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Disciplines Exam 1 > Personality Disorders 3 > Flashcards

Personality Disorders 3 Flashcards

1
Q
  • Provide reassurance, validate patient’s concerns
  • Encourage reporting of symptoms and concerns
A

Provider strategies for provider tx pt w/ Avoidant PD

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2
Q
  • Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
  • Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
A

Narcissistic PD

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3
Q
  • demanding, entitled attitude
  • Excessive praise toward caregiver may turn to devaluation, in effort to maintain sense of superiority
  • Denial of illness or minimization of symptoms
A

Problematic behavior of pt w/ Narcissistic PD

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4
Q
  • Dramatic and urgent demands for medical attention
  • Angry outbursts at provider if not responded to
  • Patient may contribute to prolong illness or encourage medical procedures in order to get attention
  • May abuse substances and medications
A

Problematic behavior of pt w/ Dependent PD

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5
Q
  • Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection.
  • Is unwilling to get involved with people unless certain of being liked.
  • Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.
A

Avoidant PD

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6
Q

Supportive psychotherapy

  • Establish and maintain a treatment alliance
  • Provide patient with understand of their diagnosis and problems → avoid labeling patient as _____.
  • Help patient develop more complete awareness of maladaptive behaviors
  • Work with patient to identify realistic, attainable goals
  • Therapist provides encouragement, reassurance, advice, and coaching, while modeling adaptive behavior
A

Tx for Narcissistic PD

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7
Q
  • Views self as socially inept, personally unappealing, or inferior to others.
  • Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.
A

Avoidant PD

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8
Q

Mnemonic for Narcissistic PD

A

S – special (believes they are special and unique)

P – preoccupied with fantasies (unlimited success, power, brilliance…)

E – envious

E – entitlement

E – excess admiration required

C – conceited (grandiose sense of self importance)

I – interpersonal exploitation

A – arrogant (haughty)

L – lacks empathy

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9
Q
  • Provide reassurance and schedule frequent periodic check-ups
  • Be consistently available but provide firm realistic limits to availability
  • Enlist other members of the health care team in providing support for patient
  • Help patient obtain outside support systems
  • Avoid hostile rejection of patient
A

Provider strategies for pt w/ Dependent PD

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10
Q
  • Flirtatious and seductive
  • Creative and imaginative
  • Play hunches rather than thinking things out
  • Spontaneous without thought to consequences
  • Lack analytical ability
A

Histrionic PD

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11
Q
  • Urgently seeks another relationship as a source of care and support when a close relationship ends.
  • Is unrealistically preoccupied with fears of being left to take care of himself or herself.
A

Dependent PD

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12
Q
  • Personality style → dramatic
  • Predominant theme → excessive emotionality and attention seeking
A

Histrionic PD

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13
Q

Mnemonic for Dependent PD

A

D – difficulty making everyday decisions

E – excessive lengths to obtain nurturance and support from others

P – preoccupied with fears of being left to take care

E – exaggerated fears of being unable to care for himself or herself

N – needs others to assume responsibility for his or her life

D – difficulty expressing disagreement with others

E – end of a close relationship is the beginning of another relationship

N – noticeable difficulties in initiating projects or doing things on his or her own

T – “take care of me” is his or her motto

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14
Q
  • Displays rapidly shifting and shallow expression of emotions.
  • Consistently uses physical appearance to draw attention to self.
A

Histrionic PD

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15
Q

•Substance abuse disorders

A

Comorbid disorder for Histrionic PD

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16
Q
  • Outright rejection of patient’s demands, resulting in patient distancing self from caregiver
  • Excessive submission to patient’s grandiose stance
A

Problematic behavior of provider tx pt w/ Narcissistic PD

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17
Q
  • Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
  • Requires excessive admiration.
A

Narcissistic PD

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18
Q
  • Depression is common due to fragile self-esteem
  • Lying to oneself by distorting the facts so they feel more important
A

