Chapter 24: Personality Disorders
A person diagnosed with obsessive-compulsive personality disorder is consistently late for appointments and says, "I have to check the safety features and fluid levels on my car six times before I leave home." Which nursing diagnosis has the highest priority? 1. Anxiety 2. Altered family processes 3. Altered role performance 4. Impaired social interaction
1. Anxiety Internally, this person is fearful of imminent catastrophe. This fear produces anxiety. Persons diagnosed with obsessive-compulsive personality disorder try to control the environment through perfectionism and orderliness. Traits include compulsivity, oppositionality, lack of emotional expressiveness, and perfectionism. Social interactions, family processes, and role performance for this individual will improve after the anxiety is reduced; therefore, these diagnoses have a lower priority.
Which personality disorders are categorized as cluster C? Select all that apply. 1. Avoidant 2. Paranoid 3. Antisocial 4. Dependent 5. Obsessive-compulsive
1. Avoidant 4. Dependent 5. Obsessive-compulsive Avoidant, dependent, and obsessive-compulsive disorders are cluster C personality disorders. Paranoid personality disorder is in cluster A. Antisocial personality disorder is in cluster B.
Which behavior is demonstrated by a patient who engages in splitting? 1. Evidences a lack of personal boundaries. 2. Sees things as divided into "all good" or "all bad." 3. Places responsibility for behavior outside the self. 4. Unconsciously represses undesirable aspects of self.
2. Sees things as divided into "all good" or "all bad." Splitting demonstrates the failure to integrate the positive and negative into a cohesive whole. An individual is not seen as a person with good and bad traits, but rather as all good or all bad. Splitting is not described accurately by unconsciously repressing undesirable aspects of self, placing responsibility for behavior outside the self, or evidencing a lack of personal boundaries.
Which patient assessment data support the diagnosis of schizoid personality disorder? Select all that apply. 1. Has never been married 2. Is employed as a nightshift janitor at an office complex 3. Reports, "I like people but I have only two good friends" 4. Raised in foster care after age 7 because of death of parents 5. Shares that, "I don't really care whether people are afraid of me"
1. Has never been married 2. Is employed as a nightshift janitor at an office complex 4. Raised in foster care after age 7 because of death of parents 5. Shares that, "I don't really care whether people are afraid of me" People with schizoid personality disorder exhibit a poor ability to function in their lives. Relationships are particularly affected because of the prominent feature of emotional detachment. People with this disorder do not seek out or enjoy close relationships and are viewed as loners. Neither approval nor rejection from others seems to have much effect. Friendships, dating, and sexual experiences are rare. Employment may be jeopardized if interpersonal interaction is necessary; individuals with this disorder may be able to function well in a solitary occupation. From a psychological perspective, people with this disorder often are raised in a cold and neglectful atmosphere in which they may conclude that relationships are unsatisfying and unnecessary.
Which assessment question focuses on the characteristic behaviors of a patient diagnosed with borderline personality disorder? Select all that apply. 1. Have you ever attempted suicide? 2. Have you ever been told you are sarcastic? 3. Over a few hours can your mood shift dramatically? 4. Do you experience visual or auditory hallucinations? 5. How would you describe your romantic relationships?
1. Have you ever attempted suicide? 2. Have you ever been told you are sarcastic? 3. Over a few hours can your mood shift dramatically? 5. How would you describe your romantic relationships? Areas of assessment related to borderline personality disorder typically include history of mood shifts, tendencies toward sarcasm and anger, as well as intense, unstable romantic relationships and suicidal behaviors. Hallucinations are not characteristic of this disorder.
A nurse assesses an individual diagnosed with schizoid personality disorder. Which characteristics are most likely? Select all that apply. 1. Male gender 2. Hyperactivity 3. Complaints of depression 4. Multiple somatic complaints 5. Uncle diagnosed with schizophrenia
1. Male gender 3. Complaints of depression 5. Uncle diagnosed with schizophrenia There is increased prevalence of schizoid personality disorder in families with a history of schizophrenia or schizotypal personality disorder. More men are diagnosed with this problem and depression is often present. Hyperactivity is associated more commonly with borderline personality disorder. Somatic complaints are more common in persons diagnosed with antisocial personality disorder.
