W6 Personality Disorders Flashcards
1
Q
What are personality disorders?
A
Enduring patterns of inner experience and behavior that deviate markedly from cultural expectations.
2
Q
What is the definition of personality?
A
Psychological qualities contributing to an individual’s enduring and distinctive patterns of thinking, feeling, and behaving.
3
Q
What is a key characteristic of personality disorders?
A
Inflexible and pervasive across personal and social contexts.
4
Q
What are the four key impairments caused by personality disorders?
A
- Cognition (thoughts)
- Affectivity (emotions)
- Interpersonal relationships
- Impulse control
5
Q
What are the three clusters of personality disorders defined in the DSM-5?
A
- Cluster A – Odd or Eccentric
- Cluster B – Dramatic, Emotional, or Erratic
- Cluster C – Anxious or Fearful
6
Q
Name a disorder in Cluster A.
A
Paranoid PD, Schizoid PD, Schizotypal PD
7
Q
Name a disorder in Cluster B.
A
Antisocial PD, Borderline PD, Histrionic PD, Narcissistic PD
8
Q
Name a disorder in Cluster C.
A
Avoidant PD, Dependent PD, Obsessive-Compulsive PD
9
Q
What is the focus of this module?
A
Borderline Personality Disorder (BPD).
10
Q
What are the nine diagnostic criteria for Borderline Personality Disorder?
A
- Frantic efforts to avoid abandonment
- Unstable interpersonal relationships
- Identity disturbance
- Impulsivity in self-damaging areas
- Recurrent suicidal behavior or self-harm
- Affective instability
- Chronic feelings of emptiness
- Intense anger difficulties
- Transient paranoia or dissociation
11
Q
True or False: People with BPD often have stable emotional regulation.
A
False
12
Q
What does emotional dysregulation involve?
A
- Inhibiting inappropriate behavior
- Self-soothing
- Focusing attention despite emotional arousal
13
Q
What is a common misconception about BPD?
A
That it means being irrational, over-emotional, or manipulative.
14
Q
What is the biopsychosocial model in relation to BPD causes?
A
- Biological: Genetic vulnerability
- Psychological: Childhood trauma
- Social: Difficult family environments
15
Q
What is the primary nursing response to a patient with BPD in crisis?
A
- Prompt support
- Validation and empathy
- Person-centred interventions
16
Q
What are the long-term treatment goals for individuals with BPD?
A
- Prevent suicide and self-harm
- Avoid unnecessary hospitalization
- Improve relationships and functioning
- Develop emotional regulation skills
- Support recovery and self-efficacy
17
Q
What is the primary form of treatment for BPD?
A
Psychotherapy-based, including DBT, CBT, ACT, and MBT.
18
Q
Fill in the blank: People with BPD often experience _______ crises triggered by minor events.
A
emotional
19
Q
What is transference in the context of nursing?
A
Patient projects past feelings onto the nurse.
20
Q
What is countertransference in nursing?
A
Nurse experiences strong emotional reactions to the patient.
21
Q
True or False: BPD is a choice.
A
False
22
Q
What should be avoided when interacting with patients with BPD?
A
Judgment or shame.
23
Q
What is a key principle for nursing care in BPD?
A
Be compassionate, empathetic, and non-judgmental.
24
Q
What is a personality disorder according to the DSM 5?
A
An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.
25
How are personality disorders categorized in the DSM 5?
Into clusters A, B, or C.
26
What is Paranoid Personality Disorder characterized by?
A pervasive distrust and suspiciousness of others.
27
List four symptoms of Paranoid Personality Disorder.
* Suspects others are exploiting or deceiving him or her
* Is preoccupied with unjustified doubts about the loyalty of friends
* Reads hidden threatening meanings into benign remarks
* Bears grudges for insults or injuries
28
What is Schizoid Personality Disorder marked by?
A pervasive pattern of detachment from social relationships and a restricted range of emotional expression.
29
List four symptoms of Schizoid Personality Disorder.
* Neither desires nor enjoys close relationships
* Chooses solitary activities
* Has little interest in sexual experiences
* Shows emotional coldness or detachment
30
What defines Schizotypal Personality Disorder?
A pervasive pattern of social and interpersonal deficits marked by acute discomfort with close relationships and cognitive or perceptual distortions.
