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Mental Health Nursing > Personality Disorders > Flashcards

Personality Disorders Flashcards

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1
Q

Antisocial personality disorder

A

A syndrome in which a person lacks the capacity to relate to others, does not experience discomfort in inflicting or observing pain in others, and may manipulate others for personal gain. Common characteristics and behaviors include crimes against society, aggressiveness, inability to feel remorse, untruthfulness and insincerity, unreliability, and failure to follow any life plan.

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2
Q

Avoidant personality disorder

A

A personality disorder in which the central characteristics are an extreme sensitivity to rejection and robust avoidance of interpersonal situations.

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3
Q

Borderline personality disorder

A

A disorder characterized by disordered images of self, impulsive and unpredictable behavior, marked shifts in mood, and instability in relationships with others. Ineffective and harmful self-soothing habits, such as cutting, promiscuous sexual behavior, and numbing with substances are common and may result in unintentional death. Primary defense mechanism: splitting. High mortality rate

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4
Q

Dependent personality disorder

A

A personality disorder in which a person has a pattern of establishing relationships in which he or she is submissive, passive, self-doubting, and avoidant of responsibility.

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5
Q

Diathesis-stress model

A

A general theory that explains psychopathology using a multi-causational systems approach.

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6
Q

Dialectical behavior therapy

A

An evidence-based therapy developed by Dr. Marsha Linehan to successfully treat chronically suicidal persons with borderline personality disorder. Combines cognitive and behavioral techniques with mindfulness, which emphasizes being aware of thoughts and actively shaping them. The goals are to increase the patient’s ability to manage distress, improve interpersonal effectiveness skills, and enhance the therapist’s effectiveness in working with this population.

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7
Q

Histrionic personality disorder

A

A personality disorder in which there is a dramatic presentation of oneself with pervasive and excessive emotionality in order to seek attention, love, and admiration.

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8
Q

Narcissistic personality disorder

A

A disorder characterized by a pervasive pattern of grandiosity, need for admiration, and lack of empathy for others.

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9
Q

Obsessive-compulsive personality disorder

A

A disorder in which the key characteristic is perfectionism with a focus on orderliness an control. Never throws anything away, never spends money.

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10
Q

Paranoid personality disorder

A

A personality disorder in which the key characteristics are distrust and suspiciousness toward others based on the belief (unsupported by evidence) that others want to exploit, harm, or deceive. These individuals re hypervigilant, anticipate hostility, and may provoke hostile responses by initiating a “counterattack”

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11
Q

Personality

A

Deeply ingrained personal patterns of behavior, traits, and thoughts that evolve, both consciously and unconsciously, as a person’s style and way of adapting to the environment.

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12
Q

Personality disorder

A

An enduring pattern of experience and behavior that deviates significantly from the expectations within the individual’s culture

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13
Q

Schizoid personality disorder

A

A personality disorder in which there is a serious defect in interpersonal relationships. Characteristics include lack of warmth, aloofness, and indifference to the feelings of others. The person with this disorder does not seek out or enjoy close relationships. Shows indifference to praise or criticism from others. Depersonalization may occur as a result of the person’s limited interactions with others. Can be a precursor to schizophrenia or delusional disorder.

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14
Q

Schizotypal personality disorder

A

A personality disorder in which strikingly odd characteristics (e.g., magical thinking, derealization, perceptual distortions, rigid ideas) are expressed. Responding inappropriately to cultural cues is common for these individuals. Speech patterns may be distinctive or bizarre. Usually seek out help during periods of depression or for anxiety that they experience in social relationships.

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15
Q

Splitting

A

Primary defense or coping style used by persons with borderline personality disorder. A primitive defense mechanism in which the person see self or others as all good or all bad, failing to integrate the positive and negative qualities of the self and others into a cohesive whole.

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16
Q

Chemical neurotransmitter theory

A

Proposes that certain neurotransmitters may regulate and influence temperament.

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17
Q

Learning theory

A

Emphasizes that the child developed maladaptive responses based on modeling of or reinforcement by important people in the child’s life.

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18
Q

Cognitive theory

A

Emphasizes the role of beliefs and assumptions in creating emotional and behavioral responses that influences one’s experiences within the family environment.

