Personality Disorders Powerpoint
Personality Disorders Study Notes
A Singular Identity
Every personality is unique; likened to a crimson tulip in a field of white.
Concept of Personality
Definition: Personality is an evolving pattern of thinking, perceiving, and experiencing that encompasses one's enduring attitudes and beliefs.
Acquired in early childhood and develops into lifelong behavioral patterns.
Personality traits are stable over time and influence an individual's appearance, behavior, and reactions to life's events.
Interesting Fact: Personality at age 3 can predict personality at age 26.
Personality Disorders
Definition: Unhealthy patterns of behavior leading to significant issues in:
Relationships
Employment
Education
Prevalence: Occurs in approximately 13% of the population.
Characteristics of Personality Disorders
An inflexible, maladaptive pattern of perceiving and relating to the world.
The pattern is enduring over a broad spectrum of social, occupational, and personal areas.
Typically traced back to adolescence or early adulthood affecting cognition, emotion, interpersonal functioning, or impulse control.
Common self-destructive behaviors include:
Self-mutilation
Eating disorders
Substance abuse
Shoplifting
Categories of Personality Disorders
Three General Categories:
Erratic Disorders: Disorders related to emotional control, e.g., antisocial, borderline, histrionic, narcissistic.
Eccentric Disorders: Traits that render individuals socially odd or suspicious, e.g., schizoid, schizotypal, paranoid disorders.
Anxious Disorders: Patterns driven by anxiety, e.g., avoidant, dependent, obsessive-compulsive disorders.
Spectrum of Personality Disorders
Current framework includes 10 personality disorders; a revision is anticipated.
Cluster A: Paranoid, Schizoid, Schizotypal
Paranoid Personality Disorder:
General Characteristics: Pervasive suspicion, inability to trust others, and unconcern about others' perceptions.
Key Features:
Unjustified doubts about the loyalty of friends.
Reluctance to confide due to fears of misuse of information.
Persistent grudges; perceive character attacks.
Recurrent unjustified suspicions regarding fidelity in relationships.
Etiology:
Often stems from abusive or controlling parenting, leading to fear and mistrust.
Schizoid Personality Disorder:
Features: Pervasive detachment from social relationships, emotional coldness, lack of interest in close relationships or sexual experiences.
Signs:
Chooses solitary activities; lacks close friends; indifferent to praise or criticism.
Schizotypal Personality Disorder:
Features: Acute discomfort with social relationships, cognitive or perceptual distortions, odd behavior.
Signs to Identify:
Ideas of reference; odd beliefs; unusual perceptual experiences; excessive social anxiety.
Nursing Assessment and Interventions for Cluster A
Assessment:
Gauge degree of mistrust and anxiety; check for delusions and insecurity; prioritizing safety.
Interventions:
Build trust through honesty; avoid confrontation; engage clients in treatment plans.
Cluster B: Dramatic, Emotional Disorders
Common characteristics include difficulty maintaining close relationships and potential labile moods.
Key Types
Antisocial Personality Disorder:
Disregard for others' rights; manipulative and deceitful behavior; impulsive; starts before age 15.
Borderline Personality Disorder:
Instability in relationships and self-image; fear of abandonment; includes self-harming behaviors.
Core Features: Impulsivity in life-threatening areas; extreme emotional reactions.
Histrionic Personality Disorder:
Excessive attention-seeking, rapid emotional shifts. (E.g., inappropriate sexual behavior)
Narcissistic Personality Disorder:
Grandiose sense of self along with a lack of empathy and a profound need for admiration.
Cluster C: Anxious, Fearful Disorders
Characteristics include significant anxiety and fear affecting personal achievements.
Key Types
Avoidant Personality Disorder:
Indicators: Social inhibition; feeling inferior; reluctance to engage in personal risks.
Example: Football star Ricky Williams experienced severe anxiety related to being scrutinized despite his fame.
Dependent Personality Disorder:
Traits: Over-reliant on others; difficulties in decision-making; discomfort when alone.
Obsessive-Compulsive Personality Disorder:
Preoccupation with order, perfectionism; rigid adherence to rules and organization; reluctance to delegate tasks.
Difference Between OCPD and OCD
OCPD is characterized by a rigid mode of functioning and lack of insight, whereas OCD is an anxiety disorder resulting in discomfort.
Treatment of Personality Disorders
Primary treatments include psychotherapy and cognitive-behavioral therapy.
Other modalities: Occupational therapy, art therapy, family therapy, and medication therapy.
Summary and Key Terms
All personality disorders share:
Inflexibility in stressful situations.
Difficulty in social interactions.
Provocation of interpersonal conflict.
Merging of personal boundaries with others.
Key Terms Recap:
Characteristics and definitions of antisocial, avoidant, borderline, dependent, histrionic, narcissistic, obsessive-compulsive, paranoid, and passive-aggressive personality disorders.
Personality Disorders
For additional ancillary materials related to this chapter. please visit thePoint.
LEARNING OBJECTIVES
After learning the content in this chapter, the student will be able to:
Describe the difference between personality traits and personality disorders.
Identify and group 10 personality disorders.
Describe the main behavioral characteristics for each group.
Describe characteristic behaviors of each personality disorder.
Identify coexisting mental health conditions that may be seen in the individual with a personality disorder.
Describe the treatment options available for the individual with a personality disorder.
Describe the nursing process for the client with a personality disorder.
KEY TERMS
entitlement
ideas of reference
magical thinking
narcissism
passive-aggressive
personality disorders
personality traits
self-mutilation
splitting
Introduction
Each individual is born with a set of traits, temperament, and patterns of behavior that helps make up their distinctive personality. These inborn qualities are further shaped by the individual’s family and peers, interactions with others, and life experiences. Distinguishing aspects of personality are demonstrated in the individual’s thoughts, feelings, and attitudes regarding themselves and the world around them. Behavior characteristics are demonstrated in the person’s thinking processes, emotional reactivity, interpersonal relationships, and self-control.
