chapter 18: personality disorders Flashcards
(39 cards)
how do personality disorders translate? (2)
- consistent & enduring pattern of behaving & relating to self, others & environment
- not always clear on continuum
What are expected findings consistent with all personality disorders? (3)
- personality traits that are persistent , maladaptive & inflexible that affect some aspect of functioning → anger, manipulation, irritable, impulse, risk taking, & irresponsible
- often evokes strong, negative reactions from others → result in dysfunctional relationships
- often described as being tx resistant because poor insights and meds may not work
what is the goal of tx for personality disorders? (4)
- meds focus on tx of sx
- identify problems or triggers; can be inflexible,maladaptive response to stress, dysfunction in relationships & work, conflict in relationships
- psychotherapy is the most helpful intervention because we are not always consciously aware of our own personality
- dialectical behavior therapy (DBT) for BPD
What are the defining characteristics and guidelines for nursing interventions?
person in distress does better in tx b/c they feel something is wrong
What are the kinds of personality disorders in cluster A (odd)? (hint: 3)
1) paranoid
2) schizoid
3) schizotypal
What are the characteristics of paranoid personality disorder?
mistrust & suspicions of others; guarded, restricted affect
What are the sx of paranoid personality disorder? (3)
- pervasive mistrust/suspiciousness
- use of projection
- conflict with authority
What are interventions for paranoid personality disorder? (3)
- formal businesslike; must counteract mistrust
- pt involvement in care → may help with tx plan ; schedules in writing for them
- validate ideas before acting
What is schizoid personality disorder characterized by?
detachment from social relationships; restricted affect; involved with things more than people
What are sx of schizoid personality disorder? (hint: 5)
1) pattern of social detachment minimal interactions
2) indifferent when working with others
3) flat affect
4) little emotion cold & serious
5) ‘fantasy life’
What are interventions for schizoid personality disorder? (4)
- focus on improved function in community
- greater chance of success if he or she can relate needs to one person
- atypical antidepressant (bupropion) or atypical antipsychotics may be used for sx
- Avoid being too nice or friendly; dont pressure pt into socializing
What are the characteristics of schizotypal personality disorder?
acute discomfort in relationships; cognitive or perceptual distortions; eccentric behavior
What are the sx of schizotypal personality disorder? (hint: 5)
1) magical thinking
2) odd appearance
3) restricted range of emotions
4) anxiety in social relationships but unhappy alone
5) more likely to be in cults
What are interventions for schizotypal personality disorder? (4)
- focus on self care & social skills
- encourage daily routine
- appropriate outlets for discussing unusual beliefs
- psychotherapy used & low dose antipsychotics for tx
What personality disorders are considered cluster B (dramatic)? (4)
- antisocial
- borderline
- histrionic
- narcissistic
What have those with cluster B personality disorders more likely to experience?
more trauma/ child abuse
What are the characteristics of antisocial personality disorder?
disregard for rights of others, rules, and laws
What are the sx of antisocial personality disorder? (hint: 6)
1) disregard for rights of others
2) deceit & manipulation
3) lack of remorse or empathy
4) externalize blame
5) no morals or ethics
6) appear confident but sense of self is shallow
What are nursing interventions for antisocial personality disorder? (4)
- support ability to self reflect on own behavior & identify unacceptable behaviors
- promote responsible behaviors
- take a time out to control emotions & problem solve
- enhancing role performance
What is borderline personality disorder characterized by?
unstable relationships, self-image and affect; impulsivity; self-mutilation
What are sx of borderline personality disorder? (5)
1) intense, labile emotions
2) impulsivity
3) self-harm behaviors
4) highly reactive to abandonment
5) empty feeling splitting → inability to view both positive & negative parts of others as part of a whole
What are the interventions for borderline personality disorder? (7)
- asses for suicide risk → esp comorbidity of bipolar; “safety plan”
- be aware of manipulation, splitting, and dissociative states → nurse should reinforce that ALL team members are caring for the pt to diminish risk of splitting
- clear consistent limits; respond calm & matter of fact
- avoid rejecting or rescuing
- coping strategies for stressful situations
- low dose antipsychotics, antidepressants or anxiolytics used to tx sx
- DBT for psychotherapy
What is histrionic personality disorder characterized by?
excessive emotionality & attention seeking
What are the sx of histrionic personality disorder? (hint: 5)
1) excessive emotional & attention seeking
2) exaggeration of closeness of relationships
3) insincere shallow emotions
4) low frustration tolerance
5) seductive/ provocative/ flamboyant dress
