Disturbed Personal Identity Nursing Diagnosis and Nursing Care Plan

Last updated on May 18th, 2022 at 07:02 am

Disturbed Personal Identity Nursing Care Plans Diagnosis and Interventions

Disturbed Personal Identity NCLEX Review and Nursing Care Plans

Disturbed personal identity, also known as identity disturbance, is a term used to define a person’s incoherent or inconsistent concept of self. It differs significantly from the expectations of the person’s culture.

Disturbed Personal identity could indicate that a person’s aims, views, and actions are in constant motion, or that the individual adopts the personality characteristics of those around them as they attempt to find and preserve their individuality.

It is relatively stable, prevalent, and inflexible, and begins in the adolescent years or early adulthood, resulting in suffering or impairment.

These disorders are diagnosed when personality characteristics become rigid and inappropriate, interfering with an individual’s ability to function in society or causing feelings of discomfort.

They are frequently not recognized until adulthood when the personality has fully developed. Furthermore, there is no single drug that affects personality, and therapy is focused on assisting patients to implement adjustments that are frequently long-term and slow-moving.

Signs and Symptoms of Disturbed Personal Identity

The prevailing perspective and perception of oneself are generally referred to as personal identity. Being able to see oneself as the same person in the past, present, and future is an indication of a stable sense of identity. Moreover, a steady self-concept necessitates the capability to see oneself in the same light, even though we may act in conflicting ways at times.

On the other hand, a person with a disturbed personal identity may exhibit the following clinical signs and symptoms:

Paranoid. Suspicious, has a guarded, constrained affect and is wary of others.
Schizoid. Disconnected from social interactions; little affect; preoccupied with things rather than people.
Schizotypal. Acute relationship dissatisfaction; cognitive or perceptual disturbances; inappropriate behavior
Avoidant. Inhibitions in social situations; feelings of inferiority; oversensitivity to negative feedback.
Dependent. Intense need to be cared for; compliant and clingy attitude
Obsessive-compulsive. Fixations on orderliness, perfectionism, and control.
Depressive. Feelings of despair, melancholy, and dejection
Passive-Aggressive. A pattern of inappropriate attitudes and passive resistance to expectations for appropriate performance in social circumstances.
Antisocial. Neglect on others’ rights, regulations, and laws.
Borderline. Self-mutilation; recklessness; unsteady relationships, identity, and affect.
Histrionic. Unnecessary emotional expression and a desire for attention.
Narcissistic. Grandiosity, absence of empathy, and a desire for adoration

Types of Personality Disorders

Although people may exhibit symptoms of more than one personality disorder at the same time, personality disorders are divided into three categories in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), which is the standard reference book for known mental illnesses. Each category has various types of personality disorders.

Cluster A (Eccentric Personality Disorders). People who suffer from these conditions often appear unusual or strange. Paranoid, schizoid, and schizotypal personality disorders are among these eccentric personality disorders.
Cluster B (Dramatic personality disorders). These personality disorders are characterized by powerful, fluctuating emotions as well as a twisted self-image. They are also inclined to act on impulse. Personality disorders such as antisocial borderline, histrionic, and narcissistic are among them.
Cluster C (Anxious personality disorders). Nervousness or fear are common in people with these personality disorders. Avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder are forms of these personality disorders.

Causes of Disturbed Personal Identity

Disturbed Personal Identity or Identity disturbance is no exception to the stigma attached to personality disorders. Though the exact cause of disturbed personal identity is unknown, societal factors such as desertion and dysfunctional relationships may play a role.

Both genetics and environment are thought to play a role in the development of personality disorders. Certain personality disorders appear to be linked to a family history of mental illness, although only the likelihood to develop a personality disorder, not the condition itself, may be inherited.

It may arise as a coping mechanism for a stressful scenario or excessive stress. An individual who was ignored as a child, for example, may develop a personality disorder as a means of coping. One thing is certain: personality disorders do not strike suddenly; they develop over time.

Given the fact that the exact etiology of personality disorders is unknown, several circumstances suggest raising the chance of acquiring or activating personality disorders, such as:

History of personality disorders or other mental illnesses in the family
Childhood abuse, instability, or chaos in the family
Diagnosis of behavior disorder during childhood years
Alterations in the chemistry and anatomy of the brain

Diagnosis of Disturbed Personal Identity

Understanding the distinction between personality types and personality disorders is essential. A quiet individual or someone who prefers being alone does not always have an avoidant or schizoid personality disorder.

Work, relationships, emotional states, self-identity, comprehension of facts, conduct, and emotional control are all aspects where a person’s personality type can be assessed to distinguish the difference between a personality style and a personality disorder.

