What is an antisocial personality disorder, and what are its symptoms?
QUESTION
Case Study, Mohr
CHAPTER 25, Personality Disorders
In completing the case study, students will be addressing the following learning objectives:
Explain what is meant by personality disorder.
Define personality disorder.
Apply the nursing process to the care of clients with personality disorders.
1. Charles, a 29-year-old white man, has been admitted to the psychiatric hospital. Charles does not seem depressed and openly discusses that he had attempted suicide after he had burned his employer’s office and truck. Charles told the student nurse that he had been mad at his boss because he was a “slave driver” and shows no remorse for destroying his employer’s office and truck. Charles has limited contact with his mother, who is his only family support. Charles is divorced and states that his ex-wife just got pregnant so that he would marry her. They have one child, and he is several months behind in child support. Other information that Charles gave the student nurse in an interview included that he was an ex-marine but had a dishonorable discharge due to stealing some extra government supplies that he said no one needed. In the treatment team, the psychiatrist stated that Charles was not suicidal and diagnoses him with antisocial personality disorder.
(Learning Objectives: 1, 3)
a. What is an antisocial personality disorder, and what are its symptoms?
b. Applying the nurse process to the treatment of Charles, what specific interventions would be most appropriate for the individual with antisocial personality disorder?
ANSWER
Understanding and Treating Antisocial Personality Disorder: A Case Study of Charles
Introduction
This case study focuses on Charles, a 29-year-old white man who has been admitted to a psychiatric hospital. Charles exhibits symptoms consistent with antisocial personality disorder (ASPD). This essay will explore the concept of antisocial personality disorder, its symptoms, and the application of the nursing process in the care and treatment of individuals with this disorder.
Antisocial Personality Disorder
Antisocial personality disorder is a mental health condition characterized by a persistent pattern of disregard for and violation of the rights of others. Individuals with ASPD often exhibit symptoms such as:
Lack of empathy and remorse: Charles displays a clear absence of remorse for his destructive actions and a lack of concern for the impact they have on others. This lack of empathy is a defining feature of ASPD.
Manipulative and deceitful behavior: Charles demonstrates manipulative tendencies, such as lying and manipulating others for personal gain (Kiehl, 2011). He shows no remorse for stealing government supplies during his time in the military.
Disregard for societal norms and rules: Charles openly admits to burning his employer’s office and truck, displaying a blatant disregard for societal norms and laws.
Impulsivity and irresponsibility: Charles exhibits impulsive behavior, such as his decision to attempt suicide and his failure to meet his child support obligations.
Nursing Interventions for ASPD
The nursing process provides a framework for delivering comprehensive and individualized care to clients with personality disorders like ASPD. Here are some specific interventions that would be most appropriate for Charles:
Establishing a therapeutic alliance: It is essential for the nurse to build a trusting and non-judgmental relationship with Charles. This can be achieved through active listening, empathy, and demonstrating genuine concern for his well-being.
Conducting a comprehensive assessment: A thorough assessment of Charles’s physical, mental, and psychosocial health is necessary to identify his strengths, challenges, and potential risk factors (Substance Abuse and Mental Health Services Administration (US), 2009). This assessment should include a review of his past trauma, relationships, and coping mechanisms.
Setting clear boundaries: Due to Charles’s tendency to manipulate and deceive others, it is crucial for the treatment team to establish clear boundaries. The nurse should communicate the expectations and consequences of Charles’s behavior, ensuring that he understands the limits of acceptable conduct.
Collaborating with the treatment team: An interdisciplinary approach involving psychiatrists, psychologists, social workers, and other healthcare professionals is crucial in managing ASPD (Jacobs & Mkhize, 2021). The nurse should actively participate in treatment team meetings, sharing observations and insights to develop a comprehensive care plan for Charles.
Teaching social and coping skills: As individuals with ASPD often struggle with interpersonal relationships, the nurse can provide Charles with education and guidance on effective communication, empathy-building, anger management, and problem-solving skills. These skills can empower him to develop healthier relationships and manage his emotions appropriately.
Promoting community support: Given Charles’s limited family support, the nurse should explore community resources, such as support groups, vocational training programs, and financial assistance services. These resources can help Charles rebuild his support network and enhance his overall well-being.
Conclusion
Antisocial personality disorder is a complex mental health condition characterized by a disregard for societal norms, lack of empathy, and manipulative behavior. The nursing process plays a crucial role in providing holistic care to individuals like Charles. By establishing a therapeutic alliance, conducting comprehensive assessments, setting boundaries, collaborating with the treatment team, teaching essential skills, and promoting community support, nurses can support individuals with ASPD in their journey towards better mental health and improved quality of life.
References
Jacobs, E., & Mkhize, S. W. (2021). Multidisciplinary team members’ perceptions regarding advanced psychiatric nurses’ attitudes on mental healthcare. Health Sa Gesondheid, 26. https://doi.org/10.4102/hsag.v26i0.1646
Kiehl, K. A. (2011, January 1). THE CRIMINAL PSYCHOPATH: HISTORY, NEUROSCIENCE, TREATMENT, AND ECONOMICS. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059069/
Substance Abuse and Mental Health Services Administration (US). (2009). 4 Screening and Assessment. Substance Abuse Treatment: Addressing the Specific Needs of Women – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK83253/

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