NRNP 6675 Week 7 Assignment: Controversy Associated with Personality and Paraphilic Disorders
Controversy Associated with Personality and Paraphilic Disorders
Avoidant Personality Disorder (AvPD) is a common source of controversy and difficulty in mental health. This essay intends to delve into potentially controversial aspects of AvPD, explain professional beliefs about the disorder, investigate methods for maintaining a therapeutic relationship with patients affected by AvPD, and highlight the ethical and legal considerations paramount in nursing.
Elements of Avoidant Personality Disorder that Could be Controversial
Several debates exist about the nature and treatment of Avoidant Personality Disorder (AvPD). The diagnostic overlap between AvPD and Social Anxiety Disorder (SAD) is a major topic of contention. The criteria for both diseases sometimes overlap, according to their critics, making it difficult to tell them apart. Another point of contention is the widespread ignorance and prejudice that surrounds AvPD. Many people fail to understand the severe suffering and functional damage that individuals with AvPD face because they incorrectly label them shy or introverted (Frandsen et al., 2019). Because of this misunderstanding, impacted people often go unnoticed, unsupported, and untreated. The treatment of AvPD is fraught with its difficulties. Fear of rejection and criticism can fuel avoidance and reluctance to participate in therapy, damaging the therapeutic relationship. Mental health experts should tailor therapy to the specific goals of those with AvPD. However, there is still much to learn and discuss regarding the efficacy of various treatment techniques and their long-term effects.
Professional Beliefs
As a future nurse, I base my opinions on the best available evidence regarding AvPD. Recent studies have uncovered a complicated interaction between genetics, environment, and neurobiology in the development of AvPD. People with AvPD frequently have a history of interpersonal problems that have hampered their social functioning and lowered their quality of life. Healthcare workers seeing AvPD via a biopsychosocial framework can better provide individualized care considering each patient’s unique circumstances.
Kvarstein et al. (2021) fundamental work highlights the importance of attachment theory and early life experiences in the emergence of AvPD. By gaining insight into the significance of early relational patterns, therapists can better design therapies to encourage healthy attachment and boost self-acceptance. Simonsen et al. (2021) found that cognitive-behavioral therapies were more effective than medication alone in treating AvPD. Improving social skills can be a direct result of using cognitive restructuring approaches to combat limiting beliefs and encourage the growth of healthier coping mechanisms. Group therapy may be helpful for those with AvPD, as pointed out by Leszcz (2020). Patients with social anxiety or low self-esteem can benefit from a group setting where they can work on their interpersonal skills, get constructive criticism, and make new friends.
Strategies for Maintaining a Therapeutic Relationship
Establishing and sustaining a therapeutic rapport with patients presenting with AvPD takes a delicate and tailored approach. Methods that can help speed up this procedure include:
Building Trust: When interacting with people with AvPD, it is crucial to be patient and empathetic and offer constant, nonjudgmental support. The key to creating a secure therapy atmosphere is understanding their fear of rejection and not pressing them to share personal details (Dobson, 2022).
Respectful Boundaries: Providing a structured treatment plan and respecting the patient’s demand for privacy will help calm them down. Improved cooperation and reduced emotions of vulnerability might result from open dialogue about the therapeutic process, its goals, and any obstacles that may arise (Dobson, 2022).
Gradual Exposure: Therapy can include methods of gradual exposure to events that trigger anxiety, such as systematic desensitization. Individuals with AvPD can learn to control their fear and cultivate healthy coping mechanisms by gradually facing their concerns.
Ethical and Legal Issues to Consider
Addressing ethical and legal problems while working with patients diagnosed with AvPD is essential. The following considerations are incredibly weighty:
Confidentiality: It is crucial to protect the privacy of patients. It is the nurse’s responsibility to safeguard patient information and disclose it only to those in the healthcare team who have a legitimate need to know (Varkey, 2020). Establishing trust and upholding professional boundaries is essential in obtaining informed permission and clarifying the bounds of secrecy.
