Personality disorder and anxiety

Question 2

When do personality disorders typically start to develop?

Answer 2

Personality disorders start to develop during childhood and adolescence and can be present during adulthood.

Question 3

What are some of the characteristics of personality disorders?

Answer 3

They are permanent, inflexible, and often set behavioral patterns that present in harmful or damaging ways in various situations throughout life.

Question 4

What difficulties do individuals with personality disorders face?

Answer 4

They often experience difficulties in social relationships, controlling behavior, and impulse control.

Question 5

How do behavioral patterns in personality disorders differ from normative behavior?

Answer 5

Behavioral patterns are different from normative behavior in that the culture affecting the way individuals think, perceive, observe, feel, and relate to others is not the same.

Normative behavior refers to acting in accordance with commonly accepted social rules or expectations within a group or society.

Question 6

Can individuals with personality disorders recognize their behavioral patterns?

Answer 6

Typically, the person cannot recognize the abnormality of these behavioral patterns.

Question 7

What is the focus of the lecture mentioned?

Answer 7

The lecture focuses on Borderline personality disorder (Tunne-elämältään epävakaa persoonallisuus).

Question 8

What are personality disorders?

Answer 8

A mental health condition where people have a lifelong pattern of seeing themselves and reacting to others in ways that cause problems.

Of course, everyone has bad days and behaves in uncharacteristic ways that may not be agreeable at times. However, to be classified as a personality disorder, one’s way of thinking, feeling and behaving deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time.

There are 10 specific types of personality disorders.

Question 9

What are the characteristics of personality disorders?

Answer 9

. Difficulties in understanding feelings (own and other’s)
* Personality traits are inflexible and rigid
* Difficult to tolerate everyday difficulties
* Impulsive acting
* Difficult to relate to others
* Causing serious issues, and affecting their family life, social activities, work
and school performance, and overall quality of life

Question 10

What is borderline personality disorder?

Answer 10

Borderline personality disorder (BPD) is a mental health condition characterized by pervasive patterns of instability in mood, self-image, and interpersonal relationships, as well as marked impulsivity. Fear of abandonment and chronic feelings of emptiness further compound the complexity of this disorder.

Question 11

What are some characteristics of Borderline personality disorder?

Answer 11

Difficulty with controlling and regulating emotions, can manifest through e.g. intensive emotions or emotions that change quickly.

fear of being abandoned.
—> will do everything possible to prevent this.

Impulsive behaviour
* Especially when stressed
* Seeking quick relief from difficult emotions
* Self-distructive behaviour
—> Maybe a learned habit to ease psychological pain, difficult emotions

Negative self-image, ashamed of themselves

Question 12

How should the diagnosis of borderline personality disorder be done?

Answer 12

Should be done in specialised care
▪ Based on an interview with the patient
and their next of kin and a
comprehensive assessment by
psychiatrist, nurse and psychologist
▪ Focus must be on long-term behavioural
patterns.

Question 13

What is the diagnostic criteria for borderline personality disorder?

Answer 13

Question 14

What is paranoid ideation?

Answer 14

is a transient, stress-related type of paranoia in which the person baselessly feels threatened, persecuted, or conspired against. Someone experiencing paranoid ideation might feel a general suspicion regarding the motives or intentions of others.

Question 15

What are typical reasons for not seeking help?

Answer 15

Typical reasons include depression, self-harm or suicide attempt, alcohol/substance abuse, and anxiety.

People also don’t seek help because, most people with a personality disorder don’t think there’s a problem with their behavior or way of thinking.

Question 16

What does the treatment of borderline personality disorder entail?

Answer 16

Can be treated in specialized care
* Long-term and goal-focused nurse-patient
relationship
* Medication based on symptoms presented, for
example, of depression
* Prevention of drug dependency is important
* Turvasuunnitelma (safety plan -> self-destructive
behaviour.
- Risk-assessment must be done
* Crisis management
* Treatment plan and goals must be done in
partnership with a patient
* Avoid judgmental communication

Question 17

Read townsend Unit 4 Chapter 32 page 680-681

Question 18

According to patients when is recover facilitated?

Answer 18

“According to patients’ experiences,
recovery is facilitated when the health
professional offers security, respect, trust
and understanding, but at the same time
guides towards change by being
appropriately active and using specific
strategies

Question 19

What is the goal of treatment in borderline personality disorder?

Answer 19

To help a patient to alleviate their
anxiety and agony
* To guide a person to express their
wishes and needs in a more direct
way
* To help a patient to focus on their
future and recovery

Question 20

What is the general focus and goals for DBT (Dialectical behavior therapy)

Answer 20

Learn to validate oneself
* Develop coping and other undeveloped skills
* Working towards individual’s goals in life

Question 21

How is treatment executed when dealing with DBT

Answer 21

Weekly appointments with a case manager
* Weekly peer support meeting that includes developing of crisis skills
* Possibility to contact case manager or some other professional between
meetings
* Consultation within the team of professionals
* Normally lasts 1-2 years

Question 22

Challenges with treatment?

Answer 22

Splitting
* Acting out
* Inability comply with
treatment
* Manipulating behavior
* Alcohol / substance
abuse

Question 23

How to respond to manifested challenges when dealing with borderline personality?

Answer 23

• Following the treatment plan done in partnership
• Comprehensive risk assessment and crisis plan
• Clinical counselling and co-operation in
  multidisciplinary team
• Education

Question 24

What is anxiety?

