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NMSP Exam 3 > Approach to Personality Disorders > Flashcards

Approach to Personality Disorders Flashcards

1
Q

What is the Id

A

Instinctive biological drives and desires

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2
Q

What is the Ego

A

Logical and language based problem solving

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3
Q

What is the SuperEgo

A

Moral conscience based on ideal and values of society, “I should”

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4
Q

What is the purpose of defense mechanisms

A

Reduce tension

  • Rationally seek solution
  • if cant resolve -> defense mechanism
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5
Q

in whom do primitive defences occur

A
  • Childhood
  • Dreams
  • Psychotic Adults
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6
Q

What is projection

A

grossly frank delusions about external reality. Self projects paranoid ideas out into the world.

Wife cheating because I am cheating

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7
Q

What is denial

A

Refusal to accept terms of external reality because it is too threatening

a 200 board score applies to Vascular Surgery residency at Johns hopkins

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8
Q

What is splitting

A

Seeing some people as all good and other as all bad. Often seen with Borderline Personality Disorder

pt idolizes doc but hates nurses

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9
Q

What is displacement

A

Shifts sexual or aggressive impulses to a more acceptable or less threatening target

Doc yells at nurses after a frustrating patient

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10
Q

What is regression

A

Temporary reversion to an earlier less mature, behavior

adult begins baby talk when stressed

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11
Q

What is somatization

A

Transforms negative feelings towards others into negative feelings towards self, pain, illness, anxiety

Student embarrassed by resident, stomach ache before rounds

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12
Q

What is introjection/identification

A

Opposite of projection. involves taking in other behaviors or emotions and internalizing them.

Abused child becomes abusive parent -or-

Christian and Tanner watch too much letterkenny and I suggest you let that one marinate!

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13
Q

What is isolation of affect

A

Separate feelings from ideas and events
-la belle indifference seen in conversion DO and Alzheimer’s

Person describes murder in graphic detail with no emotion

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14
Q

What is intellectualization

A

focusing on and exaggerating the intellectual aspect of a situation so as to distance oneself from anxiety

physician focuses on lab results rather than patient emotion.

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15
Q

What is blocking

A

temporarily inhibits thinking. Can include affect and behavior. Individual stops momentarily

like a pause button

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16
Q

What is acting out

A

Covering up true feelings by discharging different feelings

bullies

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17
Q

What is Reaction Formation

A

Converting unconscious wishes or impulses considered threatening into their opposite (over reaction)

Student who does not like kids becomes pediatrician

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18
Q

What is undoing

A

Do an action hoping to fix or reverse a previously unacceptable behavior

-seen in bulimia, domestic violence

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19
Q

what is Rationalization

A

Individual convinces themselves that no wrong happened and that the unacceptable is acceptable

Yes we killed civilians but we were at war, and were ordered to

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20
Q

What is passive aggression

A

Aggression towards others expressed indirectly or passively

you need to return a bowl to neighbor but delay because dog destroys garden

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21
Q

What is dissociation

A

Drastic change in identity or character to avoid stress. Common in PTSD, Substance abuse

Individual describes assault as if they were out of their body watching it

22
Q

what is humor (mature defense mechanism)

A

Overtly expressing ideas and feelings especially those too terrible to talk about

I guess I’ll go fuck myself

23
Q

What is suppression

A

Conscious and intentional decision to delay paying attention to an emotional need

after pt dies, physician continues working and will deal with it later

24
Q

What is altruism

A

Constructive service to others

I want to go to allison’s birthday but the stupid floor piss baby needs me - Abbey and Bill Probably

25
Q

What is sublimation

A

Transform unpleasant emotion into positive action

angry with PCM but instead you

exercise
Paint
Clean

26
Q

What separates someone from being a little quirky compared to having a full blown personality disorder?

A

The extent of their functional impairment.

The difference between, “ugh my pencils aren’t aligned on my desk” and I will spend 1-2 hrs making sure everything is perfect or I cant start work.