31
List five symptoms of Schizotypal Personality Disorder.
* Ideas of reference
* Odd beliefs or magical thinking
* Unusual perceptual experiences
* Odd thinking and speech
* Excessive social anxiety
32
What is Antisocial Personality Disorder characterized by?
A pervasive pattern of disregard for and violation of the rights of others.
33
List three symptoms of Antisocial Personality Disorder.
* Deceitfulness
* Impulsivity or failure to plan ahead
* Lack of remorse
34
What is a key feature of Borderline Personality Disorder?
Instability of interpersonal relationships, self-image, and affects.
35
List four symptoms of Borderline Personality Disorder.
* Frantic efforts to avoid abandonment
* Unstable and intense interpersonal relationships
* Chronic feelings of emptiness
* Impulsivity in self-damaging areas
36
What characterizes Histrionic Personality Disorder?
A pervasive pattern of excessive emotionality and attention seeking.
37
List four symptoms of Histrionic Personality Disorder.
* Uncomfortable when not the center of attention
* Inappropriate sexually seductive behavior
* Rapidly shifting and shallow emotions
* Excessively impressionistic style of speech
38
What is Narcissistic Personality Disorder defined by?
A pervasive pattern of grandiosity, need for admiration, and lack of empathy.
39
List five symptoms of Narcissistic Personality Disorder.
* Grandiose sense of self-importance
* Preoccupation with fantasies of success
* Believes he or she is 'special'
* Requires excessive admiration
* Lacks empathy
40
What defines Avoidant Personality Disorder?
A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.
41
List four symptoms of Avoidant Personality Disorder.
* Avoids activities involving interpersonal contact
* Unwilling to get involved unless certain of being liked
* Views self as socially inept
* Reluctant to take personal risks
42
What characterizes Dependent Personality Disorder?
A pervasive and excessive need to be taken care of, leading to submissive behavior.
43
List four symptoms of Dependent Personality Disorder.
* Difficulty making decisions without excessive advice
* Needs others to assume responsibility for life
* Difficulty expressing disagreement
* Feels uncomfortable when alone
44
What is Obsessive Compulsive Personality Disorder marked by?
A pervasive pattern of preoccupation with orderliness, perfectionism, and mental control.
45
List four symptoms of Obsessive Compulsive Personality Disorder.
* Preoccupation with details and rules
* Perfectionism that interferes with task completion
* Excessively devoted to work
* Inability to discard worthless objects
46
What is borderline personality disorder?
A complex mental disorder affecting up to 6% of the population, more common in females than males.
## Footnote
Living with BPD can lead to difficulties in relationships, self-perception, and emotional control.
47
What are common unhealthy coping strategies used by individuals with BPD?
Self-harm
## Footnote
This can complicate social, family, and work life.
48
What model is often used to explain the development of BPD?
The biopsychosocial model
## Footnote
This model considers biological, psychological, and social factors.
49
What percentage of individuals with BPD have experienced early life trauma?
85%
## Footnote
Early life trauma can include emotional neglect, abuse, and physical abuse.
50
What symptoms typically emerge in adolescence for those with BPD?
Impulsive behaviors, identity issues, affective instability
## Footnote
These symptoms differ from typical adolescent behavior as they tend to increase rather than decrease.
51
What are predominant symptoms of BPD in adults?
Periods of remission and relapse, chronic dysphoria, anger, feelings of emptiness, fears of abandonment
## Footnote
These symptoms can persist throughout adulthood.
52
True or False: Personality disorders self-cure with time.
False
## Footnote
Research shows that personality disorders can present for the first time in older individuals.
53
What are common coexisting mental health conditions with BPD?
* Major depressive disorder
* Dysthymic disorder
* Bipolar affective disorder
* Generalised anxiety disorder
* Panic disorder
* Agoraphobia
* Social phobia
* PTSD
* Obsessive-compulsive disorder
* Eating disorder
* Substance use disorder
* ADHD
## Footnote
Individuals with BPD often receive multiple diagnoses over their lifetime.
54
What medical conditions are associated with BPD?