Answer 24

This is apprehension, tension or uneasiness from anticipation of danger, the source of which is largely unknown or unrecognized. Anxiety may be regarded as pathological when it interferes with social and occupational functioning, achievement of desired goals or emotional comfort

Can vary from a feeling of discomfort to inability to function or ‘episodes of
horror’.
* Is it out of proportion to the situation that is causing anxiety? (this is asking whether the level of anxiety someone is experiencing is excessive or exaggerated compared to the actual situation they’re facing.)
* Anxiety can interfere with a person’s
ability to function.

Question 25

How often do we face anxiety?

Answer 25

We face anxiety on a daily basis. Anxiety provides the motivation for achievement, is a necessary force for survival. Not same as stress. Anxiety is the subjective emotional response to that stressor. Differs from fear —> object of fear is usually a concrete thing

Question 26

When should you intervene with anxiety?

Question 27

What are the physical, psychological, behavioral symptoms of anxiety?

Answer 27

Question 28

What is generalized anxiety disorder?

Answer 28

https://youtu.be/9mPwQTiMSj8?si=0WJmZyav2Z5dw9gT Generalized anxiety disorder (GAD) is characterized by persistent, unrealistic, and excessive anxiety and worry, which have occurred more days than not for atleast 6 months, and cannot be attributed to specific organic factors, such as caffeine intoxication or hyperthyroidism. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Question 29

What are the differences between anxiety and GAD.

Question 30

How does GAD impact one's daily life?

Question 31

What is panic disorder?

Answer 31

Panic is a sudden overwhelming feeling of terror or impending doom. This most severe form of emotional anxiety is usually accompanied by behavioral, cognitive, and physiological signs and symptoms considered to be outside the expected range of normalcy. is characterized by recurrent panic attacks, the onset of which is unpredictable, and manifested by intense apprehension, fear, or terror, often associated with feelings of impending doom and accompanied by intense physical discomfort.

Question 32

What are the characteristics of panic disorders?

Answer 32

* Recurring panic attacks * Onset is unpredictable * Lasts typically for couple of minutes * Sometimes nervousness and apprehension between the attacks * Intensive apprehension, feelings of fear, terror, impending doom, intense physical discomfort

Question 33

What are the symptoms of panic disorders?

Answer 33

Question 34

What to do when you encounter a patient experiencing a panic attack?

Answer 34

Question 35

What are the characteristics of phobia?

Answer 35

Fear connected to a specific object or situation * Fear can be cued due to anticipation or presence of the object * Fear can provoke anxiety or a panic attack * Note: the fear is excessive or unreasonable * Can lead to avoiding situations

Question 36

What is obsessive - compulsive disorder (OCD)

Answer 36

is a mental disorder in which an individual has intrusive thoughts (an obsession) and feels the need to perform certain routines (compulsions) repeatedly to relieve the distress caused by the obsession, to the extent where it impairs general function. The individual recognizes that the behavior is excessiveor unreasonable but, because of the feeling of relief from discomfort that it promotes, is compelled to continue the act. Common compulsions include hand washing, ordering, checking, praying, counting, and repeating words silently

Question 37

What are the characteristics of obsessive compulsive disorder?

Answer 37

. Can cause significant stress and impairment person’s life * Feeling of relief can compel a person to continue compulsive behaviour * Obsessions * Unwanted, intrusive and stressful images, thoughts, impulses * Compulsions * e.g. washing hands, ordering, counting and repeating words

Question 38

What is social anxiety disorder?

Answer 38

an excessive fear of situations in which a person might do something embarrassing or be evaluated negatively by others

Question 39

Characteristics of social anxiety disorder?

Answer 39

fear of speaking or eating in a public place, fear of using a public restroom, or fear of writing in the presence of others. * may involve general social situations, such as saying things or answering questions in a manner that would provoke laughter on the part of others

Question 40

What are the nursing interventions of anxiety disorders,

Answer 40

* Supportive nurse-patient interaction * Non-judgemental approach * Trust * Psychoeducation * Important to: * Alleviate shame and guilt * Recognize the symptoms and associating the symptoms with anxiety * Recognize the level of anxiety in different situation * Scale 1-10 * Recognize signs of escalating anxiety and different ways to intervene * Recognize events and thoughts causing anxiety, help question anxiety related thinking and finding alternative ways to think. * Help patient to find or utilise ways to cope with stress * Relaxation techniques * Physical exercise * Consider if a patient would benefit from pre planned times allocated for worries * Phobias: systematic desensitization * Also: cognitive behavioural therapy, medication

Question 41

Help with exposure

Answer 41

https://youtu.be/2QA2Xn5z-l0?si=RKAgnuvXOjATcXYG

Question 42

Worry time.

Answer 42

https://www.mielenterveystalo.fi/en/self-help/self-help-program-anxiety/6-worry-time

Question 44

What are the ten types of personality disorders?

Answer 44

Cluster A Paranoid personality disorder Schizoid personality disorder Schizotypal personality disorder Cluster B Histrionic personality disorder Narcissistic personality disorder Antisocial personality disorder (ASPD) Emotionally unstable personality disorder (EUPD), sometimes known as borderline personality disorder (BPD) Impulsive personality disorder (a subtype of EUPD) Cluster C. Dependent personality disorder Avoidant personality disorder Obsessive compulsive personality disorder