Cluster A: Schizotypal Personality Disorder Characteristics (Nursing)

00:00 Let's think about the schizotypal personality disorder.

00:04 The characteristics for schizotypal personality disorder really has some incredible deficits in their social and interpersonal skill set.

00:16 So they get high anxiety in social situations.

00:20 They're also unbelievably difficult having some conversation with people.

00:26 Their conversations go on and on, they ramble.

00:30 They don't stay on one topic.

00:34 They also may have some suspiciousness.

00:36 They may have some paranoia.

00:38 They also may have anxiety and be mistrustful.

00:44 Is this beginning to sound like there are a couple of characteristics that are shared between these different types of disorders? If you think so, you're right.

00:54 Which is why they are clustered together, as cluster A.

00:59 People with schizotypal personality disorder may be demonstrating some brief intermittent episodes of hallucinations, or delusions.

01:07 And remember the difference, the difference between hallucination and delusion.

01:11 A delusion is a thought.

01:13 A thought that the person has taken as a fact.

01:16 It's a belief that cannot be taken away, even when we give them evidence.

01:22 Whereas hallucinations, hallucinations are seeing or feeling, hearing, touching, or smelling something in an environment when it actually does not exist in that environment.

01:35 And it's important to remember that their brief.

01:38 It is not something that is pervasive and long term, that would be something else.

01:43 So we also want to think about the fact that this person, we can have this person be aware of what's going on.

01:52 But oftentimes, they don't believe what is going on, if you are trying to tell them.

02:00 They do have very restricted interpersonal relationships.

02:04 And they have marked peculiarities in their thinking in their perception.

02:09 Which, if you think about the schizotypal personality disorder, and here, they have these peculiarities, they're not very socially adept.

02:18 They kind of ramble when they're talking to people.

02:21 And suddenly one person comes in and says, "I think you are fabulous. Come in with my group.

02:27 This is what my group thinks, and we think that you are perfect, and you just fit in with us.

02:32 All you need to do is just agree with us.

02:36 You can see how a person with a schizotypal personality disorder might fall into that kind of cult, like thinking.

02:44 Also, they may have a lot of the similarities that you would see in schizophrenia, but they are not patients who have a diagnosis of schizophrenia.

02:57 They don't meet the criteria for schizophrenia.

03:02 And finally, they have these idea of reference.

03:06 They have delusions.

03:08 And so we have to be very careful as we are working with them, to keep them reality based, and not to argue with them.

03:19 It's may be very tempting.

03:21 The patients who have personality disorders are not our easiest clients to work with.

03:27 And it's always important for us to keep reminding ourselves that they are in a way trapped in their disease.

03:35 They cannot see the world differently than they do see the world.

03:40 I kind of think about, sometimes when we're talking to a person who has a personality disorder, if you can liken it to the fact that you are working with a child who is blind, and you put something on the chalkboard in front of them, and you say, "Read this to me." And the child says, "I can't see it." And so you move the child closer to the chalkboard and you say, "Read this to me." And the child says, "I'm sorry, I can't see it. I can't see it." And you move the child right up to the chalkboard and you say, "Why can't you see it?" The child is blind.

04:15 It doesn't matter how close you put the child to the chalkboard, they will not see it.

04:20 A person with a disability like schizotypal personality disorder or any of the personality disorders.

04:28 It is not a willful desire to not do what they have been asked to do.

04:32 It is an incapability, as they have this disorder to be able to get outside of this disorder.

04:41 That's why they need us.

04:43 And that's why they need us to be able to make nursing diagnoses that has nothing to do with their psychiatric diagnosis.

04:52 It has to do with them, with their struggle, with what they are doing in this moment.