Cluster C: Behaviors that are described as anxious or fearful

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Avoidant Personality Disorder: DefinitionExtreme sensitivity to rejection
Social withdrawal
Prevalence is between 0.5% and 1% and is equally common in both men and women.
Clinical Picture for Avoidant personalityAwkward and uncomfortable in social situations
Low self esteem
Shy
Fearful
Desires close relationships but avoid them because of fear of being rejected
Etiological Implications for Avoidant personalityPossible hereditary influences
Parental rejection and criticism
Reports being inhibited as a child

Nursing Interventions for Avoidant personalitiesExplore positive self aspects, positive responses from others & possible reasons for self criticism.

Help the client with positive self talk. This will help improve their self esteem

Teach social skills. Role modeling & role playing social skills can help build some confidence in social situations.

Dependent Personality Disorder: DefinitionCharacterized by a pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation
Relatively common within the population
More common among women than men
More common in the youngest children of a family than in the oldest ones
Clinical Picture for Dependent PersonalityClient has a notable lack of self-confidence that is often apparent in
Posture
Voice
Mannerisms
Typically passive and goes along with the desires of others
Overly generous and thoughtful while underplaying own attractiveness and achievements
Feelings of low self worth
Assumes passive and submissive roles in relationships
Avoids positions of responsibility and becomes anxious when forced into them
Etiological Implications for Dependent PersonalityPossible hereditary influence
Stimulation and nurturance are experienced exclusively from one source
A singular attachment is made by the infant to the exclusion of all others
Dependent – Nursing Interventions for Dependent PersonalityThe nurse must help clients to express feelings of grief & loss over the end of a relationship while fostering autonomy & self reliance.

Teach problem solving & decision making & help clients apply them to daily life.

The nurse must refrain from giving advice about problems or making decisions for clients even though the clients may ask the nurse to do.

Obsessive/Compulsive Personality Disorder DefinitionCharacterized by inflexibility about the way in which things must be done
Devotion to productivity at the exclusion of personal pleasure
Relatively common and occurs more often in men than women
Within family constellation, appears to be most common in the oldest children
Clinical Picture for Obsessive/Compulsive Personality DisorderEspecially concerned with matters of organization and efficiency
Tends to be rigid and unbending
Client polite and formal
Client rank-conscious (ingratiating with authority figures)
Strives for perfection
Check & recheck details
Low self esteem
Appears to be very calm and controlled
Underneath there is a great deal of
-Ambivalence
-Conflict
-Hostility
Etiological Implications for Obsessive/Compulsive Personality DisorderOver control by parents
Notable parental lack of positive reinforcement for acceptable behavior
Frequent punishment for undesirable behavior
Obsessive Compulsive – Nursing Interventions for Obsessive/Compulsive Personality DisorderHelp the clients accept or to tolerate less than perfect work.
Restructuring Techniques
“What is the worse that can happen?”
Enc. clients to take risks, such as letting some else plan a family/group/work activity
Passive-Aggressive Personality Disorder DefinitionExhibits a pervasive pattern of negativistic attitudes and passive resistance
Reacts badly to demands for adequate performance in social and occupational situations
Clinical Picture for Passive-Aggressive Personality DisorderAble to vent anger and resentment subtly while gaining the attention, reassurance, and dependency that are craved.
They tend to blame others for their own misfortune rather than accepting responsibility for their own situation.
Etiological Implications for Passive-Aggressive Personality DisorderContradictory parental attitudes and behavior are implicated in predisposition to passive-aggressive personality disorder
Passive- Aggressive – Nursing InterventionsExamine relationships between feelings & actions
Express appropriate ways to express feelings especially negative feelings such as anger
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