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101 Cards in this Set

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Dementia Caused by Other General Medical Conditions
* Cerebral pathology
* Elderly more vulnerable (75% elders affected by one or more chronic medical illnesses)
* 50% to 60% of patients with dementia have a disorder for which no specific medical treatment is available
Dementia caused by Head Trauma
* Single head trauma = not progressive
* repeated head injury (e.g. boxing) may lead to progressive dementia
* “Punch-drunk syndrome”
Dementia caused by Parkinson’s Disease
* Neurologic syndrome of unknown origin
* Disorder of movement
* Slow, progressive course
* IN PATIENTS WITH DEMENTIA CAUSED BY PARKINSON’S, ANTICHOLINERGIC MEDS ARE CONTRAINDICATED; LIKELY TO INCREASE LEVEL OF CONFUSION
Dementia caused by HIV
* Called AIDS dementia complex (ADC)
* Dementia seen in 2/3 of AIDS patients, but neuropathology seen in 90% of patients
* HIV-1 directly invades the CNS
* Likely to increase in the next decades
SUBSTANCE-INDUCED DEMENTIA
* DEMENTIA RESULTING FROM THE PERSISTING EFFECTS OF A SUBSTANCE/TOXIN
* DRUGS OF ABUSE ARE MOST COMMON TOXINS IN YOUNG ADULTS
* PRESCRIPTION DRUGS ARE MOST COMMON TOXINS IN THE ELDERLY
* MOST DEMENTIAS IN THIS CATEGORY ARE RELATED TO CHRONIC ALCOHOL ABUSE
* ALCOHOLIC DEMENTIA IS DIRECTLY RELATED TO THE TOXIC EFFECTS OF ALCOHOL
Caregiver Criteria
* Knowledge of disease
* Uses positive interactions during caregiving
* Plans and develops resources for self-care
* Legal and financial plans for client and self
* Backup system in case of emergency
Assessment
* Provide appropriate environment
* Establish rapport
* Tools
– Mini-Mental State Examination (MMSE)
– Dementia Mood Assessment Scale (DMAS)
– Blessed Dementia Rating Scale (DRS)
Assessment
* Perception and organization
* Attention span
* Language
* Memory
* Emotional control
* Reasoning and judgment
* Emotional state
Assessment
Mood and State of Mind
Assessments required before
* Admission to a SNF
* Use of psychotropic medication
* Use of restraint

Document:
* Direct quotes from client.
* MSE results on regular basis
Assessment - Depression
* Variable onset, abrupt
* Reversible with treatment
* Clear sensorium
* Normal attention span
* Selective memory impairment
* Intact thinking but displays:
– Hopelessness
– Helplessness
Assessment - Functional ability
* ADLs
* IADLs
Behavior related to:
* Mood
* Perceptual/cognitive deficit
* Day/night reversal
* Poor impulse control
Assessment - Physical Manifestations
* Altered nutritional status
* Aspiration
* Gait changes
* Feeling cold
* Incontinence
Nursing Diagnoses
Cluster around
* Safety and health risks
* Perceptual/cognitive disturbance
* Disruption in coping abilities
Outcome Identification
Consider
* Client outcomes
* Caregiver outcomes
Planning
Consider
* Short-term plans
* Long-term plans
Implementation
* Inform client/family/caregivers about plan.
* Promote independence as long as possible.
* Keep all interactions calm, reassuring.
* Time activity to coincide with client calm state.
* Empathize with client’s feelings.
* Validate client’s feelings with words.
* Maintain client self-esteem.
* Avoid negative responses to failures.
* Provide simple choices.
* Provide structured routines.
* Praise success.
* Simplify communication
Implementation
* Repeat as needed.
* Break tasks into separate components.
* Provide short, simple activities.
* Allow time to be by self.
* Be flexible to reduce frustration
Treatment
* Interdisciplinary team
* Medication
– HS sedation: Trazadone
– Anxiety: Alprazolam, risperidone
– Aggression: Anticonvulsants
– Dementia: Donepezil, rivastigimine, tacrine
* Therapeutic activities
Levels of Care
* Acute care
* Day care
* In-home care
* Residential care
* Skilled nursing facility
* Hospice
SCHIZOPHRENIA
* Most COMMON psychotic disorder
* Most SEVERE psychotic disorder
* Affects 1% of the population
* Not a SINGLE disease of the brain
* A HETEROGENEOUS disorder with common features
* Results in disturbances in thought processes, perception, and affect.
