personality disorders

Question 1

Those who have them are
AWARE THEY HAVE A PROBLEM
And tend to be
DISTRESSED BY THEIR SYMPTOMS

Answer 1

ego-dystonic disorders

Question 2

The Person Experiencing
A Personality Disorder
DOES NOT NECESSARILY THINK THEY HAVE A PROBLEM

Answer 2

ego-syntonic disorders

Question 3

Consistent pattern of behavior, thought and emotion a person shows throughout their entire life.
How someone ACTS, THINKS & FEELS

Answer 3

personality

Question 4

Early development and enduring through life
Influence perception of environment
OCEAN Model or dimensional traits

Answer 4

personality traits

Question 5

Reliable through life, Valid with self assessment and collateral, and Universal around world.

Answer 5

five factor model

Question 6

ocean 5 factor model

Answer 6

O- Openness:
Scoring high people are imaginative and novelty seeking new experiences
Scoring low people are conventional and practical and like consistency
C- Conscientiousness
Scoring high people follow rules, keep things orderly and planned behaviors but can be rigid
Scoring low people are spontaneous, free spirited and risk impulsivity and unreliability
E- Extroversion
Scoring high people get their energy from being around other people
Scoring low people are noted to have mental energy depleted by others and need space and time alone
A – Agreeableness
Scoring high people tend to prioritize getting along with others, helpful, kind and trustworthy but can be prone to peer pressure and group think
Scoring low people tend to be less interested in social harmony and will put less effort into helping others or be skeptical of motives of others
N – Neuroticism
Scoring high people tend to focus on negativity and worrying about bad outcomes
Scoring low people tend to be more optimistic and freedom from persistent negative moods. This does not mean they are always positive though.

Question 7

TIDE for changes associated by personality disorder

Answer 7

Traits become Inflexible, Disabling, and Extreme

Question 8

Pervasive pattern of maladaptive behaviors, cognition, mood and attitude
Impaired social, occupational, and functional living
Symptoms must be present for >1 year and with one exception, can be diagnosed as early as adolescence.

Answer 8

DSM-V

Question 9

CLuster A DSM-V

Answer 9

paranoid
schizoid
schizotypal

Question 10

CLuster B DSM-V

Answer 10

borderline
histrionic
narcissistic
antisocial

Question 11

Cluster C DSM-V

Answer 11

obsessive-compulsive
dependent
avoidant

Question 12

pervasive, persistent, and inappropriate mistrust of others
suspicious of others motives
assume that other intend to exploit, harm or deceive them
more common in men
estimated 1-4% of general population

Answer 12

paranoid personality disorder

Question 13

predisposing factors of paranoid personality disorder

Answer 13

Possible hereditary link
Subject to early parental or peer antagonism and harassment
Possibly early trauma history

Question 14

nursing considerations for paranoid personality disorder

Answer 14

gain trust
work on coping skills
acute setting: provide reassurance

Question 15

Characterized primarily by a profound defect in the ability to form personal relationships
Failure to respond to others in a meaningful emotional way
Diagnosis occurs more frequently in men than in women
Prevalence within the general population has been estimated at 3-5%

Answer 15

schizoid personality disorder

Question 16

predisposing factors for schizoid personality disorder

Answer 16

Possible hereditary factor
Childhood has been characterized as
-Bleak
-Cold
-Lacking empathy
-Notably lacking in nurturing

Question 17

nursing considerations for schizoid personality disorder

Answer 17

respect need for space
work on coping skills
acute setting: dont force group activities

Question 18

Behavior is odd and eccentric
Graver form of schizoid personality pattern
Affects approximately 3% of population

Answer 18

schizotypal personality disorder

Question 19

symptoms of schizotypal personality disorder

Answer 19

Magical thinking
Ideas of reference
Illusions
Depersonalization
Superstitiousness
Withdrawal into self

Question 20

predisposing factors for schizotypal personality disorder

Answer 20

Possible hereditary factor
Anatomic differences or neurochemical dysfunctions
Early family dynamics
Pattern of discomfort with personal affection and closeness

Question 21

nursing considerations for schizotypal disorder

Answer 21

supportive therapy and medications as needed
work on coping skills
acute setting: dont force group activities

Question 22

Pattern of socially irresponsible, exploitative, and guiltless behavior
-Disregard for rights of others
Behavior that is:
-Socially irresponsible
-Exploitative
-Without remorse

Answer 22

antisocial personality disorder

Question 23

what does antisocial personality disorder look like

Answer 23

Fails to sustain consistent employment
Fails to conform to the law
Exploits and manipulates others for personal gain
Fails to develop stable relationships
Prevalence estimates in the U.S.:
2-4% in men
1% in women
Prior to age 18, this can not be diagnosed. Often Children with these symptoms are diagnosed with Conduct Disorder or Oppositional Defiant Disorder.

