Personality Disorders: Cluster C: Avoidant Personality Disorder, Dependent Personality Disorder, Obsessive-Compulsive Disorder

Other students consider Eric, a college senior, shy. He stays in his room studying and generally avoid parties. He has no real friends at college and spends his time watching television when he has no homework. Eric has a hard time in some of his classes, especially those that require him to speak in front of the group. He never sits next to the same person twice because this helps him avoid having to socialize. Avoidant, Dependent or Obsessive-Compulsive

Avoidant

*Personality Disorders: Cluster C: Anxious and Fearful*

Avoidant--withdrawn pattern Dependent -- submissive pattern Obsessive -- conforming pattern

*Cluster C: Obsessive-Compulsive Personality* *Disorder*

Conforming pattern These are the perfectionist among us....not only ones who simply want to do their best, but the ones who panic when things aren't perfect These people exhaust themselves.

Min, is a homemaker, married at 18 and moved directly from relying on her parents to relying on her husband. She was unable to go to any stores alone and unable to drive. She relied on her husband to pick out her clothing because she felt she had no taste. She stayed in the marriage for 10 years, even though her husband was verbally abusive and had multiple affairs. After she separated from her husband, she felt devastated, even though it was a terrible relationship. Within a few months, Min remarried and felt very relieved to be taken care of again. Avoidant, Dependent or Obsessive-Compulsive

Dependent

*Cluster C: Obsessive-Compulsive Personality* *Disorder*

Diagnosed in 1% of the population Males are diagnosed twice as often as females

*Cluster C: Avoidant Personality Disorder*

Diagnosis is equal for males and females. Diagnosed in 0.5% to 1% of the general population.

*Cluster C: Avoidant Personality Disorder* Clinical Symptoms

Fearful of criticism, disapproval or rejection Feelings of inadequacy Tendency to withhold thoughts or feelings Negative sense of self and low self esteem Social inhibitions Hypersensitive to to negative evaluation.

*Cluster C: Avoidant Personality Disorder*

Few friends Withdrawn pattern Fear criticism These are classic "very low self esteem" individuals. They are extremely awkward and shy. They become increasingly withdrawn as to look like the schizoid personality but notice the difference-- The schizoid doesn't want relations with others but the avoidant would really like to have friends but is too afraid of rejections to try.

*Cluster C: Dependent Personality Disorder* Nursing Interventions

Help clients identify their strengths and needs. Clients may need assistance in daily functioning if they have little or no past success in this areas. The nurse may need to teach problem solving and decision making and help clients apply them to daily life. The nurse must refrain from giving advice about problems or making decision for clients even though clients may ask the nurse to do so. Foster clients self reliance and autonomy.

*Cluster C: Dependent Personality Disorder*

Most frequently diagnosed personality disorder. More females are diagnosed than males. Symptoms are demonstrated early in life.

Jim, a mid level executive for a food processing plant is always in trouble with the plant manager because he fails to get reports in on time. Jim, blames the secretary for the problem., saying, "I can't get anything done right unless I do it myself." However, Jin's secretary promptly types exactly what he gives her. Jim then adds new details and reorganized the report. Jim keeps all the drafts of the report and documents the time it takes for the secretary to type them. He stores these in a file that only he is allowed to use. Avoidant, Dependent or Obsessive-Compulsive

Obsessive-Compulsive

*Cluster C: Obsessive-Compulsive Personality* *Disorder* Clinical Symptoms

Preoccupation with perfection, organization, structure and control. Difficulty relaxing Rule-conscious behavior Inability to discard anything Background of stiff and formal relationships

*Cluster C: Avoidant Personality Disorder*

Social discomfort Avoid unfamiliar situation Devastated by criticism

*Cluster C: Dependent Personality Disorder*

Submissive pattern Difficulty disagreeing with others Desires help with everyday decisions

*Cluster C: Dependent Personality Disorder* Clinical Symptoms

Submissiveness and tendency to cling Inability to make decision independently Inability to express negative emotions Difficulty following through on tasks Excessive need to be taken care of

*Cluster C: Obsessive-Compulsive Personality* *Disorder* Nursing Interventions

The nurse can help the client not strive for the goal of perfection, instead can set a goal of completing the project or making the decision by a specified deadline. Encouraging the clients to take risks, such as letting someone else plan a family activity. Practicing negotiation with family or friends also may help clients relinquish some of their need for control.

*Cluster C: Avoidant Personality Disorder* Nursing Interventions

These clients require much support and reassurance from the nurse. The nurse can help them explore positive self aspects and positive responses from others. Helping clients to practice self affirmations and positive self talk may be useful in promoting self esteem.