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NURS 363: Mental Health and Wellness in Nursing > Personality Disorders > Flashcards

Personality Disorders Flashcards

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1
Q

What is personality?

A

Individual’s characteristic patterns of relatively permanent thoughts, feelings, and behaviours that define the quality of experiences and relationships.

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2
Q

What is a personality trait?

A

A stable characteristic of a person.

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3
Q

What is a personality type?

A

A way to describe a cluster of personality traits.

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4
Q

What are cluster A personality disorders?

A

paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder

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5
Q

What are cluster B personality disorders?

A

borderline, narcissistic, histrionic, antisocial

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6
Q

What are cluster C personality disorders?

A

avoidant, dependent, obsessive-compulsive

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7
Q

Which personality disorders are common among both community and clinical populations?

A

borderline, avoidant, and obsessive-compulsive personality disorders

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8
Q

What percentage of the world are affected by personality disorders?

A

10%

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9
Q

What causes a personality disorder?

A
  • Biological (genetic component and emerging research on neurochemistry
    and neurobiology)
  • Psychological factors- early childhood experiences lead to maladaptive
    coping
  • Environmental factors: family environment, experiences with siblings,
    school, trauma, neglect
  • Diathesis - stress model: multifactorial influences of biology and
    environment
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10
Q

What do individuals with personality disorders display?

A
  • Significant challenges in self-identity or self-direction
  • Have problems with empathy or intimacy within their relationships
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11
Q

Why is treatment difficult and complex for people with personality disorders?

A

Treatment is difficult and complex, as people with these disorders may have difficulty recognizing or owning the fact that their difficulties are problems of their personality.

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12
Q

Where do we see increased frequency with personality disorders?

A

Increased frequency in people receiving extensive medical and psychiatric
services
- Frequently coexists with other psychiatric disorders

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13
Q

What is a risk factor for a personality disorder?

A

Childhood trauma a risk factor

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14
Q

What are characteristics of people with Cluster A personality disorders (paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder)?

A

Individuals with these disorders demonstrate odd or eccentric behaviours (i.e. social isolation, detachment)
They may also display perception distortions, unusual levels of suspiciousness, magical thinking and cognitive distortions.

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15
Q

What are characteristics of people with Cluster C personality disorders (Dependent Personality Disorder, Avoidant personality Disorder, Obsessive compulsive personality Disorder)

A

These people have a pervasive pattern of anxious behaviours with rigid patterns of social shyness, hypersensitivity, need for orderliness, relationship dependency

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16
Q

What are characteristics of people with Cluster B personality disorders (Borderline Personality Disorder, Narcissistic Personality Disorder, Histrionic Personality Disorder, Antisocial Personality Disorder)

A

These people respond to life’s demands with dramatic, erratic and at times chaotic traits.

Problems with impulse control, emotion processing and regulation, and **interpersonal difficulties **characterize cluster B.

Persons with Borderline Personality Disorder are represented in in-patient and out-patient services more than other personality disorders.

17
Q

How does hospitalization factor into treatment for people with borderline personality disorder?

A

Hospitalization is not a recommended treatment for persons with BPD, however they have increased admissions due to safety concerns. Short admissions are recommended.

18
Q

What are major characteristics of borderline personality disorder?

A

Marked by Impulsivity: immediate reactions leading to extreme behaviours such as violence, hostility, anger.

Tendency toward** destructive self soothing behaviours** such as cutting, sexual promiscuity and substance abuse.

Emotional lability: Responds with emotions out of proportion to the situation. Extreme sensitivity to rejection and separation.

External locus of control.

Chronic suicide ideations common.

ALL THIS = CHAOTIC INTERPERSONAL RELATIONSHIPS: family, co-workers, friends, lovers

19
Q

What is splitting as it related to people with borderline personality disorder?

A

Splitting: persons with BPD often see things as all good or all bad. Often plays out as initially seeing nurse as the “best” until a limit is set or somehow shifts for the person, then they are “the worst” nurse. This happens in their personal life as well with partners, jobs, etc.

20
Q

How can nursing teams effectively handle patients with borderline personality disorder?

A
  • Teamwork is essential in the care of persons with BPD. All staff must consistently follow the care plan,
  • Therapeutic relationships are essential with strong boundaries.
  • Handling of behaviours in a calm, matter of fact way that is supportive to the patient.
21
Q

What is involved in the nursing assessment of patients with borderline personality disorder?

A

Mental status assessment
Suicide assessment
Substance abuse history
Self assess
Outcome: Stabilize and discharge

22
Q

What is involved in the treatment of borderline personality disorder?

A

Often present with a myriad of symptoms. Antidepressants, mood stabilizers, antipsychotics, Recently an opioid receptor antagonist (Naltrexone) being tried as found to decrease self harm behaviours, anti anxiety meds common.
Psychotherapy,
Dialectical Behavioural Therapy (DBT)

23
Q

What are some interventions for someone with Borderline PD?

A
  • Assess and monitor for suicide
  • Do not assume all complaints are manipulation (i.e. physical)
  • Give support for direct communication and for fulfilling responsibilities
  • If possible, have one staff member work with*
  • Focus on self responsibility (obtaining resources)
  • Help patient ID own role in lead up to hospitalization
  • Teach problem solving process
  • Help ID strengths and successful coping and teach other coping
  • Observe how functions in different situations and give feedback
  • Discuss discharge planning frequently and positively
24
Q

When providing care for a patient diagnosed with borderline personality disorder, what symptoms will the nurse regularly assess and document?
The patient’s mood shifts, impulsivity, and splitting
The patient’s grief, anger, and social isolation
The patient’s altered sensory perceptions and suspicion
The patient’s perfectionism and preoccupation with detail

A

The patient’s mood shifts, impulsivity, and splitting

25
Q

Which of the following is the priority nursing intervention for a patient diagnosed with borderline personality disorder?
Protect other patients from manipulation
Respect the patient’s need for social isolation
Assess for suicidal and self-mutilating behaviours
Provide clear, consistent limits and boundaries

A

Assess for suicidal and self-mutilating behaviours

26
Q

After days of constant dramatic praise for the nurse by a patient diagnosed with borderline personality disorder, and subtle insults to the rest of the staff, some members of the team may start to feel inadequate and resentful of the nurse. They begin to make critical remarks about minor events to prove that the nurse is not perfect. What is occurring within the nursing team?
Devaluation
Staff splitting
Incivility
Horizontal violence

A

Staff splitting

27
Q

A patient with borderline personality disorder (BPD) exhibits negative affect, which includes emotional _____________, described as rapidly moving from one emotional extreme to another.

A

lability

28
Q

A patient with borderline personality disorder (BPD)is admitted to an inpatient psychiatric unit following a suicide attempt. Which of the following patient statements best reflects the coping style commonly used by people with BPD?
“My provider says I might get out of here tomorrow. Do you think I’m ready to go?”
“Last night the nurse let me go outside and smoke. I can’t believe you aren’t letting me. I used to think you were the best nurse here.”
“I will never again speak to any of my messed-up family members. I know that this will help me be more functional.”
“I promise I am not feeling suicidal. I won’t hurt myself.”

A

“Last night the nurse let me go outside and smoke. I can’t believe you aren’t letting me. I used to think you were the best nurse here.”

NURS 363: Mental Health and Wellness in Nursing (22 decks)

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