Mental Health Part 2 Flashcards
what is a personality?
complex pattern of characteristics that are not easily altered
distinctive pattern of perceiving, feeling, thinking, coping and behaving
emerges within a complex biopsychosocial framework
are people aware of what their personality is like?
largely outside of their awareness
what are 3 qualities of a personality disorder?
pervasive, inflexible, and stable?
what does pervasive mean? (personality disorder)
it will affect all aspects of life (social, work, school, etc.)
what does inflexible mean? (personality disorder)
difficult to change
why are personality disorders stable?
individual can plot through life without major disruptions but notice disorder characteristics during times of stress, adversity, crisis
what are some features and diagnostic criteria of personality disorders?
maladaptive cognitive schema, affectivity and emotional instability, impaired self-identity and interpersonal functioning, and impulsivity and destructive behaviour
what is maladaptive cognitive schema?
the way that they interpret the world, env’t and the way they screen info they get, react to it and make an assumption that is incongruent with the situation which leads to misinterpretation.
what is affectivity and emotional instability?
people have heightened emotional arousal with minor or slight information that causes a dramatic resonse
what is impaired self-identity and interpersonal functioning?
impression of self is heightened and grand ego or the opposite if BPD or dependent personality bc self-esteem is low.
mold their personality based on someone else. adapt pesonality based on what they think people want to hear
what are some of the Et r/t PD?
temperament, env’t, co-morbidity, genetic, emotional/behavioural
what kinds of env’t factors influence getting a PD?
maltreatment and temperament as children. childhood neglect can inc BPD.
many have to do with attachment, childhood abuse
what co-morbidites are often present in PD?
anxiety disorders, avoidance personality, social phobia, BPD, depression (all kind of personality disorders)
what personality disorders fit under cluster A?
schizotypal PD, Paranoid Personality Disorder, Schizoid Personality Disorder
what are some characteristics of cluster A PD?
odd, eccentric
social awkwardness and withdrawal
dominated by distorted thinking
delusional or paranoid thinking
dont fit in
perceptual distortion and eccentric, ideas of reference, odd beliefs, or magical thinking, flat or incongruent emotional responses…. what is this?
schizotypal PD
what is ideas of reference?
getting messages from the news via code that no one else understands and the person must follow these
what does magical thinking entail?
believes thoughts/actions/words have the power to prevent something from happen or that they can read peoples minds.
describe paranoid personality disorder?
pervasive distrust and suspiciousness of other people
assume ppl are out to harm them, take adv of them or humiliate them
hold grudges, are litigous, pathological jealousy
what does litigious mean?
threatening to sue people all the time
describe schizoid personality disorder
-Pervasive pattern of social detachment and a
restricted range of emotional expression
- Tend to be socially isolated, don’t seek out or
enjoy close relationships and almost always chose
solitary activities
Appear indifferent to both criticism and praise
Lacking a desire for intimacy
are individuals with schizoid personality disorders who don’t want relationships, anxious?
no, it is not r/t anxiety, they just don’t care for a relationship
what PD are in cluster B?
Histrionic PD
Narcisstic PD
Antisocial PD
Boderline PD
are people with cluster B personality disorder aware of their disorder?
no they lack insight, denial
what are some characteristics of cluster B pD?
dissociation or denial
abuse behaviours
-splitting/dichomotous thinking (black and white), emotional dysregulation (react before thinking)
what is histrionic PD?
Inappropriate, sexually seductive or provocative
behaviour
Seek excitement and attention (attention-seeking
behaviours)
Outwardly appear charming and lively but have a
threatened self-esteem and sense of attractiveness
Describes relationships as more intimate than they
are
what is narcissistic personality disorder?
Grandiosity
Believes that they are special, unique and can
only be understood by high status people or
institutions
Sense of entitlement
Needs constant admiration
Lacks empathy and takes advantage of others to
achieve his/her own needs
what kind of care is best when dealing with someone with narcissistic PD?
be firm and direct and set limits with the pt and make a care plan that is concrete
do people with narcissistic PD have insight?
they might but don’t care what other people think
are people with narcissistic PD adaptable?
yes, when their needs are not being met by someone they will manipulate someone else to get what they want
what is antisocial PD?
