T3 - Personality Disorders Intro and Cluster A PD (Josh) Flashcards
The core problem with Personality disorders is —
the inability to form close relationships
The — are diagnosed more frequently in women.
Borderline, Histrionic, and Dependent Personality Disorders
Defense mechanisms used by individuals w/ PD.
Repression
Suppression
Regression
Undoing
Splitting
Externalization
Denial
Projection
Defense Mechanism for PD:
unconscious mechanism by which anxious, threatening thoughts/feelings are kept from becoming conscious
Repression
Medications for Paranoid Personality?
- Antipschotics (Risperidal or Zyprexa)
- SSRI
- Antianxiety meds
memory, organization of sensory information
Which lobe?
Temporal lobe
Antipsychotics for PD:
risperidone
olanzapine
haloperidol
Schizotypal PD effects –
3% of population (more in men)
PD Therapies:
This type of cognitive behavior therapy focuses on coping skills and gradual behavior changes in an accepting and supportive environment; learning how to take better control of behaviors and emotions.
Dialectical behavior therapy.
Which are the most challenging psychiatric disorders to treat?
Personality Disorders
- b/c personality is, by definition, an integral part of what defines the individual
Defense Mechanism for PD:
an action or words designed to cancel some disapproved thoughts, impulses, or acts in which the person relieves guilt by making reparation
Undoing
Defense Mechanism for PD:
viewing people, things, events as all good or all bad; the inability to integrate the positive and negative in people, life situations
Splitting
This theory describes the toddler’s individualization from the primary caregiver
Important landmark in early development is ability to form a lasting bond
Mahler’s Object Relations Theory
Effective therapies for PD
Individual Psychotherapy (most effective)
Cognitive Behavior Therapy
Dialectical Behavior Therapy
Schizoid affects more men or women?
men
- affects 0.7% of population
PD Therapies:
This form of psychological treatment involves actively retraining the way you think about problems, which in turn improves your emotions and behaviors.
Cognitive behavior therapy
Which Personality Disorder?
- Detachment, social withdrawal
- Indifference to other’s feelings
- Restricted emotional range
- Prefers solitary interests and occupations
- No close friends, loner
Schizoid Personality Disorder
- Cluster A: Odd/Eccentric
– – is a group of brain structures responsible for emotion, behavior, long-term memory.
Limbic System
— includes six stages of moral development that progress in sequence and are not bound by age.
Kohlberg’s Moral Development Theory
The Antisocial Personality Disorder is diagnosed more frequently in –.
men
What are Standard Assessments for Personality Disorders?
- Minnesota Multiphasic Personality Inventory (MMPI)
Mental Status Exam
- note: MMPI is self-reporting
Best Meds for Cluster A PD:
antideppressants
low-dose antipsychotics
SSRIs for PD:
fluoxetine sertraline citalopram paroxetine escitalopram
Group or Individual Therapy is best for Paranoid Personality?
Individual Therapy
Rather than aiming for a cure, treatments typically focuses on –
enhancing client’s coping skills
solving short-term probs
building relationship skills
Schizoid Personality Disorder looks like –
loners / hermits
Which meds for Schizotypal PD?
low does antipsychtics (clozapine)
SSRI
This therapy recognizes the fragility of the self esteem in clients with a personality disorder and works to build a kind, caring therapeutic relationship.
Dialectical Behavior Therapy
Defense Mechanism for PD:
pretending the truth is not reality
Denial
Defense Mechanism for PD:
resorting to earlier more comfortable level of functioning that is less demanding and responsible
Regression
Cluster A PD: Odd/Eccentric
Neuroimaging shows an association b/t Cluster A symptoms and –
decreased prefrontal grey matter
increased corpus callosum white matter
Cluster A Personality Disorders:
Paranoid Personality
Schizoid Personality
Schizotypal Personality
Nursing care for Schizoid PD:
- respect need for privacy, need for physical and emotional distance (need close human contact but easily overwhelmed)
- give time to express feelings, teach social skills, avoid arguing and defensiveness
– – have been shown to be the most effective intervention for modifying some forms of difficult behavior displayed by people with personality disorders
Psychotherapeutic interventions
How many adults have a personality disorder?
