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Understanding Personality Disorders: Traits, Dysfunction, and Treatment

This chapter discusses the definition and common characteristics of personality disorders, including their prevalence and comorbidity. It explores the theories behind the development of these disorders and the various clusters they are classified into. The application of the nursing process in assessment, diagnosis, and treatment planning is also covered.

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Understanding Personality Disorders: Traits, Dysfunction, and Treatment

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  1. Chapter 10 Personality Disorders

  2. Personality disorders • Personality Definition -Style of how a person deals with the world -Traits are stylistic peculiarities that all people bring to social relationships (shyness, seductiveness, etc) • Personality Disorder Definition -Personality traits exaggerated to the point that they cause dysfunction in their relationships -DSM IV classified as Axis II -They do not believe there is anything wrong with them, but rather their problems occur by other people or events • Common characteristics -Inflexible and maladaptive responses to stress -Disability in working and living -Tendency to evoke intense personal conflict -Capacity to “get under the skin” of others

  3. Prevalence and comorbidity • Prevalence -14.8% met the standard diagnostic criteria • Comorbidity -Often co-occur with substance abuse, somatization, eating disorders, PTSD, depression and anxiety • Theory -Genetics: significant role in the development -Neurobiological Factors: brain imaging suggest abnormalities in prefrontal, corticostriatal and limbic networks related to decreased serotonin neurotransmission and behavioral disinhibition -Psychological Influences: childhood abuse & trauma -Cultural Considerations: Certain subgroups high risk

  4. DSM IV: Cluster A The odd and eccentric personality disorders • Often referred to as “odd” or “eccentric” • Most strongly related to schizophrenia • Common features: avoid interpersonal relationships, have unusual beliefs, indifferent to reactions of others -Paranoid Personality Disorder -Schizoid Personality Disorder -Schizotypal Personality Disorder

  5. DSM IV Cluster B: the dramatic, emotional, erratic personality • Characteristics: Dramatic, erratic or flamboyant behavior • Overlap with Axis I Comorbidity • Manipulation is common defensive mechanism -Antisocial Personality Disorder -Borderline Personality Disorder -Histrionic Personality Disorder -Narcissistic Personality Disorder

  6. DSM IV: Cluster C the anxious and fearful disorders • Common features: high levels of anxiety and outward signs of fear • Show social inhibitions in a sexual sphere • Often fearful & reluctant to show irritation and anger even when justified -Avoidant Personality Disorder -Obsessive-Compulsive Personality Disorder -Dependent Personality Disorder

  7. Application of the nursing process • Assessment • Primitive Defenses • Assessment Tools: Assessment of history & self assessment • Assessment Guidelines • Diagnosis • Outcomes Identification • Planning • Implementation • Communication Guidelines • Milieu Therapy • Psychotherapy: Psychodynamic, CBT, Dialectical Behavior Therapy • No medications for treatment of these disorders but treating the symptoms is helpful • Evaluation • Evaluating treatment effectiveness in the population- difficult

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