1. Dsm-Iv Definition Of Personality

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1. DSM-IV definition of personality

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—the aggregate of the physical & mental qualities; traits; characteristics; mode of behaviors of the individual, as these interact in characteristic fashion with the environment that sets him/her apart from other individuals.

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2. Freud’s structure of the personality

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(psychoanalytic theory)—The Id, the Ego, the Superego

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3. Function of the Id, Ego, Superego—

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The Id—primitive instincts (sex, aggression—the “pleasure principle”)—
The Ego—the integrator between the Id & Superego and the inner & outer worlds—the “Reality Principle”—
The Superego—the ethical component—represents moral & social values—

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4. Freud’s topography of the mind—

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Conscious—memories within an individual’s awareness, under the control of the ego
Preconscious—memories that may have been forgotten but that can be recalled with attention, under partial control of the superego
Unconscious—memories that cannot be brought to conscious awareness, may be repressed

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5. Freud’s stages of development and the task associated—

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Oral Stage: birth—18 months—relief from anxiety through oral gratification
Anal Stage: 18mos—3 yrs—gaining independence & control
Phallic Stage: 3—6 yrs—development of sexual identity
Latency Stage: 6—12 yrs—relationships w/same-sex peers
Genital Stage: 13—20 yrs—relationships w/opposite sex

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6. Erickson’s eight stages of man and the developmental task at each stage

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Trust vs. Mistrust—trust in mother & others
Autonomy vs. Shame & Doubt—self-control & independence
Initiative vs. Guilt—sense of purpose, ability to initiate & direct one’s own activities
Industry vs. Inferiority—achieve self-confidence
Identity vs. Role Confusion—develop a secure sense of self
Intimacy vs. Isolation—form lasting relationships
Generativity vs. Stagnation—achieve life goals & the welfare of future generations
Ego Integrity vs. Despair—derive meaning from life & a positive sense of self-worth

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7. Be able to identify which developmental theory matches with what theorist—

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Sigmund Freud—Psychoanalytic Theory
Sullivan—Interpersonal Theory (personality development through interpersonal relationships)
Erickson—Psychosocial Theory (personality development through social processes)
Piaget—Cognitive Development Theory (personality development through the ability to think)

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Compensation

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—covering up by emphasizing a trait that’s more important

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Denial

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—refusing to acknowledge the existence of the situation

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Displacement—

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transfer of feelings to a safer object

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Identification

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—acquiring certain attributes of someone that’s admired

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Introjection—

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integrating the beliefs & values of another into one’s own ego

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Isolation—

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separating the memory from the emotion

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Projection

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—attributing your unacceptable feelings to another

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Rationalization

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—making excuses or reasons for unacceptable behavior

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Reaction Formation—

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exaggerating opposite thoughts or behaviors

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Regression

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—retreating to an earlier stage of development

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Repression

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—involuntary blocking unpleasant feelings

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Sublimation

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—re-channeling drives or impulses

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Suppression

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—voluntarily blocking unpleasant feelings (this is the only conscious defense mechanism)

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Cluster A
Paranoid

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persistatly bears grudges perceives attacking on his or her character always on the look out focused on job or wife hostile usually has controlling abusive parents age of onset all through childhood

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Cluster A
Schizoid—

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A profound defect in the ability to form personal relationships or to respond to others in any meaningful, emotional way
indifferent to praise or critisisim emotionally cold detatched or flat affect

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Cluster A
Schizotypal

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Magical thinking inconsistant with cultural norms
social anxiety no close friends does not decompensate to schixoprenia but may have brief psychotic symptoms

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Cluster B
Antisocial

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—a pattern of socially irresponsible, exploitative, and guiltless behavior, evident in the tendency to fail to conform to the law, develop stale relationships, or sustain consistent employment; exploitation and manipulation of others for personal gain is common.

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Cluster B
Borderline

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—an intense fear or being abandond weak boundaries a disorder characterized by a pattern of intense and chaotic relationships, with affective instability, fluctuation and extreme attitudes regarding other people, impulsivity, direct and indirect self-destructive behavior, and a lack of a clear or certain sense of identity, life plan or values.

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Cluster B
Histrionic—

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Conscious or unconscious overly dramatic behavior for the purpose of drawing attention to oneself

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Cluster C
Avoidant—

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avoidants purposefully avoid people due to fears of humiliation & rejection

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Cluster C
Dependent

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—characterized by a long-standing need for the person to be taken care of and a fear of being abandoned or separated from important individuals in his or her life. This pervasive fear leads to "clinging behavior" and usually manifests itself by early adulthood

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Cluster C
Obsessive/Compulsive—

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Recurrent thoughts or ideas (obsessions) that an individual is unable to put out of his or her mind, and actions that an individual is unable to refrain from performing (compulsions). The obsessions and compulsions are severe enough to interfere with social and occupational functioning.

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11. Be able to identify behaviors associated with personality disorders.
Splitting—

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dividing staff, pitting one against the other OR the pt. thinks everything is all good or all bad

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Manipulation

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—to influence or manage shrewdly or deviously for personal gain

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Projection

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—attributing one’s own feelings, attitudes, or desires on to others

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Entitlement

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—a sense of ownership (everyone owes them something)

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Dependency

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—relying on others, willingness to be subordinate

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Narcissism—

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exaggerated sense of self-worth (used to mask low self-esteem)

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Passive/aggressive

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—sly, devious undermining actions that express the opposite of what is really being felt.

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Acting out—

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causing a disturbance or commotion

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12. Be able to select the appropriate nursing interventions for patients with personality disorders¬¬—

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•Assess the pts. ability to control impulses
•Assess potential for self mutilation/suicide
•Hold daily staff conferences
•Schedule contacts
•Communicate clearly, allow them to ventilate their feelings
•Provide a consistent & structured environment
•Strictly adhere to agreed upon treatment
•Set limits, be clear about your role
•Avoid becoming defensive or engaging in arguments
•Avoid splitting, be not a persecutor nor a rescuer
•Review requests made with other staff before granting them

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Be able to select the appropriate nursing interventions for patients with personality disorders

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•Be clear & consistent, explain rules as best you can & expect compliance
•Apply the rules consistently to all
•Avoid power struggles, balance confrontation & support
•Know your clients & have realistic expectations
•Maintain a positive attitude about change
•Provide feedback for positive behavior changes
•Be authentic, be trustworthy
•Be cordial & interested, but not friendly
•Require that the pt. take responsibility for his behavior
•Ask questions that assist the pt. to think through behaviors & consequences

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Be able to select the appropriate nursing interventions for patients with personality disorders

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•Don’t personalize their behavior
•Model professional behavior & good relationship skills
•Use caution with what you say about self & staff
•Encourage participation in treatment
•Be a team player
•MAINTAIN YOUR BOUNDARIES!!!

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cluster B
Narcissistic—

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The characteristic of exaggerated sense of self-worth. Narcissistic individuals lack empathy and are hypersensitive to the evaluation of others.