Diagnostic Division: Ego Integrity

Definition: Inability to form a valid appraisal of the stressors, inadequate choices of practiced responses, and/or inability to use available resources.

RELATED FACTORS
Situational/maturational crises; High degree of threat; Inadequate opportunity to prepare for stressor; Disturbance in pattern of appraisal of threat; Inadequate level of confidence in ability to cope; Inadequate level of perception of control; Uncertainty; Inadequate resources available; Inadequate social support created by characteristics of relationships; Disturbance in pattern of tension release; Inability to conserve adaptive energies; Gender differences in coping strategies; [Work overload; No vacations; Too many deadlines]; [Impairment of nervous system; Cognitive/sensory/perceptual impairment; Memory loss]; [Severe/chronic pain]

DEFINING CHARACTERISTICS

Subjective
Verbalization of inability to cope or inability to ask for help; Sleep disturbance; Fatigue; Abuse of chemical agents; [Reports of muscular/emotional tension]; [Lack of appetite]

Objective
Lack of goal-directed behavior/resolution of problem, including inability to attend to and difficulty with organizing information; [Lack of assertive behavior]; Use of forms of coping that impede adaptive behavior [including inappropriate use of defense mechanisms, verbal manipulation]; Inadequate problem solving; Inability to meet role expectations/basic needs [e.g., skipping meals, little/no exercise]; Decreased use of social support; Poor concentration; Change in usual communication patterns; High illness rate [e.g., high blood pressure, ulcers, irritable bowel, frequent headaches/neckaches]; Risk taking; Destructive behavior toward self [including overeating, excessive smoking/drinking, overuse of prescribed/OTC medications, illicit drug use]; [Behavioral changes, e.g., impatience, frustration, irritability, discouragement]