personality disorders Flashcards

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1
Q

personality disorder

A

influence the way they perceive and relate to the environment
occur when traits deviate markedly from the expectations of the individuals culture, become rigid and inflexible, contribute to maladaptive patterns of behavior or impairment in functioning, and lead to distress

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2
Q

Cluster A: eccentric

A

paranoid
schizoid
schizotypal

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3
Q

Cluster B: Erratic

A

Borderline
Narcissistic
histrionic
antisocial

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4
Q

Cluster C: Anxious

A

Avoidant
Dependent
Obessive-compulsive

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5
Q

paranoid personality disorder (A)

A

paranoia
distrustful nature
doubts loyalty
keeps grudges
easily offended
suspects that others are exploiting, harming, or deceiving them
pre-occupied with loyalty or trustworthiness
reluctant to confide
suspicious of fidelity of spouse or sexual partner
sees hidden or threatening meanings in benign remarks or events
bears grudges, unforgiving of slights, insults, or injury
quick to become angry or to counter-attack

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6
Q

treatment of paranoid personality disorder (A)

A

reject treatment
psychotherapy is 1st line of treatment
antianxiety meds (diazepam)
antipsychotics for agitation

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7
Q

tips for nurses working with cluster A paranoid personality (A)

A

appointments and schedules are strictly adhered to
do not be to nice and friendly can cause suspicion
instead give clear and straightforward explanations
use simple language and neutral affect
limit setting is essential for threatening behaviors

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8
Q

schizoid personality disorder characteristics (A)

A

symptoms appear in childhood and adolescence
loners, poor academic performance
increased prevalence of disordered family life
avoid close relationships
depersonalization, detachment

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9
Q

guidelines for nurses for schizoid PD (A)

A

avoid being to nice or friendly
do not try to increase socialization
assess for symptoms the patient is reluctant to discuss
protect against group’s ridicule

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10
Q

treatment for schizoid personality disorder (A)

A

psychotherapy
group therapy
antidepressants, 2nd generation antipsychotics

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11
Q

schizotypal personality disorder characteristics (A)

A

severe social and interpersonal deficits
anxiety in social situations
rambling conversation
paranoia, suspiciousness, anxiety, distrust
brief intermittent episodes of hallucination or delusion
can be made aware of their own odd beliefs
may be vulnerable to involvement with cults or unusual religious/occult groups

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12
Q

nursing guidelines for schizotypal personality disorder

A

respect patients need for social isolation
be aware of and intervene appropriately with patient’s suspiciousness
perform careful diagnostic assessment for symptoms that may need intervention (SI)
withhold judgement or ridicule

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13
Q

treatment of schizotypal personality disorder

A

supportive psychological care
investigate possible involvement with cults
low-dose antipsychotics

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14
Q

Histrionic personality disorder (B) characteristics

A

excitable, dramatic, often high functioning
bold external behaviors
limited ability to develop meaningful relationships
attention seeking, self centered, low frustration level
excessive emotions; may be provocative; smothering
no insight into disorder or role in ruining relationships

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15
Q

guidelines for nursing care of histrionic (B)

A

know that seductive behavior is a response to distress
keep interactions professional
ignore flirtations
model concrete language
help patient clarify inner feelings
teach and role-mode; assertiveness
assess for suicidal ideation

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16
Q

treatment of histrionic (B)

A

psychotherapy

17
Q

Narcissistic personality disorder (B) characteristics

A

feelings of entitlement, exaggerated self importance
lack of empathy; tendency to exploit others
weak self-esteem and hypersensitivity to criticism
constant need for admiration
less functional impairment than other personality disorders

18
Q

guidelines for nurse care histrionic (B)

A

remain neutral
promote a stronger patient self-identity
avoid power struggles or becoming defensive
role-model empathy

19
Q

treatment of narcissistic (B)

A

difficult to treat: patients not likely to seek help or confront shortcomings
CBT to deconstruct fault thinking
group therapy; lithium for mood swings

20
Q

borderline personality disorder (B)

A

pervasive patterns of instability of interpersonal relationships, self image and affect
frantic efforts to avoid real or imagined abandonment
pattern of unstable and intense interpersonal relationships
identity disturbances (unstable self image)
impulsivity that is potentially self-damaging (spending, sex, substance abuse)
recurrent SI, gestures, or threats; or self mutilating behaviors
affective instability due to a marked reactivity of mood
chronic feelings of emptiness
inappropriate, intense anger or difficulty controlling anger
transient, stress-related paranoid ideation or sever dissociation
beginning by early adulthood
view themselves as a victim

21
Q

risk factors of borderline personality disorder

A

high genetic association
neurobiological
cognitive: separation-individuation

22
Q

treatments of borderline personality disorder

A

biological treatment- psychotropics geared toward symptom relief
psychological therapies- CBT, DBT, schema-focused therapy

23
Q

antisocial personality disorder (B) characteristics

A

antagonistic behaviors
disinhibited behaviors
profound lack of empathy
absence of remorse or guilt
symptoms peak mid-teens to 20’s; symptoms may abate and improve on their own aby age 40

24
Q

treatment for antisocial personality disorders (B)

A

no specific meds
mood-stabilizers
also possible: SSRIs, benzos, ritalin

25
Q

psychological therapies for antisocial personality disorders (B)

A

some evidence that this patient population may bond with psychotherapists
CBT
MBT
DBT

26
Q

Avoidant personality disorder (C) characteristics

A

low self-esteem
shyness that increases with age
feelings of inferiority
reluctance to engage with new people subject to depression, anxiety, humiliation, and failure

27
Q

guidelines for care with avoidant personality disorder (C)

A

friendly, accepting, reassuring approach
dont push
acceptance of patient fears
group therapy
exercises to enhance new social skills
design exercises to prevent failures
assertiveness training

28
Q

treatment for avoidant personality disorder (C)

A

individual therapy
trust building
assertiveness training
group therapy
anti-anxiety agents
anti-depressants

29
Q

dependent personality disorder (C) characteristics

A

high need to be taken care of
submissiveness
fears of separation and abandonment
manipulating others to take responsibilities
intense anxiety when left alone even briefly

30
Q

guidelines for dependent personality disorder (C)

A

help address current stressors
set limits that dont make the patient feel punished
be aware of strong countertransference
use therapeutic relationship as a testing ground for assertiveness training

31
Q

treatment of dependent personality disorder (C)

A

psychotherapy is treatment of choice

32
Q

obsessive-compulsive personality disorder characteristics

A

rigidity, inflexible standards for others and self
constant rehearsal of social responses
excessive goal-seeking that is self-defeating or relationship-defeating
strict standards interfere with project completion
unhealthy focus on perfection

33
Q

guidelines for nursing care for OCD

A

guard against power struggles
remember that the patient has a difficult dealing with unexpected changes
provide structure, but with time to complete habitual behaviors

34
Q

treatment of OCD

A

group and behavioral therapy
clomipramine or fluoxetine for obsession’s, anxiety, and depression