ATI Chapter 18
Personality disorders
Personality
- Ingrained, enduring pattern of behaving and relating to self, others, and
environment
- Perceptions, attitudes, emotions
- Usually not consciously aware of own personality
- Personality disorders
o Impairment of personality functioning
o Personality traits that are maladaptive
o Identity problems
o Dysfunctional relationships
Maladaptive or Dysfunctional Personality Traits
- Negative behaviors toward others
- Anger and/or hostility
- Irritable, labile moods
- Lack of guilt or remorse, emotionally cold and uncaring
- Impulsivity, poor judgment
- Irresponsibility, lack of accountability for own actions
- Risk-taking, thrill-seeking behaviors
- Mistrust
- Exhibitionism
- Entitlement
- Dependency, insecurity
- Eccentric perceptions
Personality Disorders #1
- Cluster A—odd or eccentric behaviors
o Paranoid personality disorder
o Schizoid personality disorder
o Schizotypal personality disorder: Most like schizophrenia and have magical
thinking
Personality Disorders #2
- Cluster B—erratic or dramatic behaviors
o Will give us the most trouble socially and occupationally
o Most issues in a psychiatric setting
o Childhood abuse and neglect is at a higher risk!
o Antisocial personality disorder: Seen on co-dependency units
Admitted due to choosing a psychiatric unit over attending jail
o Borderline personality disorder
o Histrionic personality disorder
o Narcissistic personality disorder
Personality Disorders #3
- Cluster C—anxious or fearful behaviors
o Avoidant personality disorder: Those who fear negative evaluation the most
Will not try for job promotion because they fear screwing up or people not liking
them
, o Dependent personality disorder: Those who need an excessive amount of input
by others to make decisions
Cant pick out own clothing without input from others
Encountered as care takers of other people
o Obsessive personality disorder: Those who are obsessed with trats of
perfectionism
Tend to be hoarders
Cautious of social rank
Very in tube to rules and regulation
Other Clusters of Behavior Related to Maladaptive Personality Traits
- Depressive behavior: More of a personality trait
o Down and negative about everything
o Always have been that way
o Often behavior that is role modeled
- Passive-aggressive behavior: Those that smile to your face but then go slash your
tires in the parking lot
o Can be problematic if this is your boos or such
o Combination of environment, genetics, or heredity
Onset and Clinical Course
- Relatively common (10%–20% of general population)
- Incidence higher in lower socioeconomic groups
- 40% to 45% of people with primary diagnosis of major mental illness also
have coexisting personality disorder that significantly complicates treatment.
o May be admitted for a suicide attempt
- Often described as being “treatment resistant”
- Lack of perception by person that behavior is problem
- Sometimes, the behavior is a point of pride.
o Narcissists are happy that they have been a jerk
o Think about pollical speeches when someone asks about problematic events, they
deflect it on someone else
Etiology
- Personality develops through the interaction of hereditary dispositions and
environmental influences.
- Biologic theories
o Temperament (traits: harm avoidance, novelty seeking, reward
dependence, persistence)
- Psychodynamic theories
o Character
Self-directedness (responsible, goal-oriented)
Cooperativeness (integral part of society)
Self-transcendence (integral part of the universe)
Cultural Considerations
- Judgments of personality must be viewed with consideration of ethnic,
cultural, and social background.
o Guarded or defensive behavior due to language barriers
o Religious or spiritual beliefs
o Different views of avoidant and dependent behavior
o Cultural value of work and productivity
Personality disorders
Personality
- Ingrained, enduring pattern of behaving and relating to self, others, and
environment
- Perceptions, attitudes, emotions
- Usually not consciously aware of own personality
- Personality disorders
o Impairment of personality functioning
o Personality traits that are maladaptive
o Identity problems
o Dysfunctional relationships
Maladaptive or Dysfunctional Personality Traits
- Negative behaviors toward others
- Anger and/or hostility
- Irritable, labile moods
- Lack of guilt or remorse, emotionally cold and uncaring
- Impulsivity, poor judgment
- Irresponsibility, lack of accountability for own actions
- Risk-taking, thrill-seeking behaviors
- Mistrust
- Exhibitionism
- Entitlement
- Dependency, insecurity
- Eccentric perceptions
Personality Disorders #1
- Cluster A—odd or eccentric behaviors
o Paranoid personality disorder
o Schizoid personality disorder
o Schizotypal personality disorder: Most like schizophrenia and have magical
thinking
Personality Disorders #2
- Cluster B—erratic or dramatic behaviors
o Will give us the most trouble socially and occupationally
o Most issues in a psychiatric setting
o Childhood abuse and neglect is at a higher risk!
o Antisocial personality disorder: Seen on co-dependency units
Admitted due to choosing a psychiatric unit over attending jail
o Borderline personality disorder
o Histrionic personality disorder
o Narcissistic personality disorder
Personality Disorders #3
- Cluster C—anxious or fearful behaviors
o Avoidant personality disorder: Those who fear negative evaluation the most
Will not try for job promotion because they fear screwing up or people not liking
them
, o Dependent personality disorder: Those who need an excessive amount of input
by others to make decisions
Cant pick out own clothing without input from others
Encountered as care takers of other people
o Obsessive personality disorder: Those who are obsessed with trats of
perfectionism
Tend to be hoarders
Cautious of social rank
Very in tube to rules and regulation
Other Clusters of Behavior Related to Maladaptive Personality Traits
- Depressive behavior: More of a personality trait
o Down and negative about everything
o Always have been that way
o Often behavior that is role modeled
- Passive-aggressive behavior: Those that smile to your face but then go slash your
tires in the parking lot
o Can be problematic if this is your boos or such
o Combination of environment, genetics, or heredity
Onset and Clinical Course
- Relatively common (10%–20% of general population)
- Incidence higher in lower socioeconomic groups
- 40% to 45% of people with primary diagnosis of major mental illness also
have coexisting personality disorder that significantly complicates treatment.
o May be admitted for a suicide attempt
- Often described as being “treatment resistant”
- Lack of perception by person that behavior is problem
- Sometimes, the behavior is a point of pride.
o Narcissists are happy that they have been a jerk
o Think about pollical speeches when someone asks about problematic events, they
deflect it on someone else
Etiology
- Personality develops through the interaction of hereditary dispositions and
environmental influences.
- Biologic theories
o Temperament (traits: harm avoidance, novelty seeking, reward
dependence, persistence)
- Psychodynamic theories
o Character
Self-directedness (responsible, goal-oriented)
Cooperativeness (integral part of society)
Self-transcendence (integral part of the universe)
Cultural Considerations
- Judgments of personality must be viewed with consideration of ethnic,
cultural, and social background.
o Guarded or defensive behavior due to language barriers
o Religious or spiritual beliefs
o Different views of avoidant and dependent behavior
o Cultural value of work and productivity
