Personality
Disorders
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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