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19
Q

Psychoanalytic theory

A

Focuses on the use of primitive defense mechanisms by individuals with personality disorders. Defense mechanisms such as repression, suppression, regression, undoing, and splitting have been identified as dominant.

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20
Q

Theory of the development of paranoid personality disorder

A

Maybe found in people who grew up in households where they were the objects of excessive rage and humiliation which resulted in feelings of inadequacy. Projection is the dominant defense mechanism; they blame others for their shortcomings. This personality disorder is thought to be related on a continuum with psychotic disorders such as schizophrenia.

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21
Q

Theory for the development of schizoid personality disorder

A

Maybe based on a genetic predisposition to shyness. People with this disorder are often raised neglectful atmosphere in which they may conclude that relationships are unsatisfying and Unnecessary.

22
Q

Theory For the development of schizotypal personality disorder

A

A schizophrenia spectrum disorder and genetically linked. There is a higher incidence of schizophrenia related disorders in family members of people with schizotypal personality disorder.

23
Q

Theory for the development of antisocial personality disorder

A

Genetically linked and twin studies indicate a predisposition to this disorder. This predisposition is set into motion by childhood environment of inconsistent parenting, significant abuse and extreme neglect.

24
Q

Theory for the development of borderline personality disorder

A

Traditionally have been thought to developed as a result of early abandonment which results in an unstable view of self and others. This abandonment is made more intense by a biological predisposition, and twin studies identify heritability of 69%.

25
Q

Theory for the development of histrionic personality disorder

A

Explained psycho dynamically as beginning at 3 to 5 years of age with an overly intense attachment to the opposite sex parent which results in fear of retaliation by the same-sex parent. inborn character traits such as emotional expressiveness and egocentricity have also been identified as predisposing an individual to this disorder.

26
Q

Theory For the development of narcissistic personality disorder

A

Maybe the result of childhood neglect and criticism. the child does not learn that other people can be the source of comfort and support. as adults, they hide feelings of emptiness with an exterior of invulnerability and self-sufficiency. Little is known about inborn trait or heritability for this disorder.

27
Q

Theory for the development of avoidant personality disorder

A

Has been linked with parental and peer rejection and criticism. a biological predisposition to anxiety and physiological arousal in social situations has also been suggested. genetically, this disorder may be part of a continuum of disorders related to social phobia (social anxiety disorder).

28
Q

Theory for the development of dependent personality disorder

A

Maybe the result of chronic physical illness or punishment of Independent behavior in childhood. The inherited trait of submissiveness may also be a factor which has been found to be 45% heritable

29
Q

Theory for the development of obsessive-compulsive personality disorder

A

Excessive parental criticism, control, and shame may be related. Child responds to this negativity by trying to control his environment through perfectionism and orderliness. Heritable traits such as compulsivity, oppositionality, lack of emotional expressiveness, and perfectionism have all been implicated in this disorder.

30
Q

Assessment guidelines for personality disorders

A
  1. assess for suicidal or homicidal thoughts. if these are present the patient will be immediate attention.
  2. Determine whether the patient has a medical disorder or another psychiatric disorders that may be responsible for the symptoms especially a substance abuse disorder.
  3. View the assessment about personality functioning from within the person’s ethnic cultural and social background.
  4. Ascertain whether the patient experienced a recent important loss. personality disorders are often exacerbated after the loss of significant supporting people or in a disruptive social situation.
  5. Evaluate for a change in personality in middle adulthood or later which signals the need for a thorough medical workup or assessment for unrecognized substance use disorder.
31
Q

Nursing diagnosis for crisis, high levels of anxiety

A

Ineffective coping
anxiety
self-mutilation

32
Q

Nursing diagnosis for anger and aggression; child, elder, or spouse abuse.