* Severe deterioration of social and occupational functioning.
* Group of mental disorders that feature: Withdrawal, Affective Problems, Interrupted Thought Processes.
May appear dull & colorless; dependent & apathetic; emotionally isolated
SCHIZOPHRENIA
* NOT A SINGLE DISEASE OF THE BRAIN
COMMON FEATURES SCHIZOPHRENIA
* THOUGHT DISTURBANCES
* PREOCCUPATION WITH FRIGHTENING INNER EXPERIENCES
* DISTURBANCES OF AFFECT
* DISTURBANCES OF BEHAVIOR
* DISTURBANCES OF SOCIALIZATION
THEORIES of ETIOLOGY
* Genetic
* Neurochemical
* Neuropathological
* Viral
* Immunological
* Structural Abnormalities
INCREASED LEVELS OF _____ MAY BE RELATED TO SCHIZOPHRENIA
DOPAMINE
STIMULANTS MAY _____ SYMPTOMS OF SCHIZOPHRENIA
WORSEN
SCHIZOPHRENIA POSITIVE SYMPTOMS
* HALLUCINATIONS
* DELUSIONS
* THOUGHT DISORDER
CAUSATION: INCREASED LEVLES OF DOPAMINE
TREATMENT
* HOSPITALIZATION
* TYPICAL ANTIPSYCHOTICS
* REDUCED STIMULI
* INTERACTIVE THERAPY
REGARDING SCHIZOPHRENIA ARE POSITIVE OR NEGATIVE SYMPTOMS MORE EASILY TREATED?
POSITIVE
WHAT ARE NEGATIVE SYMPTOMS OF SCHIZOPHRENIA?
THESE DON'T TEND TO DRAW ATTENTION AS POSITVE SYMPTOMS MIGHT.
WHAT IS AFFECT?
HOW ONE MIGHT SHOW EMOTION
SCHIZOPHRENIA - NEGATIVE SYMPTOMS
* APATHY
* LACK OF MOTIVATION
* BLUNTED AFFECT
* LOSS OF EMOTIONAL WOARMTH
* IMPAIRED SOCIAL SKILLS
* AVOLITION
CAUSATION? - POSSIBVLY INCREASED LEVELS OF SEOTONIN
TREATMENT? - POSSIBLY ATYP[ICLA ANTIPSYCHOTICS
POSTIVE SYMPTOMS OF SCHIZOPHRENIA POSSIBLEY REALTED TO INCREASED LEVELS OF?
DOPAMINE
NEGATIVE SYMNPMS OF SCHIZOPHRENIA POSSIBLY R/T INCREASEDL LEVELS OF ?
SEROTONIN
SCHIZOPHRENIA
BLEULER
SCHIZOPHRENIA (SPLIT MINDEDNESS)
* INCONGRUENCE AMONG THOUGHT, EMOTION, BEHAVIOR
* FOUR AS:
- AFFECT
- AUTISM
- AMBIVALENCE
- ASSOCIATIONS
BLEULER'S FOUR A'S
- AFFECT
- AUTISM
- AMBIVALENCE
- ASSOCIATIONS
TYPICAL ANTIPSYCHOTICS
* REDUCE POSITIVE SYMPTOMS
* CAUSE MOVEMENT DISORDERS
TARDIVE DYSKINESIA
USED TO TREAT POSITIVE SYMTOMS
ATYPICAL ANTIPSYCHOTICS/NON-TRADITIONAL
* BLOCK SEROTONIN RECEPTORS
REDUCE NEGATIVE SYMPTOMS
* DO NOT AFFECT MOVEMENT
* INFLUENCE GLUTAMATE
IMPROVE COGNITION
* IMPROVE TD
* HAVE FEW ANTICHOLINERGIC SIDE EFFECTS
NURSE'S ROLE - PSYCHOPHARMACOLOGY
* ADMINISTER
* ASSESS EFFECTS AND SIDE EFFECTS
* PROMOTE EDUCATION
* TEACH LIFELONG SKILLS FOR COMMUNITY LIVING
* MONITOR QUALITY OF LIFE ISSUES
TREATMENT - SCHIZOPHRENIA
* ANTIPSYCHOTIC MEDICATIONS ARE PRIMARY TREATMENT
* TWO TYPES OF ANTIPSYCHOTIC MEDICATIONS: TRADITIONAL AND AYTPICAL
* TRADITIONAL ANTIPSYCHOTICS PRIMARILY TREAT POSITIVE SYMPTOMS
