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Module 6 > UNIT 4-PERSONALITY DISORDER > Flashcards

UNIT 4-PERSONALITY DISORDER Flashcards

1
Q

What is a stable personality

A
  1. Eduring patterns that are flexable and adaptive
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2
Q

What is a Pathologic personality

A

Enduring patterns that are inflexible and malaadaptive

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3
Q

What is are the characteristcs of a stable personality?

A
  1. Stable & relistic sense of self
  2. Accurate interpretation of social situations & understanding of relational motives & actions of others
  3. Capacity to serve self & others
  4. Flexible & adaptive states
  5. Find genuine joy in life & relationship
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4
Q

What are characteristics of a pathologic/disordered?

A
  1. Unstable & unrealist sense of self
  2. Misinterpret social situations and lack of understanding of relational motives & action of other
  3. Lacks capacity to serve self & others
  4. Inflexable and maladaptive states
  5. Suffer due to disorder
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5
Q

What is the etiology/therories/patho of personality disorder?

A
  1. Nature vs. Nuture: correlation vetween 1st relative but also could be learned behaviors
  2. Genetic links
    • Paranoid personality DO
    • Schizoid
    • Schizotypal
    • Obsessive compulsive personality
    • Antisocial personality disorder
  3. Neurobiological
    • disturbances in 5ht and gaba
    • Abnormal brain structure
  4. Pyscholoigcal influence
    • Childhood trauma
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6
Q

Behavioral patterns in personality is….

A

how we respond to a situation esp. stress

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7
Q

Cognition patterns in personality is…

A

our perception and thinking

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8
Q

Affective in personality patterns is….

A

emotional responses

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9
Q

Social/interpersonal patters in personality is…

A

how we relate to others

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10
Q

Thoughts (cognition) without vs. with PD…

A

Without: Accurate perception & interpretation of events

With PD: Inaccurate persception & interpretation of events

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11
Q

Feelings (affectivity) without vs. with PD..

A

Without PD: Ability to modulate; fits with situation
With PD: Inability to modulate; extreme & inappropriate

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12
Q

Behaviors without PD vs. With PD

A

Without PD: Socially appropriate within control
With PD: Lack of impulse control; unable to delay gratification

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13
Q

Social traits without PD vs with PD?

A

WIthout PD: other directed; empathetic
With: Ego-syntronic- seeing things as good even though actions are not good

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14
Q

What common characteristics of disordered personality

A
  1. Onset in early adolescnce or early adulthood
  2. Distored sense of self- exaggerated or deminished
  3. Pervasive and inflexable patterns- maladaptive
  4. Leads to distress or impiarment

** impaired social distress**

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15
Q

What are risk factors for personaility disoders?

A
  1. Family hx of personality disorders or other mental illness
  2. Low socioeconomic status
  3. Verbal, physical or sexual abuse during childhood
  4. Neglect, unstable or choatic family life childhood
  5. Being diagnosed with childhood conduct disorder
  6. Loss of parents through dealth or traumatic divorce during childhood

Usually not diagnosed until adulthood however lots of s/s are seen during childhood

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16
Q

complications of personality disorders?

A
  1. depression & or anxiety
  2. Child abuse/neglect
  3. Alcohol or substance abuse
  4. Educational and employment problems- trouble maintaing counting and finishing
  5. Eating diorders (BPD)
  6. Suicidal behavior or self-Injury (BPD)
  7. Reckless or risky behavior; drinving sex (BPD/ASPD)
  8. Aggression/violence (ASPD)
  9. Incarceration (ASPD)
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17
Q

What are we assessing when we are looking at personality disorders?

A
  1. General appearance & motor behavior
  2. Mood and affect
  3. thought processes & content
  4. seensorium & intellectual processess
  5. Judgement & insight
  6. Self-concept
  7. Roles & relationship
  8. Physiolocic considerations
  9. Use of defense mechanisms
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18
Q

What are the different diagnostic classifications for personality disorders?

