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CMN 554 Module 4 Study Guide | Personality Disorders & Psychiatric Nursing | Questions & Answers | Verified | Latest Update 2026

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This CMN 554 Module 4 Study Guide provides comprehensive review materials, questions, and verified answers for students studying personality disorders and related psychiatric mental health topics. Fully updated for 2026 coursework and exams, it is ideal for WGU and other nursing programs. Topics include Cluster A, B, and C personality disorders, diagnostic criteria, clinical manifestations, therapeutic communication, nursing interventions, treatment approaches, risk factors, and patient-centered care strategies. The guide includes exam-style questions, scenario-based practice, and concise chapter summaries, making it suitable for quizzes, unit exams, midterms, finals, certification preparation, and self-study.

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CMN 554
Module 4 Primary Study Guide
(Personality Disorders)2026
GUARANTEED PASSING TIPS
Sadock - Chapter 26
Personality (character)
Personality is both complex and unique: on one hand, people differ greatly from one
another in multiple components of behavior, and, on the other hand, each person expresses only
one of his or her many potential lifestyles. The common characteristic of all existing definitions of
personality is that they are functional, that is, they focus on questions related to motivation and
mental adaptation of the organism. Specifically, Allport defined personality as the “dynamic
organization within the individual of those psychophysical systems that determine his/her unique
adjustment to his/her environment.”
Allport elaborated on this definition by explaining that the expression “dynamic
organization” emphasizes that personality is an organized system (“unitas multiplex”) that is
constantly evolving and changing. The phrase “within the individual” means that personality refers
to intrapsychic processes, not judgmental comparisons of one person to another. The term
“psychophysical” means that personality is neither exclusively mental nor exclusively neural but a
combination of the two. The expression “unique adjustment to the environment” has both
functional and evolutionary significance pointing to personality as a mode of survival and, more
generally, learning and adaptation, which is unique to each individual. Allport’s use of the verb
“determine” suggests that personality traits are determining dispositions that limit a person’s
behavioral repertoire.
It is now known that people are self-aware and have enough freedom of will to change their
behavior in directions that are not necessarily predictable or determined by their past. Accordingly,
Allport’s definition has been modified as follows: human personality is the dynamic organization of
the psychobiological systems by which a person shapes and adapts in a unique way to a changing
internal and external environment. In other words, personality is a way of describing the dynamical
processes that occur within the person to shape and adapt to life experiences by self-aware
learning and proactive planning. The maturation and integration of human personality involves
one’s growing in self-awareness through experiences across a wide range of situations.
It has been widely accepted that personality develops through the interaction of hereditary
dispositions and environmental influences. Waddington’s notion of genetic canalization (or
“epigenetic landscape”) has been revised to include reciprocal interactions among genetic
endowment, environmental stimulation, and changes in self-awareness across the life span.
Genetic differences account for about half of the variance in differences between people for most
normally distributed temperament traits. The remaining 50 percent of the variance in differences
between people is attributed to environmental influences. Most of the environmental influences
are unique to each individual, particularly for temperament traits, but parental rearing and
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sociocultural norms have a substantial influence on a person’s character development. Of note,
adoption studies suggest somewhat lower heritability of about 30 percent for personality traits.
The higher heritability estimates from twins are the result of nonadditive genetic influences (e.g.,
higher-order interaction among alleles at each locus or among loci), which is the same for
monozygotic twins but contributes little to the resemblance of other relatives. Epistasis (i.e.,
interactions among multiple gene loci) is so strong for both temperament and character that it was
difficult to identify specific genes for personality until methods were developed to take epistasis
into account.
However, heritability estimates refer only to genetic influences on the differences between
people at one point in time. People are able to change from one time to another as a result of
growth in self- awareness in ways that are only partly constrained by their past genetic expression.
For example, intelligence quotient (IQ) is highly heritable, but there has been increase of about 3.3
IQ points per decade that requires frequent restandardization of IQ tests. The increase in IQ scores
in successive birth cohorts is called the “Flynn effect.” The increase in IQ is attributable to skill in
problem solving on the spot (“fluid intelligence”), such as recognition of similarities, rather than
skills dependent on past individual education, such as vocabulary size (“crystallized intelligence”).
Likewise, the differences between people in Self-Transcendence at one point in time is 49 percent
heritable, but the prevalence of self-transcendent experiences increased from 48 percent in 1987
to 76 percent in 2000 in English people according to studies of the zoologist David Hay. These rapid
changes in fluid intelligence and self-transcendence cannot be explained by genetic evolution.
Character and fluid intelligence can develop rapidly within individuals in response to cultural
developments that influence human society as a whole.




