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Psychosocial Care > Test 3 - Personality Disorders > Flashcards

Test 3 - Personality Disorders Flashcards

1
Q

implications of personality d.o

A

complicate task of diagnosing/managing comorbidities

poorer tx outcomes and health status

higher rates of health care use and cost

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2
Q

4 goals of personality d.o management

A
  1. recognize it
  2. develop working relationship w. pt
  3. avoid chronic difficulties in pt-provider relationship
  4. build rapport → relax
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3
Q

t/f: you will likely not cure personality d.o

A

t!

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4
Q

characteristics of personality d.o (8)

A

frequent mood swings

angry outbursts

anxiety → difficulty making friends

center of attention

feel cheated/taken advantage of

difficulty delaying gratification

lack of awareness about behavior

externalizing/blaming world for behavior/feelings

rigid/inflexible personality

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5
Q

axis II is same same

A

personality d.o → outdated terminology

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6
Q

__% of population > 18 yo meet criteria for pd

A

14.9

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7
Q

most personality d.or are ego __

A

syntonic

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8
Q

egosyntonic definition

A

pt do not view thoughts/behaviors as unacceptable

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9
Q

egodystonic definition

A

pt distressed by sx

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10
Q

most mental disorders are ego__

A

dystonic

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11
Q

is there any pharm to treat personality d.o as a whole

A

no! → just symptomatic tx

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12
Q

what helps determine pharm for personality disorders

A

clustering symptoms

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13
Q

tx for personality d.o is based on __

and not __

A

symptom profile

type of d.o

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14
Q

regardless of dx, you should __ to determine pharm

A

cluster symptoms

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15
Q

4 symptom clusters for personality d.o

A

cognitive/perceptual organization

impulsivity/aggression

mood instability

anxiety/inhibition

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16
Q

pharm for cognitive perceptual organization cluster

A

atypical antipsychotics

+/- SSRIs

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17
Q

pharm for impulsivity aggression cluster (4)

A

antipsychotics

beta blockers

lithium

carbamazepime (tegretol)

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18
Q

pharm esp effective in kids w. impulsivity/aggression

A

beta blockers

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19
Q

phenytoin may reduce __ violence

but likely has no effect on __ violence

A

impulsive/aggressive

premeditated

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20
Q

what class of drug is phenytoin

A

anticonvulsant

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21
Q

pharm for mood instability cluster (3)

A

mood stabilizers

SSRI or other antidepressant

atypical antipsychotic

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22
Q

pharm for anxiety/inhibition (2)

A

SSRI or related antidepressant

bensodiazepine

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23
Q

best pharm for short term relief of anxiety/inhibition cluster

A

benzodiazepine

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24
Q

benzodiazepine might be effective for __

but NOT __

A

borderline personality d.o

xanax

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25
Q

pharm for borderline personality d.o

A

longer acting benzo

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26
Q

personality disorders have __ onset

A

gradual

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27
Q

patterns of indifference to others

diminished range of emotional experience/expression

socially isolated

A

schizoid personality d.o

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28
Q

schizoid personality is __tonic

and really only a d.o bc

A

syn

difficult for friends/family

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29
Q

prevalence of shcizoid personality d.o

A

3.1% of americans

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30
Q

peculiar patterns of behavior

perceptual and cognitive disturbance

unusual speech

A

schizotypal personality d.o

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31
Q

how do you distinguish schizotypal personality d.o from psychosis

A

schizotypal pt is egodystonic

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32
Q

incidence of schizotypal personality d.o

A

3%

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33
Q

schizoid PLUS schizotypal

A

detachment

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34
Q

disorder characterized by choice to be alone, need for privacy, poor tolerance of conflict

A

detachment

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35
Q

considerations of care for detached pt (4)

A

respect need for privacy/distance

provide adequate time for care

minimize conflict

low-key approach

focus on technical aspects of care

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36
Q

detached pt may reject (2)

A

provider’s personal over involvement

social support

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37
Q

__ testing might be helpful for schizotypal pt

A

reality

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38
Q

possible pharm for schizotypal pt (depending on sx)

A

antipsychotics

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39
Q

suspicion of other’s motives

overly reactive to minor slights/insults

extraordinary precautions to avoid being exploited/injured

A

paranoid personality d.o

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40
Q

prevalence of paranoid personality d.o

A

4.4%

41
Q

tx considerations for suspicious paranoid pd (8)

A

carefully informing mistrustful pt about procedures

exact details of procedures

comprehensive info regarding risk/benefit

hx regarding abrupt termination of care

empathizing w. tension/guardedness

counteract fears of disrespect/intrusion

low-key, friendly approach

not overly intimate

42
Q

cluster a disorders are characterized as

A

odd/eccentric

43
Q

3 cluster a disorders

A

schizoid pd

schizotypal pd

paranoid pd

44
Q

pattern of distrust and suspiciousness that others’ motives are interpreted as malevolent

A

paranoid pd

45
Q

pattern of detachment from social relationships and a restricted range of emotional expression

A

schizoid personality d.o

46
Q

acute discomfort in close relationships, cognitive or perceptual distortions, eccentricities of behavior

A

schizotypal pd

47
Q

irresponsible and antisocial behavior beginning prior to 15 yo

disregard/violation of others’ rights

A

antisocial pd

48
Q

onset of antisocial pd must be prior to __ yo

but dx can not be made until pt is __ yo

A

15

18

49
Q

personality traits of antisocial pd (3)