A

Cluster A (weird) odd & eccentric
Cluster B (WILD) Dramatic emotional & erratic
Cluster C (whimpy) Anxious fearful insucure and inadequacy

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19
Q

What PD are included in cluster A

A
  1. Paranoid (PPD)
  2. Schizoid (SZPD)
  3. Schizotypal (STPD)
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20
Q

What are PD included in cluster B

A
  1. Antisocial (ASPD)
  2. Borderline (BPD)
  3. Historionic (HPD)
  4. Narcissistic (NPD)
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21
Q

What PD are included into cluster C

A
  1. Avoidant (AVPD)
  2. Dependant (DPD)
  3. Obessive-compulsive (OCPD)
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22
Q

What are commonly seen symptoms in cluster A PD?

A
  1. Odd or eccentric behavior
  2. Suspicious
  3. Cold
  4. Irrational
  5. Withdrawn
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23
Q

What are commonly seen symptoms in cluster B PD

A
  1. Dramatic, emotional behavior
  2. Attention-seeking behavior
  3. Labile
  4. SHallow
  5. Increased rates of substance abuse and suicide
24
Q

What are commonly seen symptoms in cluster C PD

A
  1. Anxious fearful behavior
  2. Tense
  3. Overcontrolled
  4. Depressed
25
Q

What is an affective domain?

A
  1. Emotional expression
  2. ability to emphathzie
26
Q

What is cognitive domain?

A
  1. THoughts and perceptions
  2. motivation for actions
27
Q

What is social domain

A
  1. Interactions with others
  2. Relationship styles
28
Q

What do we need to know about Paranoid personality disorder affective, cognitve and social domain

A

Affective domain
1. Hostile
2. irrtable
3. Angry mood/affect

Cognitive domain
1. Pervasive, persistent & inappropriate distrust/suspicousness

Social domain
1. Difficulty with intamcy
2. Pathological jealousy
3. Unforgiving

believe someone is out to get them affects there entire life.
MISTRUST & PARANOIA

29
Q

Nursing interventions for paranoid personality disorder includes?

A
  1. Serious & straight forward approach– no jokes, sarcasam
  2. Honor commitments w/patient
  3. Involve patient in treatment plan- very important that be improved due to trust issues. They need to know the plan and what to expect
  4. Teach patient to validate ideas with a trusted person before acting on an idea
  5. Present informtion in concrete manner
30
Q

What do we need to know about the affective domain, cognitive domain, social domain of schizoid personality disorder?

A

Affective domain
1. often blunted or flat
2. Restricted

Cognitive domain
1. Provery of thought
2. Vague communicaiton

Social domain
1. Present as aloof
2. Rarely date or marry
3. Loners
4. dont connect with others

True loners, dont wish to have relationships, uncomfortable in social situations, rather keep busy with tinkering. Not able to pick up social ques.

Patient doesnt care about the plan of care. Will have to work very hard to get them on borad because they dont care one way or the other. They wont benefit from group activites . They benefit from having a one go to person

31
Q

What is our nursing interventions for schizoid personality disorder?

A
  1. Understand patient will not benefit from forced social interaction
  2. May need case management services; lacks ability to plan for future needs
  3. Patient may be difficult to include in devleoping POC-indifference

Humor not okay. This patient needs some time to prepare and process. They care about how events will impact hem socially. Benefits from written schedule.

32
Q

What do we need to know about affective, cognitve and social domain of shcizotypal PD

A

Affective
1. inappropriate
2. constricted

Cognitive
1. Paranoid ideation
2. Magical thinking
3. Ideas of reference

Social
1. Often avoided by other r/t odd behvior & appearance
2. Indifference to others

Most closely related to schizophrenia.. Little odd ducklings. Bizarre behavior behavior and dress. Suspicious of how others will respond to them

33
Q

What is our nursing interventions for schizotypal?