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From the structural standpoint, personality can be decomposed into temperament, character,
and psyche.
Roughly speaking, temperament involves basic emotions, character involves rational concepts
about self and interpersonal relations, and the psyche involves intuitive self-awareness and fluid
intelligence. Self-awareness and fluid intelligence influence personality development
substantially, so measures of temperament and character provide an incomplete understanding
of personality development. Basic functions of personality are to feel, think, and perceive, and to
incorporate these into purposeful behaviors.


Psychobiology of Temperament
Temperament traits of Harm Avoidance, Novelty Seeking, Reward Dependence, and
Persistence are defined as heritable differences underlying one’s automatic response to danger,
novelty, social approval, and intermittent reward, respectively. These four temperament traits are
closely associated with the four basic emotions of fear (Harm Avoidance), anger (Novelty Seeking),
attachment (Reward Dependence), and ambition (Persistence).
Individual differences in temperament and basic emotions modify the processing of
sensory information and shape early learning characteristics, especially associative conditioning
of unconscious behavior responses and preattentive components of perception. Temperament is
conceptualized as heritable biases in emotionality and learning that underlie the acquisition of
emotion-based, automatic behavioral traits and habits observable early in life and relatively stable
over one’s life span.
Each of the four major dimensions is a normally distributed quantitative trait, moderately
heritable, observable early in childhood, relatively stable in time, and moderately predictive of
adolescent and adult behavior. The four dimensions have been shown to be genetically
homogeneous and independently inherited from one another in large, independent twin studies in
the United States, Australia, Sweden, Korea, and Japan. Temperamental differences, which are not
very stable initially, tend to stabilize during the second and third years of life.
Accordingly, ratings of these four temperament traits at age 10 to 11 years were moderately
predictive of personality traits at ages 15, 18, and 27 years in a large sample of Swedish children.
Whereas character traits develop in a specific direction toward socially favored cultural norms, the
number of people who increase in Harm Avoidance, Reward Dependence, and Persistence is
about the same as the number who decrease, so that the average of these traits remains the same
from ages 20 to 45 years. Novelty Seeking decreases about 10 percent per decade as a person’s
impulse control matures.
The four dimensions have been repeatedly shown to be universal across different cultures,
ethnic groups, and political systems on every inhabited continent. In summary, these aspects of
personality are called temperament because they are heritable, manifest early in life, are
developmentally stable, and are consistent in different cultures. Temperament traits are like
crystallized intelligence in that they do not show the rapid changes within increasing age or across
birth cohorts that are observed for fluid intelligence and character traits. Table 26–1 summarizes
contrasting sets of behaviors that distinguish extreme scorers on the four dimensions of
temperament. Note that each extreme of these dimensions has specific adaptive advantages and
disadvantages, so neither high nor low scores inherently mean better adaptation.
The component traits (“facets”) for each of the four temperament dimension have distinct
learning characteristics and correlate more strongly with one another than with other components
of temperament. They share a common source of covariation that is strong and invariant
regardless of changes in the environment and past experience. Each of the four temperament

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dimensions has unique genetic determinants according to family and twin studies, as well as
studies of genetic associations with specific DNA markers.
The four dimensions of human temperament correspond closely to those observed in other
mammals.
Multiple levels in the phylogeny of learning abilities in animals from invertebrates to man indicate
that learning has multiple component processes that are hierarchically organized and interact
extensively throughout development (Fig. 26–1).
In Figure 26–1, temperament corresponds to the processes of sensation, association, and
motivation that underlie the integration of skills and habits based on emotion.
Figure 26–1 is useful to specify the hierarchical phylogenetic and ontogenetic organization
of learning and its relevance to the concepts of temperament and character, not to compare
learning in humans at a particular age to learning in lower animals. Specifically, temperament and
character are conceptualized on the basis of two types of memory and learning that have been
described in humans and primates. These are called procedural memory (i.e., behavioral
conditioning) and semantic memory (i.e., long-term propositional or declarative memory).
Temperament (the “emotional core” of personality) involves procedural memory regulated by
complex distributed circuits in the cortico-striatolimbic system, primarily the sensory cortical
areas, amygdala, and the caudate and the putamen.
Procedural memory underlies associative learning and involves presemantic perceptual processing of
visuospatial




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