A

charming

manipulative

lack of guilt

50
Q

high incidence of antisocial pd in

A

prisons

51
Q

antisocial pd is characterized by __ insanity

A

moral

52
Q

you may only be able to dx antisocial pd from __

bc pt is often a __

A

hx provided by others

poor historian

53
Q

prevalence of antisocial pd

A

3.6%

54
Q

care considerations for antisocial pd

A

manipulative

hidden agenda

set clear limits

communicate in nonpunitive manner

insistence on clearly medically indicated tx

psychiatric consult if malingering present

55
Q

hidden agenda ex of antisocial pd pt (2)

A

avoiding criminal justice

drug seeking

56
Q

pattern of grandiosity

exaggerated sense of self importance

preoccupation w. achievement

unable to empathize w. others

A

narcissistic pd

57
Q

incidence of narcissistic pd

A

< 1%

58
Q

narcissistic pd is more prevalent in

A

males

59
Q

instability in mood and interpersonal relationships

intense, unstable relationships

splitting

rapid mood changes

+/- rage

identity disturbance

deficits in impulse control

A

borderline pd

60
Q

prevalence of borderline pd

A

2% of gen pop

61
Q

borderline pd is mc in

A

females → 75%

62
Q

ex of impulse control deficit in borderline pd

A

wrist slashing

drugs

63
Q

__ is almost pathomneumonic for borderline pd

A

fear of abandonment

64
Q

70-75% of borderline pd pt have hx of

A

at least 1 self injurious act

65
Q

rate of successful suicide in bpd

A

9%

66
Q

rf for suicidal behavior in bpd (5)

A

older age

prior suicide attempts

antisocial personality

impulsive actions

depressive moods

67
Q

bpd may complicate accurate dx of

A

mdd

substance abuse

68
Q

tx considerations for bpd (10)

A

remain emotionally neutral

avoid responding to provocation

acknowledge anger, frustration, annoyance

verbally recognize pt’s feelings

request appropriate behavior

actively structure consult

schedule pt w. abandonment issues or somatization for brief, frequent visits

supportively confront medical noncompliance

conduct pe w. nurse present

support psychotherapy

69
Q

if provider feels frustrated leaving pt consult, there is a high likelihood of

A

bpd

70
Q

t/f: there is a low rate of psychotherapy completion in bpd

A

T! →

50% drop out w.in 6 mo, 75% w. in 1 year

71
Q

psychoactive substance use is associated w. (2)

A

bpd

histrionic pd

72
Q

pervasive pattern of excessive emotionality/ attention seeking

self-centered, demanding, vain, constantly seeking approval

shallow emotions, easily aroused

A

histrionic pd

73
Q

prevalence of histrionic pd

A

1.8%

74
Q

why might histrionic pd pt create atmosphere of inappropriate familiarity w. medical staff

A

an attempt to distract themselves from inner anxiety rt medical illness

75
Q

tx consideration for histrionic pd

A

respectful professional manner w.o abbreviating time spent w. pt

76
Q

cluster b pd are characterized by (2)

A

emotional

erratic

dramatic

77
Q

4 cluster b pd’s

A

narcissistic

antisocial

bpd

histrionic

78
Q

pattern of grandiosity

need for admiration

lack of empathy

A

narcissistic pd

79
Q

pattern of disregard for, and violation of, rights of others

A

antisocial pd

80
Q

pattern of instability in interpersonal relationships, self-image, and affects

marked impulsivity

A

bpd

81
Q

pattern of excessive emotionality and attention seeking

A

histrionic pd

82
Q

social discomfort

fear of negative evaluation

timidity

tendency toward social isolation

very sensitive to criticism

A

avoidant pd

83
Q

avoidant pd is similar to __

but more extreme

A

social anxiety

84
Q

dependence and submissive behavior

need for advice/support

anxious/helpless when alone

easily hurt by criticism

agreeable

A

dependent pd

85
Q

unlike avoidant, dependent pd tends to

A

stay involved w. others

86
Q

dependent pd pt’s can frequently be found in

A

mental health clinics

87
Q

dependency combined w. overdemandingness

A

dependent pd

PLUS

bpd

88
Q

tx considerations for dependent + bpd

A

empathetic recognition of need for reassurance and anxiety of being alone

PLUS

limit-setting, clarity, consistency, structure

89
Q

perfectionism

inflexibility

ambitious, unobtainable standards

preoccupied w. rules and efficiency

emotionally restricted

moralistic, judgmental, intolerant of others emotionality and imperfection

A

obsessive compulsive pd

90
Q

obsessive compulsive pd is ego__

A

syntonic

91
Q

tx considerations for obsessive compulsive pd

A

respect need to be in control

provide complete info/test results asap

encourage pt participation in planning/scheduling steps toward medical stability

92
Q

cluster c pd are characterized by (2)

A

anxious

fearful

93
Q

3 cluster c pd

A

dependent pd

avoidant pd

obsessive-compulsive pd

94
Q

pattern of submissive/clinging behavior

A

dependent pd

95
Q

pattern of social inhibition, feelings of inadequacy, hypersensitivity to negative eval, excessive need to be taken care of

A

avoidant pd

96
Q

pattern of preoccupation w. orderliness, perfectionism, control

A

obsessive compulsive pd

97
Q

odd

eccentric

A

cluster a

98
Q

dramatic

emotional

erratic

A

cluster b

99
Q

anxious

fearful

A

cluster c

Psychosocial Care (6 decks)

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