1. Personality Disorders Chapter 10

2. 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 Personality disorders

3. 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 Prevalence and comorbidity

4. 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 DSM IV: Cluster A The odd and eccentric personality disorders

5. 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 DSM IV Cluster B: the dramatic, emotional, erratic personality

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. 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 Application of the nursing process