A nurse is assisting with planning care for a client who has been brought to the inpatient mental health unit by law enforcement officers after becoming aggressive in a local bar. The nurse should identify that this finding is consistent with which of the following disorders?

A. Splitting is a defense mechanism commonly used by clients with borderline personality disorder. It involves viewing people or situations as entirely good or entirely bad, leading to rapidly shifting opinions and emotional reactions. This black-and-white thinking can create division among healthcare providers, as the client may idealize one staff member while devaluing another, causing conflict within the team.
B. Reaction formation occurs when a person expresses the opposite of their true feelings, often due to discomfort with their actual emotions. While seen in some personality disorders, it is not a hallmark feature of borderline personality disorder and does not typically contribute to team division.
C. Denial involves refusing to acknowledge reality or facts that cause distress. Though common in various mental health conditions, it does not specifically create division among healthcare providers in the way splitting does. Clients with borderline personality disorder may use denial, but it is not their primary defense mechanism.
D. Regression is a defense mechanism where an individual reverts to earlier developmental behaviors in response to stress. While it can be seen in borderline personality disorder, it does not typically lead to splitting within the healthcare team, as it primarily affects the client’s own coping mechanisms rather than interpersonal dynamics.

A. Borderline personality disorder. Borderline personality disorder falls under Cluster B, which includes dramatic, emotional, and erratic disorders. Individuals with this disorder often exhibit impulsivity, intense emotional instability, fear of abandonment, and unstable relationships.
B. Antisocial personality disorder. Antisocial personality disorder is part of Cluster B and is characterized by a disregard for social norms, lack of empathy, and manipulative or deceitful behavior. Individuals with this disorder often engage in impulsive and irresponsible actions.
C. Dependent personality disorder. Dependent personality disorder belongs to Cluster C, which includes anxious and fearful disorders. Individuals with this disorder exhibit excessive reliance on others, difficulty making decisions, and an intense fear of abandonment, leading to submissive and clingy behavior.
D. Paranoid personality disorder. Paranoid personality disorder is categorized under Cluster A, which consists of odd and eccentric personality disorders. It is characterized by pervasive distrust, suspicion of others, and a tendency to interpret others' actions as malicious.