* Higher rates of chronic diseases (e.g., diabetes, cardiovascular disease)
* Sexually transmitted infections
* Polycystic ovarian syndrome
* Pain sensitivity
* Somatic complaints
## Footnote
Trauma may lead to dysregulation of cortisol affecting these conditions.
55
What may be observed in the appearance of a person with BPD during a mental state exam?
Superficial lacerations, scarring visible
## Footnote
This observation can indicate self-harm behaviors.
56
What mood variations might be observed in a person with BPD?
Labile, angry, anxious, sad, bored, empty, irritable, excited, elated, tense
## Footnote
Their mood may change rapidly and dramatically.
57
What is a common theme in the thought content of individuals with BPD?
Hopeless and helpless themes
## Footnote
They may express feelings of worthlessness and loneliness.
58
What is the cognitive state of a person with BPD during assessment?
Orientated to time, place, person, but may have poor memory and concentration
## Footnote
Cognitive impairments can affect their ability to focus.
59
What should a risk assessment for a person with BPD consider?
Long-term and acute risks, including suicide risk and risk to others
## Footnote
It is crucial to differentiate between chronic and immediate risk factors.
60
Fill in the blank: Individuals with BPD often display impaired _______.
Judgement
## Footnote
This can affect their decision-making and safety.
61
What should be assessed regarding coping strategies in individuals with BPD?
What has helped in the past, key strengths, main supports
## Footnote
Understanding coping strategies can inform treatment approaches.
62
What is the experience of living with BPD like?
Everyone's experience of living with BPD is different.
63
What is the purpose of the National Consensus Statement?
It is a vision for a better system for people living with BPD.
64
What are the key components of the National Consensus Statement?
* Endorsement of a national model of care for people with BPD
* National framework for family and carers
* National training framework for health professionals
* Establishment of a BPD Centre of Excellence in each state and territory of Australia.
65
What approach is recommended for supporting people with BPD?
A team approach involving the person, their partner or carer, their family, and health professionals.
66
Why is a management plan important for people with BPD?
It ensures clarity of roles and actions, preventing inconsistency and chaos among treatment providers.
67
What is a crisis plan?
A plan in addition to the management plan for people who frequently present to health services in crisis.
68
Identify one helpful strategy for managing intense emotions.
Express/respond to my intense emotions.
69
Fill in the blank: A strategy to help with relationships is to state a ______ and stick to it.
boundary
70
What should someone do if they feel rage?
Remove themselves from the situation and wait until the feeling passes.
71
What is a key principle of trauma-informed care?
Recognizes and responds to the impacts of trauma on individuals' lives.
72
True or False: Trauma-informed care seeks to actively re-traumatize individuals.
False
73
What is the role of the Blue Knot Foundation?
It is the National Centre of Excellence for Complex Trauma.
74
List two strategies to help distract oneself.
* Watch a movie
* Exercise — walking/running/dance/stroll on the beach
75
What does a trauma-informed program recognize?
The widespread impact of trauma and potential paths for recovery.
76
Fill in the blank: To support people living with BPD, nurses should take a ______ informed approach.
trauma
77
What is one way to comfort oneself according to the strategies provided?
Cuddle a soft toy.
78
What is the importance of consistent and predictable responses in interactions with health services?
It helps the person with BPD to feel safe.
79
What are thoughtful boundaries in the context of care for BPD?
Boundaries that are communicated clearly and not punitive.
80
What is one benefit of keeping regular appointments with a support network?
It helps maintain connections even when feeling 'okay'.
81
List three things that help someone relax.
* Meditation
* Yoga
* Breathing techniques
82
What is the significance of creating a personalized crisis plan?
It provides guidance when the individual is well and can help manage crises effectively.
83
What should one do when feeling overwhelmed during a crisis?
Let someone know how I am feeling.
84
What is the primary recommendation regarding the use of medications for borderline personality disorder (BPD)?
Medicines should not be used as primary therapy for BPD because they have only modest and inconsistent effects and do not change the nature and course of the disorder.
85
In what situations can medications be considered for BPD patients?
Medications can be considered in acute crisis situations where psychological approaches are not sufficient.
86
What should be done with medications once a crisis in a BPD patient has been resolved?
Medications should be withdrawn once the crisis has been resolved.
87
What are some reasons individuals with BPD may engage in self-harm?
