Understanding Maladaptive Behavior and Normality

Maladaptive Behavior

• It is defined as behavior that hinders or hurts a person from reaching their full potential.
• Impacts the person and their interactions.
• Characteristics include being unusual, unacceptable, and causing personal distress.
• It is subjective, differing across time and cultures.
• A behavior considered unusual in one context may be normal in another.
• Culture defines and limits what is considered 'normal', but these definitions can change.
• Can be objective, involving faulty perception of reality, self-defeating actions, or dangerous behavior.
• Everyone has some degree of it.
• Some days, people exhibit it more than others.

Normality

• Evaluation focuses on personal ideas of what is normal.
• Variations from one's own 'normal' are often seen as odd, unhealthy, or unacceptable.
• Mental health needs harmony with oneself and the environment.
• It requires conformity to cultural and community requirements plus intact reasoning and judgement.
• It should not violate medical 'deviation'.
• Normal mental health changes over time.
• It reflects cultural norms, societal expectations, values, professional biases, individual differences, and the political climate.
• All Kinds of Minds

Personality Disorders

• Inflexible and dysfunctional traits lead to problems in functioning and subjective distress.
• Patients suffer from lifelong, inflexible, and dysfunctional patterns in relating and behaving.
• These patterns often cause distress to others.
• Some individuals with personality disorders may not find their behaviors distressing themselves.
• Instead, they experience distress due to others' reactions.
• The criteria include disturbance in two or more of the following: cognition, affectivity, interpersonal function, and impulse control.

Cluster A: Odd-Centric Behavior

• Includes Paranoid, Schizoid, and Schizotypal personalities.

Paranoid Personality

• Characterized by suspiciousness of others, doubting trust and loyalty.
• Includes fear of confiding, unjustified suspicion of spouse/sexual partner.
• Involves interpreting remarks as demeaning/threatening plus holding grudges.
• Causes angry and threatening reactions when perceived as being attacked.

Schizoid Personality

• Marked by a lack of desire for solitary activities and little interest in sexual activities.
• Involves avoiding activities, and being cold and detached.
• Includes a lack of close friends and indifference to praise or criticism.

Schizotypal Personality

• Defined by magical/odd thinking, unusual perceptual experiences/bodily illusions.
• Features vague, stereotypical/overelaborate speech, suspiciousness, blunted affect, and eccentric appearance.
• Includes few relationships and excess social anxiety.

Nursing Responsibilities for Cluster A

• Always be honest, professional, and respectful to build trust.
• Avoid asking too many personal questions.
• Provide clear instructions to avoid confusing or scaring the patient.
• Focus on one-on-one care and support.

Cluster B: Dramatic, Emotional, Erratic Behaviors

• Includes Antisocial, Borderline, Histrionic, and Narcissistic personalities.

Antisocial Personality

• Display deceitfulness and lying/conning.
• Involves engaging in illegal activities and acting aggressively.
• Includes a lack of guilt/remorse plus being irresponsible in work/finance.
• Includes being impulsive and disregarding safety.

Nursing Responsibilities for Antisocial Personality

• Begin by explaining what is allowed and isn't.
• Consistently enforce rules and don't allow flexibility.
• Help the patient understand how their actions affect others.
• Help them understand why people react to their behavior.

Borderline Personality

• Defined by frantic efforts to avoid real or imagined abandonment.
• Requires unstable and intense interpersonal relationships plus identity disturbance.
• Defined by impulsivity, affective instability, and recurrent suicidal or self-mutilating behavior.
• Characterized by rapid mood shifts, chronic feelings of emptiness, problems with anger.
• Features transient dissociative and paranoid symptoms.

Nursing Responsibilities for Borderline Personality

• Empathize with the patient's feelings without becoming personally involved.
• The nurse should be caring, focusing on providing healthcare, not being a friend.
• Validate the patient's feelings and pain without judgment.
• Help patients recognize dysfunctional behaviors.
• Assist patients in expressing feelings, managing harmful behaviors, staying safe from self-harm, and developing healthy coping mechanisms.

Narcissistic Personality

• Exhibiting grandiose self-importance plus fantasies of unlimited power, success, and brilliance.
• Involves believing they are special or unique and requiring admiration.
• Sense of entitlement, taking advantage of others, lack of empathy plus envy.
• Characterized by arrogant or haughty behavior.

Nursing Responsibilities for Narcissistic Personality

• Remind them that everyone is equal.
• Be consistent to prevent the patient from taking advantage.

Histrionic Personality

• Requires being the center of attention and displays sexually seductive or provocative behaviors.
• Shows shallow, rapidly shifting emotions.
• Uses physical appearance to draw attention plus speech that lacks depth.
• Dramatically expresses emotions, is easily influenced and exaggerates intimacy.