* TRADITIONAL ANTIPSYCHOTICS ASSOCIATED WITH NUMEROUS AND DISTRESSING EXTRAPYRAMIDAL SIDE EFFECTS
SCHIZOPHRENIA DSM-IV-TR CRITIERIA
* LASTING SIX MONTHS
* ACTIVE PHASE SYMTOMS AT LEAST ONE MONTH AND TWO OF THE FOLLWING ACTIVE SYMTPOMS -
* HALLUCINATION
* DELUSIONS
* DISORGANIZED OR CATATONIC BEHAVIOR
* DISORGANIZED SPEECH
DSM-IV-TR Criteria
Subtypes of Schizophrenia
* Paranoid
* Disorganized
* Catatonic
* Undifferentiated
* Residual
PREMORBID BEHAVIOR/STAGES (VIEWED IN FOUR PHASES)
* PHASE I: SCHIZOID PERSONALITY. INDIFFERENT, COLD, AND ALOOF, THESE INDIVIDUALS ARE LONERS. THEY DO NOT ENJOY CLOSE RELATIONSHIPS WITH OTHERS.
* PHASE II: PRODROMAL PHASE. INDIVIDUALS ARE SOCIALLY WITHDRAWN AND HAVE BEHAVIOR THAT IS PECULIAR/ECCENTRIC. IMPAIRED ROLE FUNCTION, HYGIENE AND DISTURBANCES IN COMMUNICATION, IDEATION, AND PERCEPTION.
* PHASE III: SCHIZOPHRENIA. ACTIVE PHASE OF DISORDER. PSYCHOTIC SYMPTOMS ARE PROMINENT, INCLUDING DELUSIONS, HALLUCINATIONS, IMPAIRMENT IN WORK, SOCIAL RELATIONS, AND SELF CARE.
* PHASE IV: RESIDUAL PHASE. SX SIMILAR TO PRODROMAL PHASE WITH FLAT AFFECT AND IMPAIRED ROLE FUNCTION BEING PROMINENT
PHASE I
SCHIZOID PERSONALITY. INDIFFERENT, COLD, AND ALOOF, THESE INDIVIDUALS ARE LONERS. THEY DO NOT ENJOY CLOSE RELATIONSHIPS WITH OTHERS
PHASE II
PRODROMAL PHASE. INDIVIDUALS ARE SOCIALLY WITHDRAWN AND HAVE BEHAVIOR THAT IS PECULIAR/ECCENTRIC. IMPAIRED ROLE FUNCTION, HYGIENE AND DISTURBANCES IN COMMUNICATION, IDEATION, AND PERCEPTION
PHASE III
SCHIZOPHRENIA. ACTIVE PHASE OF DISORDER. PSYCHOTIC SYMPTOMS ARE PROMINENT, INCLUDING DELUSIONS, HALLUCINATIONS, IMPAIRMENT IN WORK, SOCIAL RELATIONS, AND SELF CARE
PHASE IV
RESIDUAL PHASE. SX SIMILAR TO PRODROMAL PHASE WITH FLAT AFFECT AND IMPAIRED ROLE FUNCTION BEING PROMINENT
Paranoid Schizophrenia
* Characterized by paranoid delusions.
* Client may be argumentative, hostile, and aggressive
Disorganized Schizophrenia
* Chronic variety with flat or inappropriate affect.
* Silliness and incongruous giggling is common.
* Behavior is bizarre.
* Social interaction is impaired
Catatonic Schizophrenia
* Catatonic Stupor: Characterized by extreme psychomotor retardation. The individual is usually mute. Posturing is common.
* Catatonic Excitement: Extreme psychomotor agitation. Purposeless movements that must be curtailed to prevent injury to client & others
Residual Schizophrenia
* Category used with the individual who has a history of at least one episode of schizophrenia with prominent psychotic symptoms.
* Also known as ambulatory schizophrenia.
