Managing Patients with Personality Disorders

In various healthcare contexts, the provision of nursing care can be challenging due to patients’ peculiar characteristics, including mental health concerns. As a subgroup of mental illnesses, personality disorders (PDs) incorporate long-term behavioral and thought patterns that reduce an individual’s flexibility and adaptability to diverse circumstances, thus severely impairing his or her social functioning. This paper will describe various PDs and discuss how nursing professionals can apply their knowledge to manage patients with these diagnoses successfully.

There are three clusters or subtypes of PDs, and comprehending the classification is essential since each group of conditions has unique implications for nurses’ approaches to patient communication and education. Cluster A disorders incorporate conditions characterized by eccentric behaviors and odd or distorted thinking patterns, for instance, schizotypal, schizoid, and paranoid PDs (Haeyen et al., 2018; Preti et al., 2020). As for cluster B conditions, including narcissistic, borderline, histrionic, and antisocial PDs, their common features are overdramatic and excessively emotional approaches to thinking and reacting to external stimuli (Haeyen et al., 2018). Finally, cluster C PDs are permeated by individuals’ anxiety and fear that can emerge in the absence of objective threats or high-risk situations (Haeyen et al., 2018). Common conditions in this subgroup are obsessive-compulsive, avoidant, and dependent PDs. Each set of features might require communication-related accommodations, including changing the way of formulating statements, being emotionally available, and practicing patience.

Understanding this categorization, nurses can couple this knowledge with their professional ethics competencies and care settings’ characteristics to manage such populations effectively. For nurses caring for patients previously diagnosed with PDs, knowing and avoiding some potential triggers associated with each PD cluster and each condition helps minimize misunderstanding and the risks of unexpected aggression. Since cluster A conditions are fraught with distrust, suspicion, emotional withdrawal, poor understanding of social clues, and odd behaviors, nurses might need to choose their means of expression carefully to communicate messages (Feinstein, 2022). Specifically, the language should be clear and unambiguous, without the signs of condemnation, and nurses might have to verbalize intentions and motives behind their actions to keep patients calm and relaxed (Feinstein, 2022). Regarding cluster B conditions, talking patiently and being supportive but letting patients know when their behaviors violate the nurse’s boundaries is helpful (Feinstein, 2022). For cluster C conditions, listening to the patient carefully and devoting enough time to addressing follow-up questions and clarifications are therapeutic (Feinstein, 2022). Adapting these general strategies to the setting’s requirements and peculiarities could be instrumental in serving populations with PDs.

Aside from mastering new communication skills, it is crucial for nurses to deepen their knowledge of PDs to avoid taking patients’ behaviors as a personal offense. Patients vary in terms of awareness of their behaviors’ maladaptive nature and can be greatly dissimilar when it comes to self-management and self-control strategies, so unpleasant incidents are not impossible (Feinstein, 2022). Learning to view patients’ PDs as barriers they cannot overcome rather than personality features is, therefore, crucial in dealing with such populations.

In summary, PDs disrupt communication and are greatly diverse in their behavioral manifestations, and learning about such disorders’ types is essential to adapt nursing services to patients’ unique challenges and expectations. Using the knowledge of three separate subgroups of PDs, care providers can develop effective communication strategies to foster mutual understanding despite patients’ perceptual and cognitive distortions. An understanding of PDs’ varying susceptibility to external control should also support nurses in serving such populations without taking their behaviors personally.


Feinstein, R. E. (2022). Managing patients with personality disorders in medical settings. In R.E. Feinstein (Ed.), Personality disorders (pp. 179-212). Oxford University Press.

Haeyen, S., van Hooren, S., van der Veld, W., & Hutschemaekers, G. (2018). Efficacy of art therapy in individuals with personality disorders cluster B/C: A randomized controlled trial. Journal of Personality Disorders, 32(4), 527-542. Web.

Preti, E., Di Pierro, R., Fanti, E., Madeddu, F., & Calati, R. (2020). Personality disorders in time of pandemic. Current Psychiatry Reports, 22(12), 1-9. Web.

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NursingBird. 2023. "Managing Patients with Personality Disorders." January 8, 2023.

1. NursingBird. "Managing Patients with Personality Disorders." January 8, 2023.


NursingBird. "Managing Patients with Personality Disorders." January 8, 2023.