personality disorders (ch 24) Flashcards

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1
Q

A set of deeply ingrained, enduring patterns of
thinking, feeling and behaving
-includes temperament, character, values
-shaped by biology and social learning

A

personality

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2
Q

continuous patterns or traits that hinder a person’s ability to maintain meaningful relationships, feel fulfilled, and enjoy life

A

personality disorders

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3
Q

4 common characteristics of all personality disorders

A
  1. inflexible and maladaptive responses to stress
  2. disability in working and loving
  3. ability to evoke interpersonal conflict and provoke negative reactions
  4. capacity to have intense effect on others
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4
Q

DSM 5 criteria for personality disorder (generalized)

A
  • enduring deviation of inner experience and behavior
  • atleast 2: cognition, affect, interpersonal functioning, impulse control
  • inflexible in broad range of situations
  • leads to distress
  • traced back to adolescence/early adult
  • not due to other mental disorder
  • not due to substance or other medical condition
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5
Q

cluster A personality disorders (PaSS on the party)

A

Paranoid
Schizoid
Schizotypical

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6
Q

nursing considerations for interactions for paranoid pt (in cluster a personality disorder)

A
  • avoid being overly friendly
  • be clear and straightforward
  • get it in writing
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7
Q

S+S schizoid personality (cluster a personality disorder)

A
  • no desire for relationships
  • loners
  • emotional coldness
  • flat affect
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8
Q

nursing considerations for interactions for schizoid pt (in cluster a personality disorder)

A
  • don’t try to re-socialize
  • avoid being too friendly
  • through assessment questioning
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9
Q

S+S schizotypical personality (cluster a personality disorder)

A
  • withdrawn
  • odd beliefs, fantasy or magical thinking
  • social anxiety
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10
Q

nursing considerations for interactions with schizotypical pt (in cluster a personality disorder)

A
  • respect need for isolation

- other considerations for schizoid and paranoid

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11
Q

cluster b personality disorders (BAHNed from party)

A

Borderline
Antisocial
Histrionic (dramatic)
Narcissistic

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12
Q

S+S antisocial personality in cluster b personality disorder

A
  • stealing, lying, cruelty
  • deceitful
  • irresponsibility
  • lack of remorse
  • can be charming
  • interacts with. manipulation, aggression
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13
Q

nursing considerations for interactions with antisocial personality (cluster b personality disorder)

A
  • avoid being manipulated by flattery, seductiveness, guilt

- set clear expectations to be followed

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14
Q

what is kholberg theory of moral development

A
  • bottom tier: obtain personal rewards, avoid personal punishment
  • middle tier: obey laws and contracts, follow family and group rules
  • top tier: ethical principles, inner conscience
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15
Q

S+S borderline personality in cluster b personality disorder

A
  • intense, unstable relationships
  • impulsive and damaging behaviors
  • acting out instead of expressing emotions
  • suicidal/self harm in response to rejection
  • chronic emotional emptiness
  • outbursts of emotion
  • splitting
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16
Q

DSM 5 for borderline personality disorder (I DESPAIR)

A

Identity disturbance

Dysphoria/emptiness
Emotional instability
Suicide and self harm
Psychotic/dissociative
Anger
Impulsivity
Relationships
17
Q

nursing consideration with borderline personality disorder

A
  • avoid manipulation
  • avoid rejecting or rescuing client
  • be straightforward with clear consistent boundaries
  • assess for safety
18
Q

S+S histrionic personality disorder in cluster b

A
  • draw attention to selves
  • concerned with appearance
  • excessive emotionality
  • shallow
  • smothering
  • no empathy
  • instant gratification with affection
19
Q

nursing considerations for histrionic PD

A
  • remain professional

- reinforce personal qualities

20
Q

S+S narcissistic PD in cluster b

A
  • uses others to meet needs
  • persistent entitlement
  • belittles others
  • grandiose, lacks empathy
  • controlling, power struggles
  • overcompensation for lack of self esteem
21
Q

nursing considerations for narcissistic PD

A
  • convey self confidence
  • avoid power struggles
  • reinforce social appropriateness
22
Q

S+S dependent PD in cluster C

A
  • overly agreeable, passive
  • unable to be without a relationship
  • clingy, lacks own interests
  • difficulty with decisions
23
Q

nursing considerations for dependent PD

A
  • identify real v perceived needs
  • meet needs (with limits)
  • teach assertiveness
24
Q

S+S obsessive compulsive disorder in cluster c

A
  • inflexible, rigid control
  • perfectionistic
  • highly moral and ethical
  • lists, rules, schedules
25
Q

nursing considerations for OCD

A
  • avoid power struggles

- look for intellectualization, rationalization, reaction formations

26
Q

S+S avoidant PD in cluster c

A
  • social phobia
  • feeling of inadequacy
  • fears criticism and rejection
  • avoids new situations
27
Q

nursing considerations for avoidant PD

A
  • friendly and reassuring

- gradually introduce to social situations

28
Q

cluster c personality disorders (party is Dead On Arrival)

A

Dependent
Obsessive compulsive
Avoidant

29
Q

therapy that helps individuals to identify and change inaccurate core perceptions of themselves and others and relationship problems.
-helps with reduction of anxiety and SI

A

cognitive behavioral therapy (CBT)

30
Q

evidence based therapy that treats chronically suicidal pts with borderline personality disorder
-focuses on mindfulness

A

dialectical behavior therapy (DBT)

31
Q

therapy that focuses on the way individuals view themselves with borderline personality disorder

A

schema focused therapy

32
Q

med options borderline personality disorder

A
  • SSRIs
  • anticonvulsants
  • 2nd gen antipsychotics
  • lithium
33
Q

typical behavior of cluster a PDs

A

odd/eccentric

34
Q

typical behavior of cluster b PDs

A

dramatic, emotional, erratic

35
Q

typical behavior of cluster c PDs

A

anxious, fearful