Medical history and physical assessment. The healthcare professionals including both doctors and nurses will take a comprehensive medical history and complete a physical examination of the person exhibiting symptoms. Although there are no specialized laboratory tests to identify personality disorders, the doctor may utilize a wide range of diagnostic tests, such as X-rays and blood tests, to rule out physical condition as the source of the symptoms.
Referral to a mental health professional. If the symptoms are not due to a medical cause, the patient may be referred to a psychiatrist or psychologist, who is qualified to diagnose and manage mental illnesses.
Use of DSM-V. To screen a person for a personality disorder as defined by the DSM-V, psychiatrists and psychologists employ specifically tailored interview and assessment methods.

Treatment for Disturbed Personal Identity

People with personality disorders may be reluctant to seek treatment on their own because they can operate normally in society despite their disorder’s constraints.

As a result, many people with personality disorders are left untreated. The majority of personality disorders are persistent and untreatable, and they are extremely difficult to overcome.

Treatment, on the other hand, can help alleviate some of the distressing symptoms associated with a variety of personality disorders.

Psychotherapy. Psychotherapy is a method of counseling that focuses on examining problematic thought habits and teaching new thinking and behavior patterns. It is the most common therapeutic treatment for disturbed personal identity. Its goal is to help people enhance their coping and interpersonal abilities.
Medications. In some circumstances, medicines may be used to address severe or incapacitating symptoms that emerge. Antidepressants, antipsychotics, anti-anxiety drugs, and impulse-stabilizing medications are some of the medications that may be used.

Prevention of Disturbed Personal Identity

There is currently no known strategy to prevent personality disorders and disturbed personal identity; however, treatment may alleviate many of the associated issues.

Obtaining treatment as soon as symptoms develop can aid to minimize the impact on an individual’s life, family, and relationships.

Disturbed Personal Identity Nursing Diagnosis

Disturbed Personal Identity Nursing Care Plan 1

Borderline Personality Disorder (BPD)

Nursing Diagnosis: Disturbed Personality Identity secondary to Borderline Personality Disorder as evidenced by impulsive behavior, unstable personal relationships, tendency of self-inflicted injury, and intense feelings of emptiness.

Desired Outcome: The patient will be safe, injury-free, and demonstrate satisfaction with personal relationships.

Nursing Interventions for Disturbed Personal Identity	Rationale
Promote patient’s safety all the time.	Suicidal thoughts, as well as the existence of a plan, availability of means for carrying out the plan, and self-harm acts, must all be taken seriously by the nurse, and necessary interventions must be provided.
Establish the therapeutic relationship with the patient by setting boundaries.	The nurse must give structure and boundary setting in the therapeutic relationship regardless of the clinical context. In a medical environment, this would involve seeing the patient for pre-scheduled appointments rather than whenever the patient shows up and requires prompt treatment from the nurse. The nurse can also set the tone by attending appointments on schedule and setting clear, realistic treatment goals. Boundaries are often essential for patients with Borderline Personality Disorder (BPD) to help them see their surroundings as more constant and predictable.
Demonstrate attention and empathy to the patient’s concerns.	This communicates to the patient that the nurse is engaged with him or her and ready to offer assistance. Despite the patient’s conduct and the obstacles it presents, maintain a warm demeanor while staying unbiased.
Answer questions of the BPD patient in a clear, non-technical manner.	Since patients with BPD may have altered communication styles, it is indeed important to speak clearly, simply, and without the complexity that can alienate the patient even more. Maintain a neutral stance and encourage the patient to communicate his or her thoughts and queries.
Teach the BPD patient about using effective communication techniques.	Basic communication techniques, including eye contact, listening skills, taking turns speaking, confirming the context of another’s message, and using “I” statements, should be taught to BPD patients.
Assist the BPD patient in coping and controlling his emotions	The nurse can assist BPD patients to recognize their feelings and practice enduring them without having extreme responses such as destroying property or self-harm; journaling can also assist these patients in being more conscious of their emotions.
Plan the patient’s day-to-day tasks.	Patients can handle time alone by reducing downtime by planning activities. Patients may develop a written plan that involves meetings, buying groceries, reading a book, and getting some exercise.
Work with other mental health providers	Psychotropic medicines and psychotherapy may be required for BPD patients. When a nurse collaborates with other mental health practitioners, he or she takes part in a more holistic approach to therapy and has the resources required to better communicate with patients.
Ensure that a member of staff is around to act as a witness throughout the physical examination of the BPD patient.	Since many BPD patients had been abused as children, their imagination borders may be quite hazy. As a result, any procedure that the patient perceives as intrusive, such as a physical examination, may trigger sexual or abusive thoughts.

