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EXAM 4 MENTAL HEALTH
Personality Disorders
| Question | Answer |
|---|---|
| Cluster A | Odd or Eccentric Behaviors. Includes: Paranoid Personality Disorder, Schizoid Personality Disorder, Schizotypal Personality Disorder |
| Paranoid Personality Disorder | Characterized by mistrust and suspicions of others. Often interpret others actions as potentially harmful. Withdrawn, always watching for danger, restricted affect, unable to demonstrate warmth of empathic emotions. Sarcastic for no reason. Often feels attacked by others, singled out, may devise elaborate plans for protection, or revenge. Uses defense mechanism projection (everyone else is to blame). Often conflicts with authority figures (boss). At risk for violence. |
| Nursing Interventions for Paranoid Personality Disorder | Serious, straight forward approach. Teach client to validate ideas before taking action. Involve the patient in care planning |
| Schizoid Personality Disorder | Pervasive pattern of detachment from social relationships and a restricted range of emotional expression in interpersonal settings. Appears emotionally cold, uncaring. No leisure/enjoyment or pleasure in any activities. Marked difficulty expressing emotions (especially anger). Rich and fantasy life, though may not share that information. Typically well accomplished intellectually. Self-absorbed loners in almost all aspects of life. |
| Nursing Interventions in Schizoid Personality Disorder | Improve clients functioning in the community. Assist in finding a case manager |
| Schizotypal Personality Disorder | Characterized by a pervasive pattern of social and interpersonal deficits marked by acute discomfort with and reduced capacity for close relationships as well as by cognitive or perceptual distortions and behavioral eccentricities. May experience transient psychotic episodes in response to extreme stress. May develop schizophrenia. Odd appearance, unique language. Magical thinking. Anxiety around others. Cannot respond to normal social cues, bizarre thinking or ideas,. |
| Nursing Interventions in Schizotypal Personality Disorder | Develop self-care skills. Improve community functioning. Provide social skills training |
| Cluster B | Erratic or Dramatic Behaviors. Includes: Antisocial Personality Disorder, Borderline Personality Disorder, Histrionic Personality Disorder, Narcissistic Personality Disorder |
| Antisocial Personality Disorder | Definition: Characterized by a disregard for the rights of others, deceit, and manipulation. Very superficial. Aggressive/hostile. Does not follow social norms. Displays false emotions, may exploit those around them. |
| Nursing Interventions in Antisocial Personality Disorder | Limit setting. Confrontation. Teach client to solve problems effectively and manage emotions of anger and frustration |
| Borderline Personality Disorder | Pervasive pattern of unstable interpersonal relationships, self-image, affect. Marked impulsivity. Have splinting, often walk/toe the line, like all disorders mixed together. Usually occurs with major depression. |
| Nursing Interventions in Borderline Personality Disorder | Promote safety. Help the client to cope and control emotions. Cognitive Restructuring techniques. Structure time. Teach social skills, communication skills, coping and emotion control. |
| Histrionic Personality Disorder | Drama Queens, need to be the center of attention. Very insecure, does not life to be alone. Excessive emotionality and attention seeking. Often perceives relationships as closer than they really are. Insincere and shallow emotions. |
| Nursing Interventions in Histrionic Personality Disorder. | Teach social skills. Provide factual feedback about behavior, role playing therapy, exploration of strengths and assets |
| Narcissistic Personality Disorder | May express violent rage to criticism (Verbal or physical). They believe they are superior. Normally relaxed and carefree attitudes but often point out every else's flaws. Appears confident but they actually have a very low self of esteem |
| Nursing Interventions in Narcissistic Personality Disorder | Matter-of-fact approach. Gain cooperation with needed treatment. Teach client needed self-care skills, limit setting, self-awareness skills to avoid anger and frustration |
| Cluster C | Anxious or Fearful Behaviors. Includes: Avoidant Personality Disorder, Dependent Personality Disorder, Obsessive Personality Disorder |
| Avoidant Personality Disorder | Low self-esteem, wants to be alone. Social inhibition, feelings of inadequacy, hypersensitive to negative evaluation. May demonstrate antisocial QUALITIES but it is NOT antisocial personality disorder |
| Nursing Interventions in Avoidant Personality Disorder | Support and reassurance. Cognitive restructuring techniques. Promote self-esteem. |
| Dependent Personality Disorder | Needs to be taken care of. Submissive, lacks confidence, low self-esteem. Clinging behavior. |
| Nursing Interventions for Dependent Personality Disorder | Foster client's self-reliance and autonomy. Teach problem-Solving and Decision-Making skills. Cognitive restructuring techniques |
| Obsessive Personality Disorder | Preoccupation with orderliness, perfectionism, and control. Formal and serious, inflexible, over achievers, follows rules, lists, schedules. Low self-esteem. |
| Nursing Interventions in Obsessive Personality Disorder | Encourage negotiation with others. Assist client in making timely decisions and complete work. Restructuring techniques. |
| Treatment for Perceptual Distortions (Cognitive)/Psychotic Symptoms | Antipsychotics |
| Treatment for Chronic Cognitive Anxiety | SSRIs, MAOIs, Benzos |
| Treatment for Severe Anxiety | MAOIs, Antipsychotics |
| Treatments for Mood Dysregulation | Lithium, Anticonvulsants, Antipsychotics |
| Treatment for Emotional Symptoms | SSRIs, Atypical Antipsychotics |
| Treatment for Dysphoria/Atypical or Resistant Depression | MAOIs |
| Treatment for Aggression | Lithium, Anticonvulsants, Benzos |