Which behavior would be consistent with defining characteristics for the nursing diagnosis of ineffective coping? Select all that apply. 1. Manipulation 2. Aggressiveness 3. Interdependence 4. High levels of anxiety 5. Difficulty in relationships
1. Manipulation 2. Aggressiveness 4. High levels of anxiety 5. Difficulty in relationships The characteristics for the diagnosis of ineffective coping include crisis; high levels of anxiety, anger, and aggression; child, elder, or spouse abuse; and difficulty in relationships and manipulation. Interdependence would not be considered a symptom for ineffective coping.
The nurse explains to a patient with a borderline personality disorder that the patient's former psychiatrist resigned and a new psychiatrist has been hired. Which patient reaction is most likely? 1. Rage 2. Silence 3. Anxiety 4. Withdrawal
1. Rage An individual with a borderline personality disorder tends to experience anger or rage when feeling rejected or ignored. Silence, withdrawal, and anxiety are not expected reactions.
Which statement concerning impulse control training is true? Select all that apply. 1. The cost and benefit of actions are explored. 2. Focus is on social and interpersonal interactions. 3. Problem-solving strategies are taught and practiced. 4. Interactions are weighed more heavily than outcomes. 5. Patients are encouraged to stop and think before acting.
1. The cost and benefit of actions are explored. 2. Focus is on social and interpersonal interactions. 3. Problem-solving strategies are taught and practiced. 5. Patients are encouraged to stop and think before acting. Impulse control training assists the patient to mediate impulsive behavior through application of problem-solving strategies to social and interpersonal situations. Activities include assisting the patient to identify courses of possible action and their costs and benefits, cue himself or herself to "stop and think" before acting impulsively, evaluate the outcome of the chosen course of action, and practice problem solving (role playing) within the therapeutic environment. Interactions are not weighed more heavily than are outcomes
A patient is very sensitive to criticism, lacks empathy toward others, and remains neutral. Which treatment strategy does the primary health care provider instruct the nurse to include in the patient's treatment plan? Select all that apply. 1. "Administer naloxone to the patient." 2. "Give psychotherapy to the patient." 3. "Teach socialization techniques in a group." 4. "Administer lithium carbonate to the patient." 5. "Teach socialization techniques individually."
2. "Give psychotherapy to the patient." 3. "Teach socialization techniques in a group." 4. "Administer lithium carbonate to the patient." The patient with narcissism is very sensitive to rejection and criticism. The patient does not have empathy toward others and remains neutral. Lithium carbonate can be administered to the patient to treat mood swings. Socialization techniques must be taught to the patient in a group. Group therapy helps in increasing empathy in the patient. Psychotherapy must be given to the patient when the patient acknowledges the condition of narcissism. Naloxone is an opioid receptor antagonist, so it should not be administered to the patient. It can cause substance abuse in the patient. Teaching the patient individually will not improve empathy and social skills in the patient.
Which statement made by a patient illustrates a primary coping style of persons with borderline personality disorder (BPD)? 1. "My health care provider says I might get out of here tomorrow. Do you think I'm ready to go?" 2. "Last night the nurse let me go outside and smoke. I can't believe you aren't letting me. I used to think you were the best nurse here." 3. "I will never again speak to any of my messed up family members. I know that this will help me be more functional." 4. "I promise I am not feeling suicidal. I won't hurt myself."
2. "Last night the nurse let me go outside and smoke. I can't believe you aren't letting me. I used to think you were the best nurse here." A primary coping style used by patients with BPD is called splitting. Splitting is the inability to incorporate positive and negative aspects of oneself or others into a whole image. The individual may tend to idealize another person (friend, lover, health care professional) at the start of a new relationship and hope that this person will meet all of his or her needs. At the first disappointment or frustration, however, the individual quickly shifts to devaluation, despising the other person. The statements "My health care provider says I might get out of here tomorrow. Do you think I'm ready to go?", "I will never again speak to any of my messed up family members. I know that this will help me be more functional," and "I promise I am not feeling suicidal. I won't hurt myself" do not describe splitting, which is a primary coping style of patients with BPD.
Which conditions are comorbidities of borderline personality disorder? Select all that apply. 1. Bipolar disorder 2. Anxiety disorder 3. Substance abuse 4. Depressive disorder 5. Schizoaffective disorder
2. Anxiety disorder 3. Substance abuse 4. Depressive disorder Comorbidities for borderline personality disorder include substance abuse, anxiety disorder, and depressive disorder. Bipolar and schizoaffective disorders are not comorbidities of borderline personality disorder.