Personality traits are persistent ways in which an individual views and relates to other people and to society as a whole. These traits include the way the individual controls their behavior including how they emotionally respond to situations, how they think about themselves or others, and how they relate to other people. People with healthy personalities are able to adapt to life stressors and form interpersonal relationships. Some personality traits are seen as negative. These negative traits tend to be more extreme for the individual with a personality disorder, creating difficulty in their personal and social relationships as well as functioning in regular day-to-day activities.
Personality disorders are deeply ingrained, persistent, inflexible, and maladaptive patterns of behavior that are in conflict with a cultural norm. Unless they become frustrated with their life pattern or relationships, most individuals with a personality disorder are oblivious to their problem. The atypical behavior is usually frustrating or aggravating to those around them, which leads to difficulties in relationships. Most individuals with a personality disorder have demonstrated their uncommon personality characteristics and symptoms by adolescence or early adult life.
Unlike in other mental disorders that have varying intensity of symptoms, the symptoms seen in personality disorders tend to be consistent and constant. The individual rarely seeks treatment because of their inability to identify the problem or denial that a problem actually exists. When treatment is obtained, adherence to the treatment plan is often inconsistent and therefore less successful.
Individuals with personality disorders tend to share some common characteristics that define them as having inflexible and maladaptive behaviors. Because behavior is the result of the way an individual perceives and thinks about the world around them, these characteristics tend to permeate their personal and social lives. The individual tends to view their life in terms of all good or all bad with little understanding that something or someone can have both qualities. In some of the personality disorders, there are characteristics of behaving in an arrogant and self-indulgent manner, with the inability to delay satisfaction of their needs to allow for the wishes or needs of another person. Many of the personality disorders have roots in the way the individual was raised.
Some individuals display passive-aggressive behaviors, in which they indirectly and subtly act on hostile feelings by displaying a passive and pleasant affect, but act based on underlying pessimism and bitterness. These behaviors may take the form of self-destructive acts meant to manipulate another person into conforming to the individual’s wishes. The individual may project faults onto others to avoid dealing with their own feelings of inadequacy or incompetence. For example, an individual displaying passive-aggressive behavior might avoid deadlines, such as through procrastination or other delay strategies, in order to sabotage the efforts of others. If the passive manipulation fails, the individual may respond with angry emotional outbursts.
There are 10 generally recognized personality disorders, each having a particular set of behaviors and symptoms. They are often grouped by their main behavioral characteristics (Fig. 12.1). In the first group, the behaviors come across as aloof or eccentric, while those in the second group are seen as dramatic, emotional, or erratic. The behaviors seen in the third group are described as anxious or fearful. Psychiatrists will often call these “Cluster A,” “Cluster B,” and “Cluster C” disorders.
Test Yourself
Name and group 10 personality disorders.
What are the main behavioral characteristics for each group?
Personality Disorders Characterized by Aloof or Eccentric Behaviors
This group includes paranoid, schizoid, and schizotypal personality disorders. Individuals with these disorders tend to be described as aloof or distant, or exhibit eccentric behaviors.
Paranoid Personality Disorder
Paranoid personality disorder is characterized by an individual interpreting the actions of others as intentionally trying to harm, mistreat, or demean them. There is an ongoing mistrust or suspicion of others and their motives for interacting with the individual. This distrust occurs even though there is no obvious reason for their suspicions.
Figure 12.1 Personality disorders grouped according to the particular behavioral characteristics exhibited.
Signs and Symptoms
Individuals with paranoid personality disorders are often viewed as being cold and aloof. Their suspicious nature leads them to be watchful, resentful, and guarded in their interactions with others. They are unable to believe that others can be good to them. A compliment might be perceived as a ploy to secure something in return. A well-intended act of kindness may be viewed as a scheme or an attempt to trick them. There is a reluctance to share personal information with others for fear that it will be used against them later. Angry or hostile outbursts are perceived as necessary to defend against what they interpret as the disloyalty and deceit of others. They are unable to accept constructive criticism, but at the same time are critical of others. Grudges are maintained with no hint of forgiveness for a perceived insult or injustice.
Individuals with paranoid personality disorder usually have a long history of inability to achieve closeness in interpersonal relationships. Many jealous accusations of infidelity and indiscretion are made toward partners or spouses. They attempt to maintain control of the relationship by confronting the partner with demanding questions concerning places they have gone or their intent for going (e.g., vehicle mileage may be monitored to support the perceived disloyalty). This suspicion is further seen in their projection of blame for their own faults onto others. Their need to counterattack for a perceived injustice often leads to lawsuits against those blamed for the action. Their rigid, inflexible nature prevents any type of mutual agreement to resolve a problem. Although they tend to work better independently, those with paranoid personality disorder are often quite efficient and dedicated to their employment situation. Their interests are often in areas such as electronics, physics, and inventive ideas. Box 12.1 lists common symptoms seen in an individual with a paranoid personality disorder.
BOX 12.1
Symptoms of Paranoid Personality Disorder
Cold and aloof manner
Rigid and inflexible
Doubts about loyalty and honesty of others
Watchful and guarded
Resentful, accusing, and argumentative
Inability to tolerate criticism
Mistrustful and unable to confide in others
Feelings that others are out to deceive them
Angry or hostile outbursts
Maintenance of grudges against others
Controlling relationships
Extreme jealousy
Projection of faults to others
Inability to perceive self as a problem
Schizoid Personality Disorder
Individuals with schizoid personality disorder are withdrawn, detached from others or what is going