Personality Disorders ppt

Question 1

Personality Disorder in general are:

Answer 1

Impairment of personality functioning

Personality traits that are maladaptive

Identity problems

Relationships are dysfunctional.

Question 2

Cluster A personality Disorders:

Answer 2

Paranoid personality disorder

Schizoid personality disorder

Schizotypal personality disorder

Question 3

Cluster B Personality Disorders

Answer 3

Antisocial personality disorder

Borderline personality disorder

Histrionic personality disorder

Narcissistic personality disorder

Question 4

Cluster C Personality Disorders

Answer 4

Avoidant personality disorder

Dependent personality disorder

Obsessive personality disorder

Question 5

How common are Personality Disorders? What percent of the population have it?

Answer 5

Relatively common (10%–20% of general population)

Question 6

What percent of people with a primary diagnosis of major mental illness also have personality disorder?

Answer 6

40% to 45% of people with primary diagnosis of major mental illness also have coexisting personality disorder that significantly complicates treatment.

Question 7

Cluster A: Paranoid Personality Disorder - what is the clinical picture

Answer 7

Pervasive mistrust/suspiciousness*

Conflict with authority figures

Question 7

What is the nursing interventions for Paranoid Personality Disorder?

Answer 7

Formal, business-like approach

Client involvement in plan of care

Validate idea before action

Question 8

Cluster A Personality Disorder Schizoid Personalty Disorder- What is the clinical picture?

Answer 8

Clinical picture
Prefer being alone and choose to do activities alone*

Question 9

Cluster A Personality Disorder Schizoid Personalty Disorder- Nursing Interventions

Answer 9

Focus on improved functioning in community

Client has greater chance of success if he or she can relate his or her needs to one person.

Question 10

Cluster A Personality Disorder Schizotypical Personality Disorder - What is the clinical picture?

Answer 10

Belief in special powers, such as mental telepathy or superstitions*

Question 11

Cluster A Personality Disorder Schizotypical Personality Disorder -Nursing Interventions

Answer 11

Focus on self-care and social skills

Encouragement of daily routines

Identifying appropriate outlets for discussing unusual beliefs

Question 12

Cluster B: Antisocial personality disorder

Answer 12

Characterized by disregard for rights of others, deceit, and manipulation

Question 13

Cluster B: Antisocial personality disorder assessment

Answer 13

Assessment

History (acts of cruelty, abusive parenting)

General appearance and motor behavior (usually normal)

Mood and affect (display of false emotions)

Thought process and content (narrowed view of world)

Sensorium and intellectual processes (oriented, average or above average IQ)

Judgment and insight (do not consider morals or ethics)

Self-concept (appear confident, but the self is shallow and empty)

Roles and relationships (manipulate and exploit those around them)

Question 14

Cluster B: Antisocial personality disorder Intervention

Answer 14

Therapeutic relationship; promoting responsible behavior ( firm limit setting, straightforward approach matter of fact approach, enforce consequences)

Clearly convey your expectations of the client, as well as the consequences for failure to meet them.

Avoid power struggles and confrontations.

Question 15

For Antisocial personality Disorder, what are medications used for?

Answer 15

Treat disorganized thinking.

Stabilize mood swings.

Ease the acute symptoms of concurrent psychiatric disorders.

Question 15

What is used to treat controlling aggressive outbursts?

Answer 15

Lithium or a beta-adrenergic blocker (e.g., propranolol ) may be useful in controlling aggressive outbursts.

Question 15

For pts with Antisocial Personality Disorder, as a nursing intervention, what should you encourage the client to do?

Answer 15

Encourage the client to:
Express feelings.
Analyze own behavior.
Be accountable for own actions.

Question 16

What are other treatments used for Antisocial personality disorder?

Answer 16

Psychotherapy, focused on the individual and family.

Group therapy may also be useful.

Question 17

What else fits under Antisocial Personality Disorder?

Answer 17

Sociopath

Sociopath is NOT an official DSM-V diagnosis; fits under Antisocial Personality

Question 18

Sociopath

Answer 18

A pervasive pattern of disregard for and violation of the rights of others, since age 15 years, as indicated by three or more of the certain symptoms.

Question 19

Sociopath is diagnosed by three or more symptoms of the following:

Answer 19

Failure to conform to social norms concerning lawful behaviors, such as performing acts that are grounds for arrest.

