Personality disordersa voiceover sp12

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Personality Disorders SPRING 2012

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Personality disordersa

Transcript of Personality disordersa voiceover sp12

  • 1. Personality Disorders SPRING 2012

2. Personality is essentially the style of how a person deals with theworld. Personality traits then are stylistic peculiarities thatall people bring to social relationships, including traits suchas shyness, seductiveness, rigidity, or suspiciousness(Groves, 2004). In people with a personality disorder(PD), these traits are exaggerated to the point that theycause dysfunction in their relationships (Groves, 2004). The DSM-IV-TR classifies personality disorders as Axis IIdiagnoses (along with mental retardation). It also definesa PD as: An enduring pattern of inner experience andbehavior that deviates markedly form the expectations ofthe individuals culture, is pervasive and inflexible, has anonset in adolescent or early adulthood, is stable over timeand leads to distress or impairment. 3. Clinical Picture Personality disorders (PDs) involve long-term andrepetitive use of maladaptive and often self-defeating behaviors. Do not recognize their symptoms as uncomfortable;thus they do not seek treatment unless a severecrisis occurs. 4. Clinical Picture All PDs have four characteristics in common: (1)inflexible and maladaptive response to stress; (2)disability in working and loving; (3) ability to evokeinterpersonal conflict; (4) capacity to frustrateothers. Tend to be perceived as aggravating anddemanding by health care workers, so the potentialfor value judgments is high, and effective care is atrisk. 5. Personality disorders DSM-IV-TR Cluster A DisordersOdd or EccentricBehavior 6. Cluster A PersonalityDisorders Paranoid Personality Disorder Schizoid Personality Disorder Schizotypal Personality Disorder 7. Cluster B PersonalityDisorders Antisocial Personality Disorder Borderline Personality Disorder Histrionic Personality Disorder Narcissistic Personality Disorder 8. Cluster C PersonalityDisorders Avoidant Personality Disorder Dependent Personality Disorder Obsessive-Compulsive Personality Disorder 9. Epidemiology andComorbidity In the general population, is 10% to 15%, dependingon severity. Personality disorders are predisposing factors formany other psychiatric disorders Etiology 10. Assessment Patient History o Suicidal or homicidal ideation o Current use of medications and other substances, food, and money o Involvement with the courts; and current or past physical, sexual, or emotional abuse. o Information about the patients current level of crisis and dysfunctional coping styles Self-Assessment 11. Diagnosis Ineffective coping Anxiety Risk for other-directed violence Risk for self-directed violenceImpaired social interaction, Social isolationFear, Disturbed thought processes Defensive copingSelf-mutilation 12. Outcomes Identification Realistic goal setting (change occurs soslowly) Small steps are necessary Minimizing self-destructive or aggressivebehavior Reducing the effect of manipulativebehaviors linking consequences to both functional anddysfunctional behaviors Initiating functional alternatives to prevent acrisis Ongoing management of anger, anxiety,shame, and happiness 13. Planning Patients with personality disorder are usuallyadmitted to the hospital for reasons other than theirpersonality disorder (borderline, antisocial). Plan for the following Behaviors: impulsive, suicidal, self-mutilating, aggressive, manipulative Possibly psychotic under stress manipulative, aggressive, and impulsive. 14. Borderline PersonalityDisorder 15. Ineffective Coping/ Self- mutilation 16. Implementation/Evaluation Management of behaviors/limit setting Milieu Management Pharmacological Interventions Case Management Psychotherapy Evaluation 17. Summary People with PD present complex behavioralchallenges for people around them People with PD have (1) inflexible and maladaptiveresponses to stress (2) disability in working and loving (3) ability to evoke strong intense personal conflict(4) capacity to get under the skin PDs often occur with axis 1 comorbidities Do not believe there is anything wrong with them Use more primitive defenses in response to stress Self assessment when working with PD patients