Which of the following should a nurse include as a primary outcome for an individual with schizoid personality disorder?
Validates ideas before taking action
Able to function independently in the community
Copes and controls emotions
Recognizes limits
The Correct Answer is B
Schizoid personality disorder is a Cluster A condition marked by pervasive detachment from social relationships and a restricted range of emotional expression. Individuals often appear emotionally cold, prefer solitary activities, and show little interest in forming close relationships. They are not distressed by their isolation and typically function best when left alone. These individuals may maintain employment and basic self-care but avoid interpersonal engagement. The disorder is chronic and ego-syntonic, meaning the person does not view their behavior as problematic. The focus of care is on maintaining independent functioning, ensuring safety, and supporting basic needs rather than altering personality traits.
Rationale for correct answer
B. The goal of care for individuals with schizoid personality disorder is to support independent functioning in the community. These individuals are often capable of managing daily tasks and employment if allowed to do so without excessive social demands. Promoting autonomy and ensuring they can meet their basic needs without relying on others aligns with both therapeutic goals and the individual’s preferences.
Rationale for incorrect answers
A. The need to validate ideas before acting is more relevant to disorders involving impulsivity or distorted thinking, such as borderline or schizotypal personality disorders. Schizoid individuals are not typically impulsive or socially reactive, and they do not seek validation from others.
C. Emotional regulation is not a primary concern in schizoid personality disorder because these individuals already exhibit emotional detachment and flat affect. They do not experience intense emotional swings or dysregulation that would necessitate this outcome.
D. Recognizing limits is more applicable to individuals with narcissistic or borderline traits who may overestimate their abilities or violate boundaries. Schizoid individuals are already withdrawn and self-limiting, often under-engaging rather than overreaching.
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Correct Answer is D
Explanation
Schizoid personality disorder is a Cluster A condition marked by pervasive social detachment, restricted emotional expression, and preference for solitary activities. Individuals with this disorder neither desire nor enjoy close relationships, including family bonds. They appear emotionally cold, indifferent to praise or criticism, and often choose isolated lifestyles. These traits are ego-syntonic, meaning the person does not perceive them as problematic. The clinical focus is on supporting basic functioning and recognizing the discomfort these individuals feel with interpersonal engagement, rather than attempting to increase socialization or emotional expression.
Rationale for correct answer
D. The diagnosis of social isolation is appropriate because the client avoids others due to discomfort with human interaction, not due to fear or low self-esteem. This aligns with the core features of schizoid personality disorder, where the individual prefers solitude and shows emotional indifference.
Rationale for incorrect answers
A. Anxiety related to poor self-esteem is not consistent with schizoid personality disorder. These individuals are emotionally detached, not anxious or self-critical, and their lack of relationships stems from preference rather than insecurity.
B. Ineffective coping due to communication deficits implies a desire or need to engage, which schizoid individuals lack. Their indifference to criticism is not a sign of poor coping but a reflection of their emotional constriction.
C. Altered sensory perception and magical thinking are features of schizotypal personality disorder, not schizoid. Schizoid individuals do not exhibit perceptual distortions or eccentric beliefs.
Take Home Points
- Schizoid personality disorder involves emotional detachment, solitary lifestyle, and indifference to social feedback.
- Social isolation is a fitting nursing diagnosis due to the client’s discomfort with interpersonal interaction.
- It must be differentiated from schizotypal disorder, which includes perceptual distortions and magical thinking.
- Unlike avoidant personality disorder, schizoid individuals do not avoid others due to fear of rejection or low self-esteem.
Correct Answer is A
Explanation
Paranoid personality disorder is a Cluster A condition marked by pervasive distrust and suspicion of others. Individuals with this disorder often believe that others are exploiting, harming, or deceiving them, even without evidence. They are hypervigilant, reluctant to confide in others, and may interpret benign remarks or events as threatening. These clients often appear guarded, hostile, or aloof, and they may isolate themselves due to their suspiciousness. Unlike psychotic disorders, their beliefs do not reach delusional intensity, but their thought patterns are rigid and resistant to change. They are often difficult to engage in therapeutic relationships due to their mistrust.
Rationale for correct answer
A. The statement “Everyone wants to hurt me” reflects the suspiciousness and pervasive mistrust characteristic of paranoid personality disorder. These clients often isolate themselves and interpret others’ actions as threatening, even in neutral or supportive environments.
Rationale for incorrect answers
B. Exploiting others for cigarettes reflects manipulative and irresponsible behavior more typical of antisocial personality disorder, a Cluster B condition. Paranoid individuals are more likely to avoid interaction than to manipulate others.
C. Shyness and avoidance due to low self-esteem are features of avoidant personality disorder, a Cluster C condition. Paranoid individuals avoid others due to mistrust, not feelings of inadequacy.
D. Allowing others to make decisions reflects submissiveness, which is characteristic of dependent personality disorder. Paranoid individuals are controlling and mistrustful, not passive or deferential.
Take Home Points
- Paranoid personality disorder involves pervasive mistrust and misinterpretation of others’ intentions as hostile.
- These individuals often isolate themselves and are resistant to forming trusting relationships.
- It must be differentiated from avoidant personality disorder, which involves social withdrawal due to fear of rejection.
- Unlike Cluster B disorders, paranoid individuals are not manipulative or emotionally volatile.
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