Narcissistic PD

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19
Q

Early development

  • Hypersensitive due to parental criticism
  • Difficulty temperament produces early rejection
A

Avoidant PD

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20
Q

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts

A

Avoidant PD

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21
Q
  • May not be forthcoming about symptom severity, may easily agree with provider out of fear of not being liked
  • Tend to withhold information
  • Avoids questioning / disagreeing with providers
A

Problematic behavior of pt w/ Avoidant PD

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22
Q

•Risk major depression if they lose the person they depend on

A

Dependent PD

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23
Q

Cognitive behavioral therapy

  • Focus on breaking the negative cycle of avoidance
  • Identify and correct dysfunctional attitudes and thoughts
  • Reduce negative thought patterns and build social skills
  • Graduated exposure to social situations
  • Learn skills to improve intimacy
A

Tx for Avoidant PD

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24
Q
  • Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
  • Is often envious of others or believes that others are envious of him or her.
  • Shows arrogant, haughty behaviors or attitudes.
A

Narcissistic PD

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25
Q

•No strong clinical trials of medication efficacy nor are there any medications approved for use by the FDA

A

Narcissistic PD

26
Q

Mnemonic for Histrionic PD

A

P – provocative (or seductive) behavior

R – relationships, considered more intimate than they are

A – attention, must be at center of

I – influenced easily

S – speech (style) - wants to impress, lacks detail

E – emotional lability, shallowness

M – make-up - physical appearance used to draw attention to self

E – exaggerated emotions – theatrical

27
Q

•Development linked to early disruptions in learning independence

A

Dependent PD

28
Q
  • Has a style of speech that is excessively impressionistic and lacking in detail.
  • Shows self-dramatization, theatricality, and exaggerated expression of emotion.
  • Is suggestible (i.e., easily influenced by others or circumstances).
  • Considers relationships to be more intimate than they actually are.
A

Histrionic PD

29
Q
  • Show extreme pleasure as the center of attention and who behave in whatever way necessary to ensure that this happens
  • Exaggerated emotional reactions, approaching theatricality, in everyday behavior
  • Need for immediate gratification → demand reassurance, praise or approval
A

Histrionic PD

30
Q
  • Overly dramatic, attention seeking behavior, with tendency to draw caregiver into excessively familiar relationship
  • Inadequate focus on symptoms and their management, with over emphasis on feeling states
  • May provide answers they believe provider wants to hear
  • Tendency to somatize
A

Problematic behavior of pt w/ Histrionic PD

31
Q

•No strong clinical trials of medication efficacy nor are there any medications approved for use by the FDA

A

Avoidant PD

32
Q
  • Inability to set limits to availability, thus leading to burnout
  • Hostile rejection of patient
A

Problematic behavior of provider tx pt w/ Dependent PD

33
Q
  • Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).
  • Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).
A

Narcissistic PD

34
Q

Individual psychotherapy

•Solution-focused therapy → short-term alleviation of difficulties within the patients life

A

Tx for Histrionic PD

35
Q
  • Is preoccupied with being criticized or rejected in social situations.
  • Is inhibited in new interpersonal situations because of feelings of inadequacy
A

Avoidant PD

36
Q
  • Has difficulty expressing disagreement with others because of fear of loss of support or approval. (Note: Do not include realistic fears of retribution.)
  • Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).
A

Dependent PD

37
Q
  • Generous validation of patient’s concerns, with attentive but factual response to questions
  • Allow patients to maintain sense of competence by rechanneling their “skills” to deal with illness, obviating need for devaluation of caregivers
  • Present treatment recommendations in the context of their right to the best care
A

Provider strategies for tx pt w/ Narcissistic PD

38
Q

•Mood disorders, social phobia, obsessive-compulsive disorder, eating disorders

A

Comorbid disorders of Dependent PD

39
Q
  • Is uncomfortable in situations in which he or she is not the center of attention.
  • Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.
A