Reasons include relief of acute painful emotions, distraction, communication, self-punishment, and visual representation of self-image.
88
List three things to do when responding to someone who has self-harmed.
* Express concern and actively listen
* Validate the distress that led to the harm
* Encourage alternative coping strategies
89
What are some things to avoid when talking with someone about deliberate self-harm?
* Minimise the person’s feelings
* Use labels like ‘self-mutilator’
* Accuse the person of 'attention seeking' behaviour
90
What is the focus of treatment for people with BPD according to NHMRC guidelines?
Treatment should be provided by community-based mental health services and include structured psychological therapies specifically designed for BPD.
91
Name two psychotherapy treatments that are more effective for BPD than treatment as usual.
* Cognitive behavioural therapy (CBT)
* Dialectical behavioural therapy (DBT)
92
What is the primary purpose of Dialectical Behavioural Therapy (DBT)?
DBT aims to help individuals living with symptoms of Borderline Personality Disorder (BPD) by teaching new skills.
93
Who developed Dialectical Behavioural Therapy (DBT)?
Dr. Marsha Linehan
94
What are the four areas of skills taught in Dialectical Behavioural Therapy (DBT)?
* Mindfulness skills
* Interpersonal effectiveness skills
* Emotion regulation skills
* Distress tolerance skills
95
True or False: DBT emphasizes cognitive methods more than traditional Cognitive Behavioural Therapy (CBT).
False
96
Fill in the blank: The first randomized controlled trial of DBT found significant improvements for women living with BPD experiencing _______.
chronic suicidal thoughts
97
What should a nurse do when a patient has been using self-harm as a coping strategy?
Assess suicide risk and encourage the patient to dress the wound themselves if it does not require medical intervention.
98
What is a common misconception about self-harm among people with BPD?
Self-harm is often incorrectly labeled as 'attention seeking' behavior.
99
What should be the nurse's role when medications are prescribed for BPD?
Educate people on their options for treatment.
100
What is one of the key functions of self-harm for individuals with BPD?
To provide a visual representation to others of their self-image.
101
What is Loving Kindness?
Loving kindness is a mindfulness practice designed to increase love and compassion for ourselves and others.
102
What does practicing Loving Kindness protect us from?
It protects us from developing and holding on to judgmentalness, ill will, and hostile feelings.
103
How is practicing Loving Kindness similar to prayer?
It involves actively sending loving and kind wishes and reciting words that express goodwill.
104
List the steps to practice Loving Kindness.
* Choose a person to send kindness toward
* Sit comfortably and breathe deeply
* Radiate kindness through warm wishes
* Gradually extend kindness to others
* Practice daily
105
What is the acronym DEAR MAN used for?
It is used to teach interpersonal effectiveness skills.
106
What are some goals of using DEAR MAN?
* Obtaining legitimate rights
* Getting someone to do something
* Saying no to unreasonable requests
* Resolving conflicts
* Being taken seriously
107
What does the 'D' in DEAR MAN stand for?
Describe the current situation.
108
What should you do when expressing feelings in DEAR MAN?
Express your feelings and opinions about the situation.
109
How should you assert yourself in DEAR MAN?
Ask for what you want or say no clearly.
110
What is the purpose of the 'R' in DEAR MAN?
Reinforce the positive effects of getting what you want.
111
What does 'stay mindful' mean in the DEAR MAN acronym?
Keep your focus on your goals and do not get distracted.
112
What does 'appear confident' involve in DEAR MAN?
Using a confident voice tone and maintaining good eye contact.
113
What is the final component of DEAR MAN?
Negotiate by being willing to give to get.
114
Fill in the blank: Loving Kindness can be directed first toward _______.
[yourself]
115
True or False: DEAR MAN is only useful for resolving interpersonal conflicts.
False
116
What is the main focus of emotion regulation skills?
To manage and respond to emotional experiences.
117
What is the purpose of distress tolerance skills?
To help individuals tolerate and survive crises without making the situation worse.
118
What is required for a diagnosis of BPD according to DSM-5?
A person must meet 5 or more of the specified criteria
119
What is the first criterion for diagnosing BPD?
Frantic efforts to avoid real or imagined abandonment
120
What describes the nature of interpersonal relationships in BPD?
