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Exam 4-DWB > personality disorder > Flashcards

personality disorder Flashcards

1
Q

Obsessive- Compulsive disorder involves what

A
  • anxiety;
  • obsessions;
  • compulsions;
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2
Q

Obsessions

A

characterized by intrusive thoughts that produce uneasiness, apprehension, fear, or worry

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3
Q

Compulsions

A

repetitive behaviors aimed at reducing the associated anxiety

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4
Q

what are common compulsions

A
  • washing/cleanliness;
  • repeat checking {orderly routine to ensure safety in house};
  • hoarding and compulsive buying;
  • harmful acts {i.e. person goes over bump in road and fears it is a body; may harm others veering in and out of traffic to return to make sure it was not a person
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5
Q

18% of people with OCD will start having symptoms when

A

before the age of 18

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6
Q

Management of OCD

A
  • CBT and exposure-ritual-prevention;
  • other psychotherapy;
  • medications: SSRIs, SNRIs, tricyclics
  • ECT
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7
Q

What should not be given for OCD

A
  • benzodiazepines because will not treat OCD, and may become compulsion
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8
Q

Characteristics of schizophrenia

A
  • thought disturbance;
  • disrupted social behavior;
  • inability to determine what is real
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9
Q

positive schizophrenia symptoms, patient experiences

A

things others do not

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10
Q

negative schizophrenia symptoms indicate

A

lack of a full emotional life

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11
Q

Positive schizophrenia symptoms

A 
Hallucinations:
  - auditory;
  - visual;
  - tactile;
  - gustatory;
  - olfactory;
Delusions;
disordered thoughts and speech
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12
Q

Delusions with schizophrenia

A

beliefs in something that is not real

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13
Q

Disordered thoughts and speech with schizophrenia

A

word salad: say random words at any given time

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14
Q

Negative schizophrenia symptoms

A
  • emotional blunting, flat affect;
  • inability to form relationships;
  • poverty of speech {can’t find words to express one’s self};
  • inability to experience pleasure
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15
Q

Prevalence of schizophrenia

A

1% of total population;

more prevalent in males than females

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16
Q

most commonly, first symptoms of schizophrenia occurs when

A

in late adolescence and early 20s;

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17
Q

CAUSES of schizophrenia

A
  • definitive cause unknown, likely multifactorial;
  • genetics;
  • prenatal development;
  • early environment;
  • neurobiology;
  • psychological/social processes
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18
Q

FNP role for pt with schizophrenia

A
  • treatment in conjunction with psychiatry;
  • need to address other medical issues;
  • i.e. smoking cessation, home safety, coordination of care
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19
Q

FNP needs to address what with patients with schizophrenia

A
  • other medicatl issues;
  • side effects from meds:
    • weight gain;
    • obesity;
    • obesity can lead to DM, htn, and HLD which will all need to be treated concurrently with psychiatric meds;
  • elevated blood sugars
20
Q

Personality disorders cluster A

A 
- odd type;
includes:
 - paranoid;
 - schizoid;
 - schizotypal
21
Q

Personality disorder cluster B

A

dramatic type;

  • antisocial;
  • borderline;
  • histrionic;
  • narcissistic
22
Q

Personality disorder cluster C

A

anxious type;

  • avoidant
  • dependent;
  • obsessive-compulsive
23
Q

Personality disorder Cluster D

A

unspecified {only psychopathy is considered a diagnosis};

  • passive-aggressive;
  • sadistic;
  • self-defeating;
  • psychopathy
24
Q

DSM fluidity with clusters

A

cluster C and D are currently in flux;

25
Q

Treatment concerns for personality disorders

A
  • doesn’t always require treatment;
  • complex disorders demand specialty treatment;
  • recognition and appropriate referral is crucial on primary care level
26
Q

Cluster A Paranoid characterized by

A

paranoia and a pervasive, long-standing suspiciousness and generalized mistrust of others, without any basis in reality

27
Q

Cluster A Paranoid signs and symptoms

A
  • hypersensitivity;
  • hypervigilance;
  • identification of things in their environment that support their paranoia
28
Q

Scenario for cluster A Paranoid

A

patient may see someone standing by the door as “waiting for them” versus someone who is simply waiting for a ride, unrelated to them

29
Q

Cluster A: Schizoid characterized by

A

a lack of interest in social relationships

30
Q

Cluster A: Schizoid signs and symptoms

A
  • tend toward a solitary lifestyle;
  • secretiveness;
  • emtional coldness;
  • apathy;
  • may have rick and elaborate, exclusively internal, fantasy world
31
Q

Cluster A: Schizotypal characterized by

A

a need for social isolation;

32
Q

Cluster A: Schizotypal signs and symptoms

A
  • uncomfortable in big groups;
  • shy in social situations;
  • odd behavior or thinking;
  • often unconventional beliefs;
  • peculiar speech patterns and odd modes of dress;
  • paranormal and superstitious beliefs;
  • may respond abnormally in conversation, not respond at all, or talk to self;
33
Q

Cluster B: Dramatic subtype

A
  • extremely dramatic in their presentation;

- comes with frustrating and/or dangerous behavior

34
Q

What is the most difficult personality disorder to deal with

A

Cluster B: Dramatic subtype

35
Q

Cluster B: Antisocial (Sociopathic) characterized by

A

a pervasive pattern of disregard for, or violation of, the rights of others {go out of their way};

36
Q

Cluster B: Antisocial (Sociopathic) signs and symptoms

A
  • less moral sense or conscience than others;

- commonly have patterns of crime, legal problems, and aggressive, impulsive behavior

37
Q

Cluster B: Borderline marked by

A
  • impulsivitiy and instability of affect
38
Q

Cluster B: Borderline signs and symptoms

A
  • interpersonal relationship disruption;
  • abnormal self-image;
  • tend to project internal sx onto others;
  • intense fears of abandonment;
  • extreme anger and irritability;
  • idealization and devaluation
39
Q

Describe idealization and devaluation in borderline personality disorder

A
  • effusive in praise of provider {you get me};
  • adamant that provider is awful;
  • all good or all bad and no in between;
  • even if they see you as good now, it will change to bad later;
  • avoid believing the praise because you shouldn’t believe the torment later;
40
Q

Cluster B: Histrionic characterized by

A
  • a pattern of excessive attention-seeking emotions;
41
Q

Cluster B: Histrionic symptoms can include

A
  • aggressive sexual behavior;
  • inappropriate seductive behavior;
  • egocentrism;
  • self-indulgence;
  • manipulative behavior to achieve their needs
42
Q

does males or females suffer from histrionic personality disorder more

A

females 4:1

43
Q

Cluster B: Narcissistic: characterized by

A

excessive preoccupation with personal adequacy, power, prestige, and vanity;

44
Q

Cluster B: Narcissistic symptoms

A

unable to see or appreciate how their behavior affects other people, or worse, willfully cause harm to others for personal gain

45
Q

Tips for primary care providers when dealing with personality disorders

A
  • difficult to manage d/t gray areas;
  • difficult to know when to medicate;
  • draw boundearies with disruptive/demanding patients;
  • enforce same rules for all patients;
  • disruptive behavior constitutes referral

Exam 4-DWB (20 decks)

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