Personality Disorder Flashcards
1
Q
personality
A
evolving char and bx which person can be born with or dev in life incl major traits, intent, drivers, values, self-concept, abilities, emo patterns
2
Q
What determines bx?
A
Personality
3
Q
Personality dx
A
Enduring pattern of deviant inner experience and bx
- differs from cultural expectations and adapt to maladaptive bx
- pervasive, inflexible, stable
- lead to distress and impair
- dysfxn in cog, relx, affect, impulse control
4
Q
rf for personality dx
A
- genetic and NT
- psychosocial and enviro - parent, what kids see, trauma
- diathesis stress model
5
Q
comps of personality dx
A
- interpersonal relx impair
- dysfxn in cog
- affect dysfxn
- impulse control
6
Q
Overall tx
A
- psychopharm
- ind therapy
- DBT
- fam edu and therapy
- social skill
- group therapy
- tx but depends on degree of impairment and motivation
7
Q
Overall dx of personality dx
A
- specific and notable pattern of feel, think, bx
- enduring over time
- pervasive across many sites
- involve inner exp and ext bx
- differ signif from cultural expectations
- involve 2+ of think, feel, impulse control, interpersonal fxn
- lead to signif distress/impair in social, legal, occup, money, safety
- not better accounted for by other MH condx, med condx, subs
8
Q
Cluster A PD
A
eccentric and odd
- PaSS on the party
- paranoid, schizoid, schizotypal
9
Q
Sx of Cluster A PD
A
- neg sx like with schiz
- ind don’t lose contact with reality and less severe than w/ schiz
- remove self from others
- can be made aware of their thinking
10
Q
Paranoid PD
A
- longstanding intense distrust and sus
- anx and reluctant to confide with others, fear of harm
- jealous, controlling adults
- vindicate and unwilling to forgive
- hypervigilant, quick to anger, provoke others, counterattack
- insecure and fear being harmed
11
Q
Therapy for paranoid PD
A
role play (but group therapy can be scary)
12
Q
NC for paranoid PD
A
- counteract mistrust
- adhere to schedule and boundaries (esp when threatened)
- avoid overly friendly but acknowledge feels
- simple, direct lang
- neutral, kind affect
13
Q
Schizoid pd
A
- lowers, poor academic solitary
- inc prev of dx fam life
- avoid close relx - rarely marry
- depersonalize, detach, flat
- cold, detach, distant
14
Q
schizoid pd NC
A
- avoid too nice
- don’t inc socialize
- assess sx pt does not want to discuss
- protect against ridicule from other pt, hc worker
- protect personal space while encouraging participation gently
- psycho/group, anti dep dec 2nd gen antipsychotics
15
Q
schizoptypal pd
A
- severe social and interpersonal deficits
- rambling convo
- paranoia, sus, anx, distrust, odd, eccentric
- brief eps of halluc or delus
- can be made aware of odd beliefs and magical thinking, clairvoygant
- sus to cults and religious events, ideas of reference; events occur for you
- constricted, inappropriate affect
16
Q
NC for schizotypal PD
A
- respect social iso
- intervene in sus as needed esp SI
- reinforce appropriate bx and dress
- perform careful dx assess for dangerous sx (SI)
- may use lower dose antipsychotics
17
Q
Cluster B personalities
A
- dramatic, emo, antagonistic, erotic
- BAHNed from the party
- BPD, antisocial PD, histrionic, narcissistic
18
Q
Borderline PD
A
- suicidal bx, gestures, threat; self-mutilate
- affective instability, mood swing
- ID disturbance - empty feel, dysphoria, boredom
- intense anger, prob controlling rage
- paranoid ideation or severe dissociation under stress
- intense sensitivity to criticism
- perform bx as others wish
- efforts to avoid real or imagined abandonment
- unstable interpersonal relx
- impulsive in 2 areas that are self-damaging (money, sex, self-harm, sub use)
- see selves as victims
19
Q
Splitting
A
Ind can’t integrate and accept pos and neg feelings
- ppl incl self and life situations all good or bad
- love or hate you
20
Q
NC for BPD
A
- comprehensive access–rf and emo triggers
- tend to get worse when admitted
- build trust and therapeutic enviro with consis, empathy, validation
- teach coping for emo reg—deep breath
- safety plan (esp in crisis, who to call)
- set boundaries and conflict resolution, be predictable and available
21
Q
Antisocial PD
A
- antagonistic, disinhibited, lack empathy, remorse, guilt
- violate others rights, hurt others, con others, false names
- avoidance of conduct dx before 15y age
- need to prove superiority
- center of universe
- irritable and aggressive
- superficially cheerful but deceitful
- more males
- more outward probs
22
Q
NC for antisocial PD
A
- IC blocks to therapetic relx
- ID dysfxn think patterns, dev new prob solve bx
- self responsibility facilitation
- anger control asst
- help build new support system
- self-awareness enhancement
23
Q
histrionic PD
A
- excitable, dramatic, high fxn
- bold, attn seeking-provocative
- excess emo, smothering
- no insight, limit relx
- consider relx more intimate than they are
- intentional desire to gain emo support
24
Q
How to distinguish histrionic PD from bp dx
A
- doesn’t fluc like bipolar
- can be hard to separate from mania
25
NC for histrionic PD
- ignore flirtation
- model concrete lang
- help clarify inner feels
- can be SI
- set firm boundary with staff and peers
- often with anx, sub use, other PD
26
Narcissitic PD
- feel entitled, self-impatient
- lack empathy, exploit others
- fear abandonment
- low SE and hypersens
- constant need for admiration
- only want to interact with other special ppl
27
NC for narcissistic PD
- promote strong pt/strong sense of self
- outward strong, inward fragile
- clear boundary
- avoid power struggle
- avoid defenesless
- remain neutral
28
Cluster C personalities
- party is DOA (dead on arrival)
- anxious
- dependent, obsessive-compulsive, avoidant
29
Dependent PD
- overwhelm need to be cared for; clinging
- fear separate/abandon
- manipulate others to take responsibilities; submissive
- intense anx when left along even briefly
30
NC for dependent PD
- psychotherapy
- address current stressors and feel alone
- set limits
- be aware of strong countertransference
- therapeutic for assertiveness training
- encourage ind and self-efficacy
31
Obsessive compulsive dx
- rigid, inflexible; workaholics
- excess goal seeking that is self-defeating or relx-defeating
- strict standards interfere with project completion
- unhealthy focus on perfection
32
How does OCD differ from obsessive-compulsive PD
does not interfere greatly with daily functioning
33
NC for obsessive-compulsive PD
- seek help when overwhelmed and can't keep up with org
- guard against power struggle
- remember pt has prob dealing with unexpected changes
- provide struc but with time to complete habitual bc
- promote calm, supp enviro
34
Meds for OCPD
fluoxetine or clomipramine
35
Avoidant PD
- low self-esteem, lonely, overly sensitive
- shyness inc with age
- feel inferior
- reluctant to engage with new ppl
- subject to dep, anx, anger
- preocc with reject, fail, humiliation
36
NC for avoidant PD
- friendly, accept, reassure
- enhance social skills
- accept pt fears
- designs exercises to prevent fail
37
Tx for avoidant PD
- trust build
- group therapy
- assertiveness training
- antidep/antianx