Unstable, intense interpersonal relationships (idealisation ↔ devaluation)
121
What is meant by identity disturbance in BPD?
Unstable self-image
122
What kind of impulsivity is associated with BPD?
Impulsivity in self-damaging areas (e.g. sex, spending, substance use)
123
What is a common behavior seen in individuals with BPD?
Recurrent suicidal behaviour, gestures, or self-harm
124
What does affective instability in BPD refer to?
Mood swings, reactivity
125
What is a chronic emotional state experienced by those with BPD?
Chronic feelings of emptiness
126
What type of anger issues are characteristic of BPD?
Inappropriate, intense anger or difficulty controlling anger
127
What kind of paranoia or dissociation may occur in BPD?
Transient, stress-related paranoia or dissociation
128
Q1: Which term best describes a pattern of inner experience and behavior that deviates from cultural expectations and is pervasive, inflexible, and stable over time?
A. Anxiety disorder
B. Personality disorder
C. Mood disorder
D. Adjustment disorder
Q1: Which term best describes a pattern of inner experience and behavior that deviates from cultural expectations and is pervasive, inflexible, and stable over time?
A. Anxiety disorder
B. Personality disorder ✅
C. Mood disorder
D. Adjustment disorder
129
Q2: Which of the following is NOT one of the DSM-5 diagnostic criteria for Borderline Personality Disorder?
A. Chronic feelings of emptiness
B. Grandiose sense of self-importance
C. Identity disturbance
D. Impulsivity in self-damaging activities
Q2: Which of the following is NOT one of the DSM-5 diagnostic criteria for Borderline Personality Disorder?
A. Chronic feelings of emptiness
B. Grandiose sense of self-importance ✅
C. Identity disturbance
D. Impulsivity in self-damaging activities
130
Q3: Which cluster of personality disorders is characterised as dramatic, emotional, or erratic?
A. Cluster A
B. Cluster B
C. Cluster C
D. Cluster D
Q3: Which cluster of personality disorders is characterised as dramatic, emotional, or erratic?
A. Cluster A
B. Cluster B ✅
C. Cluster C
D. Cluster D
131
Q4: Which therapy was specifically developed to treat Borderline Personality Disorder?
A. Acceptance and Commitment Therapy (ACT)
B. Cognitive Behavioural Therapy (CBT)
C. Dialectical Behaviour Therapy (DBT)
D. Interpersonal Therapy (IPT)
Q4: Which therapy was specifically developed to treat Borderline Personality Disorder?
A. Acceptance and Commitment Therapy (ACT)
B. Cognitive Behavioural Therapy (CBT)
C. Dialectical Behaviour Therapy (DBT) ✅
D. Interpersonal Therapy (IPT)
132
Q5: Which of the following is considered a maladaptive coping strategy associated with emotional dysregulation in BPD?
A. Journaling
B. Meditation
C. Self-harm
D. DBT skills
Q5: Which of the following is considered a maladaptive coping strategy associated with emotional dysregulation in BPD?
A. Journaling
B. Meditation
C. Self-harm ✅
D. DBT skills
133
Q6: Which of the following is TRUE regarding medication for BPD according to NHMRC guidelines?
A. Antidepressants are the first-line treatment
B. Medication is the primary therapy
C. Benzodiazepines are preferred for managing crises
D. Medication may be used short-term alongside psychotherapy
Q6: Which of the following is TRUE regarding medication for BPD according to NHMRC guidelines?
A. Antidepressants are the first-line treatment
B. Medication is the primary therapy
C. Benzodiazepines are preferred for managing crises
D. Medication may be used short-term alongside psychotherapy ✅
134
Q7: What is the primary goal of trauma-informed care in mental health nursing?
A. To diagnose PTSD
B. To avoid triggering trauma and support recovery
C. To minimise medication use
D. To challenge the client’s beliefs
Q7: What is the primary goal of trauma-informed care in mental health nursing?
A. To diagnose PTSD
B. To avoid triggering trauma and support recovery ✅
C. To minimise medication use
D. To challenge the client’s beliefs
135
Q8: Which of the following DBT skill areas focuses on maintaining relationships and asserting needs effectively?