Question 24

nursing considerations for antisocial personality disorder

Answer 24

dont try to convince or coax to do the “right thing”
risk to other-directed violence
chronic low self-esteem
impaired social interactions
unable to delay gratification

Question 25

Pattern of intense, chaotic relationships Fluctuating and extreme attitudes regarding others Highly impulsive Emotionally unstable Directly and indirectly self-destructive Lacks a clear sense of identity Affects about 1-2% of population More common in women than in men

Answer 25

borderline personality disorder

Question 26

what does borderline personality disorder look like

Answer 26

Chronic depression and anxiety Inability to be alone Patterns of interaction Clinging and distancing behaviors Splitting Manipulation Self-destructive behaviors Impulsivity often REACTING not responding with emotions leading their behaviors

Question 27

predisposing factors for borderline personality disorder

Answer 27

Biological influences -Biochemical -Genetic -Neurobiological Psychosocial influences -Childhood trauma and abuse -Developmental factors -Lack of autonomy

Question 28

nursing considerations for borderline personality disorder

Answer 28

risk for self mutilation or self harm impaired social interactions work on developing coping skills disturbed self image anxiety severe panic attacks

Question 29

diagnosing borderline personality disorder

Answer 29

The client with borderline personality disorder: Has not harmed self Can verbalize true source of anger Expresses anger appropriately Relates to more than one staff member Completes activities of daily living independently Does not manipulate one staff member against the other in order to fulfill own desires

Question 30

treatment modalities for BPD

Answer 30

Interpersonal psychotherapy Milieu or group therapy Cognitive/behavioral therapy Dialectical behavior therapy Psychopharmacology

Question 31

xfColorful, dramatic, and extroverted behavior in excitable, emotional people Prevalence is estimated 2-3% More common in women than in men

Answer 31

Histrionic Personality Disorder

Question 32

Clinical Picture Histrionic Personality Disorder

Answer 32

Attention-seeking Overly gregarious Seductive Manipulative Exhibitionistic Highly distractible Self-dramatizing Difficulty paying attention to detail Easily influenced by others Difficulty forming close relationships Strongly dependent Somatic complaints are common

Question 33

Predisposing factors Histrionic Personality Disorder

Answer 33

Possible link to the noradrenergic and serotonergic systems Possible hereditary factor Learned behavior patterns – Attention for their conduct feeds their dopamine reward system.

Question 34

nursing considerations for histrionic personality disorder

Answer 34

complicated grieving work on coping skills family therapy is often needed

Question 35

Exaggerated sense of self-worth Lack of empathy Belief in an inalienable right to receive special consideration Prevalence of the disorder is estimated at 6% Diagnosed more often in men than in women

Answer 35

Narcissistic personality disorder

Question 36

Clinical picture Narcissistic Personality Disorder

Answer 36

Overly self-centered Exploits others in effort to fulfill own desires Mood is usually optimistic, relaxed, cheerful, and care-free Grandiose mood Mood can easily change if clients do not: Meet self-expectations Receive the positive feedback that they expect Criticism from others may cause them to respond with rage, shame, and humiliation

Question 37

Predisposing factors Narcissistic Personality Disorder

Answer 37

As children, fears, failures, or dependency needs were responded to with criticism, disdain, or neglect Parents were often narcissistic themselves Parents may have overindulged the child and failed to set limits on inappropriate behavior

Question 38

Extreme sensitivity to rejection Social withdrawal Prevalence is about 1% Equally common in men and women Low Openness, Low Extroversion, High Neuroticism with anxiety and prone to negative thoughts They want relationships but are trapped by fear of rejection and abandonment

Answer 38

Avoidant Personality Disorder

Question 39

Clinical picture Avoidant Personality Disorder

Answer 39

Uncomfortable in social situations Desire close relationships but avoid them because of fear of being rejected Perceived as timid, withdrawn, or cold and strange Often lonely and feel unwanted View others as critical and betraying

Question 40

Predisposing factors Avoidant Personality Disorder

Answer 40

No clear cause is known May be a combination of biological, genetic, and psychosocial influences Primary psychosocial influence: parental rejection and censure Low Self Esteem

Question 41

Nursing Considerations Avoidant Personality Disorder

Answer 41

NOT TYPICALLY SEEKING HELP work on coping skills therapy to improve self image and confidence

Question 42

Pattern of relying on others for emotional support Relatively common within the population More common in women than in men Stays in bad relationships to avoid being alone Moves quickly to a new relationship if they are alone.

Answer 42

Dependent Personality Disorder

Question 43

clinical picture dependent personality disorder

Answer 43

Have a notable lack of self-confidence apparent in: Posture, voice mannerisms Overly generous and thoughtful, while underplaying own attractiveness and achievements Low self-worth and easily hurt by criticism and disapproval Avoid positions of responsibility and become anxious when forced into them Assume passive and submissive roles in relationships

Question 44

predisposing factors for dependent personality disorder

Answer 44

Possible hereditary influence Stimulation and nurturance are experienced exclusively from one source Singular attachment is made by infant to the exclusion of all others

Question 45

Inflexibility about the way in which things must be done Devotion to productivity at the exclusion of personal pleasure Relatively common Occurs more often in men than in women Most common in oldest children Low in Openness as things have to be done in a certain way. Won’t delegate, get lost in detail and unable to throw out things.

Answer 45

OCD

Question 46

Predisposing factors OCD

Answer 46

Overcontrol by parents Notable parental lack of positive reinforcement for acceptable behavior Frequent punishment for undesirable behavior

Question 47

clinical picture of OCD

Answer 47

Especially concerned with matters of organization and efficiency Tend to be rigid and unbending Socially polite and formal Rank-conscious EGO SYNTONIC! They do not see their behaviors as odd or maladaptive. They don’t feel distressed by them. The way they are doing things is the right way to do them. OVERLY CONSCIENTIOUS PERSONALITY DISORDER