Which is the best treatment method for the patient who speaks of several failed relationships and appears arrogant and lacks empathy for others? 1. Psychotherapy 2. Cognitive-behavioral therapy 3. Administration of citalopram 4. Administration of venlafaxine
2. Cognitive-behavioral therapy A patient who appears arrogant and lacks empathy for others tells about several failed relationships. These are signs and symptoms of narcissistic personality disorder. The best treatment for narcissistic personality disorder is cognitive-behavioral therapy. The patient is taught to replace narcissistic thoughts that have formed irrational core beliefs with more appropriate thoughts and beliefs. Psychotherapy is effective in managing patients with histrionic personality disorder. Citalopram is a selective serotonin reuptake inhibitor that effectively treats avoidant personality disorder. Selective norepinephrine reuptake inhibitors such as venlafaxine are also effective in treating avoidant personality disorder.
Which behaviors are demonstrated characteristically by a patient diagnosed with narcissism? 1. Perfectionism and preoccupation with detail 2. Grandiose, exploitive, and rage-filled behavior 3. Angry, highly suspicious, aloof, and withdrawn behavior 4. A dramatic expression of emotion, while easily being led
2. Grandiose, exploitive, and rage-filled behavior Narcissistic patients give the impression of being invulnerable and superior to others to protect their fragile self-esteem. A dramatic expression of emotion while easily being led, perfectionism and preoccupation with detail, and angry, highly suspicious, aloof, and withdrawn behavior are not generally associated with narcissism.
What are the personality traits associated with borderline personality disorder? Select all that apply. 1. Shyness 2. Impulsivity 3. Disinhibition 4. Hypersensitivity 5. Aggressive disregard 6. Emotional dysregulation
2. Impulsivity 4. Hypersensitivity 6. Emotional dysregulation Borderline personality disorder is highly associated with impulsivity, hypersensitivity, and emotional dysregulation. People with this disorder act quickly and impulsively in response to their emotions, without considering the consequences. Because of their hypersensitive trait, they exhibit separation anxiety. The emotional dysregulation trait is indicated by frequent mood swings. The genetic trait of shyness predisposes people to schizoid personality disorder. People with the disinhibition trait show a lack of concern for the consequences of their actions. They are predisposed to antisocial personality disorder. People with an aggressive disregard trait who exhibit violent tendencies with no concern for others often have an antisocial personality disorder.
A nurse observes that a patient with osteoarthritis behaves rudely to the staff and refuses to take treatment. On inquiry, the nurse learns that the patient thinks that all staff members are planning to harm and deceive him or her. What is the patient likely to be suffering from? 1. Schizoid personality disorder 2. Paranoid personality disorder 3. Narcissistic personality disorder 4. Obsessive-compulsive personality disorder
2. Paranoid personality disorder Patients with paranoid personality disorder are suspicious and believe that others want to exploit, harm, and deceive them. They develop a defense system and try to counterattack the other person, and reject the treatment. They behave rudely and develop jealousy toward others. Patients with schizoid personality disorder have reduced emotional attachment and depression. Patients with obsessive-compulsive personality disorder have repetitive behavior. They remain preoccupied with minute details. In narcissistic personality disorder, patients are extremely worried about their prestige. They feel intense shame and fear of abandonment by others.
A patient diagnosed with an antisocial personality disorder becomes frustrated and angry when unable to get connected to the internet. The patient then curses loudly, disrupting, frightening, and disturbing others. Which nursing actions are therapeutic? Select all that apply. 1. Seclude the patient for 1 hour to allow for deescalation. 2. Say to the patient, "Step aside and I will get you connected to the internet." 3. Ask the patient, "How were you feeling when you were having this difficulty?" 4. Encourage the patient to recognize signs of mounting tension and seek assistance. 5. Tell the patient, "Further outbursts will result in suspension of your computer privileges."
3. Ask the patient, "How were you feeling when you were having this difficulty?" 4. Encourage the patient to recognize signs of mounting tension and seek assistance. 5. Tell the patient, "Further outbursts will result in suspension of your computer privileges." Therapeutic responses by the nurse include exploring the situation, encouraging description, setting limits on and expectations of the patient's behavior, suggesting other means of coping, and identifying results of inappropriate behavior. The nurse should assist the patient to identify the source of anger as well as the function that anger, frustration, and rage serve. It is inappropriate to seclude this patient because criteria for seclusion are not met. This scenario provides an opportunity for a therapeutic encounter, so the nurse should process it with the patient rather than completing the task for the patient.