Disregards and violates others’ rights
No remorse for wrongdoing and no empathy
Irritability and aggressiveness
Marked readiness to blame others or to offer
plausible rationalizations for their behaviour
History of a conduct disorder before age 15 years
do people with antisocial PD lack insight?
no because they don’t care.
what disorder do they need a hx of in order to be diagnosed with anti-social disorder?
conduct disorder wich can emerge around 6-11 years old where they violent or criminal behaviour emerges (property stealing, animal abuse, arson).
do people with anti-social PD seek help for change? is it curative?
no because they don’t think anything is wrong or they don’t care.
not curative
nursing mgmt for someone with ASPD?
assess: quality of relationship (are they manipulating you, hold them accountable for their behaviour), impulsivity (other directed violence when needs not met), risk factor for violence (perceived disrespect form the pt directed at you (pt thinks you are disrespecting them)
what is BPD?
Unstable relationships, self image and affect
Impulsivity
Mood lability
Unstable and intense interpersonal relationships
and fear of rejection
Recurrent suicidal behaviour, gestures, threats,
self-mutilation
what is the Et of BPD?
Neurobiologic and genetic factors (FMRI shows frontal limbic highlighted)
Psychosocial risk factors (maltreatment)
Psychological theories
Biosocial theories
what is your primary nursing (potential) diagnosis
At risk for harm!!
___% of BPD will attempt suicide and __% will be successful
70, 10
what are some characteristics of BPD?
affective instability (irratic responses)
identity disturbances (poorly developed)
unstable interpersonal relationships (love or hate, fear or abandonment, seeks reassurance, tends to idolize)
cognitive dysfunction (extreme interpretation of events)
dysfunctional/maladaptive behaviours: impulsive, unpredictable, parasuicide
what is parasuicide?
Deliberate self-injury with the intent to harm oneself Compulsive self-injurious behaviour Episodic self-injurious behaviour Repetitive self-mutilation
why do people use self harm (parasuicide) as a coping measure?
releases endorphins and biochemicals and opiate neurotransmitters that is soothing and decreases anxiety.
what does episodic self-injurious behaviour mean?
planned self injury
what is dialectical behavioral therapy?
mindfulness and re-engagement with ones body
what are the 4 components of DBT?
- skills group- practice emotional regulation and modulation in group
- interpersonal effectiveness skills- developing assertiveness, problem solving and self esteem, self worth
- mindfullness- reengagement with body and recognizing and living in the moment
- distress tolerance- knowing that distress is normal part of life
what is the interdisciplinary treatment for BPD?
psychopharmacotherapy and DBT
what personality disorders are associated with cluster c
obsessive compulsive personality disorder
dependent personality disorder
avoidant personality disorder
what are some characteristics of cluster C?
Anxious or fearful thinking or behaviour In isolation: -Orderly -Anxious Passive-Aggression: -Self-chosen failure (take on tasks they are unable to complete) -Masochistic (self-defeating behaviour) -Dysthymic (mild symp of depression)
how does obsessive compulsive PD present?
Inhibited, stubborn, rigid and a perfectionist
Preoccupied with orderliness or perfection
Excessively devoted to work and productivity and
excludes recreation and friendships
Reluctant to delegate tasks to others
Can have difficulty discarding worthless objects
how does dependent disorder present?
Difficulty making everyday decisions without
significant advice and reassurance from others
Need to be taken care of
Submissive behaviour as they fear disagreement
and the loss of support/approval
Urgently needs to replace one relationship when
another one ends
how does avoidant disorder present?
Socially inhibited, shy and lonely
Sense of inadequacy with low self-esteem
Desperate for relationships but avoid social
contact
Reluctant to take risks or try new activities as
they might be embarrassed
what PD is this: person has a hx of conduct disorder?
anti-social disorder
what PD is this: a nurse comes into the room and the pt says they will only talk to a doctor.
narcissistic. only talks to people that are superior (they think they are superior and unique)
what PD is this: enjoys solitary activities and does not seek out or enjoy close relationships
schizoid personality disorder
what PD is this: tends to hold grudges and displays pathological jealousy
paranoid PD
what PD is this: says they hear the news telling them things in code
Schizotypal PD
what PD is this: outwardly charming and inappropriate, sexual behaviour
histrionic PD
