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PERSONALITY CAN BE DEFINED as an ingrained enduring pattern of behaving and relating to self, others, and the environment; it includes percep-tions, attitudes, and emotions. These behaviors and characteristics are consistent across a broad range of situations and do not change easily. A person usually is not consciously aware of her or his personality. Many factors influence personality: some stem from biologic and genetic makeup, whereas some are acquired as a person develops and interacts with the environment and other people.
Personality disorders are diagnosed when personality traits become inflexible and maladaptive and significantly interfere with how a person functions in society or cause the person emotional distress. They usually are not diagnosed until adulthood, when personality is more completely formed. Nevertheless, maladaptive behavioral patterns often can be traced to early childhood or adolescence. Although there can be great variance among cli-ents with personality disorders, many experience significant impairment in fulfilling family, academic, employment, and other functional roles.
Diagnosis is made when the person exhibits enduring behavioral patterns that deviate from cultural expectations in two or more of the following areas:
· Ways of perceiving and interpreting self, other people, and events (cognition)
· Range, intensity, lability, and appropriateness of emotional response (affect)
· Interpersonal functioning
· Ability to control impulses or express behavior at the appropriate time and place (impulse control)
Personality disorders are longstanding because person-ality characteristics do not change easily. Thus, clients with personality disorders continue to behave in their same familiar ways even when these behaviors cause them difficulties or distress. No specific medication alters per-sonality, and therapy designed to help clients make changes is often long term with very slow progress. Some people with personality disorders believe their problems stem from others or the world in general; they do not recognize their own behavior as the source of difficulty. For these reasons, people with personality disorders are difficult to treat, which may be frustrating for the nurse and other caregivers as well as for family and friends. There are also difficulties in diagnosing and treating clients with person-ality disorders because of similarities and subtle differ-ences between categories or types. Types often overlap, and many people with personality disorders also have coexisting mental illnesses.
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