A
  1. Improve self-care skills
  2. work towards improved function in community (appearance, dialouge)
  3. incldue in groups to work towards improved skills

candid lines to help in social situations, teach whats approrpriate wear. Benefits with groups because its low steaks oppurtunity to practice social skills

34
Q

What should we know about the affective, cognitive and social domain of anitsocial PD (cluster B)

A

Affective
1. Expressive but not genuine

Cognitive
1. Egocentric
2. Grandiose
3. Impulsive

Social
1. 3-4 times more common in men
2. Explotitive of others
3. Sense of entilitement

Hostile towards society, show up before age 15 usually. Usually diagnosed as a conduct disorder in childhood and if it continues until adulthood itll be dianosed as anitosocial PD. Usually seen 1st as trouble in school

Very charming upfront to get what they want- no regard of safety for others and very little for themselves can progress into violent behavior. NO remorse for hurting others even if they get introuble for it

35
Q

What is are our nursing interventions for antisocial personality disorder?

A
  1. Limit setting
  2. Confrontation w/o shame
  3. Consistency within tx team
  4. Wowk on problem solving- to difficult to be flexible due to the high likely hood manipulation.

Highest priority is safety to themselves or others. Safety above all else. They tend to try and harm others while sucking up to nursing staff. They are also really good a reading and playing off of emotions so we have to be aware. Remain clam and continue tx this is why its so important… helps avoid splitting.

36
Q

What do we need to know about the affective, cognitive, and social domain of borderline personality disorder

A

Affective
1. Intense, labile emotions
2. Anxious
3. Empty (affective instability)

Cognitive
1. Identify distrubance
2. Dichotomous thinking
3. May have psychotic episodes under stress

Social
1. Manipultive relationship
2. Fear abandoment and being alone
3. 3 x more common in women than men

37
Q

What are s/s of BPD?

A
  1. Fear of abandoment
  2. Extereme mood swings
  3. Unstable relationships
  4. Impuslsive relationships
  5. Impulsive self-destructive tendancies
  6. Unstable self-image
  7. Self harm
  8. Paranoia dissociation
  9. Chronic feeling of emptiness
38
Q

What are s/s of schizotypal PD

A
  1. Lack of close friends or confidants
  2. Bizarre behavior
  3. Suspicous attitudes towards others
  4. Supersititous beliefs
  5. excessive social anxiety that doesnt improve with familiarty
39
Q

What is our nursing interventions for BPD?

A
  1. Ensure safety; eating disorders, self-mautilation, risk taking, suicidal ideation
  2. No self-harm contracts when indicated
  3. Establish firm boundries
  4. Establish therapeutic relationship; non-judgemental & professional
  5. Provide safe environment for expression of feelings/emotions (no”tough love”)
  6. Do not be reative
  7. Teach to recognize and tolerate feelings; decatastrophizing
    • treat threats seriously. They need to feel like you are someone they can trust. It is a HUGE step if they come to you with a thought

They want control. Concerete judgement statements.

40
Q

What do we need to know about the affective, cognitive and social domain of histrionic personality disorder?

A

Affective
1.Dramatic & extroversted

Cognitive
1. Self-centered
2. Guided by feelings more than thinking

Social
1. Sexual, seductive
2. Attention seeking
3. Manipulitive

Constantly seeking attention and they thrive off of it. Concerned with physical appearance.. Somatic symptoms to get attentions. They have a feeling they act on it.

41
Q

What is our nursing interventions for histrionic personality disorder?

A
  1. Offer feedback on behavior while offereing appropriate alternatives
  2. Model appropriate social skills
  3. Teach use of “i” messages to express needs in socially appropriate way
42
Q

What do we need to know about the affective, cognitive, social domain of narcissistic PD?

A

Affective
1. Labile

Cognitive
1. Arrogant, egotistical, grandiose thinking

Social
1. Lack of empathy for others– whats in it for me, sense of entitlement

43
Q

What is our nursing interventions for narcissistic personality disorder?

