A nurse is discussing the three clusters of personality disorders. Which of the following personality disorders is part of cluster C

Findings Consistent with Antisocial Personality Disorder (ASPD)

1. Experience with the legal system since teenage years: Individuals with ASPD often exhibit a pattern of behavior that violates societal norms and legal codes, leading to frequent encounters with the legal system. The client has a history of criminal behavior, including shoplifting, auto theft, and resisting arrest, which aligns with the diagnostic criteria for ASPD.

2. Substance use: Substance abuse is common among individuals with ASPD. The client's history of driving under the influence of alcohol and possession and sale of marijuana demonstrates a disregard for the law and social norms, which is characteristic of ASPD.

3. Acceptance of responsibility: A key feature of ASPD is a lack of remorse or responsibility for one’s actions. The client’s statement, "That car wreck was not my fault! That judge just has it out for me," indicates a refusal to accept responsibility for their actions and a tendency to blame others, which is consistent with ASPD.

4. Relationship with family: Estrangement from family members is often seen in individuals with ASPD due to their manipulative, deceitful, or exploitative behavior, which can damage personal relationships. The client's estrangement from their family supports this pattern of unstable and problematic relationships.

Findings Not Consistent with ASPD

5. Adhering to financial responsibilities: The client does not adhere to financial responsibilities, as evidenced by their eviction for failure to pay rent. This behavior is consistent with ASPD, where individuals often exhibit irresponsibility, particularly in financial matters.

6. Employment status: Employment status alone is not a definitive indicator of ASPD. While the client is currently employed by a food delivery service, which suggests some level of functional ability, it does not provide enough context regarding their overall adherence to social norms or work behavior.

7. Compassion toward others: The client displays a lack of compassion toward others, which is a hallmark of ASPD. They refer to other clients in a derogatory manner ("losers") and show disdain for their feelings. This behavior reflects the lack of empathy and disregard for others typical in ASPD.

8. Rechanneling anger with physical activity: While engaging in physical activity to manage anger is generally a positive coping strategy, it does not specifically relate to the diagnostic criteria for ASPD. The client's use of physical activity to mitigate anger does not negate the presence of other antisocial traits.

A. Stand directly in front of the client when talking. Standing directly in front of a client with a history of anger and aggression can be perceived as confrontational and may escalate the situation. It's better to stand at an angle and maintain an open posture to appear less threatening. Therefore, this choice is incorrect.

B. Avoid wearing necklaces during client care. Wearing necklaces or other loose jewelry can pose a safety risk if a client becomes aggressive and grabs them. Avoiding such items is a precaution to prevent potential harm. This choice is correct.

C. Provide immediate verbal feedback for escalating behavior. Providing immediate verbal feedback is important to de-escalate aggressive behavior by addressing it promptly and setting clear boundaries. This helps in managing the client's behavior effectively. This choice is correct.

D. Bring security with you for all client interactions. While bringing security can be necessary in certain high-risk situations, it is not appropriate or practical for all interactions and can increase the client's anxiety or aggression. Instead, security should be involved based on risk assessment and the specific context. Therefore, this choice is incorrect.

E. Review the layout of the facility. Knowing the layout of the facility is important for ensuring safety and planning escape routes if a situation becomes unsafe. It helps staff navigate the environment efficiently in case of an emergency. This choice is correct.