Personality Disorders Flashcards
In people with personality disorders (PD), personality traits are
exaggerated and rigid to the point that they cause dysfunction in their relationships.
What is personality
How we perceive and interact with the world.
what are personality traits
Stylistic peculiarities that all people bring to social relationships
what are personality disorder traits
- Difficulty accurately perceiving and interpreting the world around them
- Difficulty with impulse control
- Inappropriate emotional responses
- Blaming
what is blaming for personality disorder traits
Genuinely unaware that their personality traits are causing the problems
what are the characteristics of personality disorders
- avoidance and fear of rejection
- blurring of boundaries between self and others
- insensitive to others needs
- demanding
- fault finding
- inability to trust
- lack of individual accountability
-passive-aggressive traits - tendency to provoke interpersonal conflict
They dont see any of it as a problem
what is the cause of personality disorders
-due to a combination of hereditary and temperamental traits, as well as environmental and developmental events.
when do personality traits form
- present in infancy but emerge in adolescence
what are the genetic factors involved in personality disorders
- dominant role of genetics
what are the neurobiological factors involved in personality disorders
- Aggressive, impulsive behaviors
- Affective instability
what are the psychological influences for personality disorders
- child hood neglect
- childhood trauma
Excessively harsh and erratic discipline, alcoholic parent(s), and abusive and chaotic home life are risk factors for
borderline PDs (BPDs) and antisocial PDs in particular.
Sexual abuse is a risk factor for
BPD
what cultures are at risk for personality disorders
Native and African Americans, young adults, low socioeconomic status, and those who are divorced, separated, widowed, and never married are more at risk
what are cluster a disorders
- Resembles schizophrenia but with no psychosis
- Odd, eccentric behavior and speech (in phrasing; may only make sense to them)
- -Reactions from others may lead to paranoid thinking
- Cognitive perceptual distortions without psychosis
- May display magical thinking and rituals
- Give-and-take conversations difficult
- Genuinely unhappy about lack of relationships
- Social anxiety and unhappiness may increase over time
what are cluster b disorders
- emotionally reactivity, poor impulse control, manipulation
- unclear sense of identity
- Persistent disregard for others
- Persistent violation of others’ rights
- Absence of remorse for hurting others (callousness)
- Sense of entitlement
- Deceitfulness
- Impulsiveness; risky behaviors to “feel alive”
what are cluster c disorders
- high anxiety and outward signs of fear
- inhibited internalizing blame, even when not to blame
what are the characteristics of cluster a disorders
-Flat affect, appearing indifferent to both praise and criticism
-Unable to establish relationships
-Restricted range of interpersonal emotions
(spend a lot of time day-dreaming)
-Invest little energy in human relationships; conversely, may invest enormous energy in nonhuman interests
-Often creative, original thinkers
what is paranoid personality disorder (PPD)
- Pervasive, persistent, inappropriate suspiciousness and distrust of others
- Present as hostile, irritable, injustice collectors; jealous, lacking warmth
- May appear businesslike and efficient, but generate fear and conflict in others
- Find malice in benign comments and behaviors
what is the characteristic’s of cluster b disorder
- Unstable, intense relationships (goes from “you are the best” to “you are the worst”)
- Instability of affect; unstable, frequent mood changes
- Emotional lability (shifting from anxiety, to irritability, etc.) Emotional dysregulation
- Poor impulse control; self-destructive; suicide-prone
- Chronic depression
- Projected identification
- Splitting (sometimes known as black and white/good or bad-thinking)
- Abandonment Issues (frantic efforts to avoid real or imagined abandonment)
what is cluster b: Histrionic Personality Disorder
- Manipulative, insensitive, excessive emotionality and attention seeking
- Need to become and remain the center of attention, love, and admiration
- Superficial, shallow, short-lived relationships
