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Module 6 (Psych Mental Health) > Personality Disorders > Flashcards

Personality Disorders Flashcards

(92 cards)

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1
Q

Personality

A

how we perceive and interact with the world

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2
Q

Manipulation

A

responds as manipulating others

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3
Q

Splitting

A

driving wedges in between staff

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4
Q

Stable personality

A

enduring patterns that are flexible and adaptive
- roll with the puches

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5
Q

Pathologic personality

A

enduring patterns that are inflexible and maladaptive
- brittle

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6
Q

Stable personality what type of sense of self

A

stable and realistic
- accurate interpretation of social situations and understanding of relational motives and actions of others
- capacity to serve self and others
- flexible and adaptive states
- find genuine joy in life and relationships

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7
Q

UNStable personality what type of sense of self

A

unstable and unrealistic
- Misinterpret social situations and lack understanding of relational motives & actions of others
- lacks capacity to serve self and others
- inflexible and maladaptive states
- suffer due to disorder

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8
Q

PATHO of Personality Disorders

A

Nature vs Nurture: 1st-degree relatives
Genetic
- paranoid personality disorder
- schizoid
- schizotypical
- OCD
- Antisocial personality disorder
- borderline personality
Neuro
- disturbances of 5-HT and GABA
- Abnormal brain structures (amygdala)
- irritability and hypersensitivity
CHILDHOOD TRAUMA
- maladaptive coping and does not change as an adult

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9
Q

Personality Patterns
- Cognition
- Affective
- Social
- Behaviors

A

Cognition - perception and thinking
Affective - emotional responses
Social/Interpersonal - relate to others
Behaviors - how we respond to a situation (stress)

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10
Q

Thoughts w/o PD

A

Accurate perception & interpretation of events

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11
Q

Thoughts with PD

A

Inaccurate perception & interpretation of events

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12
Q

Affectivity w/o PD

A

Ability to modulate; fits with situation

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13
Q

Affectivity w/ PD

A

Inability to modulate; extreme & inappropriate

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14
Q

Behaviors without PD

A

Socially appropriate
Within control

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15
Q

Behaviors with PD

A

Lack of impulse control; unable to delay gratification

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16
Q

Social w/o PD

A

Other directed; empathetic

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17
Q

Social w/ PD

A

Ego-syntonic
- intoned to one’s self
- they see it as appropriate

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18
Q

PD is treatment-resistant due to

A

little insight and improvement slow
high in divorce, criminal activity, and suicide

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19
Q

Distorted Personality onset

A

early adolescent or early adulthood

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20
Q

A distorted Personality is a distorted sense of

A

self

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21
Q

Distorted Personality has what type of patterns

A

pervasive and inflexible - maladaptive

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22
Q

Distorted Personality leads to

A

distress or impairment

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23
Q

Risk Factors of PD

A

Family hx mental illnesses
low socioeconomic
verbal, physical, or sexual abuse during childhood
neglect, unstable, or chaotic family life during childhood
being dx with childhood conduct disorder
loss of parents through death or traumatic divorce during childhood

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24
Q

What is a key feature of all PD?