Disturbed Personal Identity Nursing Care Plan 2

Dissociative Disorders

Nursing Diagnosis: Disturbed Personality Identity secondary to Dissociative Disorders as evidenced by demonstration of multiple identities, memory loss, confusion, and detachment.

Desired Outcome: The patient will express comprehension that he or she is using dissociative behaviors during stressful circumstances and learn ways to cope in those stressful situations than employing dissociation.

Nursing Interventions for Disturbed Personal Identity	Rationale
Constantly ensure patient’s safety by raising the side rails, and close supervision among others.	Considering dissociative behaviors can be disturbing for patients, reassuring them of their safety and security with the nurse’s presence is vital.
Identify the stressors in the patient’s life.	The development of a successful plan of patient care and resolution of issues requires identifying the factors that caused extreme anxiety.
Consistently reorient the patient to time, place, and person as necessary. Present facts simply and promptly, without questioning fallacious thinking, and without making confusing or deceptive remarks.	The patient’s inability to keep his or her orientation is a signal of worsening or advancement of the condition. Delusional patients are particularly sensitive to others and can detect deceit. Mistrust or delusions are exacerbated by vague words or uncertainty.
Enable the patient to write his or her name regularly and keep a record of it to compare and observe variations.	These are crucial steps in limiting further worsening and improving the patient’s level of function in the case of dissociative disorders.
Evaluate the patient’s emotions.	Exploring their emotions in response to the stressor can help them realize that the disturbance they are experiencing is normal or even expected during times of extreme stress.
Take caution when touching the patient, especially if the patient’s thoughts show ideas of harassment.	Patients who are distrustful of touch may regard it as dangerous and react violently.
Educate the patient on how to intercede when irrational or negative ideas take over by employing thought-stopping strategies.	The command “stop!” or make a loud noise (such as clapping of the hands) to distract oneself from unpleasant ideas. This noise or command diverts the person’s attention away from the negative thoughts that frequently accompany unpleasant emotions or behaviors.
Keep a comfortable and peaceful atmosphere, and approach the patient slowly and calmly.	If patient with dissociative disorders is startled or overstimulated, they may exhibit agitated or violent behaviors.
Motivate coping strategies.	Ask the patient to evaluate past stress-coping strategies and decide if the behavior was adaptive or maladaptive.
Boost the patient’s self-confidence.	Provide positive feedback for the patient’s efforts to reform, as this improves self-esteem and inspires the patient to continue desirable behaviors.
Enable the patient to join socialization activities or support groups when available and appropriate.	Exposing the patient with dissociative disorders to social groups or activities can ensure that the patient’s level of function is maximized.

Disturbed Personal Identity Nursing Care Plan 3

Sexual Dysfunction

Nursing Diagnosis: Disturbed Personality Identity secondary to Sexual Dysfunction.

Desired Outcome: The patient will display appropriate and culturally acceptable acts for the given gender and exhibit pleasure with his or her sexuality pattern.

Nursing Interventions for Disturbed Personal Identity	Rationale
Constantly ensure patient’s safety by raising the side rails, and close supervision among others.	Considering dissociative behaviors can be disturbing for patients, reassuring them of their safety and security with the nurse’s presence is vital.
Determine the patient’s causes of stress.	Assist the patient in determining the dimension of time linked with the commencement of the problem and talking about what was going on in his or her life at the time.
Encourage the patient to talk about his or her condition.	Encouraging the patient to talk about any disease processes that may be influencing the sexual dysfunction. This will make the patient aware that there are other ways to achieve sexual fulfillment through sex counseling if the patient and partner so choose.
Determine what influences the patient’s sexuality.	Consider the cultural, social, and religious aspects that may play a role in disagreements over different sexual behaviors.
Ensure privacy and accept the patient’s sexual concerns without being judgmental.	Sexuality is a very private and sensitive matter; if the patient does not fear being judged by the nurse, he or she is more willing to disclose this information. Privacy also promotes the development of trust in a patient-nurse relationship.
Assist the patient to express his feelings about the changes in his image and bodily function.	The act of verbalizing perceived or actual changes might help to lessen anxiety and facilitate continuous conversation. Encourage the patient to distinguish between feelings about physical changes and feelings about self-worth.
As needed, provide positive encouragement to the patient.	Examine the patient’s actions and the reactions he or she elicits from others’ desirable behaviors, such as social attention (e.g., smiling or nodding).
Make a referral to support and self-help organizations.	Participating in support groups can help patients realize that they are not alone in their concerns, and they can utilize this information to find alternatives or solutions for specific treatment options.
Examine and validate the patient’s feelings about a change in sexual function.	The severity of the problem is determined by the patient’s value or emphasis placed on sexual performance rather than by basic thoughts of sexuality.
Explore the root of any self-negating statements made by the patient with sexual dysfunction.	There are a variety of reasons for sexual dysfunction, which could be the source of this coping issue. Other factors, such as a job transfer or poor family connections, might exacerbate the problem and result in poor self-esteem, needing additional interventions that cannot be addressed only through the ability to execute intercourse.
Evaluate the patient’s past coping techniques to see if they were effective.	Previous coping success influences successful adjustment; although past coping skills may or may not be effective in the current situation.

