Personality disorders form a class of a problem of mental health where the behavior, beliefs, and attitudes of individual cause issues that are longstanding to that person’s life. In this context, Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, 5th edition (DSM-5) defines personality disorder as a pattern that is enduring of behavior and inner experience which deviates evidently from an individual’s cultural expectations. Moreover, personality disorder is inflexible and pervasive, has an onset in early adulthood in adolescence, is unchanging over time, and results in impairment or distress. This personality disorder can reveal itself in various types upon diagnosis and can be treated. Therefore, this paper focuses on discussing different personality disorders characteristics, etiology, and the role of a nurse when working with personality disorder patients.
Characteristics of Antisocial Personality Disorder
According to Dean and Korobanova (2015), the antisocial personality disorder’s pervasive pattern observed is characterized by the violation of, and disregard for, others rights. Individuals with this personality disorder score low in socialization, characterized by an incapacity for affection and egocentricity. Thus, these people act in a way that is insensitive, irresponsible, reckless, deceitful, and exploitative. This pattern of behavior frequently results in legal, occupational and interpersonal difficulties leading to distress to others and even self (Dean & Korobanova, 2015). Darton (2013) further accentuates that early onset of such difficulties contributes to disruption of development that is normal like educational attainment, finding employment, social adjustment, and finding stable housing. Additionally, people with this type of personality disorder have significant criminal records.
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Characteristics of Narcissistic Personality Disorder
As stated by Marsh (2016), individuals with narcissistic personality disorder believe that special reason exists which makes them better, more deserving, or different from other people. They have a self-esteem that is fragile and thus, mostly relies on people to recognize their needs and worth. Additionally, individuals with this personality disorder tend to feel upset when ignored by other people and tend to act in a manner that puts their needs above others’ needs, demand to be above others, and thus, categorized as selfish people. Moreover, they like taking advantage of other people.
Characteristics of Borderline Personality Disorder
Also referred to as “emotionally unstable personality disorder,” individuals with this type of personality disorder have unstable emotions, which makes them feel that they lack a strong sense who they really are (Darton, 2013). Because of the unstable emotions, these individuals suffer from mood swings, often accompanied with angry outbursts, they can quickly change from one emotion that is intense to another. May also have short-term psychotic episodes, making them see things or hear voices which others do not, and tend to get angry very quickly and struggle with anger control (Darton, 2013). Marsh (2016) adds that their unstable emotions trigger them to do things on impulse, which they later regret. Besides, people with this personality disorder tend to think of committing suicide especially when depressed, and have a history of broken or stormy relations because they have difficulties maintaining relationships.
Characteristics of Avoidant Personality Disorder
This type of personality disorder is characterized by anxiety (Marsh, 2016). As such, individuals who suffer from it may avoid social activities or work unless they are accompanied by others. This anxious behavior makes them feel inferior to other people, isolated and lonely. They constantly worry about being rejected, shamed by others or being ridiculed. Because of the feeling of rejection, these individuals avoid friendships, intimacy, and relationships as well as feel reluctant to attempt new things in case they embarrass themselves (Marsh, 2016). Rizeanu (2015) affirms that people with avoidant personality disorder expect criticism and approval and may tend to have a high sensitivity towards such.
Analyzing the interaction of biological determinants and psychosocial stress factors in etiology of personality disorder
Broadly speaking, two main factors contribute to the personality development of people, and therefore, to personality disorder development. These include biological factors such as temperament and genetic make-up of an individual; and environmental factors like life experiences, especially early experiences in childhood (Rizeanu, 2015). However, personality disorders can also be caused by the interaction of biological determinants and psychosocial stress factors of an individual. In this context, psychosocial stress factors are factors which cause stress due to social interaction or a change in social situation (Abbar, Caer, Schenk, & Castelnau, 2013). Because stress can be maladaptive, it can make people react in certain ways. For instance, avoiding crowds when one does not feel comfortable in it. These factors, when they interact with biological determinants or genetics of an individual can result in personality disorder. For example, genetics links to anxiety and fear can interact with maladaptive psychosocial stress can lead to the development of avoidant personality disorder.
The Role of Nurses When Working with Patients with Personality Disorder
According to Queensland Health (n.d), nurses who work with personality disorder patients should follow these guidelines to ensure that they cope well with these patients. These guidelines include one, nurses should always be alert and monitor the risk for suicide. Second, nurses should develop a relationship with these patients based on trust and empathy, whilst also maintaining suitable boundaries. Third, they should ensure that their care responsibility duties are well addressed regarding presenting physical and medical issues and remaining alert to the risk of suicide. Besides, nurses should develop functional and effective skills of solving problems, in a way that is empowering to the patient. Additionally, nurses should ensure good communication and collaboration with other service providers and staff members to ensure that there is consistency in approach and treatment.
Conclusion
A personality disorder is not a disease but a mental condition which can be managed and treated. It can manifest itself in several types as discussed above because etiology varies. As such, because of the long-lasting difficulty personality disorder brings to the behavior of an individual, nurses find some patients with a particular type of disorders very difficult to work with. However, it is the role of nurses, alongside their professional knowledge to manage these patients and work with them effectively to ensure treatment is effective.
References
Abbar, M., Caer, Y., Schenk, L., & Castelnau, D. (2013). Psychosocial stress factors and suicidal acts. L'Encephale , 19 , 179-185.
Darton, K. (2013). Understanding personality disorders. Mind . Retrieved November 22, 2018, from https://www.mentalhealth.org.nz/assets/A-Z/Downloads/understanding-personality-disorders-UK-Mind-2013.pdf
Dean, K., & Korobanova, D. (2015). Antisocial personality disorder: managing the healthcare relationship.
Marsh, L. (2016). Personality disorders. National Association for Mental Health . Retrieved November 22, 2018, from https://www.mind.org.uk/media/4792976/understanding-personality-disorders-2016-pdf.pdf
Queensland Health (n.d). Caring for a person who has a Personality disorder. Retrieved November 22, 2018, https://www.health.qld.gov.au/__data/assets/pdf_file/0034/444598/disorders.pdf
Rizeanu, S. (2015). Personality disorders. Romanian Journal of Experimental Applied Psychology , 6 (4).
