Health and healing week 5

half done need to do neurocognitive disorders

childhood personality

• When and infants need for food, comfort, safety, and socializations are consistently met, a sense of trust and self –worth develops.

• Toddlers develop object constancy. They retain a bond with another person despite distance, they have that knowledge that a loved person or object continue o exist even though they are out of sight

adolescence personality

• Well, developed, Peer group becomes important. Personality is well established.

• Adolescents support each other in their struggles. As they look forward to the future, they broaden their views of the world. Suddenly they are worried about global problems, and life beyond college

young adult personality

• Self-sufficient

• Involved in give or take relationships

• Make occupational choices,

• starting families

• growing in self-awareness

• Sensitive to and accepting of the feelings of others

middle adulthood personality

• Comfortable enough with themselves and their relationships to encourage independence.

• Growing and evolving relationships with friends and significant others.

• Experiencing changes in demands on their time

older adulthood personality

• must cope with loss and change

• strength of their personalities carries them through life’s rougher time

• life takes on deeper meaning

• sudden change in personality is not normal in aging

personality disorders

• Long term patterns of behavior and inner experiences that differ significantly from what is expected. They affect the way of thinking about self and others

• significant challenges in self identity and self direction

• problems with empathy and intimacy in relationships

• diagnosis and prescriptions can be difficult be of limited insight

personality disorder clusters

• eccentric

• erratic

• fearful

cluster A

• characterized by odd or strange behaviors

• eccentrics behaviors such as social isolation or detachment

• paranoid personality disorder schizoid personality, schizotypal personality disorder

Cluster B

• erratic cluster

• dramatic behavior

• 4 diff disorders

  • antisocial

  • borderline

  • histrionic

  • narcissistic

• psychopaths and sociopaths may carry criteria from some or all 4 disorders within the cluster

cluster C

• fearful

• common characteristic is anxiety

• three disorders

  • avoidant

  • dependent

  • obsessive compulsive

• each disorder is related to certain expressions of anxiety

theories related to PD

• biological

• behavioral

biological theories - PD

• One’s temperament (the biological bases that underlie moods, energy levels, and attitudes) is genetically linked. (Scientist estimate 20-60% of temperament is determined by genetics)

• Abnormalities in certain neurotransmitters, such as dopamine and serotonin, are linked to maladaptive behaviors. Dopamine is associated with reward and motivation. Serotonin is associated with happiness, focus and calmness

• The brain mechanism that connects emotions with intellect may be missing or inefficient in individuals with a personality disorder

behavioral theories - PD

• the result of

  • conditioned responses cause by previous events (PTSD)

  • unmet needs during critical developmental periods

personality disorders - general epidemiology

• estimated in 10% of the population

• frequently seen in people receiving medical and psychiatric services

• frequently coexisting with other psychiatric disorders

• childhood trauma identified as a risk factor

PD comorbidities

• commonly seen in disorders of mood, eating and substance misuse

• emotional dysregulation

• difficult managing painful emotions in healthy effective ways

• personality traits amplified during time of crisis and illness

borderline personality disorder

• affective instability

• identity disturbances

• unstable interpersonal relationships

• cognitive dysfunction

• impulsivity

• impaired problem solving

• self injurious behavior

borderline personality disorder core beliefs

• i’m bad, unworthy

• people will abandon me because of this

• push pull - i love you i hate you

treatment and therapy

• cognitive therapy

• behavioral therapy

• group therapy

• family therapy

• dialectic behavior therapy

cognitive therapy

• psychosocial interventions to improve mental health, change cognitive distortions and

• improve emotional regulation.

• Change unhealthy ways of thinking, feeling, behaving.

• Can be a effective way to treat depression and anxiety

behavioral therapy

• helps change destructive behaviors

• Range of treatments and techniques used to change a person's maladaptive responses to specific situation

group therapy

• one therapist working with several people at one time

• all dealing with similar problems

family therapy

• help improve communication and solve family conflicts

dialectic behavior therapy

• form of CBT

• gives emphasis more towards regulating emotions being mindful and learning to accept pain

• helps PTs find ways to accept themselves feel safe and mange their emotions to help regulate potentially destructive or harmful behaviors

personality disorders key points

• share characteristics of inflexibility and difficulties in interpersonal relationships that impair social or occupational functioning

• personality disorders are more likely caused by a combination of biological and psychosocial factors

• people with personality disorders often enter psych treatment BC of distress from a comorbid major mental illness

• nurses may experience intense emotional reactions to individuals with personality disorders and need to make use of clinical supervision to maintain objectivity

• despite the relatively fixed patterns of maladaptive behaviors some individuals with personality disorders are able to change their behaviors over time as a result of treatment