NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder

NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder

NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder

Explain the diagnostic criteria for your assigned personality disorder.

Paranoid, Schizotypal, and Schizoid Personality Disorder Example

Cluster A personality disorders include schizoid, schizotypal, and paranoid personality disorders. The personality disorders are grouped because they have similar symptomatology and risk factors, both environmental and genetic. Personality disorders are classified in Axis II of the multiaxial diagnostic criteria. Personality disorders refer to a mental condition that alters a person’s thinking, functioning, feelings, behavior, and relations with other people. (Oltmanns, et al., 2018).

NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder

Conditions in cluster A are associated with awkwardness in group instances, distance from the intimate association, and distortion of thinking. Typically, abnormal thinking and odd behavior are exhibited. The proximity of clinical manifestations among the disorders presents a significant challenge in their diagnosis and, consequently, treatment. To solve this puzzle, one can use a criterion outlined in the fifth edition of the Diagnostic and statistical manual for mental disorders. This paper examines schizoid personality diagnostic criteria, explains evidence-based interventions, and gives a classic example of a person with the disorder’s clinical signs. NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder

Diagnostic criteria for schizoid personality disorder

Schizoid personality disorder diagnosis is based on the DSM-5 diagnostic criteria. Diagnosis can only be made if the disorder has resulted in long-term divergence from cultural prospects causing marked distress or significant impairment, (Rolston, 2017 NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder). To be diagnosed with schizoid personality disorder; DSM-5 directs that one must have at least four among the symptoms below:

  • Preference to be alone, engage in solitary activities, lacking interest in relationships both personal and social.
  • They are emotionally detached with a limited expression of emotion.
  • They obtain only a little or no pleasure from most activities that most people find fun.
  • Have very little interest in having sex with other people or not at all.
  • Impervious of praise or critics. Indifferent and cold to other people.
  • Lack the urge to take pleasure in close friends or have confidants.
  • These people cannot recognize or associate with what is regarded as typical social cues.

According to Levi-Belz et al. (2019), the persons who suffer from this disorder hardly seek treatment on their own. With persistent disengagement and disregard to social unions and restricted emotional expression, general doctors find it hard to diagnosis the disorder, with psychiatrists being the best to handle it. Therefore, for one to be diagnosed with a schizoid personality disorder, one must meet the American Psychiatric Association publication criteria. NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder

Evidence-based psychotherapy and psychopharmacologic treatment.

Treatment modalities involve both psychopharmacological interventions and evidence-based psychotherapy. These treatment modalities are long-standing as they may take months to years. The mainstay of treatment is the application of evidence-based psychotherapy. The healthcare provider needs first to acknowledge that there is a need for personal space then recognize the difficulty of opening up. There is a need to gently guide the person and not push so hard. The main aim is at learning skills on how to cope, done through the establishment of a trusting relationship with the therapist. The intervener may face a real struggle as they have to use topics that are appealing to the patient. Psychotherapy for this condition follows three different paths, namely cognitive brain therapy, supportive therapy, and family therapy. Cognitive brain therapy focuses on the acquisition of social skills, such as learning to recognize and appreciate social cues. Cognitive brain therapy aims at improving psychosocial outcomes (Mankiewicz & Renton, 2019), with the modified form, known as talk therapy, being essential. Supportive therapy encourages the application of skills gained in the adaptation process as one needs constant encouragement. It is applied in group therapy where the patient interacts with others and puts into practice the interpersonal skills gained. 

Evidence-based pharmacotherapy is offered as adjuvant treatment. There are no specific medications given for schizoid personality disorder. However, symptomatic treatment is provided through anecdote-centered prescriptions (Binder, 2019). Current management guidelines advise the sparing use of medications in the management of personality disorders. Anxiety medications are given in the event of the perception of symptoms pointing to anxiety. Antidepressants can also be given to manage depressive mood disturbances.

Case Scenario

A classic example of schizoid personality disorder can be observed from a patient seen recently. As I will call him, Patient X was brought in by his mother for the sake of confidentiality. The mother made allegations about his disturbing character. Patient X was undeterred by what came from his mother’s mouth. Patient X a thirty-eight-year-old writer with no available publication of his work. Patient X has no girlfriend, not even a confidant. Occasionally he plays a computer game or does stamp collection without any hype or fuss. The mother believes he does not care about anyone’s thoughts towards him. Recently the sister to Patient X had a birthday to which he did not turn up despite being in the same house. The accusations of being self-involved and being the reason for not even having a sexual partner were in vain as there was not even the slightest of responses. Patient X has met the diagnostic criteria for schizoid personality disorder as he is detached emotionally, prefers his own company, is indifferent to critics, and lacks a sexual partner.