Autonomy and Informed Consent: Individuals with AvPD may have difficulty making decisions and being aggressive. By giving accurate and understandable information, nurses may help patients actively participate in their care (Varkey, 2020). Therapeutic partnerships flourish when doctors and patients work together to make treatment decisions.
Duty to Warn: Nurses have a legal and ethical responsibility to take reasonable precautions to protect patients and others when patients indicate they intend to hurt themselves or others. To effectively manage these circumstances, healthcare personnel must work together and follow all the laws and regulations.
APD raises many questions and sparks heated discussions among professionals in the mental health field. Nurses can better care for patients with AvPD if they are aware of and prepared to address the ethical and legal issues that may arise as a result of their work, as well as the potential for controversy surrounding AvPD, the use of evidence-based practices, and strategies to preserve therapeutic relationships. Healthcare providers can aid AvPD patients’ health and recovery by taking an interdisciplinary approach that considers the disease from multiple angles.
References
Dobson, K. S. (2022). The therapeutic relationship in cognitive-behavioral therapy. Cognitive and Behavioral Practice, 29(3). https://doi.org/10.1016/j.cbpra.2022.02.006
Frandsen, F. W., Simonsen, S., Poulsen, S., Sørensen, P., & Lau, M. E. (2019). Social anxiety disorder and avoidant personality disorder from an interpersonal perspective. Psychology and Psychotherapy: Theory, Research and Practice, 93(1). https://doi.org/10.1111/papt.12214
Kvarstein, E. H., Antonsen, B. T., Klungsøyr, O., Pedersen, G., & Wilberg, T. (2021). Avoidant personality disorder and social functioning: A longitudinal, observational study investigating predictors of change in a clinical sample. Personality Disorders: Theory, Research, and Treatment. https://doi.org/10.1037/per0000471
Leszcz, M. (2020). Group therapy for patients with medical illness. American Journal of Psychotherapy, 73(4), 131–136. https://doi.org/10.1176/appi.psychotherapy.20200005
Simonsen, S., Popolo, R., Juul, S., Frandsen, F. W., Sørensen, P., & Dimaggio, G. (2021). Treating avoidant personality disorder with combined individual metacognitive interpersonal therapy and group mentalization-based treatment. Journal of Nervous & Mental Disease, Publish Ahead of Print. https://doi.org/10.1097/nmd.0000000000001432
Varkey, B. (2020). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119
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Controversy Associated with Personality and Paraphilic Disorders
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.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
The Assignment
In 2–3 pages:
- Explain the controversy that surrounds your selected 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.
By Day 7 of Week 7
Submit your Assignment.
submission information
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- To submit your completed assignment, save your Assignment as WK7Assgn_LastName_Firstinitial
- Then, click on Start Assignment near the top of the page.
- Next, click on Upload File and select Submit Assignment for review.
Rubric
NRNP_6675_Week7_Assignment_Rubric
| NRNP_6675_Week7_Assignment_Rubric | ||
| Criteria | Ratings | Pts |
| This criterion is linked to a Learning OutcomeIn 2–3 pages, address the following: • Explain the controversy that surrounds your selected personality or paraphilic disorder. | 15 to >13.0 ptsExcellent 90%–100%The response includes an accurate and concise explanation of the controversy within the field related to the disorder.
13 to >11.0 ptsGood 80%–89%The response includes an accurate explanation of the controversy within the field related to the disorder. 11 to >10.0 ptsFair 70%–79%The response includes a somewhat vague or inaccurate explanation of the controversy within the field related to the disorder. 10 to >0 ptsPoor 0%–69%The response includes a vague or inaccurate explanation of the controversy within the field related to the disorder. Or the response is missing. |
15 pts |
| This criterion is linked to a Learning Outcome• Explain your professional beliefs about your selected disorder, supporting your rationale with at least three scholarly references from the literature. | 25 to >22.0 ptsExcellent 90%–100%The response includes a thorough and well-organized explanation of the student’s professional beliefs about the disorder. Rationale demonstrates critical thinking and is strongly supported with three scholarly references.
