Exam 3 Chapter 23

Question 1

when traits become rigid and inflexible and contribute to maladaptive patterns of behavior or impairment in functioning

Answer 1

personality disorder

Question 2

separation anxiety resolves between 24-36 mos

Answer 2

Mahler

Question 3

Yellow bile

Answer 3

irritable and hostile

Question 4

pessimistic and melancholic

Answer 4

black bile

Question 5

overly optimistic and extraverted

Answer 5

blood

Question 6

apathetic phlegmatic

Answer 6

phlegm

Question 7

moral insanity of old

Answer 7

became personality d/o

Question 8

3 Clusters of PD

Answer 8

A: odd or eccentric
B: draumatic, emotional or irratic
C: anxious or fearful

Question 9

Paranoid
Schizoid
Schizotypal

Answer 9

Cluster A: odd or eccentric

Question 10

Antisocial
Borderline PD
Histrionic
Narcisistic

Answer 10

Cluster B: draumatic, emotional or erratic

Question 11

Avoidant
Dependent
OCD

Answer 11

Cluster C: anxious or fearful

Question 12

pervasive, persistent and inappropriate mistrust of others
1:4 in population
men>women

Answer 12

Paranoid

Question 13

profound defect in relationships
unable to experience pleasure
bland and constricted affect
shy, anxious, introverted kid with bleak, cold childhood lacking empathy and learning

Answer 13

Schizoid

Question 14

alouf and isolated
living in own world
odd, eccentric behavior that does not decompensate into schizophrenia
magical thinking, ideas of reference, illusions, depersonalization

Answer 14

Schizotypal

Question 15

socially irresponsible, exploitative, guiltless behaviors that reflect a disregard for the rights of others

Answer 15

antisocial

Question 16

pattern of intense and chaotic relationships with affective instability and fluctuating attitudes toward other people.
Impulsive, self-destructive, lack a clear sense of identity
women (4) > men (1)

Answer 16

borderline pd

Question 17

colorful, dramatic, extroverted behavior in excitable, emotional ppl
woemn > men
self dramatizing, attention seeking overly agregarious and seductive

Answer 17

histrionic

Question 18

demonstrate what our society tends to foster and admire in its members: to be well-liked, successful, popular, extroverted, attractive, and sociable. However, beneath these surface characteristics is a driven quality-an all-consuming need for approval and a desperate striving to be conspicuous and to evoke affection or attract attention at all costs. Failure to evoke the attention and approval they seek often results in feelings of dejection and anxiety

Answer 18

histrionic

Question 19

highly distractible and flighty by nature
display themselves as carefree and sophisticated on one hand, and inhibited and naive on the other. Tend to be highly suggestible, impressionable, and easily influenced by others.

Answer 19

histrionic

Question 20

Nothing they do works consistently, such children experience frustration in getting their parents’ attention and exaggerate behaviors basic to their gender stereotype to secure compliments and affection. Otherwise, they are ignored. Such children enter adolescence with a nearly insatiable thirst for attention and love

Answer 20

Histrionic PD

Question 21

exaggerated sense of self-worth
lack empathy
believe they have the inalienable right to receive special consideration, and that their desire is sufficient justification for possessing whatever they seek.
6% population and men>women

Answer 21

Narcissistic

Question 22

lack humility, being overly self-centered, and exploiting others to fulfill their own desires

Answer 22

Narcissistic

Question 23

optimistic mood, relaxed, cheerful and carefree
fragile self-esteem
if they do not gain the approval they persued: rage, shame, humiliation, or dejection

Answer 23

narcissistic

Question 24

as children, fears, failures, or dependency needs responded to with criticism, disdain, or neglect.
Unable to view others as sources of comfort and support
project an image of invulnerability and self-sufficiency to conceals true sense of emptiness and contributes to inability to feel deeply.

Answer 24

Narcissistic

Question 25

extremely sensitive to rejection which may lead to a socially withdrawn life. There may be a strong demand for companionship, but are too fearful of rejection. Extreme shyness and fear of rejection create needs for unusually strong assurances of unconditional acceptance. 2%, men=women

Answer 25

avoidance pd

Question 26

timid, withdrawn, cold, strange

Answer 26

avoidance pd

Question 27

speech is slow and constrained with frequent hesitations, fragmentary thought sequences, and occasional confused and irrelevant digressions. Depression, anxiety, and anger at oneself for failing to develop social relations are commonly experienced

Answer 27

avoidance pd

Question 28

primary psychosocial predisposing influence to _____ disorder is parental rejection and censure, which is often reinforced by peers.

Answer 28

avoidance

Question 29

a pattern of relying on others excessively for emotional support

Answer 29

dependent d/o

Question 30

more common in women than men and in the youngest child of the family

Answer 30

dependent d/o

Question 31

a notable lack of self-confidence that is apparant in posture, voice, and mannerisms

Answer 31

dependent d/o

Question 32

see the world through rose colored glasses

Answer 32

dependent d/o

Question 33

pessimistic, discouraged, rejected; suffering is done in silence

Answer 33

dependent d/o

Question 34

avoid positions of responsibility and become anxious when forced into them

Answer 34

dependent d/o

Question 35

psychosocially, ________ is fostered in infancy when stimulation and nurturance are experienced exclusively from one source.