A patient at the mental health center says to the nurse, "Most of the staff does not care about me, but you are different. You understand my problems." When the nurse tells this patient about an upcoming career change, the patient becomes very angry. An hour later, the patient loudly announces, "I'm going to cut my wrists. I need to be hospitalized immediately." Given this scenario, which personality disorder is most likely? 1. Avoidant 2. Histrionic 3. Borderline 4. Narcissistic
3. Borderline The scenario describes splitting of staff and impulsivity associated with self-mutilation. These are common behaviors among persons diagnosed with borderline personality disorder. Persons diagnosed with narcissistic personality disorder are exploitive, grandiose, and disparaging. Persons diagnosed with avoidant personality disorder are excessively anxious in social situations and hypersensitive to negative evaluation. Persons diagnosed with histrionic personality disorder are seductive, flamboyant, attention seeking, and shallow.
Which statement about persons diagnosed with personality disorders is accurate? 1. Patients readily recognize their problems and seek professional assistance. 2. Extended hospitalization is the best intervention and commonly needed for stabilization. 3. Characteristics of these disorders are most evident in social and interpersonal interactions. 4. Research has produced multiple medications that effectively manage symptoms of personality disorders.
3. Characteristics of these disorders are most evident in social and interpersonal interactions. The presence of a personality disorder interferes with, or complicates, social and interpersonal function. Individuals who meet criteria for these disorders have problems with empathy or intimacy within their relationships. Persons diagnosed with personality disorders tend not to perceive themselves as having a problem but instead believe their problems are caused by how others behave toward them. Although short-term hospitalization may sometimes be necessary when acute problems occur, extended hospitalizations tend to be counterproductive for this population. In the United States, there are no Federal Drug Administration-approved medications specifically for treating personality disorders; however, some health care providers prescribe selected psychotropic medications for off-label use.
Which statements are true of antisocial personality disorder (APD)? Select all that apply. 1. Persons with APD display magical thinking. 2. It is the least studied of the personality disorders. 3. Frontal lobe dysfunction is a brain change identified in APD. 4. Persons with APD are concerned with personal pleasure and power. 5. It is characterized by rigidity and inflexible standards of self and others. 6. It is characterized by deceitfulness, disregard for others, and manipulation. 7. Persons with APD usually present for treatment because of awareness of how their behavior is affecting others.
3. Frontal lobe dysfunction is a brain change identified in APD. 4. Persons with APD are concerned with personal pleasure and power. 6. It is characterized by deceitfulness, disregard for others, and manipulation. APD is the most studied and researched personality disorder with characteristics that include personal pleasure-seeking and deceitful disregard for others that is associated with a frontal lobe dysfunction. Rigidity and inflexible standards describes obsessive-compulsive personality disorder. Magical thinking describes schizotypal personality disorder. People with APD usually present with depression or because of the consequences of their behaviors, not because they care about the effects of their actions on others.
When assessing a patient for personality disorders, the nurse notices that a patient behaves in a melodramatic way and acts flirtatiously. What personality disorder is the nurse most likely to suspect in the patient? 1. Schizoid personality disorder 2. Paranoid personality disorder 3. Histrionic personality disorder 4. Narcissistic personality disorder
3. Histrionic personality disorder People with histrionic personality disorder have emotional attention-seeking behaviors. They are often melodramatic and act flirtatiously. People with paranoid personality disorder are extremely suspicious and often believe others will harm them. People with schizoid personality disorder exhibit emotional detachment and are viewed as loners. People with narcissistic personality disorder are arrogant and need constant admiration.
A patient was diagnosed with narcissistic personality disorder. Which aspect of the nursing assessment is most important? 1. Pain rating 2. Level of anxiety 3. Nutritional status 4. Attention span, hyperactivity
3. Nutritional status Anorexia nervosa and substance use disorders are often comorbidities for persons diagnosed with narcissistic personality disorder; therefore, it is important for the nurse to assess the patient's nutritional status. Although it's important to assess pain in all patients, the greater risk in this scenario applies to the patient's nutritional status. Anxiety is associated with antisocial, avoidant, and obsessive-compulsive personality disorders. Attention-deficit/hyperactivity disorder is more often a comorbidity of borderline personality disorder.
