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Flashcards in 6 Personality Disorders Deck (78):

What are the 3 Behavioral Features of Personality Disorders?

1. Behavioral tends to be rigid & inflexible, resulting in distress and/or maladaptive coping skills
2. Extreme anxiety, distress, depression, impulsivity common
3. Difficulty adapting to change, tolerating frustration, forming healthy relationships


What are the 4 Challenges of Personality Disorders?

1. Often deny problems, lack insight
2. Use displacement and projection
3. Display an uncanny ability to create crisis
4. Nurses need to develop innovative treatment strategies


What are the 5 Special Needs in Patients with Personality Disorders?

1. Understand factors associated with personality development
2. Recognize impact of early trauma
3. Deal with intense personal reactions
4. Work with team to develop consistency and avoid splitting
5. Recognize the need to maintain boundaries


In Personality Disorders, what is Splitting? (2)

1. Primitive ego defense
2. Person unable to integrate and accept both negative and positive feelings (the pt splits things into 2: good or bad, nothing in between)


What is counter transference? (2)

1. Nurse’s behavioral and and emotional response to the patient
2. Feelings may be related to unresolved feelings towards significant others in the nurse’s past which can triggered by the patient’s behavior


what is boundaries?

Level of participation and interaction between individuals and subsystems


What are the 4 important concepts of Personality Disorders?

1. Understanding the etiology of personality disorders helps to minimize negative reactions
2. Working with these clients seen as a challenge rather than a burden
3. Patience, self-awareness, creativity and non-judgmental attitude important
4. Important to set consistent and firm boundaries


Name 3 things about the Theories of the Origins of Personality Disorders.

1. Emphasize the significance of primary care-givers in child growth and development
2. Child must master socialization within the family, foundation for later relationships
3. Early interactions mediate infant’s/child’s perception of the world


Name 3 things about the Developmental Factors of the
Mahler’s Theory of Object Relations.

1. Theory of object relations are important in conceptualizing personality disorders
2. Personality disorders represent a disturbance/disruption in separation and individuation
3. Individual with BPD is thought to be fixed in the rapprochement phase of development


Mahler’s Stages of Separation-Individuation: Normal autism. what is the age and task for this phase?

Birth to 1 year
task: fulfillment of basic need for survival and comfort


Mahler’s Stages of Separation-Individuation: symbiosis. What is the age and task for this phase?

1 to 5 months
Task: awareness of external source for need fulfillment


Mahler’s Stages of Separation-Individuation: separation-individual differentiation. What is the age and task for this phase?

5 to 10 months
TastK recognizes separateness from caretaker


Mahler’s Stages of Separation-Individuation: Practicing. what is the age and task for this phase?

10 to 16 months
task: increased independence and separateness of self


Mahler’s Stages of Separation-Individuation: rapprochement. What is the age and task for this phase?

16 to 24 months
task: seeks emotional refueling from caretaker to maintain feeling of security


Mahler’s Stages of Separation-Individuation: consolidation. What is the age and task for this phase?

24 to 36 months
task: sense of separateness established on the caretake. it was to object constancy, resolution of separation anxiety.


Name 2 things about psychodynamic theory.

1. Object relations internalized relationships recollected from early primary-caregivers
2. Object constancy


Name 3 things about Object constancy.

1. Phase of separation/individuation process when the child learns to relate in an effective, constant manner
2. Sense of separateness is established
3. Child able to internalize the loved object


What are the neurobiologic factors of Personality Disorders?

---Dysregulation in serotonin and dopamine implicated in impulsivity, aggression and suicidal behaviors


what are the 3 personality disorders in the Cluster A of DSM5 personality disorders?

1. Paranoid Personality Disorder
2. Schizoid Personality Disorder
3. Schizotypal Personality Disorder


what are the 4 personality disorders in the Cluster B of DSM5 personality disorders?

1. Antisocial Personality Disorder
2. Borderline Personality Disorder
3. Histrionic Personality Disorder
4. Narcissistic Personality Disorder

** they are overly emotional


what are the 3 personality disorders in the Cluster C of DSM5 personality disorders?

1. Avoidant Personality Disorder
2. Dependent Personality Disorder
3. Obsessive-compulsive Personality Disorder


What is Paranoid Personality Disorder?

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


Paranoid personality disorder's Prevalence rate: ___ of the general population



Paranoid personality disorder is more commonly diagnosed in what gender?



What are the Clinical pictures of paranoid personality disorder? (4)

1. Constantly on guard, hyper-vigilant
2. Avoid interactions with others
3. Persistently bears grudges
4. Intimidating


Name one thing about paranoid personality disorder. hint: genetics

Possible hereditary link; higher incidence in relatives of people with schizophrenia


Name 3 things about Schizoid Personality Disorder.

1. Pattern of detachment form social relationships and a restricted range of emotional expression
2. Profound defect in the ability to form personal relationships
3. Lifelong pattern of social withdrawal


What is the prevalence rate of Schizoid Personality Disorder?

between 3 and 7.5%


Which gender is most frequently diagnosed with Schizoid Personality Disorder?



What are the 4 Clinical pictures of Schizoid Personality Disorder?

1. Cold, aloof, indifferent
2. Prefer to work alone, unsociable
3. Takes pleasure in few if any activities
4. no interest in sex


What is Schizotypal Personality Disorder?

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


What is the Prevalence of Schizotypal Personality Disorder?



What are the clinical pictures of Schizotypal Personality Disorder?

Ideas of reference
Odd beliefs or magical thinking
Unusual perceptual experiences
Suspiciousness, paranoia
Inappropriate affect
Lack of close friends


What is the genetic relationship of Schizotypal Personality Disorder with schizophrenia?

More common among first-degree biological relatives of people with schizophrenia


What is Antisocial Personality Disorder?

