CONTROVERSY ASSOCIATED WITH PERSONALITY AND PARAPHILIC DISORDERS
Personality disorders represent perhaps the most challenging disorders that psychiatric-mental health nurse practitioners will have to address in their professional careers. Personality disorders can co-occur in every mental health disorder and, in some cases, can mask other disorders. Although difficult to treat, the PMHNP must be able to identify personality disorders and endeavor to work with the patient to not only recognize the disorder but also treat a disorder that patients often do not believe exist.
Although there is tremendous variety in what is considered normal sexual interests, paraphilic disorders occur when a persistent behavior or fantasy causes distress, harm, or risk of harm to oneself or others. Some paraphilic disorders include pedophilia, exhibitionism, fetishism, and voyeurism.
This week, you will explore controversies related to personality and paraphilic disorders, as well as clinical, ethical, and legal issues that should be considered when working with patients with such diagnoses.
Between 10% and 20% of the population experience personality disorders. They are difficult to treat as individuals with personality disorders are less likely to seek help than individuals with other mental health disorders. Treatment can be challenging as they do not see their symptoms as painful to themselves or others.
Paraphilic disorders are far more common in men than in women, and generally quite chronic, lasting at least two years. Treatment of these disorders usually involves both psychotherapeutic and pharmacologic treatments.
In this Assignment, you will explore personality and paraphilic disorders in greater detail. You will research potentially controversial elements of the diagnosis and/or treatment and explain ethical and legal considerations when working with these disorders.
TO PREPARE
Review this week’s Learning Resources and consider the insights they provide on assessing, diagnosing, and treating personality and paraphilic disorders.
Select a specific personality or paraphilic disorder from the DSM-5-TR to use for this Assignment.
Use the Walden Library to investigate your chosen disorder further, including controversial aspects of the disorder, maintaining the therapeutic relationship, and ethical and legal considerations.
THE ASSIGNMENT
In 2–3 pages:
Explain the controversy that surrounds your selected disorder. – Obsessive-Compulsive Personality Disorder
Explain your professional beliefs about this disorder, supporting your rationale with at least three scholarly references from the literature.
Explain strategies for maintaining the therapeutic relationship with a patient that may present with this disorder.
Finally, explain ethical and legal considerations related to this disorder that you need to bring to your practice and why they are important.
LEARNING RESOURCES
Required Readings
• National Institute for Health and Care Excellence: NICE Guidelines. (2010). Antisocial personality disorder: Prevention and managementLinks to an external site..
https://www.nice.org.uk/guidance/cg77
• Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.
o Chapter 19 “Personality Disorders”
• Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
o Chapter 67, “Disorders of Personality”
o Chapter 68, “Developmental Risk for Psychopathy”
o Chapter 69, “Gender Dysphoria and Paraphilic Sexual Disorders” (pp. 988–993 only)
• Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
o Chapter 14, “Personality Disorders”
Required Media:
• Buchanan, N. T. (2020, April 13). Lecture 14 part 3: Paraphilic disordersLinks to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=ykkMo9t0bxs
•
• MDedge. (2020, January 22). Personality disorders with Dr. Frank YeomansLinks to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=ESQIDslCX_s
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