27
Q

To have a personality disorder, a person must display an enduring pattern that deviates from expected culture. The pattern must manifest in 2/4 of the following. What are the 4 areas

A
  1. Cognition
  2. Affectivity
  3. Interpersonal Functioning
  4. Impulse control.
28
Q

What are the group A personality disorders

A

Schizotypal
Paranoid
Schizoid

29
Q

What are the group B personality disorders

A

Borderline
Histrionic
Anti-social
Narcissist

30
Q

What are the group C personality disorderss

A

Dependent
Avoidant
OCPD

31
Q

What is Paranoid personality disorder

A

suspicious, grudge holding, angry person who suspects they are being victimized by exploitation or deception

32
Q

How do you manage paranoid personality disorder

A

Be supportive
Respect pts thoughts but dont collude!
Be open Honest and respectful
Explain everything and dont cover up mistakes

once rapport is established, provide alternative explanations

33
Q

What is Schizoid personality disorder

A

removed and remote due to self isolation from lack of interest in socialization
Solitary people, little interest in sexual contact with others
flat affect

34
Q

How do you manage schizoid personality disorder

A

Respect their space
Don’t judge disconnection
Do not impose social expectations

35
Q

What is Schizotypal personality disorder

A

Closer relationships than Paranoid or Schizoid - but still difficulty with intimacy
Odd, magical thinking
Delusions of reference and unusual perceptual experiences
Excessive social anxiety

36
Q

How do you manage schizotypal personality disorder

A

Do not judge or ridicule

37
Q

Describe Borderline Personality Disorder

A

Appear in a state of crisis, highly unpredictable, cannot tolerate being alone, splitting, high comorbidities

38
Q

How do you manage Borderline Personality disorder

A

Form clear and consistent boundaries
be calm in your responses
Never provide special exceptions (phone call on holidays)
Refer to Dialectical Behavior Therapy

39
Q

Describe histrionic personality disorder

A

Needs to be center of attention and may use seductive behavior to accomplish that.
Increased risk for somatic symptom disorder, conversion disorder, and depressive disorders

40
Q

How do you manage histrionic personality disorder

A

Maintain boundaries
Provide reassurance
Address seductive behaviors in straightforward manner while maintaining professional boundaries

41
Q

Describe Antisocial Personality disorder

A

Pervasive disregard for violation of rights of others

  • steal
  • con
  • aggressive

Individual must be 18 for diagnosis but patterns appear at 15

Incorrectly referred to as psychopath/sociopath

42
Q

How do you manage Antisocial personality disorder

A

Firm limits
Clear and consistent boundaries
Caution when prescribing controlled substances

43
Q

Describe NArcissistic personality disorder

A

requires excessive admiration
entitled
Envies others or believed they are envied
Often feel contempt for others

44
Q

How do you manage Narcissistic personality disorder

A

Acknowledge patient as special
Avoid power struggles
reinforce that they are respected and special
monitor for depression/suicidality

45
Q

What is avoidant personality disorder

A

pervasive pattern of social inhibition with feelings of inadequacy

  • doesn’t want to hang out unless they know they are liked
  • unusually reluctant to take personal risks for new activities
46
Q

How do you manage Avoidant personality disorder

A

Avoid critical comments
reinforce appropriate help seeking behaviors
Be patient with your patient

47
Q

What is dependent personality disorder

A

need to be taken care of leading to submissive/clinging behavior
Subordinate their own needs to the needs of others and may accept demeaning tasks to gain acceptance.

48
Q

How do you manage dependent personality disorder

A

Tolerate repeated requests for reassurance
Schedule pre-established times
be careful when encouraging changing an abusive relationship

49
Q

Describe obsessive compulsive personality disorder

A

Preoccupied with details, rules, lists, order, organization, or schedules
Perfectionism that interferes with task completion
Limited interpersonal skills, unwilling to compromise

50
Q

How do you manage OCPD

A

Avoid power struggles
Allow patient to have control when they can (XR med QD or IR med BID)
Encourage limited information-seeking (or else they come back saying LOOK the DSM told me….)

NMSP Exam 3 (18 decks)

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