Deceitfulness, repeated lying, use of aliases, or conning others for pleasure or personal profit.

Impulsivity or failure to plan.

Irritability and aggressiveness, often with physical fights or assaults.

Reckless disregard for the safety of self or others.

Consistent irresponsibility, failure to sustain consistent work behavior, or honor monetary obligations.

Lack of remorse, being indifferent to or rationalizing having hurt, mistreated, or stolen from another person.

Question 20

Cluster B: Borderline Personality Disorder

Answer 20

Characterized by pervasive pattern of unstable interpersonal relationships, self-image, marked impulsivity

Question 21

Borderline Personality Disorder Assessment

Answer 21

History (disturbed early relationships with parents)

General appearance and motor behavior (wide range of dysfunction)

Mood and affect (dysphoric)

Thought process and content (polarized and extreme thinking about self and others)

Sensorium and intellectual processes (fully oriented to reality)

Judgment and insight (impaired judgment and lack of concern for safety)

Self-concept (unstable view of self, self-harm)

Roles and relationships (hate being alone but experience social isolation, chronic feeling of emptiness)

Physiological and self-care considerations (impulsive behavior)

Question 22

Borderline Personality Disorder Interventions

Answer 22

Safety (no-self-harm contract)

Therapeutic relationship (structured, with limit setting)

Strict adherence to boundaries

Communication skills

Coping, emotion control

Reshaping thinking patterns (cognitive restructuring, thought stopping, positive self-talk, decatastrophizing)

Structuring of daily activities

Question 23

Histrionic Personality Disorder Clinical Picture

Answer 23

Excessive emotionality and attention seeking; exaggeration of closeness of relationships; insincere and shallow emotions

Question 24

Histrionic Personality Disorder Nursing Interventions

Answer 24

Feedback about social interactions; social skills training through role-playing; exploration of strengths and assets

Question 25

Narcissistic Personality Disorder Clinical Picture

Answer 25

Pervasive pattern of grandiosity; need for admiration; lack of empathy; arrogant or haughty attitude; superior view; fragile, vulnerable self-esteem; ambitious; “Narcissistic Injury”

Question 26

Narcissistic Personality Disorder Nursing Interventions

Answer 26

Self-awareness skills to avoid anger and frustration; matter-of-fact approach; limit setting

Teach that mistakes are acceptable.

Question 27

Avoidant Personality Disorder Clinical Picture

Answer 27

Social discomfort; low self-esteem; hypersensitive to negative evaluation

Question 28

Avoidant Personality Disorder Nursing Interventions

Answer 28

Self-affirmations; positive self-talk; reframing and decatastrophizing; social skills training

Question 29

Dependent Personality Disorder Clinical Picture

Answer 29

Need to be taken care of; submissive and clinging behavior; frequently anxious

Question 30

Dependent Personality Disorder Nursing Interventions

Answer 30

Emphasize decision making to increase self-responsibility.

Praise decision making and independent actions.

Teach assertiveness.

Assist to clarify feelings, needs, and desires.

Increase self-esteem.

Question 31

Obsessive–Compulsive Personality Disorder Clinical Picture

Answer 31

Preoccupation with perfectionism; formal and serious demeanor; constricted emotional range; preoccupied with orderliness; low self-esteem; harsh self-evaluations

Question 32

Obsessive–Compulsive Personality Disorder Nursing Interventions

Answer 32

Difficulties with decision-making; cognitive restructuring; risk-taking

Question 33

Elder Considerations for Personality Disorders

Answer 33

Disorders persist into older age.

Some may stabilize, while others “age badly.”
-Chronically angry, unhappy, or dissatisfied

Older adults with personality disorders are at higher risk for depression & suicide

Question 34

Treatment for Personality Disorder- Psychopharmacology

Answer 34

Cognitive–perceptual distortions

Affective symptoms and mood dysregulation

Depression
Anxiety

Question 35

Treatment for Personality Disorder Individual and Group psychotherapy

Answer 35

Cognitive–behavioral therapy (cognitive restructuring techniques)

Thought stopping

Positive self-talk

Dialectical behavior therapy (borderline personality disorder)

Question 36

Self awareness issues and how to deal as nurses

Answer 36

Discuss feelings of anger or frustration with colleagues.

Nurse can easily mistakenly believe client simply lacks motivation.

Be mindful of manipulation of staff members.

Don’t take flattery or criticism personally.