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. 

Learning Objectives

Students will:

  • Analyze controversies related to the diagnosis and treatment of personality and paraphilic disorders
  • Analyze professional beliefs about personality and paraphilic disorders
  • Apply strategies for maintaining a therapeutic relationship with patients with personality and paraphilic disorders
  • Analyze legal and ethical considerations related to personality and paraphilic disorders

Learning Resources

Required Readings (click to expand/reduce)National Institute for Health and Care Excellence: NICE Guidelines. (2010). Antisocial personality disorder: Prevention and management.

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. (For review as needed)

  • Chapter 22, “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 (click to expand/reduce)Buchanan, N. T. (2020, April 13). Lecture 14 part 3: Paraphilic disorders [Video]. YouTube. (2020, January 22). Personality disorders with Dr. Frank Yeomans [Video]. YouTube.

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