A patient is withdrawn and suspicious and states he or she has always preferred to be alone. The patient describes him- or herself as having "special powers" and states, "I believe we can all read each other's thoughts at times." Based on this presentation, the nurse suspects which personality disorder? 1. Avoidant 2. Narcissistic 3. Schizotypal (STPD) 4. Obsessive-compulsive
3. Schizotypal (STPD) The main traits that describe STPD are psychoticism, such as eccentricity, odd or unusual beliefs and thought processes, and social detachment by preferring to be socially isolated, as well as being overly suspicious or anxious. In obsessive-compulsive personality disorder the main pathologic personality traits are rigidity and inflexible standards of self and others, along with persistence to goals long after it is necessary, even if it is self-defeating or negatively affects relationships. People with narcissistic personality disorder come across as arrogant, with an inflated view of their self-importance. They have a need for constant admiration, along with a lack of empathy for others, a factor that strains most relationships over time. Traits of avoidant personality disorder include low self-esteem, feelings of inferiority compared with peers, and a reluctance to engage in unfamiliar activities involving new people.
A patient diagnosed with antisocial personality disorder with impaired social interaction and defensive coping receives psychotherapy treatment. Which response of the patient indicates to the nurse the treatment has been effective? 1. The patient ridicules a manic patient in the psychiatric unit. 2. The patient requests the nurse excuse him or her from a particular task. 3. The patient plays a leading role in a group activity assigned by the nurse. 4. The patient declares the government to be responsible for his or her condition.
3. The patient plays a leading role in a group activity assigned by the nurse. A patient with antisocial personality disorder shows impaired social interaction and defensive coping. A patient who plays a leading role in a group activity indicates improvement of the symptoms, which may be the result of effective treatment. This is because the patient cooperates with others and interacts well. Psychotherapy aims to help patients take responsibility for their own actions in order to improve their conditions. The patient declaring the government to be responsible does not indicate effective treatment. A request to be excused from a therapy task doesn't indicate progress or effective treatment. Psychotherapy aims to make the patient interact with others and develop sensitivity toward others. Ridiculing another patient shows that the patient with antisocial personality disorder is not sensitive and does show empathy for others.
The nurse is caring for a rheumatoid arthritis patient with borderline personality disorder. Which behavior does the nurse find in the patient compared with other patients in the ward? 1. The patient is always calm and depressed. 2. The patient abuses peers and hospital staff. 3. The patient shows extreme fluctuating emotions. 4. The patient feels uncomfortable with the nurse's attention.
3. The patient shows extreme fluctuating emotions. Patients with borderline personality disorder have unstable moods. Such patients exhibit rapid emotional shifts. They may be extremely aggressive and suddenly become extremely calm. They have a history of violence and impulsivity. They are not always aggressive but they are emotionally unstable and may exhibit a range of emotions. The patients have attention-seeking behavior and may try to attract the attention of the nurse.
A patient diagnosed with a borderline personality disorder shows the nurse multiple new, shallow self-inflicted cuts. Select the nurse's therapeutic response. 1. I will not be caught up or manipulated by your attention-seeking behavior." 2. "This suicide attempts scare me. I am placing you on suicide precautions immediately." 3. "These are shallow wounds that do not need attention. It's time for you to go to group now." 4. "I will care for your wounds, and then you should write down what you were thinking and feeling when this happened. We will discuss it later."
4. "I will care for your wounds, and then you should write down what you were thinking and feeling when this happened. We will discuss it later." An approach useful for patients with borderline personality disorder relates to responses to superficial self-destructive behaviors. The nurse should remain neutral and provide wound care in a matter-of-fact manner. Then the patient is instructed to write down the sequence of events leading up to the injury, as well as the consequences, before staff will discuss the event. This cognitive exercise encourages the patient to think independently about his or her behavior instead of merely ventilating feelings. It facilitates the discussion with staff about alternative actions. It is not therapeutic to deny the seriousness of the wounds or confront the patient with the behavior. Instituting suicide precautions reinforces the behavior.
