Personality Disorders Flashcards
what is personality?
total of thoughts, emotions, and behaviors; how a person thinks, relating to yourself, and the environment
when is personality unhealthy?
when one’s personality gets in the way of the ability to function, such as in one’s job, personal life with family and in school
can personality change?
changing personality is very hard; thus, the reason it is hard to treat personality disorders
what is built within the first fiver years of someone’s life due to the biggest brain development?
personality
what happens when personality traits become inflexible and rigid?
maladaptive patterns of behavior and functional impairment
what often co-occur with other mental health diagnosis, such as depression, anxiety, eating and substance use disorders?
personality disorders
what defines cluster A?
odd or eccentric traits
what defines cluster B?
dramatic, emotional, or erratic traits
what defines cluster C?
anxious or fearful traits
what are the personality disorder in cluster A?
paranoid
schizoid
schizotypal
what are the personality disorders in cluster B?
antisocial
borderline
histrionic
narcissistic
what are the personality disorders in cluster C?
avoidant
dependent
obsessive-compulsive
what are the DSM-5 criteria to be diagnosed with borderline personality disorder?
- avoidance of real or imagined abandonment
- pattern of unstable relationships
- identity disturbances
- impulsivity in at least two separate areas
- recurrent suicidal behavior- self-destructive and ineffective self-soothing
- affective instability- emotional dysregulation/lability
- chronic feelings of emptiness
- inappropriate anger or difficulty controlling temper- hostility, anger, and irritability
- transient or stress related paranoid ideations
what happens in relationships with those with borderline personality disorder?
they will first become very clingy and start to be come very attached after a while, the person starts to develop feelings of mistrust because they think that they are going to dump them
what is the etiology of the borderline personality disorder?
trauma response; especially in childhood
genetic
biochemical- decrease in serotonin
neurobiological- abnormalities in prefrontal cortex and limbic system
psychosocial/development factors- disruptive normal development d/t instability
what is the primary defense mechanism for borderline personality disorder?
splitting defense mechanism
how do those with borderline personality disorder utilize the splitting defense mechanisms?
cannot view a person with a positive and negative aspects
all or nothing- good or bad
they can pin people against each other by stating one person is good and one persons
what is the assessment of the borderline personality disorder?
use of questionnaires that asks:
feelings of emptiness
risky behaviors
intense feelings of abandonment
idealization of others
tendency toward anger, sarcasm, and bitterness
self-mutilation/self-harm- violent thoughts of self or others
what is deliberate self-injurious behavior causing tissue damage with intent of causing nonfatal injury to attain relief of tension?
non-suicidal self-injury/self-mutation
what are the nursing interventions of non-suicidal self-injury/self-mutation?
care for wounds in a matter-of-fact way- do not positively enforce behavior by offering sympathy or attention
encourage talk of underlying feelings
teach redirect violent behavior
what happens when those with non-suicidal self-injury/self-mutation when they are given too much attention?
rewarding which can encourage them
what are nursing diagnoses for borderline personality disorder?
risk for self-mutilation
risk for self-directed violence; risk for suicide
risk for other-directed violence
complicated grieving
impaired social interaction
disturbed personality identity
anxiety (severe to panic)
chronic low self-esteem
what is the treatment for borderline personality disorder?
teamwork and safety in treatment setting
no FDA approved medication- off label use
psychological therapies- CBT and dialectical behavioral therapy and schema-focused therapy
what identifies and changes core inaccurate perceptions of self/other relationships?
cognitive- behavioral therapy
what therapy includes CBT and mindfulness and increased ability to manage distress?
dialectical behavior therpay
what therapy shapes the view of self and changes the dysfunctional self-image?
schema-focused therapy
what can be sometimes be misdiagnosed as bipolar disorder?
borderline personality disorder
what diagnosis is reserved for adults?
anti-social personality disorder
disregard for and violation of rights of others since age 15
which personality disorder has deceitful, manipulative for personal gain, and hostile if needs are blocked, and risk takers?
anti-social personality disorder
what is another name for anti-social personality disorder?
sociopaths
what needs to be ruled out before diagnosing anti-social personality disorder?
schizophrenia and bipolar disorders
what is the DSM-5 criteria for the diagnosis for anti-social personality disorders?
