Notes for presentation

Histrionic and narcissistic personalities come under the

mental health banner however it is a personality disorder
not a mental illness.
They are 2 very similar disorders displaying some of the
same traits
A personality disorder is who they are, it a delayed
development of their personality.
There 3 classifications of personality disorders, these
are A, B & C
Histrionic and Narcissistic are grouped in cluster B
Cluster A, which is known as an odd personality,
generally individuals in this cluster prefer to live along,
they believe in what’s not real, a fantasy world, eg star
trek in real along with aliens etc
Cluster B - Behavioural, which is anti-social, histrionic,
narcissistic and borderline personality disorders
Cluster C – is the worrier, these individuals tend to over
obsess about cleanliness and perfection
Cluster B – anti-social these individuals have a long
pattern of manipulation, exploiting and violating the
rights of other, often these individuals are criminals
They have no regard for other people or their property,
These people may appear to be witty or charming; they
may have problems with substances abuse (Alcohol, or
drugs), they may lie, steal and fight with no remorse or
guilt, regarding their actions towards other.
Histrionic - likes being the centre of attention (we will talk
more about this in a min)
Narcissistic – self-gratification
Borderline – these individuals generally have feelings of
abandonment, they can be very unpredictable, they can
display dangerous impulsive behaviour, (EG excessive
spending, dangerous driving, risky unprotected sex with
multiple partners, substance abuse, shoplifting and
binge eating)
They may also display sign of physical self-destruction
such as self-harm and/ or suicide attempts.
We were given Histrionic and narcissistic personality
disorder we will talk firstly about histrionic personality
disorder –

Histrionic – this is classed as a mental health condition

however it is actually a personality disorder
Individuals with HPD consciously or un-consciously draw
attention to themselves over dramatize situations,
They may show signs of being emotionally
disconnected, however they may appear lively,
interesting, and dramatic and they crave to be the centre
of attention, they may role play as either being a victim
as in someone is out to harm them or picking on them,
on the other hand they may be totally opposite, and play
the princess role as in everything has to be perfect,
dress, hair, shoes, make-up their whole appearance and
their lives, down to perfect husband/ children
These individuals have difficulties in maintain
employment, because they start a new job, its new, it’s
exciting, and stimulating, but soon they lose interest and
quit and find a new job and they cycle starts again, this
is also applied to the relationships, both romantically and
sexually, however they may become highly dependent
on their partners, and act more childlike where the
partner has to act more like a parent than a partner, as
long as they are being the centre of attention they are
happy, they crave the stimulation (as long as it’s about
them) and the novelty of new experiences however,
what they don’t cope with is not being the centre of
attention, feelings of being plain and boring, can often
lead to depression, self-harm suicidal thoughts until they
get the attention again.
Diagnoses of HDP
HDP is diagnosed on a psychological evaluation this is
done by a doctor or a mental health provider. They will
discuss your feelings, thoughts, relationships,
behavioural patterns, they will also discuss your
symptoms they will ask questions like; when did the
symptoms start, the duration, an similar episodes in the
past and how they are effecting the normal living
activities, including the personal appearance. They will
also ask questions regarding self-harm and suicidal
thoughts
Like all personality disorders one has to be 18 years of
age to be properly diagnosed,
2-3% of the population is affected by this disorder but is
unaware, because it’s not a problem to them. It is usually
picked up due to an underlying medical condition (e.g. in
hospital due to needing surgery,)
Treatments
The treatment for HDP is mainly psychotherapy, which is
a large number of specific different methods used to
treat mental and emotional disorders.
Your treated as an individual as well as attending group
therapy sessions.
A few of the methods used can include persuasion,
suggestions, reassurance, abreaction (reliving a painful
memory from the past) and support
These methods are used to help change maladaptive
behaviour patterns (not be able to adjust to change
/stressors in the external world), interpersonal
relationships, and inner conflicts this helps the individual
to promote personal growth and to lead a more
meaningful and fulfilling existence.
Some medications will assist in treating the symptoms
however they will not treat the disorder, most
medications help relieve the signs of anxiety and
depression that some may be experiencing.
Narcissistic
This can be a result of extreme child rearing, where
parents have pampered the child to extremes or being
obsessed with being perfect for their own self-
gratification, or on the other hand the child could have
been neglected or abused his whole life and develops a
need to be wanted and loved.
NPD is a focus on one self, and self-admiration to an
extreme level,
It can be characterised by love of oneself, feelings of
superiority, delusional, preoccupation with success, and
power, preoccupied with fantasies, beauty, or ideal love
and brilliance,
However the can show arrogance, lack empathy towards
other, they are uncaring to what other feel and need (
e.g. this is when a women has not met her husband’s
expectations, or has not meet her husband’s self-
gratification needs. The husband beats his wife, as well
as belittling her, as a way of punishing her for not
fulfilling his needs. Then the husbands tends to go out
and buy flowers and apologise for his actions, she thinks
its and apology however he has done this to make
himself look good and feel better, for what he has done)
A Narcissist is like a 2 year old, who hasn’t learnt or do
not want to accept the world doesn’t revolve around
him/her.
These behaviours most likely be a concealment of
insecurities and a fragile self-esteem,
Diagnosis
A definitive diagnose is the same as the diagnoses of a
histrionic personality disorder as the both have very
similar traits. treatments are the same as well, most
people can either have one or both of these personality
disorders with one being a little more dominant that the
other. Men are more likely to be Narcissistic where
women are more likely to have a histrionic personality
disorder.
Nursing implementations
Nurses listen, observer, non, judgemental, empathetic,
honest, support, advocate, promote independence and
educate as well as preforming the basic observations
such as bp, wound management (if needed) pulse,
temperature, respirations,
With a patient who has this disorder it is important to
note, not to do the ADLS for them but to assist them, as
a feeling of dependence can develop and inhibit the
recovery process (only assist when patients absolutely
cannot do it for themselves) A nurse should always
encourage their patients to perform and complete task
for themselves (where ever possible) e.g. showering,
dressing, and basic hygiene.
Thank you for listen and any questions.