Nursing Responsibilities for Histrionic Personality

• Give attention and compliments when the patient acts kindly.
• Help the patient solve problems and manage daily tasks.
• Guide the patient to understand and share their feelings in a healthy way.

Cluster C: Anxious-Fearful Behavior

• Includes Dependent, Avoidant, and Obsessive-Compulsive personalities.

Dependent Personality

• Inability to make daily decisions without excessive advice and reassurance.
• Requires others to take responsibility for important areas of life.
• Avoids disagreeing with others due to fear of losing support or approval.
• Has trouble initiating projects due to lack of self-confidence.
• Does unpleasant tasks to gain support from others and is anxious/helpless when alone.
• Urgently seeks another relationship after one ends and is preoccupied with the fear of being alone.

Nursing Responsibilities for Dependent Personality

• Guide the patient in making daily decisions and taking responsibility.
• Assist in managing anxiety, especially when taking on more responsibilities.
• Help them confidently express feelings, needs, and wants.

Avoidant Personality

• Avoids occupations involving interpersonal contact due to fear of disapproval or rejection.
• Uninvolved with others unless certain of being liked.
• Fears intimate relationships due to fear of shame or ridicule and is preoccupied with criticism or rejection.
• Inhibited, feels inadequate in new interpersonal situations and believes they are socially inept and unappealing.
• Is reluctant to take risks or engage in new activities due to the possibility of embarrassment.

Nursing Responsibilities for Avodant Personality

• Support the patient in gradually facing their fears.
• Discuss their fears before and after facing something scary.
• Guide the patient in achieving manageable goals to build confidence.
• Encourage them to talk to others, starting with one-on-one conversations then joining small groups.

Obsessive-Compulsive Personality

• Preoccupied with details, rules, lists, and organization.
• Perfectionism that interferes with task completion.
• Too busy working to socialize and be inflexible plus over conscientious.
• Unable to discard worn-out objects and others must do things in their way.
• Reluctant to spend and hoards money plus exhibits rigid and stubborn behavior.

General Nursing Responsibilities

• Help patients learn and practice stress reduction techniques.
• Acknowledge accomplishments to boost self-esteem.

Defense Mechanisms

• These mediate reactions to emotional conflicts and external stressors.
• They provide ways to cope with stressful situations.

Specific Defense Mechanisms

• Reaction Formation: Acting opposite to true feelings.
• Projection: Blaming others for personal faults.
• Displacement: Redirecting anger to a safer target.
• Regression: Displaying immature behaviors.
• Denial: Refusing to accept reality.
• Compensation: Overcompensating for perceived weaknesses.
• Rationalization: Justifying failures with excuses.
• Identification: Imitating characteristics of another person.
• Undoing: Reversing a previous negative action.
• Suppression: Consciously avoiding feelings.
• Isolation: Withdrawing from social interactions.

Paraphilia

• Defined as an "abnormal or unnatural attraction".
• Sexual satisfaction achieved through abnormal themes: objects or non-human animals, humiliation, or suffering.
• Including nonconsenting people, or children.

Types of Paraphilia

• Exhibitionism: Exposing genitals to unsuspecting individuals (at least six months).
• Fetishism: Sexual arousal involving inanimate objects (onset in adolescence, persists six months).
• Frotteurism: Sexual arousal from rubbing genitals against a non-consenting person.
• Pedophilia: Sexual fantasies, urges, or behaviors involving sexual activity with prepubescent children.
• Masochism: Sexual pleasure from experiencing pain or humiliation.
• Sadism: Sexual pleasure from inflicting pain, humiliation, or suffering.
• Transvestic Fetishism: Achieving sexual arousal by cross-dressing.
• Voyeurism: Sexual arousal from watching people engage in private activities without their knowledge.
• Partialism: Preoccupation with specific body parts.
• Telephone Scatologia: Preoccupation with "dirty talking" on the phone.
• Zoophilia: Sex with various mammals and other animals.
• Necrophilia: Sex with corpses.
• Klismaphilia: Achieving sexual pleasure by giving themselves enemas.
• Coprophilia: Masturbating or having sex with their own feces.
• Urophilia: Deriving sexual excitement from urine-related activities, such as "golden showers".
• Infantilism: Deriving sexual pleasure from being treated like a baby.

Explore maladaptive behavior, defined as actions hindering personal growth. It varies across cultures and times, involving unusual or distressing actions. Also learn about normality, which emphasizes harmony with oneself and the environment, alongside cultural conformity and sound judgment.