Answer 35

dependent d/o

Question 36

child may come to fear a loss of love or attachment from the parental figure if independent behaviors are attempted

Answer 36

dependent d/o

Question 37

serious, formal, and have difficulty expressing emotions overly disciplined, perfectionistic, and preoccupied with rules have a devotion to productivity to the exclusion of personal pleasure more common in men>women, oldest child in family

Answer 37

OCD

Question 38

intense fear of making mistakes leads to difficulty making decisions

Answer 38

OCD

Question 39

are contemptuos of people whose behavior they view as frivolous or impulsive

Answer 39

OCD

Question 40

commonly use reaction formation

Answer 40

OCD

Question 41

praise for positive behaviors in childhood is bestowed much less frequently than punishment for undesirable behaviors; learn what they must NOT do to avoid punishment instead of what they CAN do to receive award

Answer 41

OCD

Question 42

ambulatory schizophrenia, pseudoneurotic schizophrenia, and emotionally unstable personaltiy

Answer 42

borderline pd

Question 43

prefer a frantic search for companionship, no matter how unsatisfactory, to sitting with feelings of lonliness, emptiness, and boredom; possess a chronic fear of abandonment

Answer 43

borderline PD

Question 44

people and life situations are either all good or all bad

Answer 44

splitting-primitive ego defense mechansim assoc with borderline pd

Question 45

splitting arises from lack of

Answer 45

object constancy and is manifested by an inability to integrate and accept both positive and negative feelings (borderline pd)

Question 46

Manipulation

Answer 46

to avoid or achieve relief from separation anxiety in borderline PD

Question 47

What is the neurotransmitter assoc with borderline pd

Answer 47

decreased serotonin (like depression)

Question 48

Which phase of Mahler's theory of object relations do ppl with borderline pd get stuck in?

Answer 48

reapprochement phase (16-24mos): awareness of separateness of self becomes acute; this is frightening to the child, who wants to regain some lost closeness but not return to symbiosis. The child wants the mother there as needed for emotional refueling, and to maintain feelings of security. In the case of borderline pd, mom gets threatened when baby becomes more independent-and withdraws emotional support-no more "refueling"; mom rewards clinging, dependent behaviors, and punishes independent ones

Question 49

unresolved grief for the nurturing they failed to receive results in internalized rage that manifests itself in the _____so common in ppl with borderline pd

Answer 49

depression

Question 50

``` risk for self-mutilation risk for self-directed violence risk for suicide risk for other-directed violence complicated grieving impaired social interaction disturbed personal identity anxiety (severe to panic) chronic low self esteem ```

Answer 50

nursing diagnoses for borderline pd

Question 51

``` The Client: has not harmed self seeks out staff when desire for self-mutilation is strong is able to identify true source of anger expresses anger appropriately relates to more than one staff member completes ADLs independently does not manipulate one staff member against the other in order to fulfill own desires ```

Answer 51

outcomes for borderline pd

Question 52

seldom seen in clinical settings, when they are, it is commonly a way to avoid legal consequences

Answer 52

antisocial pd

Question 53

possess a low tolerance for frustration, at impetuously, and are unable to delay gratification

Answer 53

antisocial pd

Question 54

tend to be argumentative, cruel, and malicious. Appear cold, callous, often intimidating others with brusque and belligerent manner

Answer 54

antisocial pd

Question 55

first inclination is to demean and dominate

Answer 55

antisocial pd

Question 56

believe "good guys come in last"

Answer 56

antisocial pd

Question 57

Use PROJECTION as primary ego defense mechanism; they do not accept responsibility for the consequences of their behavior

Answer 57

antisocial pd

Question 58

One of the most distinctive characteristics of these individuals is their tendency to ignore conventional authority and rules; they are flagrant in their disrespect for the law and for the rights of others

Answer 58

antisocial pd

Question 59

as a child, this patient displayed tantrums since infancy and would become furious when awaiting a bottle or diaper change. As they mature, they become bullies of other children. They are undaunted by punishment. They are daring and foolhardy in their willingness to change physical harm, and they seem unaffected by pain

Answer 59

antisocial pd

Question 60

ADHD and conduct disorders in childhood and adolescence are predisposing factors to which personality d/o?

Answer 60

antisocial pd

Question 61

Which is most damaging? presence or intermittent appearance of inconsistent impulsive parents or loss of a consistent parent

Answer 61

inconsistent impulsive parents is most damaging

Question 62

``` risk for other-directed violence defensive coping chronic low self esteem impaired social interaction ineffective health maintenance ```

Answer 62

nursing diagnoses for antisocial pd

Question 63

absence of parental discipline extreme poverty removal from the home growing up without parental figures of both sexes erratic and inconsistent methods of discipline being "rescued" each time they are in trouble (never have to suffer the consequences of their own behavior) maternal deprivation

Answer 63

predisposing factors to antisocial pd

Question 64

psychoanalytical psychotherapy

Answer 64

treatment of choice for histrionic pd treatment focuses on the unconscious motivation for seeking total satisfaction from others and for being unable to commit oneself to a stable, meaningful relationship

Question 65

Milieu or group therapy

Answer 65

appropriate for antisocial pd

Question 66

Cognitive/behavioral therapy

Answer 66

useful for ocd, antisocial, and avoidant personality

Question 67

dialectical behavior therapy

Answer 67

a treatment for the chronic self-injurious and parasuicidal behavior of clients with borderline pd. combines concepts of cognitive, behavioral, and interpersonal therapies with eastern mindfulness practices due to its success with borderline pd pts, DBT is now used with substance use disorders, eating disorders, schizophrenia, nd ptsd.

Question 68

antipsychotic meds

Answer 68

helpful in treating psychotic decompensations experienced by paranoid, schizotypal, and borderline pd's

Question 69

how to treat violent episodes observed in clients with antisocial pd?

Answer 69

lithium and propranolol

Question 70

what med do we give to pts with avoidant pd

Answer 70

anxiolytics, antidepressants like Zoloft and Paxil if panic d/o develops

Question 71

Drugs for borderline do

Answer 71

SSRIs and MAOIs