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Personality disorders are long-standing patterns of behavior and inner experience that deviate significantly from cultural expectations and impair functioning. These patterns typically begin in adolescence or early adulthood and persist across different life situations.

Unlike mood or psychotic disorders, personality disorders involve enduring characteristics—not temporary episodes—which makes them especially challenging for RN nurses to manage in clinical environments.

Common features include:

Difficulty regulating emotions
Impaired interpersonal relationships
Maladaptive coping mechanisms
Rigid and inflexible thinking
Because these traits feel natural to the patient, they often do not recognize them as problematic. Therefore, therapeutic communication becomes a core nursing intervention.

✅ The Three Clusters of Personality Disorders
Experts categorize personality disorders into three major clusters. Understanding the differences helps the registered nurse choose effective interventions and anticipate patient behavior.

🔹 Cluster A: Odd or Eccentric Behaviors
Includes:

Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder
Nursing considerations:

Use clear, direct communication
Avoid overly friendly behavior that may feel threatening
Encourage but do not force social interaction
🔹 Cluster B: Dramatic, Emotional, or Erratic Behaviors
Includes:

Borderline Personality Disorder (BPD)
Antisocial Personality Disorder
Narcissistic Personality Disorder
Histrionic Personality Disorder
Nursing considerations:

Set firm, consistent boundaries
Use structured environments
Recognize manipulation without taking it personally
Promote emotional regulation skills
For NCLEX questions, Cluster B disorders appear frequently due to the safety risks associated with impulsivity, self-harm, or aggression.

🔹 Cluster C: Anxious or Fearful Behaviors
Includes:

Avoidant Personality Disorder
Dependent Personality Disorder
Obsessive-Compulsive Personality Disorder (OCPD)