Unit 8 Personality Disorders CLUSTER C- Dependent Personality Disorder, Obsessive Compulsive Personality Disorder , Avoidant Personality Disorder Chapter 24

Question 1

Do patients with Avoidant personality Disorders fear rejection?

A. Yes
B. No

Answer 1

A. Yes

Question 2

Which of the following behaviors will exhibit avoidant personality traits

A. avoiding to try out for sports team
B. seeks to be the center of attention
C. demands special treatment
D. needs assistant with activities of daily life

Answer 2

A. avoiding to try out for sports team

Question 3

What are the characteristic of individuals with Avoidant Personality Disorder

Answer 3

-Extremely sensitive to rejection, feel inadequate, socially inhibited

-limited social life

 Avoid contact with others due to fear of rejection

 Feelings on inferiority

-low self esteem

-shyness

-they feel like their friends and peers are better than them

-avoids everyone and everything due to the fear of rejection or failure

Question 4

What do patients with avoidant personality disorder avoid

Answer 4

they avoid any situation that can bring stress, embarrassment, humiliation, or rejection

Question 5

Nursing Care for avoidant Personality Disorder

Answer 5

 Nurse should use a friendly, accepting and reassuring approach
 Remember being pushed into social situations causes severe anxiety
 offer them task you know they can accomplish
 Provide Assertiveness training
-DO NOT OFFER TASK THEY CAN FAIL AT, this can cause extreme anxiety

• Convey an attitude of acceptance toward patient fears.
• Provide the patient with exercises to enhance new social skills but use these with caution because any failure can
  increase the patient’s feelings of poor self-worth.
• Assertiveness training can help the person learn to express needs.

Question 6

Should you increase or push the patient in group therapy with Avoidant Personality Disorder?

A. yes
B.no

Answer 6

B.no

 Remember being pushed into social situations causes severe anxiety

Question 7

A patient’s husband has came into the office due to their wife clingy behavior. What personality disorder is this patient exhibiting?

A. Dependent personality disorder
B. Histrionic
C. Borderline personality disorder
D. Schizoid

Answer 7

A. Dependent personality disorder

Question 8

What are the characteristics of Dependent personality disorder?

Answer 8

 Submissive and Clinging behaviors
 Overwhelming need to be taken care of
 More vulnerable to exploitation

-lack of confidence in their own ability or judgment,

-experience intense anxiety when left alone for even brief periods of time

 may manipulate others to assume responsibility for such activities as dealing with finances or child rearing

• lack of self confidence disrupts sense of independence

Question 9

Which anxiety is common in patients with dependent personality disorders?

A. separation anxiety
B. mild anxiety
C. moderate anxiety
D. generalized anxiety

Answer 9

A. separation anxiety

Question 10

give an example of a patient exhibiting clingy behavior?

Answer 10

• will become anxious when partner is leaving for work
• will be waiting for you outside of the restroom door due to their clinginess
• I can’t do this alone , I need help

Question 11

Dependant (Da baby) statements they may say

Answer 11

• have an excessive need to be taken care of ,
  often neglects paying bills and managing finances
• I can’t pay these bills by myself
• I need someone to watch my kids

Because they lack confidence in their own ability or judgment, these individuals may manipulate others to assume responsibility for such activities as dealing with finances or child rearing.

Question 12

Nursing Care for Dependent

Answer 12

 Nursing Care
 Be aware that strong countertransference can occur due to patient demands of time

-they are not a baby , encourage independence!!!

Give positive feedback when they make their own decisions

 They feel the NEED to be In a relationship (they can be victims
of domestic violence for fear of losing the relationship).

 They feel afraid to make decisions so when treating them
give them immediate feedback for decisions made

 Nurse patient relationship can offer ground where assertiveness can be tested

Feelings of insecurity about their self- agency and lack of self-confidence may interfere with attempts at becoming more independent

Question 13

Treatment for Dependent personality Disorder

Answer 13

 Psychotherapy
-CBT

CBT can help patients develop more healthy and accurate thinking by examining and challenging automatic thoughts that result in fearful behavior. This process can help in developing new perspectives and attitudes about the need for other people.

Question 14

Control
Orderliness
Perfectionism

What personality disorder does these words relate to ?

A. Histrionic
B. Obsessive Compulsive personality disorder
C. Avoidant
D. Narcissistic Personality Disorder

Answer 14

B. Obsessive Compulsive personality disorder

Preoccupation with orderliness, perfectionism, and control are the hallmarks of this disorder.

-seen mainly in men
-genetic link

Question 15

What are the characteristics of Obsessive Compulsive personality disorder?

Answer 15

Obsessive-compulsive personality disorder is characterized by limited emotional expression, stubbornness, perseverance, and indecisiveness. Preoccupation with orderliness, perfectionism, and control are the hallmarks of this disorder.

-takes extensive time to complete task due to perfectionism
-unwillingness to compromise
 Limited emotional expression, stubbornness, perseverance and indecisiveness
 Hallmarks – preoccupation with order, control and perfectionism
 Difference from OCD and Obsessive-compulsive personality disorder
 OCD – does see thoughts and actions are unreasonable
 OCPD – Unhealthy focus on perfectionism. They think their actions are right and feel
comfortable with such self-imposed systems of rules

Question 16

“My way or the highway.”

does this statement relate to OCPD?

A.yes
B. no

Answer 16

A.yes

- very rigid beliefs, believes they are right!

Question 17

Egosyntonic

Answer 17

OCPD – Unhealthy focus on perfectionism. They think their actions are right and feel
comfortable with such self-imposed systems of rules

-does not recognize dysfunction , nothing is wrong it is apart of who they are.

Obsessive-compulsive personality disorder is character- ized more by an unhealthy focus on perfectionism. Such people “know” that their actions are right and feel comfortable with their self-imposed systems of rules.

Question 18

Egodystonic

Answer 18

OCD – does see thoughts and actions are unreasonable

-recognize dysfunction

Question 19

What comes first for patients with OCPD?

A. work
B. family and friends

Answer 19

A. work

People with obsessive-compulsive personality disorder often do feel genuine affection for friends and family. Yet leisure activ- ities and friendships are dropped in favor of excessive devotion to work and productivity.

Question 20

Nursing care of patients with OCPD

Answer 20

• Nurses should guard against power struggles with these patients, as their need for control is very high.
• Patients with this disorder have difficulty dealing with unex- pected changes.
• It is helpful to provide structure yet allow patients extra time to complete habitual behavior.
• Help patients to identify ineffective coping and to develop better coping techniques.

-
Allow them to follow their habits as much as possible (like
rearranging their environment and keeping schedules)

Question 21

Treatment for OCPD

Answer 21

The treatment course is often long and complicated. Both group therapy and behavioral therapy can be helpful, so that patients can learn new coping skills for their anxiety and see direct benefits for change from feedback within the group.

Clomipramine (Anafranil) may help reduce the obsessions, anxiety, and depression associated with this disorder. Other serotonergic agents such as fluoxetine (Prozac) may also be effective.