1 in 10
– is effective for Borderline PD.
Dialectical Behavior Therapy
– affects 0.5-2.5% of the population and is more common in males.
Paranoid Personality
Who got the rod shot through their head in 1800s?
Phineas Gage
- his injury laid groundwork for understanding Personality Disorder
The deviations of perception, thinking, and behavior w/ PD affect which areas?
Cognition
Affectivity
Interpersonal Functioning
Impulse Control
- must affect two or more of these
Class B Personality Disorders:
Antisocial
Borderline
Histrionic
Narcissistic
Identifies eight stages of development w/ specific tasks for each stage that when met, causes emotional growth
Erikson’s Psychosocial Development Theory
Schizotypal PD looks like –
eccentric behavior
50% of Schizotypal PD have –
major depression and/or another PD such as avoidant or paranoid
Which Personality Disorder?
- Odd thought and behavioral patterns
- Persistent pattern of social and interpersonal deficits
- Severe social anxiety
Schizotypal Personality
- Cluster A: Odd/Eccentric
Personality disorders tend to form in — and continue through the lifetime.
adolescence or early adulthood
— consists of psychological tasks or lessons presented in age bound stages that are mastered for the development and maturing of the personality.
Peplau’s interpersonal theory
What does medication management focus on w/ PD?
enhancing the client’s coping skills, solving short term problems, and developing relationship skills through long-term psychotherapy
specific symptom medications (depression, anxiety, etc.), education.
– theory is a complex combination of three unique components of the personality (Id, Ego, Superego), topography of the mind (Conscious, Preconscious, Unconscious), and stages of psychosexual development.
Freud’s psychoanalytic theory
Is Schizotypal PD genetic?
yes
Defense Mechanism for PD:
attributing feelings or impulses unacceptable to one’s self to another person
Projection
Which Personality Disorder?
- Mistrustful, suspicious, watchful
- Irritable, short-fuse, bad temper
- Hostile attitude
- Accusatory communication style
- Externalizes blame for problems
Paranoid Personality
Cluster A: Odd/Eccentric
Defense Mechanism for PD:
consciously refusing to think about it
Suppression
– is the father of child psychology.
Peplau
– believed that the personalty and behavior are outcomes of interpersonal relationships.
Sullivan’s Interpersonal Theory
Antianxiety Meds for PD:
Benzos
What are the Gerontological Implications of Personality Disorder?
The personality generally remains stable over time; therefore a personality change may indicate a change in physical health
How many personality disorders have been identified by DSM-5?
10
grouped into 3 clusters
Anticonvulsants for PD:
carbamazepine
valproic acid
lithium
How many clusters are there of the 10 Personality disorders?
3 Clusters:
Cluster A: Odd, Eccentric
Cluster B: Dramatic, Emotional, Erratic
Cluster C: Anxious, Fearful, Insecure, Feelings of Inadequacy
Best Meds for Cluster B PD:
anti-seizure mood stabilizing agents
MAOIs
Diagnostic criteria generally state that the patient exhibits –
an enduring pattern of perception, thinking, and behaviors that deviates significantly from the norms and expectations of his/her culture
Can Personality Disorders be cured?
No
Defense Mechanism for PD:
blaming others; refusing to take responsibility or to own or acknowledge behavior
Externalization
Class C Personality Disorders:
Avoidant
Dependent
Obsessive-Compulsive
Are medications helpful with Schizoid Personality Disorder?
Not really, unless client is experiencing major depression or severe anxiety or psychosis
The traits of the Antisocial and Borderline Personality Disorders tend to become – with age.
less evident
What four characteristics do ALL Personality Disorders Share?
1) INFLEXIBILITY; maladaptive responses to stress
2) DISABILITY in social and professional relationships
3) Tendency to provoke interpersonal CONFLICT
4) Capacity to cause IRRITATION or DISTRESS in others
Nursing care for Schizotypal PD?
- Patient may relate well to some nurses but not others
- Recognize need for physical and emotional distance
- Offer persistent consistent care
- Active listening
- Give time to make decisions
Best Meds for Cluster C PD:
antianxiety meds
andtidepressants
Social judgment, insight, motivation, goal setting and planning, executive function
Which lobe?
Frontal lobe