Conclusion

Schizoid personality disorder is among the Cluster A personality disorders. The condition is diagnosed according to the DSM-5 criteria. While there are several psychotherapeutic measures to manage it, psychopharmacological treatments are only restricted to symptomatic management. Despite being a displeasing disorder that impairs the social functioning of an individual, schizoid personality disorder can be adequately managed when properly diagnosed. NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder

NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder References

  • Binder, M. R. (2019). Introducing the term “Neuroregulator” in Psychiatry. American Journal of Clinical and Experimental Medicine, 7(3), 66–70. doi: 10.11648/j.ajcem.20190703.11
  • Levi-Belz, Y., Gvion, Y., Levi, U., & Apter, A. (2019). Beyond the mental pain: A case-control study on the contribution of schizoid personality disorder symptoms to medically serious suicide attempts. Comprehensive Psychiatry, 90(), 102–109. doi:10.1016/j.comppsych.2019.02.005
  • Mankiewicz, P. D., & Renton, J. C. (2019). Increasing psychosocial health with cognitive therapy in schizoid personality disorder: A single subject design. Athens Journal of Health and Medical Sciences, 6(4), 197–212. https://doi.org/10.30958/ajhms.6-4-1
  • Oltmanns, J. R., Smith, G. T., Oltmanns, T. F., & Widiger, T. A. (2018). General factors of psychopathology, personality, and personality disorder: Across domain comparisons. Clinical Psychological Science, 6(4), 581–589. https://doi.org/10.1177/2167702617750150
  • Rolston, C. (2017). Schizoid personality disorder. In Encyclopedia of Clinical Neuropsychology (pp. 1–2). Springer International Publishing. https://doi.org/10.1007/978-3-319-56782-2_9200-1

NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder Instructions

Paranoid, Schizotypal, and Schizoid Personality Disorder

Explain the diagnostic criteria for your assigned personality disorder.
Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned personality disorder.
Describe clinical features from a client that led you to believe this client had this disorder. Align the clinical features with the DSM-5 criteria.
Support your rationale with references to the Learning Resources or other academic resources

Comments / Note

NURS 6670 Week 3 Case 1: A Woman with Personality Disorder

A woman with personality disorder CASE #1

SUBJECTIVE

Rhonda is a 32-year-old Hispanic female who presents to your office for her initial appointment. When you ask what brought her to your office, she states: am at the end of my rope, I don’t know what else to do. She then bursts into tears. Rhonda explains that she has very few friends left, and everyone seems to have abandoned her. Rhonda explains that she goes out of her way to help other people, and to be nice to them, but this does not seem to help. NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder

Rhonda then stands up and begins to pace around your office at times using wild hand gestures to explain the circumstances that led up to her making the appointment with you. She describes the recent breakup with her boyfriend as traumatic and explains when we first met, he was the best guy in the world. He treated me really well. But he just became a complete monster! Even though he broke off the relationship with me, I was glad to see it end. I hate his guts!

Rhonda explains that her current financial situation is also precarious. She states that she recently purchased an automobile, and is not certain how she is going to pay for it. She states that she had a car that was repossessed last year at that time, and that she borrowed some money from a friend to help pay for the car; the friend later turned around and accused her of theft. It was my friend’s fault. She told me she would loan me the money and then backed out. I only took the money because she said she would loan it to me … people just can’t go back on their word like that when other people are counting on them.

Rhonda reports that she was ‘always in trouble’ as a kid. She states that people were always picking on her, to which she adds: the other kids my age were just stupid. They didn’t know how to have fun. She says, ‘I have always been impulsive, but it’s fun. Sometimes people can be such prudes … you only go around life once, so you have to make the best of it. NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder

OBJECTIVE

Rhonda is currently single. She has no children. Educationally, she had completed two semesters toward her bachelor of arts degree in fine arts. Rhonda currently works as a waitress at a local restaurant. She has held this job for about 2 weeks. Prior to this, Rhonda worked as a housekeeper for a local hotel chain. She states that she was fired from this job because her coworkers were jealous of her and planted evidence of her stealing from hotel patrons. She was also arrested for cashing checks under an alias, for which she spent 120 days in jail.

Rhonda has a history of multiple incarcerations for offences ranging from larceny to possession of controlled substances to possession of an illegal firearm. She was also arrested several times for fighting and on at least one occasion, used a baseball bat to beat up a girl who she thought was trying to set her up with the police.

MENTAL STATUS EXAM

Rhonda is alert and oriented × 4 spheres. Her speech is clear, coherent, goal directed, and spontaneous. She reports her mood as terrible! Affect is labile and seems to change rapidly with the subject being discussed. Her eye contact is normal, but at times, she appears to stare at you. Rhonda is oriented to person, place, and time. She denies visual/auditory hallucinations, no overt paranoia or delusional thought processes noted. Rhonda denies any suicidal or homicidal ideation. NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder

Decision Point One

1,BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PSYCHIATRIC/MENTAL HEALTH NURSE PRACTITIONER (PMHNP) GIVE TO RHONDA?

In your write-up of this case, be certain to link specific symptoms presented in the case to DSM5 criteria to support your diagnosis.

Borderline Personality Disorder

Histrionic Personality Disorder

Antisocial Personality Disorder

QUESTIONS

Examine Case 1: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

Decision #1: Differential Diagnosis

Which Decision did you select?
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different? NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder

Decision #2: Treatment Plan for Psychotherapy
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?

Decision #3: Treatment Plan for Psychopharmacology
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients and their family.
Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count. NURS 6670 Week 3 Paranoid, Schizotypal, and Schizoid Personality Disorder