A

impaired social interaction

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25
Complications of PD
depression/anxiety child abuse/neglect alcohol or sybstance abuse education and employment problems eating disorder (BPD) **suicidal and self-injury (BPD) reckless or risky driving or sex (BPD/ASPD) aggression/ violence and incarceration (ASPD)**
26
What s/s are more common in BPD?
eating disorder suicidal and self-injury reckless and risky behavior **more inward**
27
What s/s are more common in ASPD?
reckless or risky driving or sex aggression/ violence incarceration **more outward**
28
PD Assessments
General appearance & motor behavior - speed up or slow down Mood & affect Thought processes & content Sensorium & intellectual processes Judgment & insight **Self-concept and self-conception = communication needs** Roles & Relationships Physiologic considerations Use of defense mechanisms
29
Cluster A of PD
paranoid schizoid schizotypical
30
Cluster A of PD traits
**weird** odd eccentric - suspicious - cold and remote - irrational thoughts - withdrawn
31
Cluster B of PD
antisocial borderline histrionic narcissistic
32
Cluster B of PD traits
**wild** dramatic emotional erratic - **attention-seeking** behavior - labile - **shallow and insincere** -**increase rates of substance abuse and suicide**
33
Cluster C of PD
avoidant dependent OCPD
34
Cluster C of PD traits
**wimpy** anxious and fearful insecure and inadequacy - tense - overcontrolled - depressed
35
Affective domain
emotional expression - how big and appropriate - ability to empathize to what extent
36
Cognitive domain
thought and perceptions - motivation for actions of self and others
37
Social Domain
interactions with others - relationships style
38
Paranoid PD - affective domain
Hostile Irritable angry mood/affect
39
Paranoid PD - cognitive domain
pervasive, persistent & inappropriate distrust/suspiciousness**
40
Paranoid PD - social domain
Difficulty with intimacy  Pathological jealousy Unforgiving
41
Paranoid PD
**accusatory and assumes others will disappoint, manipulate, talk behind back** genuine **distrustful and suspicious**
42
PPD wants to ensure
loyalty of family and friends - no cheating
43
PPD reacts severely to
being lied to and slighted
44
Interventions for PPD
**Serious & straightforward** approach Honor **commitments** w/ patient **Involve patient** in treatment plan Teach the patient to **validate ideas with a trusted person** before acting on an idea - act inappropriately if distrusts them Present information in a concrete manner
45
Schizoid - affective domain
Often blunted or flat Restricted
46
Schizoid - cognitive domain
“Poverty of thought” vague communication
47
Schizoid - social domain
Present as aloof Rarely date or marry **“loners”** don't connect with others
48
Schizoid mnemonic
-ziod in schizoid = droid in Star Wars
49
Schizoid
physical contact is less pleasurable (sex and holding hands) - less likely to seek relationships **avoid social interaction** **not interested** - isolate distinct from paranoid and social anxiety flat affect and emotionally blunted - will play with machinery or pets
50
Schizoid Nursing Interventions
Understand that the **patient will not benefit from forced social interaction** May need **case mgmt** services; cannot plan for future needs Patients may be difficult to include in developing POC-indifference does not care about the treatment plan **need a lot of lead time and need time to prepare** - written schedule
51
Schizotypal PD
**lack of close friends or confidants but wants friends** **superstitious beliefs due to response of their odd behavior** bizarre behavior suspicious attitude toward others excessive social anxiety does not improve with familiarity
52
Schizotypal mnemnonic
they want a -pal
53
Schizotypal PD - affective domain
Inappropriate Constricted
54
Schizotypal PD - cognitive domain
Paranoid ideation Magical thinking - Ideas of reference -
55
Schizotypal PD - social domain
Often avoided by others r/t odd behavior & appearance indifference to others
56
Schizotypal PD Interventions
Improve **self-care skills** Work towards improved function in the community **(appearance, dialogue)** **Include in groups to work towards improved social skills**
57
Antisocial PD - affective domain
Expressive but not genuine
58
Antisocial PD - cognitive domain
Egocentric grandiose **Impulsive** **hostile towards society and others** - shamelessly exploit others
59
Antisocial PD - social domain
3-4 times more common in men <18 y/o - conduct disorder in adolescents with trouble in school Exploitive of others Sense of entitlement - can **envolve into aggression and violent behavior**
60
Antisocial PD Interventions
Limit setting and do not be flexible **Confrontation w/o shame** - be neutral and not manipulative Consistency within the treatment team - **safety from threats and verbal abuse** Work on problem-solving - work on **impulsiveness**
61
Borderline PD
**fear of abandonment** extreme mood swings unstable relationships impulsive, self-destructive, tendencies unstable self-image **self-harm = 8/10 die by suicide** paranoia, dissociation chronic feelings of emptiness
62
