Anxious Fearful Behaviors Cluster III The third cluster of personality disorders comprises conditions in which the prominent

symptoms are anxiety and fear. Major symptoms include avoiding or minimizing the experience of anxiety by avoiding relationhips. Disorders in this cluster include avoidant, dependent, and obsessive-compulsive. Avoidant Personality Disorder Characterized by a pervasive pattern of social discomfort and reticence, low self =-esteem, and hypersensitivity to negative evaluation. Characteristics Socially inhibited, shy and lonely Sense of being inadequate with low self esteem Hypersensitive to criticism Reluctant to take risks or try new activities as they might be embarrassing Desperate for relationships But avoid social contact for fear of disapproval, criticism or rejection Impacts work, social situations, intimacy Altered interpretation of illness and physician Not forthcoming with information Will not question or disagree with doctor Recommended physician approach Reassure and validate concerns Encourage talking about concerns in future Nursing Intervention Clients requires much support and reassurance Decatasthrophizing- promote self worth Facilitate trust through reliable and dependable nurse client relationship Dependent Personality disorder Characterized by a pervasive pattern of depressive cognitions and behaviors in various context. Characteristics (more common in women) Difficulty making everyday decisions without significant advice and reassurance from others Need to be taken care of, passive, unsure - others need to assume responsibilities for most areas of their life Submissive behavior as they fear disagreement and the loss of support or approval Difficulty initiating independent projects Volunteers to perform unpleasant tasks to obtain the nurture and support of others Urgently needs to replace one relationship when another one ends Fear of separation Sensation of helplessness May appear passive-aggressive Altered interpretation of illness and physician Exhaustive questioning Attention to minute detail Angry when routines are disrupted Recommended physician approach Careful history and examination Thorough explanations Do not emphasize uncertainty Involve patient in treatment program Nursing Intervention Teach on problem solving

 Fostering self reliance Promote self-worth Reduce anxiety Offer assistance only when needed Obsessive-Compulsive Behavior Characterized by a pervasive pattern of preoccupation with perfectionism, mental and interpersonal control control, and orderliness at the expense of flexibility, openness, and efficiency Characteristics (often successful men) Inhibited, stubborn, rigid and a perfectionist - interferes with task completion Preoccupied with orderliness or perfection, rules, lists, order, organization or schedules (obscures the major point of activity) Excessively devoted to work and productivity and excludes recreation and friendships Reluctant to delegate tasks to others unless they will perform those tasks exactly as he or she directs Miserly spending habit; hoards money in case of future catastrophe Unable to throw away worthless items (without sentimental value) Mental and interpersonal control Worry about loss of emotional control Altered interpretation of illness and physician Prolongs illness behavior to obtain attention Demands urgent attention Recommended physician approach Reassure See in clinic regularly (set limits on availability) Identify support network to assist patient Avoid rejecting patient Nursing Intervention Helping client to accept or to tolerate less than perfect work Assist in coping with compulsive behaviour Reduce anxiety Passive-Aggressive Characterized by a negative attitude and a pervasive resistance to demands for adequate social and occupational performance. 4 substance related disorders Substance abuse, also known as drug abuse, is a patterned use of a substance (drug) in which the user consumes the substance in amounts or with methods which are harmful to themselves or others. Substance intoxication is a type of substance-induced disorder which is potentially maladaptive and impairing, but reversible,and associated with recent use. Substance dependence, commonly called drug addiction, is a compulsive need to use drugs in order to function normally. When such substances are unobtainable, the user suffers from withdrawal. Drug withdrawal is the group of symptoms that occur upon the abrupt discontinuation or decrease in intake of medications or recreational drugs. In order to experience the symptoms of withdrawal, one must have first developed a physical and/or mental dependence (often referred to as chemical dependency). This happens after consuming one or more substances for a certain period of time, which is both dose dependent and varies based upon the drug consumed.

SUBMITTED BY: Katrina Anne P. Tomanan BSNursing 3