A. Emotion regulation
B. Interpersonal effectiveness
C. Distress tolerance
D. Mindfulness
Q8: Which of the following DBT skill areas focuses on maintaining relationships and asserting needs effectively?
A. Emotion regulation
B. Interpersonal effectiveness ✅
C. Distress tolerance
D. Mindfulness
136
Q9: Which Cluster A personality disorder is characterised by social detachment and limited emotional expression?
A. Schizotypal
B. Schizoid
C. Paranoid
D. Avoidant
Q9: Which Cluster A personality disorder is characterised by social detachment and limited emotional expression?
A. Schizotypal
B. Schizoid ✅
C. Paranoid
D. Avoidant
137
Q10: What is the appropriate nursing response to a patient who has recently self-harmed?
A. Minimise attention to the injury
B. Focus on punishment
C. Remove all coping tools without consent
D. Express anger to promote behaviour change
Q10: What is the appropriate nursing response to a patient who has recently self-harmed?
A. Minimise attention to the injury ✅
B. Focus on punishment
C. Remove all coping tools without consent
D. Express anger to promote behaviour change
138
Q11: Which of the following is a key nursing principle when supporting someone with BPD?
A. Avoid discussing emotions
B. Use tough love to promote resilience
C. Be compassionate, calm, and consistent
D. Focus only on their physical health
Q11: Which of the following is a key nursing principle when supporting someone with BPD?
A. Avoid discussing emotions
B. Use tough love to promote resilience
C. Be compassionate, calm, and consistent ✅
D. Focus only on their physical health
139
Q12: A patient with BPD says, "I hate you, don’t leave me." This is an example of which diagnostic feature?
A. Paranoia
B. Identity disturbance
C. Unstable interpersonal relationships
D. Chronic emptiness
Q12: A patient with BPD says, "I hate you, don’t leave me." This is an example of which diagnostic feature?
A. Paranoia
B. Identity disturbance
C. Unstable interpersonal relationships ✅
D. Chronic emptiness
140
Q13: What does "affective instability" in BPD most closely refer to?
A. Delusional thinking
B. Persistent low mood
C. Intense, rapidly changing emotions
D. Lack of insight
Q13: What does "affective instability" in BPD most closely refer to?
A. Delusional thinking
B. Persistent low mood
C. Intense, rapidly changing emotions ✅
D. Lack of insight
141
Q14: Which of the following is NOT a common coexisting condition with BPD?
A. Generalised anxiety disorder
B. Type 1 diabetes
C. PTSD
D. Substance use disorder
Q14: Which of the following is NOT a common coexisting condition with BPD?
A. Generalised anxiety disorder
B. Type 1 diabetes ✅
C. PTSD
D. Substance use disorder
142
Q15: Which term refers to when a patient transfers feelings from past relationships onto a clinician?
A. Countertransference
B. Transference
C. Emotional dysregulation
D. Projection
Q15: Which term refers to when a patient transfers feelings from past relationships onto a clinician?
A. Countertransference
B. Transference ✅
C. Emotional dysregulation
D. Projection
143
Q16: Why is DBT considered a suitable therapy for BPD?
A. It focuses on repressed memories
B. It provides rapid symptom resolution
C. It teaches practical emotion regulation skills
D. It eliminates the need for medication
Q16: Why is DBT considered a suitable therapy for BPD?
A. It focuses on repressed memories
B. It provides rapid symptom resolution
C. It teaches practical emotion regulation skills ✅
D. It eliminates the need for medication
144
Q17: What is the minimum number of DSM-5 criteria required to diagnose BPD?
A. Three
B. Four
C. Five
D. Six
Q17: What is the minimum number of DSM-5 criteria required to diagnose BPD?
A. Three
B. Four
C. Five ✅
D. Six
145
Q18: Which Cluster C personality disorder is associated with perfectionism and control?
A. Avoidant
B. Obsessive-Compulsive
C. Dependent
D. Narcissistic
Q18: Which Cluster C personality disorder is associated with perfectionism and control?
A. Avoidant
B. Obsessive-Compulsive ✅
C. Dependent
D. Narcissistic
146
Q19: What is a common feature of antisocial personality disorder?
A. Persistent guilt
B. Intense fear of abandonment
C. Disregard for the rights of others
D. Rapid mood swings
Q19: What is a common feature of antisocial personality disorder?