Histrionic PD

40
Q
  • Feeling overly concerned for the patient, taking on a paternalistic role that may increase patient’s sense of inadequacy
  • May feel angry and betrayed by patient if the patient’s symptoms turn out to be more extensive than initially reported
A

Problematic behavior of pt w/ Avoidant PD

41
Q
  • Personality style → devoted
  • Predominant theme → feelings of inadequacy, inability to make own decisions, submissiveness, avoidance of confrontation for fear of losing source of support
A

Dependent PD

42
Q
  • Mood disorders, social phobia, obsessive-compulsive disorder, eating disorders
  • Schizoid PD, obsessive-compulsive PD
A

Comorbid disorders of pt w/ Avoidant PD

43
Q

Individuals often appear anxious or fearful

  • Avoidant
  • Dependent
  • Obsessive-compulsive
A

Cluster C

44
Q
  • Bipolar I disorder, depression, substance abuse disorders, anxiety disorders
  • Paranoid PD
A

Comorbid disorders of Narcissistic PD

45
Q

A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts

A

Dependent PD

46
Q
  • Unrealistic, inflated sense of self-importance and lack of sensitivity to other people’s needs
  • Manipulative, self-centered, take advantage of others
A

Narcissistic PD

47
Q

•No strong clinical trials of medication efficacy nor are there any medications approved for use by the FDA

A

Dependent PD

48
Q

A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts

A

Histrionic PD

49
Q
  • Difficulty making everyday decisions → will cling to other people
  • Difficulty disagreeing with other people for fear that they will lose their temper
  • Extremely passive
A

Dependent PD

50
Q

Mnemonic for Avoidant PD

A

A – avoids occupational activities

V – views self as socially inept

O – occupied with being criticized or rejected

I – inhibited in new interpersonal situations

D – declines to get involved with people

E – embarrassed by engaging in new activities

R – restrains from intimate relationships

51
Q
  • Performing excessive workup (when patient is dramatic) or inadequate workup (when patient is vague)
  • Allowing too much emotional closeness, thereby losing objectivity
  • Frustration with patient’s dramatic or vague presentation
A

Problematic behavior of pt w/ Histrionic PD

52
Q
  • Difficult to treat for a multitude of reasons
  • Present for treatment only when a situational factor (stress) has made their ability to function and cope effectively impossible
  • Much quicker to seek treatment and exaggerate their symptoms and difficulties in functioning
  • Emotionally needy → often reluctant to terminate therapy
A

Tx for pt w/ Histrionic PD

53
Q
  • Many can function in a protected environment
  • Some marry, have children and live lives surrounded only by family members
  • If support system fails they are subject to depression, anxiety and anger
A

Avoidant PD

54
Q
  • Personality style → sensitive
  • Predominant theme → social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation
A

Avoidant PD

55
Q
  • Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.
  • Needs others to assume responsibility for most major areas of his or her life.
A

Dependent PD

56
Q
  • Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.
  • Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself.
A

Dependent PD

57
Q

Cognitive behavioral therapy

  • Focuses on patterns of thinking that are maladaptive and the beliefs that underlie such thinking
    • Inability to make important life decisions
    • Inability to initiate relationships
  • Target skills that foster independence → avoid fostering independence from healthcare system
A

Tx for Dependent PD

58
Q
  • Personality style → self-confident
  • Predominant theme → grandiosity (in fantasy or behavior), need for admiration, and lack of empathy
A

Narcissistic PD

59
Q
  • Feel like they don’t measure up to others
  • Fearful of, any involvement with other people and is terrified at the prospect of being publicly embarrassed
A

Avoidant PD

60
Q
A
61
Q
  • Show respectful and professional concern for feelings, with emphasis on objective issues
  • Avoid excessive familiarity
A

Provider strategy for tx pt w/ Histrionic PD

62
Q

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts

A

Narcissistic PD

Disciplines Exam 1 (13 decks)

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