A

Risk for other directed violence
ineffective coping
impaired parenting
disabled family coping

33
Q

Social isolation

A

Nursing diagnosis for withdrawal

34
Q

Nursing diagnosis for paranoia

A

Fear
Disturbed sensory perception
Disturbed thought processes
Defensive coping

35
Q

Nursing diagnoses for depression

A 
Hopelessness 
risk for suicide 
self-mutilation chronic 
low self-esteem 
spiritual distress
36
Q

Nursing diagnoses for difficulty in relationships, manipulation

A 
Ineffective coping 
impaired social interaction 
defensive coping 
interrupted family processes 
risk for loneliness
37
Q

Nursing diagnoses for failure to keep medical appointments, late arrival for appointments, failure to follow prescribed medical procedure or medication regimen

A

Ineffective therapeutic regimen management

non-adherence

38
Q

Suggested therapies for schizotypal personality disorder

A
  1. Supportive psychotherapy
  2. Cognitive and behavioral measures
  3. Group therapy may improve social skills
  4. Low-dose antipsychotics and antidepressants.
39
Q

Suggested therapies for paranoid personality disorder

A
  1. Psychotherapy is treatment of choice, later cognitive behavioral techniques.
  2. Group therapy may help with social skills
  3. Antidepressant or anti-anxiety agents as needed; antipsychotics may be of use especially if they become acutely psychotic
40
Q

Suggested therapies for schizoid personality disorders

A
  1. Supportive psychotherapy
  2. Group therapy
  3. Antipsychotics, antidepressants, anti-anxiety agents as needed
41
Q

Suggested therapies for borderline disorder

A
  1. Individual psychotherapy.
  2. Dialectical behavior therapy.
  3. Group therapy.
  4. Antipsychotics may control anger and brief psychosis.
  5. Antidepressants such as SSRI’s and MAOI’s
  6. Benzodiazepines help with anxiety
42
Q

Suggested therapies for antisocial personality disorder

A
  1. More responsive to psychotherapy when hospitalized than when jailed.
  2. Pharmacotherapy for anxiety, rage, and depression.
  3. Careful use of addictive agents (e.g., benzodiazepines)
  4. Ritalin may help ADHD
  5. Anticonvulsants may help impulse of behavior
43
Q

Suggested therapies for narcissistic personality disorder

A
  1. Psychotherapy only works after patient acknowledges narcissism
  2. Group therapy may help empathy
  3. Lithium may help those with mood swings antidepressants also used
44
Q

Suggested therapies for histrionic personality disorder

A
  1. Group therapy
  2. Treatment of comorbid personality disorders
  3. Antidepressants as needed
45
Q

Suggested therapies for dependent personality disorder

A
  1. Insight oriented psychotherapy, behavioral therapy, assertiveness training
  2. Family and group therapy
  3. Anti-anxiety agents and antidepressant used for specific symptoms. panic attacks can be helped with imipramine
46
Q

Suggested therapies for obsessive-compulsive personality disorder

A
  1. Supported or insightful psychotherapy

2. Clomipramine and SSRI’S for obsessional thinking and depression

47
Q

Suggested therapies for avoidant personality disorder

A
  1. Psychotherapy focuses on trust
  2. Group therapy
  3. Assertiveness training
  4. Antidepressants and anti-anxiety agents are helpful. Beta Adrenergic receptor antagonists (e.g. Atenolol) Help reduce autonomic nervous system hyperactivity
48
Q

CORRUPT (antisocial personality disorder)

A 
C: cannot conform to law
O: obligations ignored
R: reckless disregard for safety
R: remorselessness
U: underhandedness (decietfulness)
P: planning insufficient (impulsive)
T: temper (irritable and aggressive)
49
Q

IMPULSIVE (borderline personality disorder)

A 
I: impulsive
M: moodiness
P: paranoia or dissociation under stress
U: unstable self-image
L: labile and intense relationships 
S: suicidal gestures (self harm)
I: inappropriate anger
V: vulnerability to abandonment
E: emptiness (feelings of)
50
Q

PRAISEME (histrionic personality disorder)

A

P: provocative (or seductive) behavior
R: relationships considered more intimate
A: attention-seeking
I: influenced easily
S: speech (style) wants to impress; lacks detail
E: emotional lability; shallowness
M: make-up; physical appearance draws attention
E: exaggerated emotions; theatrical

51
Q

GRANDIOSE (narcissistic personality disorder)

A 
G: grandiose
R: requires attention
A: arrogant
N: need to be special
D: dreams of success and power
I: interpersonally exploitive
O: others (unable to recognize needs of)
S: sense of entitlement
E: envious
52
Q

Cutting

A

Often seen in borderline personality disorder. Alexithymia: lack the ability to express their mood with words. Do not reinforce the behavior. Matter-of-factly dress wounds. Focus instead on the client’s feelings.

Mental Health Nursing (7 decks)

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