* This is the stage that follows an acute episode
Related Disorders
* Schizophreniform
* Schizoaffective
* Delusional
* Brief psychotic disorder
* Shared psychotic disorder
* Psychotic disorder due to a general medical condition
Schizoaffective Disorder
* Schizophrenic symptoms accompanied by a strong element of symptomatology associated with the mood disorders, either mania or depression
Brief Psychotic Disorder
* Sudden onset of psychotic symptoms following a severe psychological stressor.
* Symptoms last less than one month and the individual returns to the full premorbid level of functioning
DELUSIONAL DISORDER (EXISTENCE OF PROMINENT, NONBIZARRE DELUSIONS)
* EROTOMANIC - V BELIEVES SOMEONE OF HIGHER STATUS IS IN LOVE WITH HIM/HER.
* GRANDIOSE - V IRRATIONAL IDEAS REGARDING OWN WORTH, TALENT, KNOWLEDGE, POWER.
* JEALOUS - V IRRATIONAL IDEA THAT PERSON'S SEX PARTNER IS UNFAITHFUL.
* PERSECUTORY - V BELIEVES HE/SHE IS BEING MALEVOLENTLY TREATED IN SOME WAY.
* SOMATIC - V IRRATIONAL BELIEF OF PHYSICAL DEFECT, DISORDER, OR DISEASE
Shared Psychotic Disorder
* Delusional system develops in a second person as a result of a close relationship with another person who already has a psychotic disorder with prominent delusions
Psychotic Disorder Due to General - Medical Conditions
* Symptoms of this disorder include prominent hallucinations and delusions that can be directly attributed to a general medical condition
Substance-Induced Psychotic Disorder
* The presence of prominent hallucinations and delusions that are judged to be directly attributable to the physiological effects of a substance
Self-Management
* Accept fact that it¡¦s a prolonged illness.
* Identify strengths and limitations.
* Set clear, realistic goals.
* Gradually return to responsibilities.
* Establish regular, consistent routine.
* Establish quiet, relaxed routine.
* Reduce stress
Self-Management
* Work on trusting staff.
* Take medication regularly.
* Identify relapse signs early.
* Avoid street drugs.
* Eat well.
* Get sufficient rest.
* Exercise regularly.
* Check reality with trusted person.
* Accept setbacks
Symptom Profile - Perceptual Disturbances
* Negative self-perception
* Hallucinations
* Reduce stress.
* Increase medication.
* Reduce distractions.
* Occupy mind
Symptom Profiles - Thought Disturbances
* Delusions
- Do not agree
- Empathy
* Circumstantially
* Tangentiality
* Autistic thinking
* Perseveration
* Poverty of thought
* Loose association
Teaching Tips
* Simplify material.
* Reduce distractions.
* Give verbal and visual information.
* Clear, direct terms.
* Present small segments.
* Reinforce frequently.
* Do not offer confusing choices
Symptom Profiles - Emotional Disturbances
* Flattened affect
* Poor eye contact

Behavioral Disturbances
* Risk for violence
Biologic Profiles
* Diffused, nonlocalized areas of dysfunction
* Impaired stimulus
* Inhibition
Assessment
* Subjective client reporting
* Objective
- Observation
- Rating scales
- Biologic indicators
* Mental status examination
* Positive and negative symptoms
Useful Nursing Diagnoses
* Disturbed sensory perception
* Disturbed thought processes
* Impaired verbal communication
* Ineffective coping
* Interrupted family processes
* Risk for violence
* Self-care deficit
* Social isolation
Outcome Identification
* Demonstration of reality-based thinking
* Reduction in hallucinations
* Absence of delusions
* Socialization with staff and peers
* Adherence to medication regimen
* Participation in discharge planning
Planning - Geared to
* Whole person
* Social environment
* Family
* Medical interventions
* Socialization
* Education for client and family
Implementation
* Establish relationship.
* Consider cost of plan.
* Provide:
- Stimulation.
- Structure.
- Socialization.
- Support
NURSING INTERVENTIONS FOR SCHIZOPHRENIA
* SAFETY
* ACCEPTANCE
* MEDICATION
* MEDICATION EDUCATION
* ADHERENCE
* INTERVENING IN HALLUCINATIONS
* INTERVENING IN DELUSIONS
* SOCIAL SKILLS
* SELF-CARE
* EDUCATION
INTERVENTIONS
* ASSESS/MONITOR RISK FACTORS.
* MINIMIZE ENVIRONMENTAL STIMULI.
* PROVIDE LOW-KEY INTERACTIONS.
