module 6.1: Personaility disorder Flashcards
What is a personality disorder?
abnormal, extreme, inflexible, pervasive variation from the ‘normal’ range of one or more personality attributes.
Identify the aetiology of personality disorders. (6)
- Adverse family environments
- Poor attachment
- Vulnerable temperament
- Childhood maltreatment
- maladaptive family functioning
- impaired parental bonding
- Trauma
- Genetics
Outline the key features for a diagnosis of borderline personality disorder.(5)
- extreme levels of emotional reactivity
- recurring difficulties in relationships
- high levels of anxiety
- intolerance of aloneness
- intense inner pain
may lead to:
- Self-harm
- life threatening suicidal acts
- Alcohol/drug misuse
- Thrill / sensation seeking behaviour
- Nutrition related concerns
Using the ICD-11, the diagnosis of PD will require? (4)
A pervasive disturbance in;
- experiences & thoughts about self, others, the world
- manifested in maladaptive patterns of cognition, emotional experience, emotional expression & behaviour
- Maladaptive patterns - inflexible, associated significant problems in psychosocial functioning (relationships/situations).
- Disturbance relatively stable over time & is long in duration. First manifestations in childhood - clearly evident in adolescence.
DSM-5 PDs classified based on the principal personality features. what are the characteristics for - Cluster A (odd/ eccentric) (3)
Paranoid:
- distrusting & suspicious
- highly sensitive
Schizoid:
- cold & unemotional
- lack of interest in other people
- very introspective
Schizotypal:
- socially isolative
- has unusual ideas
- often has odd behaviours and appearance
DSM-5 PDs classified based on the principal personality features. what are the characteristics for - Cluster B ( dramatic, emotional erratic) (4)
Borderline:
- unstable relationships with others
- poor self image
- unpredictable and erratic moods
- impulsive substance use & abuse
- impulsive self-harming behaviours
Narcissistic:
- strong sense of entitlement, grandiose
- seeks admiration, lack of empathy for others
Antisocial:
- tendency to violate the boundaries of others
- superficial charm
- poor behaviour control - irritable, threats, verbal abuse
Histrionic:
* excessive attention-seeking behaviours, egocentric, highly emotional
DSM-5 PDs classified based on the principal personality features. what are the characteristics for - Cluster C ( anxious / fearful) (3)
Avoidant:
- insecure
- social isolation due to fears of rejection or humiliation
Obsessive-compulsive:
- preoccupation with orderliness and control over situations
- rigid behaviour, perfectionism
Dependant:
- excessive need to be taken care of, clingy, submissive
- feelings of helplessness when not in a relationship
what are the general principles of care for PDs?
- Risk assessment
- Consistency / community of care
- communication
- limit setting
- client involvement
- treat maladaptive coping strategies
what are the ‘5 trait domains’ of PD
1) Negative affective:
* anger, anxiety, irritability, depression, vulnerability
2) Dissocial:
* manipulation, poor empathy, self-entitlement
3) Disinhibition:
* impulsive, risk taking, distractibility, recklessness
4) Anankastic:
* perfectionism, stubbornness, rules & obligations
5) Detachment:
* social withdrawal / indifference
list the 5 considerations of the nursing assessment for PDs
1) Principles of care:
* communication & engagement
* shared language
* therapeutic alliance
* boundaries ( transfer & counter-transfer)
* roles & responsibilities
* consistency
2) Risk management
* self-harming
* suicide attempts / ideation
3) Co-existing conditions & Co-morbidity
* drugs & alcohol
4) MSE
* any self-destructive behaviours (consider insight & judgement)
5) Person-centred care:
* client involvement
* collaboration & flexibility
List 4 accepted treatment protocols for PDs
1) Pharmacological therapies
2) Interactive therapies
3) Therapeutic communities & case management
4) Team nursing interventions