Which is true of pharmacologic therapies for treatment of personality disorders? 1. Research has shown that currently available psychotropic drugs have not been shown to be effective in treating personality disorders. 2. Patients with personality disorders have been shown to be resistant to accepting medication, and as a result most providers do not prescribe psychotropic drugs to these patients. 3. Patients with narcissistic personality disorder and obsessive-compulsive personality disorder have shown the most benefit from the use of antianxiety medications along with use of selective serotonin reuptake inhibitors. 4. Although there are no Food and Drug Administration (FDA)-approved drugs specific to the treatment of personality disorders, patients benefit from specific off-label uses of antipsychotics, mood stabilizers, and antidepressants, depending on which personality disorder is evident.
4. Although there are no Food and Drug Administration (FDA)-approved drugs specific to the treatment of personality disorders, patients benefit from specific off-label uses of antipsychotics, mood stabilizers, and antidepressants, depending on which personality disorder is evident. At this time in the United States, there are no FDA-approved medications for treating personality disorders. Prescribers are using the medications "off- label" until evidence-based pharmacotherapies are proven to be safe and effective. There is evidence that mood stabilizers, antidepressants, and atypical antipsychotics are helpful in specific personality disorders. Pharmacologic evidence is lacking for the treatment of persons with narcissistic and obsessive-compulsive personality disorders. Although patients with personality disorders usually do not like taking medicine unless it calms them down and are fearful about taking something over which they have no control, providers do attempt to mediate symptoms with psychotropic agents for improved quality of life.
A nurse who is idealized by a patient is at risk for 1. Developing a prejudicial, blaming orientation 2. Stringent enforcement of boundaries and limits 3. Becoming indecisive about planned interventions 4. Becoming overinvolved and being protective and indulgent
4. Becoming overinvolved and being protective and indulgent Finding an approach for helping patients with personality disorders who have enormous needs can be overwhelming for caregivers. For example, a female patient with borderline personality disorder may briefly idealize her male nurse on the inpatient unit, telling staff and patients alike that she is "the luckiest patient because she has the best nurse in the hospital." The rest of the team initially realizes that this behavior is an exaggeration, and they have a neutral response. But after days of constant dramatic praise, some members of the team may start to feel inadequate and jealous of the nurse. They begin to make critical remarks about minor events to prove that the nurse is not perfect. Open communication in staff meetings and ongoing clinical supervision are important aspects of self-care for the nurse working with these patients to maintain objectivity.
The nurse caring for a patient with a dependent personality disorder begins avoiding the patient due to the patient's repeated states of crisis and demand for extra time with the nurse. What has occurred in the nurse-patient relationship? 1.Projection 2. Conversion disorder 3. Defense mechanism 4. Countertransference
4. Countertransference Countertransference occurs when the feeling of wanting to avoid the patient is based on prior interaction with the patient. Projection is a psychological defense mechanism in which individuals attribute characteristics they find unacceptable in themselves to another person. A conversion disorder consists of neurological symptoms or deficits that develop unconsciously and cannot be explained by medical evaluation. A defense mechanism is an unconscious way to cope with anxiety.
How is the behavior of a cluster B personality disorder described? 1. Odd or eccentric 2. Anxious or fearful 3. Aggressive or destructive 4. Dramatic, emotional, or erratic
4. Dramatic, emotional, or erratic The behavior of a cluster B personality disorder is described as dramatic, emotional, or erratic. The behaviors in a cluster A personality disorder are described as odd or eccentric. Anxious or fearful behavior is descriptive of a cluster C personality disorder. Aggressive or destructive behaviors are not descriptive of any cluster of personality disorders.
A primary health care provider is planning therapy for a patient with narcissistic personality disorder. What treatment option does the nurse anticipate as most effective for the patient? 1. Assertiveness training 2. Omega-3 supplements 3. Low-dose antipsychotic medications 4. Individual cognitive-behavioral therapy
4. Individual cognitive-behavioral therapy There is no medication indicated for narcissistic personality disorder. Treatment includes individual cognitive-behavioral therapy, family therapy, and group therapy. Patients with borderline personality disorders often respond to omega-3 supplementation for mood and emotion dysregulation symptoms. Patients with narcissistic personality disorder already have an inflated view of their self-importance, and assertive training may not help them. Such training helps patients with avoidant, dependent, or histrionic personality disorders to express their needs more openly and improves their self-esteem. Patients with borderline and schizotypal personality disorders benefit from low-dose antipsychotic medications, which reduce psychotic-like symptoms and improve day-to-day functioning.