Pattern of disregard for and violation of the rights of others


What are the 5 symptoms of Antisocial Personality Disorder?

1. Failure to conform to social norms
2. Deceitfulness, repeated lying
3. Irritability and aggressiveness
4. Consistent irresponsibility
5. Lack of remorse


How old are the pts diagnosed with antisocial personality disorder usually?

at least 18


What is the prevalence rate of antisocial personality disorder?



What is the 1 genetic factor of antisocial personality disorder?

More common in first degree biological relatives of those with the disorder


What is Histrionic Personality Disorder?

Pattern of excessive emotionality and attention seeking


What are the 2 symtoms of Histrionic Personality Disorder?

1. Characterized by colorful, dramatic, and extroverted behavior
2. Difficulty maintaining long lasting relationships


what is the prevalence rate of Histrionic Personality Disorder?



Which gender is more commonly diagnosed with Histrionic Personality Disorder



What is the clinical picture of Histrionic Personality Disorder?

Self dramatizing, attention seeking, overly gregarious, seductive


What is the genetic factor associated with Histrionic Personality Disorder?

More common in among first degree biological relatives


What is Narcissistic Personality Disorder?

Pattern of grandiosity, need for admiration, and lack of empathy


What are the symptoms of Narcissistic Personality Disorder?

Individuals have an exaggerated sense of self worth, lack empathy, hypersensitive to the evaluation of others


What is the prevalence rate of Narcissistic Personality Disorder?



What are the 3 clinical pictures of Narcissistic Personality Disorder?

1. Believe they are entitled to special rights and privileges because they view themselves as superior
2. Mood usually optimistic, relaxed, cheerful
3. Exploitation of others for self gratification impairs relationships
** these pts are very egocentric all the time.


What is Avoidant Personality Disorder?

Pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation


What are 2 symptoms of Avoidant Personality Disorder?

1. Extremely sensitive to rejection
2. Socially isolates


What is the prevalence rate of Avoidant Personality Disorder?



What are the 3 clinical pictures of Avoidant Personality Disorder?

1. Awkward and uncomfortable in social settings
2. Speech slow and constrained, frequent hesitations
3. Often lonely


What is Dependent Personality Disorder?

Pattern of submissive and clinging behavior related to an excessive need to be taken care of


What are the symptoms of Dependent Personality Disorder?

Allows others to make decisions, feels helpless when alone, tolerates mistreatment, demeans self to gain acceptance
tend to depend on people who are abusive.


what is the prevalence rate of Dependent Personality Disorder?



What are the clinical pictures of Dependent Personality Disorder?

Notable lack of self confidence, passive and aquiescent to others


What is Obsessive-Compulsive Personality Disorder?

Pattern of preoccupation with orderliness, perfectionism, and control


What are the symptoms of Obsessive-Compulsive Personality Disorder?

Overly disciplined, perfectionistic, and preoccupied with rules


What is the prevalence rate of Obsessive-Compulsive Personality Disorder?



Which gender is more commonly diagnosed with Obsessive-Compulsive Personality Disorder?



What are the clinical pictures of Obsessive-Compulsive Personality Disorder?

Lack of spontaneity, inflexible, meticulous, rank conscious


Which personality disorder is also known as the "criminal behavior"?

antisocial personality disorder


How is obsessive compulsive personality disorder different from OCD?

obsessive compulsive personality disorder is different from OCD; these people are comfortable being OCD while the other one is the pt knows they are OCD and they hated it.


What is Borderline Personality Disorder (BPD)?

Pattern of instability in interpersonal relationships, self image, and affects, and marked impulsivity


What are the characteristics of pts with Borderline Personality Disorder (BPD)?

Characterized by pattern of intense and chaotic relationships, affective instability and fluctuation attitudes towards other people


What are the clinical pictures of Borderline Personality Disorder (BPD)?

Always in crisis
Inability to be alone


What are the patterns of interactions in BPD? (5)

1. Clinging and distancing
2. Splitting
3. Manipulation
4. Self-destructive behaviors
5. Impulsivity


What is the biological predisposing factor in BPD?

Biochemical possible serotonergic defect


What are the genetic predisposing factors in BPD? (2)

1. 5 times more common in among first degree biologic relatives of those with the disorder
2. Increased familial risk for depression, bipolar, substance use disorders and antisocial personality disorders


What are the psychosocial predisposing factors in BPD? (2)

1. Childhood trauma
2. 40-71% report sexual abuse


What are some nursing diagnoses for Personality Disorders?

Risk for self mutilation
Risk for self directed violence
Risk for suicide
Complicated grieving
Impaired social interaction
Disturbed personality identity
Chronic low self esteem


What are some of the treatments for Personality Disorders? (7)

1. Primary goal of tx is to reduce the inflexibility of personality features that interfere with functioning and relationships
2. Interpersonal psychotherapy
3. Psychoanalytical psychotherapy: histrionic personality disorder
4. Group therapy
5. CBT
6. Dialectical Behavioral Therapy
7. Psychopharmacology


what are the Psychopharmacology for personality disorders?

-Symptom relief
-Antipsychotics for psychotic decompensation


____ shown some efficacy in decreasing impulsivity in BPD



Combination of ___ and _____ for dysphoria, mood instability and impulsivity

SSRI and antipsychotic


___ and ___ have been used with violent behavior in antisocial personality disorder

Lithium and Inderal


What are some Nursing Interventions for personality disorders? (9)

1. Ensure safety
2. Firm, consistent and empathetic
3. Accepting and non-judgmental attitude
4. Teach alternative coping mechanisms
5. Limit setting
6. Administer PRN’s as needed
7. Low environmental stimuli
8. Safety planning
9. Reduce the inflexibility of the personality features that interfere with functioning and relationships