BPD - affective domain
Intense, labile emotions anxious empty (affective instability)
63
BPD - cognitive domain
Identity disturbance dichotomous thinking May have psychotic episodes under stress
64
BPD - social domain
Manipulative relationships fear abandonment and being alone 3 x more common in women than men **they either love you or hate you**
65
Borderline PD Interventions
**Ensure safety: Eating disorders, self-mutilation, risk-taking, suicidal ideation - No-self-harm contracts when indicated** Establish firm boundaries Establish a therapeutic relationship; non-judgmental & professional **Provide a safe environment for expression of feelings/emotions (no “tough love”)** Do not be reactive - **stay in control of the medication and situations** - official and Teach to recognize and tolerate feelings; decatastrophizing - come to nurses when you are having self-harm thoughts instead of acting on them
66
Histrionic PD background
display exaggerated emotional and attention-seeking - **dramatic**
67
Histrionic PD s/s
discomfort when not the center of attention **seductive** emotional unpredictability attention-seeking appearance affected and shallow speech dramatic/exaggerated emotions **easily influenced overfamiliarity with acquaintances**
68
Histrionic PD Dx
H&P referral for symptom questionnaires and structured dx interviews
69
Histrionic PD - affective domain
Dramatic & extroverted
70
Histrionic PD - cognitive domain
Self-centered Guided by feelings more than thinking
71
Histrionic PD - social domain
Sexual, seductive Attention-seeking Manipulative       
72
Histrionic PD interventions
Offer feedback on behavior while offering appropriate alternatives Model appropriate social skills Teach the use of “I” messages to **express needs in a socially appropriate way**
73
Narcissistic PD - affective domain
Labile
74
Narcissistic PD - cognitive domain
Arrogant, egotistical, grandiose thinking - only about them will step on others to get where they want to go
75
Narcissistic PD - social domain
Lack of empathy for others “What’s in it for me?”             Sense of entitlement
76
Narcissistic PD Interventions
Limit setting Be self-aware (don’t internalize) State expectations clearly Reality orientation
77
Avoidant PD - affective domain
Fearful & shy - hypersensitivity to rejection and failure - low self-esteem and inadequate
78
Avoidant PD - cognitive domain
Exaggerated need for acceptance
79
Avoidant PD - social domain
Strong fear of rejection, few close friends, reticent & withdrawn (but want relationships) Feelings of inferiority
80
Avoidant PD nursing interventions
Work on **positive self-affirmations** - bullet journaling Promote self-esteem Reframing Decatastrophizing
81
Dependent PD - affective domain
Helplessness
82
Dependent PD - cognitive domain
Lack of self confidence
83
Dependent PD - social domain
Excessive dependence on others - desire to be taken care of and will tolerant abuse rather than be alone - don't trust own decision-making - **perfect victims for human traffickers** Cling to others
84
Dependent PD nursing interventions
Explore problems & solutions w/o solving for them Promote independence - set up accounts - get a job - personal finances - read legal documents
85
OCPD
obsessed with order, **perfectionism, complete control, rules, details, schedules** - inflexible - easily stressed - surprisingly **inefficient (spends extra time planning and worrying)** - rigid with beliefs and moral issues - perceived as stubborn
86
OCPD - affective domain
Unable to express emotions
87
OCPD - cognitive domain
Perfectionism, procrastination, & indecision (would rather not try, than try and fail) - paralysied by perfectionims - anxious and irritable if not in control - like rules and schedules (rigid)
88
OCPD - social domain
Omnipotent (all powerful) Omniscient (all knowing) Need for control
89
OCPD nursing interventions
Practice negotiation Decatastrophizing Have the patient set realistic goals - **completion rather than perfection**
90
Common Therapies for PD
Cognitive Behavioral Therapy - healthy positive replacement of negative thoughts Dialectical Behavior Therapy - tolerate skills that everything does not need to be perfect Psychodynamic psychotherapy - unconscious thoughts and behaviors for impulse control Psychoeducation - coping strategies
91
Meds for PD
Antidepressants (SSRIs) Mood-stabilizers - GABA (not lithium) Anti-anxiety medications Antipsychotic medications for psychosis or delusions - relisten to 50 minutes for medications **Focus on symptom relief**
92
The nurse should do what for all PD patients (key takeaways)
Lead with **EMPATHY** Be self-aware of self-harm and help them though it Understand that **progress is slow** Be realistic in goal-setting **Focus on behavioral change** rather than “healing” the disorder Understand that **patients have limited insight**

Module 6 (Psych Mental Health) (12 decks)

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