A. Persistent guilt
B. Intense fear of abandonment
C. Disregard for the rights of others ✅
D. Rapid mood swings
147
Q20: What is the purpose of using a management plan for people with BPD?
A. To reduce medication reliance
B. To enforce treatment
C. To promote consistency and reduce chaos
D. To limit patient autonomy
Q20: What is the purpose of using a management plan for people with BPD?
A. To reduce medication reliance
B. To enforce treatment
C. To promote consistency and reduce chaos ✅
D. To limit patient autonomy
148
Q21: According to the biopsychosocial model, which factor contributes to BPD development?
A. Only genetic inheritance
B. Only early trauma
C. A combination of biological, psychological, and social factors
D. Personality type
Q21: According to the biopsychosocial model, which factor contributes to BPD development?
A. Only genetic inheritance
B. Only early trauma
C. A combination of biological, psychological, and social factors ✅
D. Personality type
149
Q22: What kind of emotional response may a nurse experience as a result of countertransference?
A. Apathetic detachment
B. Rational concern
C. Intense frustration or protectiveness
D. Clinical objectivity
Q22: What kind of emotional response may a nurse experience as a result of countertransference?
A. Apathetic detachment
B. Rational concern
C. Intense frustration or protectiveness ✅
D. Clinical objectivity
150
Q23: Which of the following is considered a strength-based strategy for supporting BPD recovery?
A. Ignoring distress
B. Focusing only on deficits
C. Validating emotional experiences
D. Discouraging independence
Q23: Which of the following is considered a strength-based strategy for supporting BPD recovery?
A. Ignoring distress
B. Focusing only on deficits
C. Validating emotional experiences ✅
D. Discouraging independence
151
Q24: In the MSE, what might you observe in the "mood" section of someone with BPD?
A. Consistently elevated mood
B. Labile or rapidly changing mood
C. Delusions
D. Euphoric baseline
Q24: In the MSE, what might you observe in the "mood" section of someone with BPD?
A. Consistently elevated mood
B. Labile or rapidly changing mood ✅
C. Delusions
D. Euphoric baseline
152
Q25: What is an appropriate question during a BPD risk assessment about suicide?
A. “You're not thinking of hurting yourself, are you?”
B. “Why would you want to die?”
C. “Are you thinking about suicide?”
D. “You should just focus on the positives.”
Q25: What is an appropriate question during a BPD risk assessment about suicide?
A. “You're not thinking of hurting yourself, are you?”
B. “Why would you want to die?”
C. “Are you thinking about suicide?” ✅
D. “You should just focus on the positives.”
153
Q26: Which of the following is a DBT distress tolerance strategy?
A. DEAR MAN
B. Loving kindness
C. Holding ice cubes
D. Mood journaling
Q26: Which of the following is a DBT distress tolerance strategy?
A. DEAR MAN
B. Loving kindness
C. Holding ice cubes ✅
D. Mood journaling
154
Q27: Why is setting consistent boundaries important when supporting someone with BPD?
A. To assert dominance
B. To reduce service utilisation
C. To promote predictability and safety
D. To avoid forming a therapeutic relationship
Q27: Why is setting consistent boundaries important when supporting someone with BPD?
A. To assert dominance
B. To reduce service utilisation
C. To promote predictability and safety ✅
D. To avoid forming a therapeutic relationship
155
Q28: A person with narcissistic personality disorder would most likely:
A. Avoid social interaction
B. Show intense empathy
C. Exaggerate their achievements
D. Be dependent on others
Q28: A person with narcissistic personality disorder would most likely:
A. Avoid social interaction
B. Show intense empathy
C. Exaggerate their achievements ✅
D. Be dependent on others
156
Q29: A person with dependent personality disorder is most likely to:
A. Have high autonomy
B. Avoid others
C. Fear being left to care for themselves
D. Display intense anger
Q29: A person with dependent personality disorder is most likely to:
A. Have high autonomy
B. Avoid others
C. Fear being left to care for themselves ✅
D. Display intense anger
157
Q30: Which nursing approach is considered inappropriate for someone disclosing self-harm?
A. Labeling them as a “cutter”
B. Listening empathetically
C. Validating distress
D. Encouraging wound care autonomy
Q30: Which nursing approach is considered inappropriate for someone disclosing self-harm?
