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Introduction Introduction
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Defining Difficult Personality Traits and Disorders in Oncology Settings Defining Difficult Personality Traits and Disorders in Oncology Settings
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Elements of Personality Functioning Elements of Personality Functioning
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Character Rigidity Character Rigidity
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DSM-5 DSM-5
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The DSM-5 Personality Disorders The DSM-5 Personality Disorders
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Cluster A Cluster A
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Cluster B Cluster B
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Antisocial Patients Antisocial Patients
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Borderline Patients Borderline Patients
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Histrionic and Narcissistic Patients Histrionic and Narcissistic Patients
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Cluster C Cluster C
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Avoidant Patients Avoidant Patients
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Dependent Patients Dependent Patients
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Obsessive-Compulsive Personality Disorder (OCPD) Obsessive-Compulsive Personality Disorder (OCPD)
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Etiology Etiology
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Epidemiology Epidemiology
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Diagnostic Challenges Diagnostic Challenges
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Hazards and Value of Diagnostic Labeling in Oncology Settings Hazards and Value of Diagnostic Labeling in Oncology Settings
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Management of Patients with Difficult Personality Traits and Disorders Management of Patients with Difficult Personality Traits and Disorders
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General Principles in Working with Personality Disorder Patients General Principles in Working with Personality Disorder Patients
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Cluster A: Patients Who Are Odd or Eccentric Cluster A: Patients Who Are Odd or Eccentric
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Cluster B: Patients Who Are Dramatic, Emotional, or Erratic Cluster B: Patients Who Are Dramatic, Emotional, or Erratic
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Cluster C: Patients Who Are Anxious or Fearful Cluster C: Patients Who Are Anxious or Fearful
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Problematic Patient Encounters Problematic Patient Encounters
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References References
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45 Difficult Personality Traits and Disorders in Oncology
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Published:February 2015
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Abstract
This chapter focuses on how we can assess, understand, and care for cancer patients with difficult personality traits and personality disorders. A minority of cancer patients respond to crisis with self-defeating, alienating strategies that confuse and trouble clinicians. Staff may find them aggravating, aggrandizing, chaotic, dramatic, or odd. Their dysfunctional responses may foil treatment or monopolize resources. Staff may feel anger, disinterest, neglect, guilt, even hatred toward these patients or family members. Blaming or dismissing such patients may ensue, with adverse consequences for all involved. This chapter provides insight and practical information for working with these puzzling patients. DSM diagnostic categories and the hazards of diagnostic labeling are explained. A clinical system is presented to identify patients’ coping strategies. The roles of primary oncology clinicians as well as psycho-oncology consultants are considered, including necessary jargon but focusing on practical understanding and tools.
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