A
  1. Limit setting
  2. Be self-aware (dont internalize)
  3. State expectations clearly
  4. Reality orientation
44
Q

What should we know about affective, cognitive, and social domain of avoidant PD?

A

Affective
1. Fearful & shy

Cognitive
1. Exaggerated need for acceptance

Social
1. Strong fear of rejection, few close friends, reticent & withdrawn (but want relationships)
2. Feeling of inferiority

Really fearful and shy. Hypersenstive to criticism and rejection it makes them very withdrawn and they are afriad to reach out due to rejection. Diminished sense of self

45
Q

What are our nursing interventions for avoidant personality disorder?

A
  1. Work on postive self affirmations
  2. Promote self esteem
  3. Reframing
  4. Decatastrophizing
46
Q

What should we know about affective, cognitive, and social domain of dependent PD

A

Affective
1. Helplessness

Cognitive
1. Lack of social confidence

Social
1. Excessive dependance on others
2. Cling to others

Low sense of self. Have a desire to be taken care of. So insecure in there ability that they will take abuse or neglectful situations to be taken care of. Really attractive victims for sex trafficking

47
Q

What are our nursing interventions for dependant personality disorder?

A
  1. Expore problems & solutions w/o solving for them
  2. Promote independence

Help them, be there for them so they can figure out what a solution looks like for them. They often dont know how to do things like setting up a bank account or how to apply for a job, they need alot of eduacation on personal education

48
Q

What do we need to know about the affective,cognitive, and social domain of obsessive compulsive PD?

A

Affective
1. Unable to express emotions

Cognitive
1. Perfectionism, procrastination, & indescision (would rather not try than try and fail)

Social
1. Omnipotent (all powerful)
2. Omniscent (all knowing)
3. Need for control

If they arent a 100% they can do it perfect they wont do it. They are paralyzed by there perfection. Control freak. They become stressed anxious and irritable. They like comprehensive shedules and rules

49
Q

What are the s/s of obsessive compulsive PD

A
  1. Obsessed with
    • Orderliness
    • perfectionism
    • complete control
    • rules
    • details
    • schedules
  2. Inflexable
  3. Easily stressed
  4. Supricingly inefficient
    • Spends extra time planning and worrying
  5. Rigid with beliefs and morals
  6. Percieved as stubborn
50
Q

What is our nursing interventions for obsessive-compulsive personality disorder?

A
  1. Practice negotiation
  2. Decatastrophizing
  3. Have patient set realistic goals
    • Completion rather than perfection

Working on issues… practice neogtiating. What is the absolute worst that can happen if it isnt perfect.

51
Q

What are common therapies for personality disorders?

A
  1. Cogntive behavioral therapy
  2. dialectical behavior therapy
  3. Psychodynamic psychotherapy
  4. Psychoeducation- teach about the illness and coping stratagies and problem solving skill
52
Q

What are medications to tx personality disorders?

A
  1. Antidepressants (SSRI)
  2. Mood-stabilizers
  3. Anti-anxiety medications
  4. Antipsychotic medications

focus on symptom relief

53
Q

What are some key takeaways for PD

A
  1. Lead with EMPATHY
  2. Be self-aware
  3. Understand that progress is slow
  4. Be realistic in goal setting
  5. Focus on behavioral change rather than “healing” the disorder
  6. Understand that patients have limited insight
54
Q

what are s/s of paranoid personality disorder

A
  1. Accusatory
  2. Assumes others will
    • Dissapoint
    • Manipulate
    • Talk behind bakc
  3. Ensure loyality of family & friends
  4. Generally distrustful & suspicious
  5. Reacts severly if feels theyve been
    • Lied to
    • Slighted
55
Q

What are s/s of schizoid personality disorder?

A
  1. Phsyical contact
    • Less pleasureable, ex. sexual activity, holding hands which they are less likely to seek out
  2. Flat affect or emotional blunting: dont show postive or negative
  3. Avoids social interactions
  4. Not interested- isolation distinct from paranoia and social anxiety
56
Q
A

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