- Dramatic, rapidly shifting, charming, flamboyant, and sexually seductive behaviors
- Constant, sudden emotional shifts and lability (rapid change in mood)
- Lack insight into cause of relationship failures
what is cluster c: Avoidant Personality Disorders
-Low self worth
-Appear withdrawn (avoid socialization)- “social phobias”
-Fear criticism and rejection
(ex. “I know nobody loves me”)
-Shy, timid, isolated
(Hard time with relationships and occupational functioning)
what is cluster c: Obsessive-Compulsive Personality Disorder
- Orderliness, stubbornness, attention to detail
- Indecisiveness
- Emotional constriction
- Pervasive pattern of perfection and inflexibility
- Perseveration (persistent pursuit of an action even in the face of repeated failures)
- High achievers
- Superficial, rigidly controlled intimacy
- Stinginess
what is cluster c: Dependent Personality Disorder
- Belief in inability to survive if left alone
- Excessive need to be taken care of
- Solicit caretaking through clinging and submission
- Perversely, excessively submissive
- Intense fear of separation and being alone
- Tolerant of poor, even abusive relationships. If relationship does end, the individual has an urgent need to get into another
- Inability to make decisions without excessive reassurance
what assessment is involved for personality disorders
- Assess suicidal and homicidal thoughts.
- Determine whether the patient has a medical disorder or another psychiatric disorder.
- View the assessment of personality functioning from within ethnic, cultural, and social backgrounds.
- Assess for recent and important losses.
- Evaluate for changes in personality in middle adulthood or later:
- -May signal an unrecognized substance use disorder.
- Be aware of strong negative emotions that patients evoke.
- -With nurse/patient interaction
Ego weakness” results in:
Splitting, dissociation, psychotic thinking
Blurred personal boundaries:
Closeness seems similar to a fusion of boundaries where one person begins, and one leaves off.
Criteria for outcomes for personality disorders might include the following:
- Minimizing self-destructive behaviors
- Reducing manipulating behaviors
- Linking consequences to behaviors
- Initiating alternatives to prevent crisis
- Ongoing management of emotions
- Creating lifestyle that prevents regression
what limits should be set on on manipulative behaviors:
- Arguing or begging
- Using flattery or seductiveness
- Instilling guilt and clinging
- Constantly seeking attention
- Pitting one person, staff member, or group against another
- Frequently disregarding the rules
- Constant engaging in power struggles
- Exhibiting angry, demanding behaviors
what should you avoid for personality disorders
- Discussing yourself or other staff members with patient
- Promising to keep a secret
- Accepting gifts from patient
- Doing special favors for patient
Nurses greatly enhance their ability to be therapeutic when they combine:
- Limit-setting
- Trustworthiness
- Dealing with manipulations
- Authenticity with their own natural style
Nurses greatly enhance their ability to be therapeutic when they combine
limit setting, trustworthiness, manipulation management, and authenticity with their own natural style.
what are the therapies used for personality disorders
- Psychotherapy
- Psychodynamic psychotherapy
- Cognitive-behavioral therapy
- Dialectical Behavioral therapy (DBT
what is dialectical behavior therapy
-Evidence based therapy (type of cognitive behavior therapy)
-Helps to change self-destructive behaviors associated with Borderline
-Personality Disorder (BPD)
Individual sessions/group sessions
what are the 4 core concepts of dialectical behavior therapy
- Mindfulness-living in the moment
- Interpersonal effectiveness- skills that maximize the change of achieving a goal w/o damaging a relationship or one’s self respect
- Distress tolerance- learning to bear emotional pain skillfully by accepting self and current situation
- Emotional regulation- recognizing and coping with negative emotions in a healthy manner
what does SSRIs do
treat co-morbid depression and panic attacks
what does trasodone and venlafaxine have
have low toxicity in overdose
what does carbamazepine do
targets impuslivity and self harm
what does lithium, anticonvulsants, SSRIs do
minimize aggression
what does atypical antipsychotics help with
psychotic features in BPD under stress
