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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personality d.o → outdated terminology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
pharm for borderline personality d.o
longer acting benzo
26
personality disorders have __ onset
gradual
27
patterns of indifference to others diminished range of emotional experience/expression socially isolated
schizoid personality d.o
28
schizoid personality is \_\_tonic and really only a d.o bc
syn difficult for friends/family
29
prevalence of shcizoid personality d.o
3.1% of americans
30
peculiar patterns of behavior perceptual and cognitive disturbance unusual speech
schizotypal personality d.o
31
how do you distinguish schizotypal personality d.o from psychosis
schizotypal pt is egodystonic
32
incidence of schizotypal personality d.o
3%
33
schizoid PLUS schizotypal
detachment
34
disorder characterized by choice to be alone, need for privacy, poor tolerance of conflict
detachment
35
considerations of care for detached pt (4)
respect need for privacy/distance provide adequate time for care minimize conflict low-key approach focus on technical aspects of care
36
detached pt may reject (2)
provider's personal over involvement social support
37
\_\_ testing might be helpful for schizotypal pt
reality
38
possible pharm for schizotypal pt (depending on sx)
antipsychotics
39
suspicion of other's motives overly reactive to minor slights/insults extraordinary precautions to avoid being exploited/injured
paranoid personality d.o
40
prevalence of paranoid personality d.o
4.4%
41
tx considerations for suspicious paranoid pd (8)
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
cluster a disorders are characterized as
odd/eccentric
43
3 cluster a disorders
schizoid pd schizotypal pd paranoid pd
44
pattern of distrust and suspiciousness that others' motives are interpreted as malevolent
paranoid pd
45
pattern of detachment from social relationships and a restricted range of emotional expression
schizoid personality d.o
46
acute discomfort in close relationships, cognitive or perceptual distortions, eccentricities of behavior
schizotypal pd
47
irresponsible and antisocial behavior beginning prior to 15 yo disregard/violation of others' rights
antisocial pd
48
onset of antisocial pd must be prior to __ yo but dx can not be made until pt is __ yo
15 18
49
personality traits of antisocial pd (3)
charming manipulative lack of guilt
50
high incidence of antisocial pd in
prisons
51
antisocial pd is characterized by __ insanity
moral
52
you may only be able to dx antisocial pd from \_\_ bc pt is often a \_\_
hx provided by others poor historian
53
prevalence of antisocial pd
3.6%
54
care considerations for antisocial pd
manipulative hidden agenda set clear limits communicate in nonpunitive manner insistence on clearly medically indicated tx psychiatric consult if malingering present
55
hidden agenda ex of antisocial pd pt (2)
avoiding criminal justice drug seeking
56
pattern of grandiosity exaggerated sense of self importance preoccupation w. achievement unable to empathize w. others
narcissistic pd
57
incidence of narcissistic pd
\< 1%
58
narcissistic pd is more prevalent in
males
59
instability in mood and interpersonal relationships intense, unstable relationships splitting rapid mood changes +/- rage identity disturbance deficits in impulse control
borderline pd
60
prevalence of borderline pd
2% of gen pop
61
borderline pd is mc in
females → 75%
62
ex of impulse control deficit in borderline pd
wrist slashing drugs
63
\_\_ is almost pathomneumonic for borderline pd
fear of abandonment
64
70-75% of borderline pd pt have hx of
at least 1 self injurious act
65
rate of successful suicide in bpd
9%
66
rf for suicidal behavior in bpd (5)
older age prior suicide attempts antisocial personality impulsive actions depressive moods
67
bpd may complicate accurate dx of
mdd substance abuse
68
tx considerations for bpd (10)
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
if provider feels frustrated leaving pt consult, there is a high likelihood of
bpd
70
t/f: there is a low rate of psychotherapy completion in bpd
T! → 50% drop out w.in 6 mo, 75% w. in 1 year
71
psychoactive substance use is associated w. (2)
bpd histrionic pd
72
pervasive pattern of excessive emotionality/ attention seeking self-centered, demanding, vain, constantly seeking approval shallow emotions, easily aroused
histrionic pd
73
prevalence of histrionic pd
1.8%
74
why might histrionic pd pt create atmosphere of inappropriate familiarity w. medical staff
an attempt to distract themselves from inner anxiety rt medical illness
75
tx consideration for histrionic pd
respectful professional manner w.o abbreviating time spent w. pt
76
cluster b pd are characterized by (2)
emotional erratic dramatic
77
4 cluster b pd's
narcissistic antisocial bpd histrionic
78
pattern of grandiosity need for admiration lack of empathy
narcissistic pd
79
pattern of disregard for, and violation of, rights of others
antisocial pd
80
pattern of instability in interpersonal relationships, self-image, and affects marked impulsivity
bpd
81
pattern of excessive emotionality and attention seeking
histrionic pd
82
social discomfort fear of negative evaluation timidity tendency toward social isolation very sensitive to criticism
avoidant pd
83
avoidant pd is similar to \_\_ but more extreme
social anxiety
84
dependence and submissive behavior need for advice/support anxious/helpless when alone easily hurt by criticism agreeable
dependent pd
85
unlike avoidant, dependent pd tends to
stay involved w. others
86
dependent pd pt's can frequently be found in
mental health clinics
87
dependency combined w. overdemandingness
dependent pd PLUS bpd
88
tx considerations for dependent + bpd
empathetic recognition of need for reassurance and anxiety of being alone PLUS limit-setting, clarity, consistency, structure
89
perfectionism inflexibility ambitious, unobtainable standards preoccupied w. rules and efficiency emotionally restricted moralistic, judgmental, intolerant of others emotionality and imperfection
obsessive compulsive pd
90
obsessive compulsive pd is ego\_\_
syntonic
91
tx considerations for obsessive compulsive pd
respect need to be in control provide complete info/test results asap encourage pt participation in planning/scheduling steps toward medical stability
92
cluster c pd are characterized by (2)
anxious fearful
93
3 cluster c pd
dependent pd avoidant pd obsessive-compulsive pd
94
pattern of submissive/clinging behavior
dependent pd
95
pattern of social inhibition, feelings of inadequacy, hypersensitivity to negative eval, excessive need to be taken care of
avoidant pd
96
pattern of preoccupation w. orderliness, perfectionism, control
obsessive compulsive pd
97
odd eccentric
cluster a
98
dramatic emotional erratic
cluster b
99
anxious fearful
cluster c

Psychosocial Care (6 decks)

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