AccordingtotheNationalInstituteof

MentalHealth(2014),itisestimatedthat
approximately9.1%ofthegeneralUS
populationhasapersonalitydisorder.
Approximately1%ofpeopleover18
yearsoldhaveantisocialpersonality
disorder,5.2%haveavoidantpersonality
disorder,and1.6%haveborderline
personalitydisorder.
Costtosociety
According to the National Institute of Mental
Health (2008), the United States spends
approximately $193 billion a year on major
mental health disorders.

NationalInitiatives
According to healthypeople.gov (2013),
the federal government is beginning to
work on a health reform legislation that
will give attention to the providing of
services to people with mental illness and
substance use disorders, including access
to and coverage for treatment and
prevention services.
Family Tele Connections: an option
specifically for families living far from
family connections meeting locations;
using email and online discussion
Effective treatment of BPD is nonjudgmental approaches and understanding
individual; adequate supervision is also
essential
Treatment of psychiatric symptoms
with medication when necessary.

CommunityResources
-Department of Health
E-mail: admin@amhd.org
Internet: http://www.amhd.org
-State Protection and Advocacy Agency
E-mail: info@hawaiidisabilityrights.org
-Hawaii Families As Allies
E-mail: hfaa@hfaa.net

Implicationsofcare
People with personality disorders are often
high users of health resources and demands
for care can be great. Assessment for acute
risks is important to managing their care,
knowing that impulsive & suicidal behaviors
are a cry of distress. Health care
professionals must maintain therapeutic
relationships with these patients and avoid
personalizing their reactions.
Emphasis on patient education, compliance,
and support systems are the keys in success
of treating someone with a personality

References
-Amminger, G., Chanen, A. M., Ohmann, S., Klier, C. M.,
Mossaheb, N., Bechdolf, A., & ... Schfer, M. R. (2013). Omega-3
Fatty Acid Supplementation in Adolescents With Borderline
Personality Disorder and Ultra-High Risk Criteria for Psychosis: A
Post Hoc Subgroup Analysis of a Double-Blind, Randomized
Controlled Trial. Canadian Journal Of Psychiatry, 58(7), 402-408.
-Fortinash, K., & Holiday Worret, P. (2012). Psychiatric mental
health nursing, (5th ed.). St Louis: Elsevier Mosby.
-National Institute of Mental Health. (2014) Borderline Personality
Disorder. Retrieved from
http://www.nimh.nih.gov/health/publications/borderlinepersonality-disorder/index.shtml#p ub7
-National Institute of Mental Health. (2014). The numbers count:
mental disorders in America. Retrieved from
http://www.nimh.nih.gov/health/publications/the-numbers-countmental-disorders-in-america/index.shtml

Personality
Disorder
ChristinaChow
SunYoungHelmer
AmberSuzuki

Etiology
Personality disorders are thought to be
influenced by genetics and
environmental factors. Childhood trauma
and parental neglect may contribute
greatly to the development of a
personality disorder. Onset usually
DSMIV
criteria
occurs in adolescence
or early adulthood
(Fortinash & Worret, 2012).
AxisII:A pattern of behavior that deviates
from expectations of ones culture. The
pattern is manifested in two or more of the
following areas: cognition, affectivity,
interpersonal functioning & impulse control.
The pattern can be inflexible, lead to distress
or impairment, stable and chronic, and may
not be a manifestation of another mental
disorder or due to physiological effects of a
substance or general medical condition
(Fortinash &SignsandSymptoms
Worret, 2012).

Signs and symptoms of personality

disorders can range from mild to severe
depending on the type of disorder.
Panic, depression, rage, frantic actions,
impulsiveness, dysfunctional
relationships, distorted self-mage,
suicidal thoughts or behaviors, mood
swings, feelings of emptiness, difficulty
with anger control, stress related
paranoidal thoughts, and selfdissociation.
A person must show a continuing pattern
of at least five of these symptoms to be
diagnosed with a personality disorder

Treatment
Psychotherapyisthefirstlineoftreatmentfor
personalitydisordersandmaybedonein
groups,withfamilymembers,orindividually.
Medicationhasnotbeenapprovedspecifically
totreatpersonalitydisorders,butmaybeused
inconjunctionwithpsychotherapytotreatment
othercoincidingconditionslikedepression,
anxiety,oraggression.

Psychopharmacology
Medication should never be used as primary
treatment for a patient with a personality
disorder and according to the U.S. FDA there
is no specific medication approved for that
purpose. Medications such as SSRIs,
anxiolytics, mood stabilizers, and
antipsychotics can help manage symptoms
and treat other conditions associated with
personality disorders such as depression,
anxiety, and drastic changes in mood.
EvidenceBasedArticle

TypesofPsychotherapy:
CognitiveBehavioralTherapy(CBT)
CBTfocusesthepatientongivingthepatient
toolstousethathelpthemtorecognizetheir
dysfunctionalbehaviorandchangetheir
thoughtprocesswhenbeingfacedwitha
stressor
DialeticalBehavioralTherapy(DBT)
DBTinvolvesusingdialogue&possiblyrole
playtohelpapatientrecognizeareasof
relationshipsandsituationsthatcausethem
increasedstressandleadtonegativefeelings
andbehavior.
SchemafocusedTherapy
Schemafocusedtherapyisusedinconjunction
withCBTandfocusesonthewaythepatient
viewsthemselves,theirselfimage.Reframing
thewayapatientviewthemselvesmayhelpto
correctanynegativeassociationthatmaystem
fromchildhoodexperiences.

Omega-3 acids treatment group with

personality disorder significantly improved
functioning and reduced psychiatric
symptoms compared with placebo
(Amminger et al., 2013)

Whatsbeingdoneandisitworking?
Personality disorders are difficult to diagnose
and many times this condition is
misdiagnosed or under diagnosed. A
thorough interview and discussion about
symptoms by an experienced mental health
professional can detect a personality
disorder, but a thorough medical exam must
also be done to rule out any other causes of
symptoms.

LackofProductivity
Science is still working to improve diagnosis
and treatment of personality disorders.
There is no single test that can definitively
diagnose someone. Neuro imaging studies
are showing differences in brain structure
and activity in people thought to have this
disorder that may aid in improving treatment