Personality Disorders Flashcards
1
Q
Criteria to Diagnose a Personality Disorder
A
- One or more pathological personality trait domains
- Significant impairments in personality functioning including self-functioning and interpersonal functioning: Impairments are stable across time and consistent across situations; Impairments are not better understood as normative for the individual’s developmental stage or sociocultural environment; Impairments are not solely due to the direct physiological effects of a substance (e.g., substance or medication use) or a medical condition (e.g., severe head trauma)
2
Q
Risk Factors for Personality Disorders
A
- Comorbidities, criminal offenses
- Psychosocial influences: abuse, neglect
- Genetic factors – personality traits
3
Q
Expected Findings of Personality Disorders
A
- Exhibit one or more of the following common pathological personality characteristics: Inflexibility/maladaptive responses to stress, compulsiveness and lack of social restraint, inability to emotional connect in social and professional relationships, tendency to provoke interpersonal conflict
- Lack of social restraint – attention seeking behavior
4
Q
Common Defense Mechanisms
A
- Repression: Unconsciously putting unacceptable ideas, thoughts and emotions out of awareness.
- Suppression: Voluntarily denying unpleasant thoughts and feelings.
- Regression: Sudden use of childlike or primitive behaviors that do not correlate with the person’s current developmental level
- Undoing: Performing an act to make up for prior behaviors
- Splitting: Demonstrating an inability to reconcile positive and negative aspects of oneself or others into a cohesive imagine; Often associated with BPD; Black and white thinking
5
Q
3 Clusters of Personality Disorders
A
- Cluster A: ODD, ECCENTRIC; paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder
- Cluster B: DRAMATIC, UNPREDICTABLE; antisocial personality disorder, borderline personality disorder, histrionic personality disorder, narcissistic personality disorder
- Cluster C: ANXIOUS, FEARFUL; avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder
6
Q
Cluster A - odd, eccentric
A
- Paranoid: Characterized by distrust and suspiciousness towards others based on unfounded beliefs that others want to harm, exploit, or deceive the person.
- Schizoid: Characterized by emotional detachment, disinterest in close relationships, and indifference to praise or criticism; often uncooperative.; might lose a loved one and show little emotion related to it
- Schizotypal: Characterized by odd beliefs leading to interpersonal difficulties, an eccentric appearance, and magical thinking or perceptual distortions that are not clear delusions or hallucinations
7
Q
Cluster B - dramatic, emotional, or erratic
A
- Antisocial: Characterized by disregard for others with exploitation, lack of empathy, repeated unlawful actions, deceit, failure to accept personal responsibility; evidence of conduct disorder before age 15, sense of entitlement, manipulative, impulsive, and seductive behaviors; nonadherence to traditional morals and values; verbally charming and engaging.
- Borderline: Characterized by instability of affect, identity, and relationships, as well as splitting behaviors, manipulation, impulsiveness, and fear of abandonment; often self-injurious and potentially suicidal; ideas of reference are common (everyone is talking about me); often accompanied by impulsivity.
- Histrionic: Characterized by emotional attention-seeking behavior, in which the person needs to be the center of attention; often seductive and flirtatious.
- Narcissistic: Characterized by arrogance, grandiose views of self-importance, the need for consistent admiration, and a lack of empathy for others that strains most relationships; often sensitive to criticism.
8
Q
Cluster C: anxious or fearful; insecurity or inadequacy
A
- Avoidant: Characterized by social inhibition and avoidance of all situations that require interpersonal contact, despite wanting close relationships, due to extreme fear of rejection; have feelings of inadequacy and are anxious in social situations.
- Dependent: Characterized by extreme dependency in a close relationship with an urgent search to find a replacement when one relationship ends.
- Obsessive-Compulsive: Characterized by indecisiveness and perfectionism with a focus on -orderliness and control to the extent that the individual might not be able to accomplish a given task.
9
Q
Nursing Care
A
- Self-assessment/Reflection: think about how these things are making us feel
- Milieu management: keeping ourselves and others safe
- Safety: increased risk for suicidality
- Communication Strategies: firm and supportive, really clear, firm; make sure everyone is on the same page (i.e. other nurses, CNAs, charge, etc.); offer realistic choices: let them know they cannot be violent; limit-setting and consistency: let them know they are making you uncomfortable and it will not be tolerated; maintaining neutrality
- External Limit Setting
10
Q
Avoiding Power Struggles
A
- Common struggles: defending one’s authority or credibility (i.e. a client questions your judgment as a nurse, wants to talk to the MD. Instinct is to become defensive. Consider your body language and tone of voice when you’re defensive.); personal button pushing (i.e. nurses or clients may push each other’s buttons to make them back down. Be aware of your own, do not do it to clients.); bringing up history/irrelevant issues (Do not keep score. Stay in the present.); making empty threats or issuing ultimatums (“Don’t yell at me or you will have to go to seclusion.”)
- Remind yourself it takes two to have a struggle.
- Think opportunity versus negativity.
- Use “diffusers”.
CARE Principles: - Concentrate on the relevant issue
- Acknowledge your own active listening through body language
- Respond by paraphrasing and asking questions
- Emphasize your attempt to see things from the other person’s perspective
