Personality Disorders Flashcards
(26 cards)
Personality disorders
Personality traits are maladaptive
Relationships are dysfunctional
PD is long-lasting
Treatment resistant
High risk for suicide
40-45% of people with mental illness have PD
Cluster A
“The weird”
Odd thinking, eccentric behavior
Paranoid
Schizoid
Schizotypal
Cluster B
“The wild”
Dramatic, erratic behavior
Antisocial
Borderline
Histrionic
Narcissistic
Cluster C
“The worried”
Severe anxiety and fear
Avoidant
Dependent
Obsessive-compulsive
Temperament
Set of inborn traits that organize a child’s approach to the world
Genetic origin mostly inherited
Temperament traits:
Harm avoidance
Novelty seeking
Rewarding dependence
Persistence
PDs result from different combinations of temperament traits
Splitting
Hallmark of cluster B
Everything is black or white, all good or all bad, specifically people
Lorazepam for severe anxiety teaching
Avoid use of alcoholic beverages
Phenelzine for atypical depression teaching
Avoid fermented sausage and aged cheese
Tyramine foods can cause hypertensive crisis
Excessive sweating, tremor, and fever with use of SSRIs
Serotonin syndrome
Lithium teaching for client experiencing aggression
S/S of drug toxicity
Need to consistently monitor blood levels
Amount of time that may be needed for mood changes to occur
Decatastrophizing
De-escalate, establish boundaries
“I understand you’re upset, I was in a room with another patient. I am here now, let’s take your vitals now”
Antisocial personality disorder
Exploit others and feel no empathy, very manipulative and charming. Comes from a bad childhood
Very likely has a history or killing animals and setting fires as children
Pattern of disregard and violation of other people’s rights. Psychopathy, sociopathy, dyssocial PD. More likely in men
Nursing intervention for antisocial personality disorder
Promote responsible behavior, limit setting. Consistent adherence to rules and treatment plan. Confrontation
Help with problem solving and control emotions. Problem-solving skills, time-out.
Enhancing role performance. Assess barriers to fulfilling roles, redirect to source of problem, referral to vocational jobs
Rationale for staff applying limit-setting interventions when a patient with a PD uses manipulation
External controls are necessary while internal controls are developed
Appropriate intervention for a patient with an antisocial PD who frequently manipulates others?
Refer patient’s request and questions related to care to the case manager
Borderline personality disorder
Pervasive pattern of unstable interpersonal relationships, self-image, affect, and extreme impulsivity. Responds well to IP treatment, more common in women.
History: Disturbed relationships with parents (18-30 months of age), 50% childhood sexual abuse, parental alcoholism
Dysphoric mood (unhappy, low level depression), No mania with BPD
Nursing intervention for BPD
Promote patient safety, no self-harm contract, safe expression of feelings
Promoting a therapeutic relationship, limit setting, confrontation technique
Establish boundaries, structure daily activities
Teach effective communication skills (Role playing/group therapy)
Help to cope and control emotions, reshape thinking patterns
Impulsivity
Little time elapsed between thought and action
Schizotypal
Cluster A, occult, religious symbolism, constant superstition
Eccentric behavior
Magical thinking
Schizoid
Risk for developing schizophrenia
No desire to have relationships with others, do not do well in therapy, content the way they are
Limited emotional expression
Narcissistic
Cluster B, fragile ego
Compensation coping mechanism
Everyone out to get them, win so much they are tired of winning
Mostly men, grandiose sense of self-importance, need for admiration
Dependent
Do well in therapy, tend to be in unhealthy relationships
Fear of separation, submissive and clinging behavior
Paranoid
Take everything literally, don’t do well in group settings
Pervasive mistrust, guarded
Under stress, psychosis
Must interact very formally with these patients
Histrionic
Females with impulsive behaviors, over sexualization
Excessive emotionality and attention seeking, depression, unexplained physical problems
