of being left to take care of themselves
Dependent Personality Disorder
Dialectical Behavioral Therapy or DBT was developed as an appropriate and sensitive therapy for patients with what personality disorder?
A. Histrionic Personality Disorder
B. Narcissistic Personality Disorder
C. Borderline Personality Disorder
D. Antisocial Personality Disorder
C. Borderline Personality Disorder
Dialectical Behavior Therapy (DBT) is considered one of the most effective and evidence‑based treatments for Borderline Personality Disorder (BPD) because it directly targets the core symptoms that make BPD so painful and destabilizing.
DBT was designed specifically for individuals who struggle with emotional dysregulation, impulsivity, and chronic self‑harm—making it uniquely suited for this population.
A nurse is developing a plan of care for a patient dx with Borderline Personality D/O who exhibits intense mood swings, unstable relationships, impulsive behaviors, and recurrent threats of self‑harm. Which nursing diagnoses are most commonly associated with this disorder? Select all that apply.
A. Risk for self‑mutilation
B. Risk for suicide
C. Risk for violence
D. Social isolation
E. Impaired socialization
F. Disturbed personal identity
G. Difficulty coping
ALL are correct!
These diagnoses align with the emotional instability, impulsivity, identity disturbance, and chronic self‑harm risk characteristic of Borderline Personality Disorder (BPD):
Risk for self‑mutilation — common due to impulsive self‑harm behaviors.
Risk for suicide — high due to emotional dysregulation and crisis‑driven behavior.
Risk for violence — may occur during intense anger or impulsive episodes.
Social isolation — relationships are unstable, chaotic, and often avoided after conflict.
Impaired socialization — difficulty maintaining healthy interpersonal boundaries.
Disturbed personal identity — a core feature of BPD.
Difficulty coping — chronic issues with emotional regulation and stress tolerance.