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Personality d
Question | Answer |
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This is persisten & maladaptive over time. Inflexible, emotionally unstable, lack of respect for others..... | Abnormal personality d/o |
Individuals who meet criteria for personality d/o have constant difficulty in three areas of day to day functioning... | thoughts and emotions, participation in interpersonal relationships, and managing impluses |
Cluster A personalities Odd and Eccentric | Paranoid, Schizoid, Schiztypal |
Cluster B personalities Dramatic, Emotional, or Erratic | Antisocial, Borderline, Histrionic, Narcissistic |
Cluster C personality Anxious or Fearful | Avoidant, Dependent, Obsessive compulsive |
Psychoanalytic Theory- focus is on | Defense Mechanisms: repression, suppression, undoing, and splitting |
Diathesis-Stress Model | refers to genetic and biological vulnerability and includes personality traits and temperament (tendency to respond to challenges in predictable ways). |
Pervasive distrust & suspiciousness of others & their motives. Begins early adulthood. More common in women.CM: constantly on guard. ready for any real or imagined threat.trust no 1,oversensitive,constantly test motives & honesty,wont except responsibty | Paranoid Personality Disorder |
Nursing intervention Paranoid Personality Disorder | Be serious ,formal, business like. Use concrete terms, gain trust.*Defense Mechanism-Projection |
Schizoid Predisposing Factors: | possible hereditary factors (introversion), childhood characteristics are:. Bleak,Cold,Unempathic,Notably lacking in nurturing. |
Characterized primarily by profound defect in ability to form personal relationships. Loner, lacks insight. Failure to respond to others in meaning/emotional way. More frequent in men. | Cluster A-Schizoid Personality Disorder |
Feature: unemotional detachment Clinical Picture: a. cold, aloof, indifferent, no friends. b. work in isolation, unsociable. c. appear shy, anxious, uneasy ,flattened affect, detached. | Cluster A-Schizoid Personality Disorder |
Schizoid Personality DisorderNursing Intervention (NIC) | Clear communications. Task oriented interventions. Clear statement of expectations. Avoid touch, and overly friendly approach. Establish non-threatened environment. *Prefers to be alone |
Clinical Picture:Client aloof,isolated, behavior is bland . *Everyday manifest:magical thinking, ideas of reference, superstitiousness, delusional, depersonalization,withdrawal to self.Exhibit bizarre speech. Demonstrates bland inappropriate affect. | Cluster A-Schizoypal Personality DisorderA graver form of schizoid personality |
Schizotypal Personality DisorderIntervention (NIC) | Decrease anxiety. Goal oriented task. Interpersonal teaching. Self-care teaching. Low dose antipsychotics. |
Cluster B :Personality Disorders | Personality DisordersDramatic, Emotional, or Erratic |
Colorful, dramatic, extroverted behavior in excitable and emotional people. *relationships are shallow and fleeting. | Histrionic Personality Disorder HPD |
affected clients are self-dramatizing,attn seeking,overly gregarious,seductive,manipulative, exhibitionistic.easily influenced, highly distractible,strong need for approval,difficulty forming relationships.somatic complaints | Histrionic Personality DisorderHPD |
impulsive,flirtatous,provocative | Histrionic Personality |
Mood can change because of fragile self esteem; need of positive feedback. Criticism from others may cause a response of rage,shame, humiliation. | Narcissistic Personality Disorder NPD |
Clinical Picture: exaggerated sense of self-worth. feel they have a right to special consideration. overly self-centered, exploits others. Mood-grounded in grandiosity-usually optimistic. relaxed,cheerful,and carefree.Disorder more common in men. | Narcissistic Personality Disorder |
expects to be adored as the center of attention.Other people’s needs will be ignored,often unintentionally.He wants to be admired & feel entitled to caregiving & special treatment. Nsg: be matter-of –fact, set limits, do not internalize pt’s criticism. | Narcissistic Personality |
Nsg: be matter-of –fact, set limits, do not internalize pt’s criticism. | Narcissistic Personality |
NPD and HPDNursing Interventions | Avoid a power struggles. Do not become defensive with negative criticism. Set limits clearly. Avoid non-judgmental statements. Remain professional. |
Cluster CAnxious or Fearful | Avoidant Personality Disorder. Dependent Personality Disorder. Obsessive-Compulsive Personality Disorder. Criteria for further study: Passive-Aggressive Personality Disorder |
Extremely sensitive to rejection. Social withdrawal, feel unwanted, everything is too risky. Depression, anxiety, and anger at oneself for failure to develop social relations. = men and women. | Avoidant Personality Disorder |
Nsg: support ,reassure, teach and practice social skills. | Avoidant Personality Disorder |
Sensitive to rejection, avoids interpersonal situations | Avoidant Personality Disorder |