Disturbed Personal Identity Nursing Care Plan 4

Eating Disorders

Nursing Diagnosis: Disturbed Personality Identity secondary to Eating Disorders as evidenced by distorted body image, display of powerlessness to prevent changes, extreme dependency on others, and expressed shame or guilt.

Desired Outcome: The patient will demonstrate a more realistic body image and accept accountability for individual actions.

Nursing Interventions for Disturbed Personal Identity	Rationale
Allow the patient to sketch a self-portrait.	It attempts to explore the patient’s self and body image perceptions, as well as the facts of the situation.
Urge the patient with an eating disorder to participate in a personal development program, particularly in a group session.	This intervention usually teaches people how to apply cosmetics and beautify themselves properly. Understanding ways to improve one’s looks might assist one’s self-confidence and image in the long run. Other people’s opinions might also boost one’s self-confidence.
Recommend to eliminate the patient’s “thin” clothing as weight gain happens. Consultation with an image specialist is also recommended.	Eliminating the visual evidence of one’s former weight may improve the self-esteem of the patient. It also serves as a motivator to at least maintain rather than lose weight. Consultation with a professional can help the patient on having a positive image.
Assist the patient in dealing with puberty-related changes and sexual anxieties. Also, provide sex education as applicable.	Eating disorders can develop as a result of significant physical and psychological changes that occur during adolescence. Feelings of inadequacy and a loss of control over emotions, especially sexual sensations, lead to an unconscious urge to emasculate oneself. Patient frequently believes that gaining control of one’s physical appearance, growth, and function will help them conquer their anxieties.
Promote a therapeutic relationship between the nurse and the patient.	The patient can learn to trust and try out new ideas and actions in the context of a helpful relationship.
Encourage patient’s self-concept without ethical judgment	The patient perceives himself as spiritless, although a portion of him or her may feel powerful and in charge such as when dieting or having weight loss.
Explain the rules to the patient, including the weighing schedule, staying in sight at medicine and mealtimes, and the repercussions of breaking the guidelines. Be consistent in enforcing regulations without becoming oppressive.	When it comes to building trust, consistency is crucial. The patient is informed about the consequences of not adhering to specified regulations, such as loss of privileges, as part of the behavior modification program. Failure to obey guidelines is considered a patient’s decision, and it is tolerated by the nurse matter-of-factly so that bad conduct is not reinforced.
Answer truthfully when a patient makes unrealistic remarks.	The patient with eating disorders may deny the psychological components of his or her position, citing feelings of inadequacy and depression.

Disturbed Personal Identity Nursing Care Plan 5

Schizophrenia

Nursing Diagnosis: Disturbed Personality Identity secondary to Schizophrenia as evidenced by delusions, distorted perception of the environment, inappropriate imaginary thinking, loss of memory, and being self-centered.

Desired Outcome: The patient will express acknowledgment of delusions if persistent and will perceive the environment realistically.

Nursing Interventions for Disturbed Personal Identity	Rationale
Make an effort to comprehend the importance of the ideas to the patient at the time of presentation.	The patient’s seemingly nonsensical imaginations can reveal important insights into underlying concerns and issues.
Recognize the patient’s delusions as to his interpretation of his surroundings.	Understanding the patient’s perspective can assist the nurse in comprehending the patient’s feelings.
Explain all the procedures to the patient and make sure he or she understands them before performing them	The client is less likely to feel deceived by the nurse if he or she is fully informed about the procedures.
Interact with patients based on what’s going on around them. Engage patients in reality-based activities to distract them from their delusions.	When the patient’s thoughts are focused on reality-based tasks, he or she is free of deluded thoughts and may help direct attention outwardly.
Avoid touching the patient and be cautious with gestures.	Patients who are suspicious of touch may misunderstand it as aggressive or sexual, or as an aggressive gesture. Always remember that psychotic people require a lot of personal space.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon

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