22 to >19.0 ptsGood 80%–89%The response includes a well-organized explanation of the student’s professional beliefs about the disorder. Rationale is clear and appropriately supported with three scholarly references. 19 to >17.0 ptsFair 70%–79%The response includes a somewhat vague explanation of the student’s professional beliefs about the disorder. Rationale is somewhat unclear and references either provide weak support for the rationale or are not scholarly/current. 17 to >0 ptsPoor 0%–69%The response includes a vague explanation of the student’s professional beliefs about the disorder. Rationale is unclear and references are inappropriate. Or the response is missing. |
25 pts |
| This criterion is linked to a Learning Outcome• Explain strategies for maintaining the therapeutic relationship with a client that may present with the disorder. | 30 to >26.0 ptsExcellent 90%–100%The response includes an accurate and concise explanation of strategies for maintaining the therapeutic relationship with a client that may present with the disorder.
26 to >23.0 ptsGood 80%–89%The response includes an accurate explanation of strategies for maintaining the therapeutic relationship with a client that may present with the disorder. 23 to >20.0 ptsFair 70%–79%The response includes a somewhat vague or incomplete explanation of strategies for maintaining the therapeutic relationship with a client that may present with the disorder. 20 to >0 ptsPoor 0%–69%The response includes a vague or inaccurate explanation of strategies for maintaining the therapeutic relationship with a client that may present with the disorder. Or the response is missing. |
30 pts |
| This criterion is linked to a Learning Outcome• Finally, explain ethical and legal considerations related to the disorder that you need to bring to your practice and why they are important. | 15 to >13.0 ptsExcellent 90%–100%The response includes an accurate and concise explanation of ethical and legal considerations related to the disorder that are important to clinical practice and why they are important.
13 to >11.0 ptsGood 80%–89%The response includes an accurate explanation of ethical and legal considerations related to the disorder that are important to clinical practice and why they are important. 11 to >10.0 ptsFair 70%–79%The response includes a somewhat vague or incomplete explanation of ethical and legal considerations related to the disorder that are important to clinical practice and why they are important. 10 to >0 ptsPoor 0%–69%The response includes a vague and inaccurate explanation of ethical and legal considerations related to the disorder that are important to clinical practice and why they are important. Or, response is missing. |
15 pts |
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. | 5 to >4.0 ptsExcellent 90%–100%Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
4 to >3.5 ptsGood 80%–89%Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time…. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive. 3.5 to >3.0 ptsFair 70%–79%Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment are vague or off topic. 3 to >0 ptsPoor 0%–69%Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided. |
5 pts |
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation | 5 to >4.0 ptsExcellent 90%–100%Uses correct grammar, spelling, and punctuation with no errors
4 to >3.5 ptsGood 80%–89%Contains 1-2 grammar, spelling, and punctuation errors 3.5 to >3.0 ptsFair 70%–79%Contains 3-4 grammar, spelling, and punctuation errors 3 to >0 ptsPoor 0%–69%Contains five or more grammar, spelling, and punctuation errors that interfere with the reader’s understanding |
5 pts |
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. | 5 to >4.0 ptsExcellent 90%–100%Uses correct APA format with no errors
4 to >3.5 ptsGood 80%–89%Contains 1-2 APA format errors 3.5 to >3.0 ptsFair 70%–79%Contains 3-4 APA format errors 3 to >0 ptsPoor 0%–69%Contains five or more APA format errors |
5 pts |
Total Points: 100
Learning Resources
Required Readings
- National Institute for Health and Care Excellence: NICE Guidelines. (2010). Antisocial personality disorder: Prevention and management Links 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.
- 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.
- Chapter 67, “Disorders of Personality”
- Chapter 68, “Developmental Risk for Psychopathy”
- 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.
- Chapter 14, “Personality Disorders”
Required Media
- Buchanan, N. T. (2020, April 13). Lecture 14 part 3: Paraphilic disorders Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=ykkMo9t0bxs
- MDedge. (2020, January 22). Personality disorders with Dr. Frank Yeomans Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=ESQIDslCX_s