* USE CLEAR, CONCRETE COMMUNICATION.
* IDENTIFY HALLUCINATION TRIGGERS.
* PRAISE REALITY-BASED PERCEPTIONS.
* POOR SELF ESTEEM
Intervetnions
Assist with hygiene as needed.
* Set hygiene goals.
* Assess self-concept.
* Role model social behaviors.
* Spend time with client in nonchallenging activity.
* Keep appointments.
* Listen actively
Treatment Modalities
* Psychopharmacology
* Electroconvulsive therapy
* Milieu therapy
* Psychosocial rehabilitation
* Individual therapy
- Supportive
- Re-educative
- Reconstructive
Treatment Modalities
* Group therapy
* Family therapy
* Behavior therapy
* Cognitive therapy
* Occupational therapy
* Recreational therapy
Reducing and Managing Violence
* Reduce stress.
* Clarify expectations concerning rules.
* Avoid behaviors that may be misinterpreted.
* Determine etiology.
* Avoid blame, ridicule, teasing.
* Avoid whispering
Reducing and Managing Violence
* Respect boundaries.
* Intervene early.
* Use deescalation skills.
- Nonthreatening verbal and nonverbals
* Medicate (po or IM) prn
PERSONALITY TRAITS
MAY BE ADAPTIVE OR MALADPTIVE DEPENDING ON WHETHER THE TRAIT IS INFLEXIBLE OR CAUSES SIGNIFICATN FUCTINOANL IMPAIRMENT OR SUBJECTIVE DISTRESS
WHAT ARE TWO CHARATCTERISTICS OF SYMTOMS OF PERSNAILITY DISORDEER?
1) NOT TIME LIMTED
2) NOT OCCUR OINLY IN A TIME OF CRISIS
EVERYONE HAS PERONILTY TRIATS NOT EVEYRONE HAS ...
PERSNLITY DISORDER
WITH PERSONLITY DISOFDERS INDUVUDUALS USE THE SAME DEFENCSE MECHANISME WHETHER OR NOT...
THEY FIT THE SITUATION
PERSONLITY DISODRED DEFINED
ENDUIRENG PATTERN OF INNER EXPEIRNICE AND BEHAVIOR THAT
* DEVIATES MARKEDLY FROM EXPECTATIONS OF THE INDIVUDIALS CULTRE
* IS PERVASIVE AND INFLECXIBLE
* HAS AN ONSET IN ADOLESCENCE OR EARLY ADULTHOOD
* IS STABLE OVER TIME AND LEADES TO DISTRESS OR IMPIRMENT
WHEN IS THE "NORMAL" ONSET OF PERSNOLITY DISORDERS?
ADOLESCNECE
CHARACTERSISTICS OF PERSONALITY DISORDERS
* LONGSTANDING
* PERVASICVE, INFLEXIBLE
* MALDADAPTIVE PATTERSN OF BEHAVIOR R/T OTHERS
* NOT CAUSED BY AXIS I DIOSRDERS
* LEADS TO IMPARIMENT/DISTRESS
* ONSET ADOLESCNCE
CHARACTERISITCS OF INDVUDCUAL WITH PERSONLITY DISORDER -
* LACKS GENUISNE SENSE OF SELF
* HAS IMPAIRED SELF-REGULATION
* LOOKS OUTSIDE OF SELF FOR -
- EVALUATIONS
- DIRECTIONS
- RULES
- OPINIUNS
CLUSTER A
ECCENTIRIC
CLUSTER B
ERRATIC
CLUSTER C
FEARFUL
CLSUTER A
* BEHAVIOURS THAR ARE DESCRIBED AS ODD ORECCENTRIC
* DISTRUST ANS SUSPICIOUSNESS
* SEES OTHER' MOTIVES AS MALEVOLENT (INTNED TO DO HARM)
* DETACHMENT FROM SOCIAL RELATIONSHIPS
* EMOTIONAL EXPERSSION IS RESTERICTRED
* ACUTE DISCOMFORT WITH CLOSE RELATIONSHIPS
* SENSORYDISOTORIONS
* ODD BEHAVORS, THINKING AND SPEECH
OF CLUSTER A, B, AND C WIHCH IS THE "MOST DIFFIULT TO WORK WITH"?