A. Labeling them as a “cutter” ✅
B. Listening empathetically
C. Validating distress
D. Encouraging wound care autonomy
158
Q31: What does the “DEAR” part of DEAR MAN in DBT stand for?
A. Discuss, Explain, Affirm, React
B. Describe, Express, Assert, Reinforce
C. Define, Emphasise, Act, Reflect
D. Defend, Emote, Argue, Rationalise
Q31: What does the “DEAR” part of DEAR MAN in DBT stand for?
A. Discuss, Explain, Affirm, React
B. Describe, Express, Assert, Reinforce ✅
C. Define, Emphasise, Act, Reflect
D. Defend, Emote, Argue, Rationalise
159
Q32: What is the purpose of mentalisation-based therapy (MBT) for BPD?
A. Improve insight into physical health
B. Control substance use
C. Increase ability to understand one’s own and others’ mental states
D. Treat psychosis
Q32: What is the purpose of mentalisation-based therapy (MBT) for BPD?
A. Improve insight into physical health
B. Control substance use
C. Increase ability to understand one’s own and others’ mental states ✅
D. Treat psychosis
160
Q33: According to Linehan, BPD arises from:
A. Genetic determinism
B. Faulty parenting
C. Skill deficits in emotional regulation
D. Inflexible belief systems
Q33: According to Linehan, BPD arises from:
A. Genetic determinism
B. Faulty parenting
C. Skill deficits in emotional regulation ✅
D. Inflexible belief systems
161
Q34: Which type of personality disorder involves magical thinking and unusual perceptions?
A. Schizotypal
B. Avoidant
C. Dependent
D. Narcissistic
Q34: Which type of personality disorder involves magical thinking and unusual perceptions?
A. Schizotypal ✅
B. Avoidant
C. Dependent
D. Narcissistic
162
Q35: What common affect may be observed in a person with BPD on MSE?
A. Euphoric
B. Restricted or tearful
C. Flat
D. Inappropriate laughter
Q35: What common affect may be observed in a person with BPD on MSE?
A. Euphoric
B. Restricted or tearful ✅
C. Flat
D. Inappropriate laughter
163
Q36: Which of the following is a grounding technique useful for emotional regulation?
A. Screaming
B. Self-isolation
C. Noticing 5 things you see, hear, and feel
D. Avoidance
Q36: Which of the following is a grounding technique useful for emotional regulation?
A. Screaming
B. Self-isolation
C. Noticing 5 things you see, hear, and feel ✅
D. Avoidance
164
Q37: Which principle is NOT part of a trauma-informed care approach?
A. Recognising trauma impact
B. Integrating trauma knowledge into practice
C. Avoiding discussion of past trauma
D. Preventing re-traumatisation
Q37: Which principle is NOT part of a trauma-informed care approach?
A. Recognising trauma impact
B. Integrating trauma knowledge into practice
C. Avoiding discussion of past trauma ✅
D. Preventing re-traumatisation
165
Q38: Which BPD symptom typically persists throughout adulthood according to Videler?
A. Grandiosity
B. Chronic dysphoria
C. Rapid recovery
D. Intense paranoia
Q38: Which BPD symptom typically persists throughout adulthood according to Videler?
A. Grandiosity
B. Chronic dysphoria ✅
C. Rapid recovery
D. Intense paranoia
166
Q39: Which self-soothing activity is recommended for people in crisis?
A. Drinking alcohol
B. Bubble bath
C. Avoiding all contact
D. Suppressing emotion
Q39: Which self-soothing activity is recommended for people in crisis?
A. Drinking alcohol
B. Bubble bath ✅
C. Avoiding all contact
D. Suppressing emotion
167
Q40: What is a key difference between BPD and typical adolescent moodiness?
A. BPD symptoms usually improve with age
B. BPD symptoms increase over time without treatment
C. BPD involves mild, temporary symptoms
D. BPD affects only interpersonal relationships
Q40: What is a key difference between BPD and typical adolescent moodiness?
A. BPD symptoms usually improve with age
B. BPD symptoms increase over time without treatment ✅
C. BPD involves mild, temporary symptoms
D. BPD affects only interpersonal relationships