Warm, friendly engaging manner. Give reassurance, especially when client has new or challenging situations. Social phobias may need SSRI’s to treat panic attacks.(continuum related to social anxiety) *Desire intimate relationship but fear. | Avoidant Personality DisorderNursing Interventions |
Characterized by pervasive and excessive need to be taken care of and this leads to submissive and clinging behavior and fears of separation..” Folie A deux”(madness between 2 | Dependent Personality Disorder |
passive, acquiescent to others. low self worth, easily hurt by criticism assume passive, submissive role in relationships avoid positions of responsibility *they lack self confidence..Seek a relationship with someone who will control them | Dependent Personality Disorders |
Lack self-confidence, seek someone to control them | Dependent Personality |
The AXIS I anxiety disorders describes ________ that are obsessions and compulsions. | behaviors, the rituals |
AXIS II OCD Personality Disorder wants to do it right and avoid blame. The person may appear blaming and controlling of others.They dont have the _________ | Rituals |
Nsg: Assist with daily functioning, grief resolution, teach problem solving techniques. | Dependent Personality Disorder |
Characterized by inflexibility. Devotion to productivity-excludes personal pleasure Occurs most often in men Most common in the oldest children | Obsessive Compulsive Personality Disorder |
concerned with organization and efficiency, perfectionism and control.rigid and unbending,polite and formal.rank-conscious (ingratiating and authority)appears to be calm and controlled but under- neath there is ambivalence, conflict, hostility. | Obsessive Compulsive Personality Disorder |
Cluster Bdramatic, emotional, or erratic | antisocial, borderline |
pattern of socially irresponsible,exploitative,&guiltless behaviors reflect disregard for the rights of others. usually well-groomed,charmer,impulsive,no emotional involvement,selfish,very insecure, untruthful,repeated failures(marriage,work,etc.) | Antisocial Personality Disorder |
Fails to sustain employment,conform to the law,develop stable relationships. Exploits and manipulates others for personal gain. Blames others for problems. False emotions to suit occasions. Seeks immediate gratification, believes he will not get caught | Antisocial Personality Disorder |
*Defense Mechanism-Rationalization, Denial | Antisocial Personality |
Affect-lack of anxiety or guilt. Cognitive-Egocentric, grandoise, egosyntonic | Antisocial Behavior Disorder |
Antisocial Personality Disorder ND | *Risk for other-directed violance. |
Antisocial Personality DisorderIntervention (NIC) | Safety of the client and Others. Set limits, structured setting, list responsibilities, and confront client when necessary. |
a. Interpersonal Psychotherapy. b. Psychoanalytical Psychotherapy. c. Milieu or Group Therapy. d. Cognitive/Behavioral Therapy. e. Psychopharmacology | Antisocial Personalities Disorder Treatment Modalities |
Always in state of crisis,are impulsive.Extensive use of the health care system. Behaviors:chronic depression,inability to be alone,clinging and distancing behaviors.Splittingmanipulation, self destructive behavior. *Behavior elicts RESCUE response. | Borderline Personality Disorder |
Ex of Borderline Personality Disorder Diagnosis | Risk for self-mutilation. Risk for suicide, other-directed violance. Anxiety (severe to panic). Complicated grieving with fixation in the anger stage of grieving. Impaired social interaction. Disturbed personal identity |
NI is aimed at protection of client from self-mutilation. Confront clients true source of anger. Realistic goals, clear boundaries and limits. All members of the team on the same page, clients are manipulative, instill guilt in others,splitting behavio | Borderline Personality DisorderNursing Intervention (NIC) |
DPT-a form of cognitive –behavioral therapy that focuses on gradual behavioral change within a context of acceptance and validation for the client | Dialectical Behavioral Therapy DBT It focuses on distorted thinking and behavior based on the assumption that poorly regulated emotions are the underlying problem |
shows no remorse for exploitarion and manipulation of others | antisocial |
accepts a job he does not want to do, then does a poor job and delays past the deadline | narsistic |
they are suspicious of all others with whom they come in contact with | paranoid |
swallows a bottle of pills after the therapist leaves on vacation | borderline |
believes he has a "sixth sense" and knows what others are thinking | schizotypal |
allows other people to make all important decisions for them | dependent |
refuses to enter into a relationship due to fear of regection | avoident |
demonstrates highly emotional and overly dramatic behavior | histrionic |
has a lofelong pattern of social withdrawal | schizoid |
believes that everyone must follow the rules and that the rules can never be bent, for anyone under no circumstances | obsessive compulsive |
Paranoid, Schizoid, Schiztypal are what cluster | A |
Antisocial, Borderline, Histrionic, Narcissistic are what cluster | B |
Avoidant, Dependent, Obsessive compulsive are what cluster | C |