CXLUSTER B
CLUSTER B
* BEAHVIORS THA ARE DESCRIBES AS DRAMATIC, EMOTIONAL, OR ERRATIC
* DISREGARSDS/VIOLATES REIGHTS OF OTHERS
* UNSTABLE SELF-IMATGE, AFFECT, AND INTERPERSONAL RELATIONSHIPS
* EWCESSIVE EMOTIONAL EXPRESSION AND ATNTION-SEEKING BEHAVIORS
* GRANDIOSE, NO EMPTATHY, NED TO BE ADMIRED
CLSUTER C
* BEHAVIORS THAT ARE DESRVICES AS ANXIOUS OR FEARFUL
* SOCIAL DISTRESS, FEELINGS OF INADWQUACY, OVER SENSITIVUTY
* EXCESSIVE NEED TO BE CARED FOR, RESULTING IN SUMBMSSIVE BEHAVIORS
* PRECOOCUTAPTION IWT CONTROL, ORDERLINESS, AND PERFECTIONISM
DUAL DIAGNOSIS
PERONSLITY DISORDER WITH SUBBASTANC ABUSE
DUAL DIAGNOSIS
SUBSTANCE ABUSE PROMBLM OCCUR AS INDIVUTAL ATTEMTPS TO COE WIT THERI PROMBLEMS
DSM-IV CRITERIA - DUAL DIAGANOSIS
* AN ENDURING PATTERN OF INNER EXPERIENCE AND BEHAVIOR THAT DEVIATES MARKEDLY FROM THE EXPECTATIONS OF THEINDUVUDAL'S CULTERE. tHIS PATTERN IS MANIFESTED IN TWO (OR MORE) OF THE FOLLWING AREAS -
* COGNITION (I.E. WAYS OF PEREVCIVING AND INTERPRETING SELF, OTHER PEOPLE, AND EVENTS)
* AFFECTIVITY (I.E. THE RANGTE, INTENSITY, LABILITY, AND APROPRITENTESS OF EMOTIOANL RESPONSE)
* INTERPREOSANL FUNCTIONING
* IMPULSE CONTROL

THE ENDURING PATTERN IS INFLEXIBLE AND PERVASIVE ACROSS A BROAD RANGE OF PERONAL AND SOCIAL SITUATIONS

THE ENDURING PATTERNI LEADS TO CLINCIALLY SIGNIFICANT DISTRESS RO MIPARIMENT IN SOCIAL, OCCUPATONAL OR OTHER IMPORTANT AREAS OF FUCNTIONING

THE PATTERN IS STABLE AND OF LONG DURATION, AND ITS ONSET CAN BE TRACED BAK TO AT LEAST ADOLESSCENCE OR EARLY ADULTHOOD

THE ENDURIN GPATERN IS NOT BETTER ACCOUNTED FOR AS A MANIFESTIONAT OR CONSEQUNECE OF ANOTHER METNATL DISORDER

THE ENDURING PATTERN IS NOT DUE TO THE DIRECT PHYSIOLOGIC EFFECTS OF A SYBNANCE (E.G., A DRUG ABUSE, A MEDICATION) OR A GENERAL MEDICAL CONDITION (E.G. HEAD TRAUME)
CLSUTER A - PARANODI PERONSLITY DISORDER...CLINICAL SYMPTOMS
* DISTRUST, SUSPICION
* IDFFICULTY ADUSTIONG TO CHANGE
* SENSTIIVEY, ARGUMANTION
* FEELINGS OF IREVERSIBLE INJURY BOY OTHERS - OFTEN WITHOUT EVIDENCE
* ANXIETY, DIFFIUCLTY RELAZING
* SHORT TEMPER
* DIFFICULTY WITH PROMBLME SOVING
* LACK OF TNEDR FEELINGS TOWARD OTHERS
* UNWILIINGNESS TO FORBIVE EVN MONIOR EVENTS
* EJALSUSY OF SIGNIFICANT OTHER - OFTHE WITOHT EVIDENCE
CLSUTER A - SCHIZOTYPAL PERONSLITY DISORDER - DLINCIAL SYMTOMS
* INCORRENCT INTERMPERTATION OF EXTERNAL EVENTS/EBLIEF TAHT ALLEVENTS REFER TOSELF
* SUPERSTIONS, PRECOOUTPATION WIT PARANORMAL PEHNONMEN