| Treatment for Predatory Aggression (Looking for Problems) | Neuroleptics/Antipsychotics, Lithium |
| Treatment for Affective Symptoms | SSRIs |
| Treatment Resistant | Refers to that it is difficult to change a person's personality. Changes occur slowly, over time. |
| Personality | Ingrained, enduring pattern of behaving and relating to self, others, and environment. Includes perceptions, attitudes, emotions. Usually not consciously aware of own personality. |
| Personality Disorders | Impairment of personality functioning, traits are maladaptive. Identity problems. Relationships are dysfunctional |
| Maladaptive or Dysfunctional Personality Traits | Negative behaviors toward others, anger/hostility, irritable/labile moods, lack of guilt or remorse, emotionally cold and uncaring. Impulsive, poor judgment. Irresponsible, not accountable for own actions. Risk-taking, thrill-seeking behaviors. Mistrust. Exhibitionism, entitlement. Dependency, insecurity. Eccentric perceptions. |
| Development of Personality Disorders | The combination of Inherited Dispositions (Temperament), and Environmental Influences (Character) that results in maladaptive, inflexible ways of viewing self, coping with the world, and relating to others. |
| Least Likely to Remain/Engage in Treatment | Schizotypal, Narcissistic, or obsessive-compulsive personality disorders |
| Individual and Group Psychotherapy Goals for Clients with Personality Disorders | Building trust, teaching basic living skills, providing support, decreasing distressing symptoms such as anxiety, and improving interpersonal relationship |
| Relaxation/Meditation | can help manage anxiety for clients. Improvement in basic living skills through the relationship with a case manager or therapist can improve the functional skills of people with schizotypal personality disorder. |
| Assertiveness Training Groups | can assist people to have more satisfying relationships with others and to build self-esteem when that is needed. |
| Cognitive-Behavioral Therapy | has been particularly helpful for clients with personality disorders. Several cognitive restructuring techniques are used to change the way the client thinks about him or herself and others: thought stopping, in which the client stops negative thought patterns |
| Dialectical Behavior Therapy | designed for clients with BPD by Dr. Marsha Linehan. It focuses on distorted thinking and behavior based on the assumption that poorly regulated emotions are the underlying problem |
| Treatment of Individuals with Personality Disorders | focuses on mood stabilization, decreasing impulsivity, and developing social and relationship skills. |
| Harm Avoidance | High Traits Include Fear of uncertainty, social inhibition, shyness with strangers, rapid fatigability, and pessimistic worry in anticipation of problems. Which leads to maladaptive inhibition, and excessive anxiety. Low Traits Include: Carefree, energetic, outgoing, and optimistic, which may result in unwarranted optimism and unresponsiveness to potential harm or danger. |
| Novelty Seeking | High Traits Include: Quick tempered, curious, easily bored, impulsive, extravagant, and disorderly. May be easily bored and distracted with daily life, prone to angry outbursts, and fickle in relationships. Low Traits Include: Slow-Tempered, stoic, reflective, frugal, reserved, orderly, and tolerant of monotony. They may adhere to a routine of activities. |
| Reward Dependence | High Traits Include: Tenderhearted, sensitive, sociable, and socially dependent. May become overly dependent on approval from others and readily assume the ideas or wishes of others and readily assume the ideas or wishes of others without regard for their own beliefs or desires. Low Traits Include: Practical, tough-minded, cold, socially insensitive, irresolute, and indifferent to being alone. Social withdrawal, detachment, aloofness, and disinterest in others can result |
| Persistence | High Traits Include: Hardworking and ambitious overachievers who respond to fatigue or frustration as a personal challenge. They may persevere even when a situation dictates they should change or stop. Low Traits Include: Inactive, indolent, unstable, and erratic. They tend to give up easily when frustrated and rarely strive for higher accomplishments |
| Psychodynamic theories | Character that consists of concepts about the self and the external world. It develops overtime as a person comes into contact with people and situations, and confronts challenges. Includes Self-Directedness, Cooperativeness, and Self-Transcendence. |
| Self-Directedness | The extent to which a person is responsible, reliable, resourceful, goal-oriented, and self-confident. High Traits Include: Realistic and effective, and can adapt their behavior to achieve goals. Low Traits Include: Blaming, helpless, irresponsible, and unreliable. They cannot set and pursue meaningful goals |
| Cooperativeness | The extent to which a person sees themselves as an integral part of human society. High Traits Include: Empathic, tolerant, compassionate, supportive, and principled. Low Traits Include: Self-absorbed, intolerant, critical, unhelpful, revengeful, and opportunistic-meaning they look out for themselves without regard for the rights and feelings of others |
| Self-Transcendence | The extent to which a person considers themselves to be an integral part of the universe. High Traits Include: Spiritual, unpretentious, humble, and fulfilled. - These traits are helpful when dealing with suffering, illness, or death. Low Traits Include: Practical, self-conscious, materialistic, and controlling - they may have difficulty accepting suffering, loss of control, personal and material losses, and death. |
| Biological Theories | Refers to the biologic processes of sensation, association, and motivation that underlie the integration of skills and habits based on emotions. 50% are from genetic differences. Includes the four Temperament Traits (harm avoidance, novelty seeking, reward dependence, persistence) which can be further characterized by high or low |
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