- failure to conform to social norms
- problems with authority
- deceitfulness
- impulsivity
- irritability and aggressiveness
- reckless disregard for safety, especially with others safety
- consistent irresponsibility
- lack of remorse- no empathy- callousness
what are the genetic risk factors for antisocial personality disorder?
aggressive disregard- violent tendencies without concern for others
disinhibition- no concern for consequence
what are the neurobiological risk factors for antisocial personality disorder?
lower serotonin/dopamine hyperfunction
what are the environmental risk factors for antisocial personality disorder?
childhood abuse- ACE
what are the signs and symptoms of anti-social personality disorder?
abuses substances, such as alcohol and cocaine
no satisfying interpersonal relationship
tends to manipulate others
irresponsible and exploitative
social norms are disregarded
obnoxious towards others
cold and callous
intimidate others
argumentative
legal problems- usually within jail not in psych units, but can manipulate the system
what would a person with anti-social personality disorder have a history in childhood?
- starting fires
- hurting animals and other kids
- running away
- fascination of firearms and weapons
what are the nursing diagnoses for anti-social personality disorder?
risk for other-directed violence
defense coping
chronic low self-esteem
impaired social interaction
ineffective health maintenance
what are the nursing interventions of anti-social personality disorder?
aggressive and impulsive behaviors- watch for signs
ensuring safety of client and others
diversionary activities
exercise
explain consequences of violation of limits
watch for manipulative behaviors
don’t try to convince to “do the right thing’
don’t say “you should or shouldn’t”; say “You will be expected to…”
give positive feedback or reward for good behaviors
what are the treatment modalities for sociopaths?
psychological therapy
CBT
dialectical behavioral therapy
mentalization behavioral therapy
group therapy
what therapy recognizes and understand own and other’s mental states?
mentalization behavioral therapy
what is longstanding mistrust, suspiciousness and on guard, hypervigilant, tense, irritable, and ready for threat?
paranoid personality disorder
what are the actions of the paranoid personality disroder?
avoid others
test their honesty
envious and hostile toward others with success
oversensitive
misinterpret cues in environment
magnify and distort
don’t accept responsibility for behaviors and feelings
project it to others
bears grudges
what are the cause of paranoid personality disorder?
genetic
psychosocial- parental antagonism and harassment, gradually relinquished all hope of affection and approval
what is a colorful, dramatic, and extroverted behavior- excitable/emotional people?
histrionic personality disorder
who requires constant affirmation of approval and acceptance from others and cannot provide another with sustained affection?
difficulty maintaining long-lasting relationships
which personality disorder are attention seeking, seductive/flirtatious, manipulate, and exhibitionistic, also distractible and flighty?
histrionic personality disorder
what are other key factors with histrionic personality disorder?
highly suggestible
easily influenced by others
dependent
somatic complaints
fleeting episodes of psychosis if extreme stress
what are the causes of histrionic personality disorder?
neurobiological- heightened noradrenergic activity and decreased serotonin
heredity
inconsistent parental acceptance and approval- as teens insatiable thirst for attention and love
what personality disorder has an exaggerated sense of self-worth (grandiose), arrogant, and sense of entitlement?
narcissistic personality disorder
what are some key features of narcissistic personality disorder?
lack empathy
hypersensitive to evaluation of others, especially when criticism or feedback is given
deserve special consideration to their needs- exploit others- impairs their relationships
fragile self-esteem- sensitive to criticism
preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
what are the cause of narcissistic personality disorder?
in childhood, their fears, failure, dependency needs were responded to with criticism or neglect
parents were narcissistic
parents over-indulged
which personality disorder is sensitive to rejection, socially withdrawn life, and avoid all situations that require interpersonal contact?
avoidant personality disorder
which personality disorder has a strong desire for companioinship?
avoidant personality disorder
which personality disorder is awkward/uncomfortable in social situations and views others as critical, betraying, and humiliating?
avoidant personality disorder
how is the speech in those with avoidant personality disorder?
slow and constrained
frequent hesitations
fragmented thoughts
what are the causes of avoidant personality disorder?
hereditary
infants with hyperirritability, crankiness, tension, withdrawal- temperamental disposition
parental rejection and censure- reinforced by peers= low self worth
what personality disorder has extreme dependency, excessive need to be taken care of, submissive/clinging behavior, fear of separation, feel helpless/lack self, and tolerate mistreatment?
dependent personality disorder
what does those with dependent personality disorder let others do?
they let them make decisions or needs excessive amounts of advice and reassurance
which other personality disorder is good at picking out those with dependent personality disorder and exploit them?
anti-social personality disorder
what does dependent personality disorder?
positions of responsibility
disagreements- fear loss of support or approval
what are the causes of dependent personality disorder?
genetic- dependent temperament
stimulation/nurturance exclusively from one source
parent overprotective and discourage independent behaviors