* BELEIVFF IN POSSESON OF MAGICAL CONTOL OVER OTHERS
* CONTSRTIVED OR INAPPROPRITATE AFECT
* ANXIETY IN SOCIAL SITUATIONS
ANTIAOCAI PERONLITY DISORDER -CLINCIAL SYMTPOMS
* USUSALLY MAKE SITUATUIONS UNPLEASNAT FOR OTHERS
* IRRESPONSITLITY
* FAILURE TO HONOR FINNANCIAL OBLICAGIONS, PLAN AGHEAD, PROVIDE CHILDREN WITH BASIC NEEDS
* INVOOMENT IN LLEGAL ACTIVITIES
* LACK OF GUILT
* DIFFULTY LEARNING FROM MISTAKES
* INTIIANL CHARM DISSOLVE TO DOLNEDESSS, MANIPUALTION, BLAMING OTHERS
* LACKS EMPTHAY
* IRRIBTALITY
* ABUSE OF SUSMBSNACES
BOFERLINE PERONALITY IDORDER - CLINICAL SYMPTOMS
* INTENSE STOMRY RELATIONSHIPS
* SEESS PEOPLE AS "ALL GOOD" OR "ALL BAD"
* iMPULSIVITY
* SELF MUTLAION
* DIFULTY IDENTIFYING SELF
* NEGATIVE OR ANGY AFFECT
* FEELINGS OR EMTPIMENSS AND BOREDOM
* DIFFLIULTY BEING ALONE
* FEELINGS OF ABANDOMENBT
* ENGAGES IN IMPUSLIVE ACTS (E.G. GINGING, SPENDING MONEY, RECLESS DRIVING)
* sUICICIAL IDIATONS
* EATING DISORFERS
AVOIDANT PERONSLITY DOISORDER - CLINICAL SYMNPMOMS
* FEARFUL OF CRITICISIM, DISPAPPROVAL, OR REFJECTION
* AVOIDS SOCIAL INTERACTIONS
* WITHHOLDS THOUGHTS OR FEELINGS
* NEGARTIVE SENSE OF SELF, LOW SELF-ESTTMEEM
DEPENDENT PERONLITY DISORDER - CLININCAL SYMTOMS
* SYBMSISSIVE, CLINGING
* UNALBE TO MEK DECISIONS INDEPENDENTLY
* CANNTO EXPRESS NEGATIVE EMTOIONS
* DIFICULTY FOLLWOING THORUH ON TAKS
DEPENDENT PEROSLTY DISORDER - EPIDEMIOLOGY
* MOST FREQULTNLY DIAGONOSED PERONSLATIY DISORDER
* CHLDREN OR ADOLESCNTS WITH CHRNIC PHYSICAL ILLNESS OR SEAPRATION ANXIEXT MDSIORDER MAY BE PREDISPOSED
OBSESSIVE-COMPULSIVE PERSONLITY DIOSREDER - CLINAICAL SYMTOMS
* PREOOCUAPTION WITH PERFECTION, ORGANIZATION, STRUCTURE, CONTROL
* PROCRASINATION
* ABANDOMENMENT OF PRUJUECT DUE TO DISSATTISFACTON
* EXCESSIVE DEVOITON OT WORK
* DIFULTUTY RELAXING
* RULE CONSICUO BEHAVIOR
* SELF CRRITIAM AND INABLIITY TO FORGIVE OWN ERRORS
* RELUCTANCE TO DELEGATE
* INABLITY TO DISCARD ANYTHING
* INSISTINENT ON OTHERS' CONFOMRING TO WON METHHIODSMETHODS
* REJECTION OF PRAISE
* RELUCTNACE TO SPEND MONEY
* BACKGROWUND OF STIFF AND FORMAL RELATIONSHIPS
* PREOCCUPATOIN WITH LOGIN C AND INTTELLECT
CLUSTER C INTERVENTIONS
* ASSESS SUICICIALITY
* ENCOURAGE ATTENDANCE AT GROUP
* ASSESS ESCALATIOIN OF ANGER
* ASSESS IMPUSLIIVITY, SELF-MUTALIATION
* CONATRACDT CONERNING THERATIENGIN BEHAVIOR, SELF-MUTALATION
* ENCOUARGE JOURNAL WRITING
* TEACH -
- ANGER/IMPULSE MANAGMENT
- RECOGNITION OF FALULTY THOUGHT PATTERNS
- ALTERANTAIVE BEHAVIORS