Anxiety And Personality Disorders

Front 1

Identifythe three clusters in the DSM-IV-TR for Personality Disorders.

Back 1

Cluster A=Odd or Eccentric-Paranoid PDO, Schizoid PDO, Schizotypal PDO

Cluster B=Dramatic, Emotional, or Erratic-Antisocial PDO, Borderline PDO,Histrionic PDO, Narcissistic PDO

Cluster C=Anxious or Fearful-Dependent PDO,Obsessive-Compulsive PDO, Avoidant PDO

Front 2

Nametwo possible causes of personality disorders.

Back 2

Biological factors (genetics)

Psychosocial factors (modeling orreinforcement by significant others), environmental factors (child abuse)

Front 3

Namethree possible nursing diagnoses that are appropriate for someone withpersonality disorders:use)

Back 3

Ineffective coping, anxiety, risk for other directed violence, risk forself directed violence, impaired social interaction, social isolation, fear,disturbed thought processes, defensive coping, self mutilation, chronic lowself esteem, ineffective therapeutic regimen management

Front 4

Name some assessments that needto be made upon admission with patients with personality disorders?

Back 4

Mental Status Exam—information about currentmental functioning, legal history, AODA issues, SI or violence toward others.

Front 5

What is DBT?

Back 5

Dialectical BehaviorTherapy—cognitive-behavioral approach often used to treat Borderline PersonalityDisorder. Long-term approach that provides significant teaching for clients,along with a support systems with therapists…

Front 6

What is splitting?

Back 6

It is the inability to incorporatepositive and negative aspects of oneself or others into a whole image.

Front 7

What personality disorder ischaracterized by a consistent disregard for others with exploitation andrepeated unlawful actions and showing no remorse?

Back 7

Antisocial PersonalityDisorder

Front 8

Whatpersonality disorder is characterized by extreme dependency in a closerelationship with an urgent search to find a replacement when one relationshipends?

Back 8

Dependent PersonalityDisorder

Front 9

Howwould you define personality?

Back 9

An enduring pattern of behavior that is considered to be both consciousand unconscious and reflects a means of adapting to a particular environmentand its cultural, ethnic, and community standards.

Front 10

Howwould you define personality disorder?

Back 10

An enduring pattern of inner experience and behavior that deviatesmarkedly from the expectation of the individual’s culture, is pervasive andinflexible, has an onset in adolescence or early adulthood, is stable overtime, and leads to distress or impairment.

Front 11

Whatpersonality disorder is characterized by emotional detachment …a person whodoes not seek out or enjoy close relationships?

Back 11

Schizoid Personality Disorder

Front 12

Whatpersonality disorder is characterized by distrust and suspiciousness towardothers?

Back 12

Paranoid Personality Disorder

Front 13

Whatare some interventions for working with manipulative behaviors?

Back 13

Limit setting—establishing the parameters of desirable and acceptablepatient behaviors—expectations and consequences. Frequent team meetings toassure consistency.

Front 14

Personality disorders oftenco-occur with what other psychiatric diagnoses?

Back 14

Depression, anxiety, chemical dependency…

Front 15

Whatpersonality disorder is characterized by emotional attention seeking behaviorand the need to be the center of attention?

Back 15

Histrionic Personality Disorder

Front 16

Whatcategories or types of medications might a person diagnosed with a personalitydisorder be prescribed?

Back 16

antidepressant, anxiolytic, or antipsychotic

Front 17

Theperson who experiences a sense of terror has a rapid pulse, shortness ofbreath, dizziness, limited perceptual field, and severe personalitydisorganization is probably suffering from?

Back 17

A panic attack

Front 18

Persistentintrusive thought that cannot be dismissed is called?

Back 18

An obsession

Front 19

the severest level of anxiety is?

Back 19

Panic

Front 20

Defineconversion disorder and list three possible symptom of conversion disorder.

Back 20

There is no medical explanation for the physical symptoms a person isexperiencing. The symptoms prevent an unconscious conflict from becomingconscious. Possible symptomsinclude—impaired balance, paralysis, urinary retention, blindness, deafness,and seizures.

Front 21

What are some reactions a nursemight have while working with a patient with anxiety disorder?

Back 21

Fear, anger, anxiety, frustration.

Front 22

Namesome events that might precipitate PTSD.

Back 22

Natural disaster, violence, war, accidents, crime related, sexual abuse…

Front 23

Treatmentneeded for a patient with panic level anxiety.

Back 23

Safety and medication

Front 24

Apatient who has doubts as to whether they have turned off a burner on theirstove and returns to check it. As soon as they leave their apartment, they doubtand need to recheck the stove again. This is an example of what?

Back 24

Obsessive-compulsive behavior

Front 25

Feeling as though you’re watchingyourself in a movie and that you’re dreaming when you’re awake are examples of:

Back 25

Depersonalization

Front 26

Ritualisticbehaviors or mental acts the person feels driven to perform are:

Back 26

Compulsions

Front 27

“Tuningout,” when stress is intolerable and ego disintegration is threatened, isclosely associated with the ego defense mechanism called:

Back 27

Dissociation

Front 28

Aperson who is a “worrier”, has difficulty concentrating, fears making mistakes,has sweaty palms, and sometimes has difficulty breathing probably suffers from:

Back 28

Generalized Anxiety Disorder

Front 29

Adrug that is effective in treatment of 50% of clients with OCD is:

Back 29

Clomipramine (Anafranil)

Front 30

A patient became fearful that hewould die in some sort of accident that would occur on the streets of his cityand eventually found himself unable to leave his home without experiencing apanic attack. He now stays indoors all the time. He probably suffers from:

Back 30

Agoraphobia

Front 31

Aclient with OCD has several rituals that consume his time and attention. Hesuppresses the urges to void and defecate. An appropriate intervention would be to:

Back 31

Create a schedule for taking the client to the bathroom.

Front 32

Doclients with dissociative disorders obtain secondary gains? If so, how?

Back 32

Yes, needs for attention and dependency may be met.

Front 33

Namethe characteristics of the symptoms of somatic symptom disorders.

Back 33

a.) Not explainable by physiological tests,

b.) Not under voluntary control,

c.) Have a symbolic relationship to theunderlying conflict

Front 34

Whatis the priority goal for a client experiencing severe to panic level anxiety?

Back 34

Anxiety Reducation

Front 35

Denial

Back 35

Denial-anxiety producing stimulus is blockedout of consciousness. e.g.lost job and goes shopping, refuses tobelieve child is mentally ill when faced with overwhelming evidence to thecontrary and fights to have him discharged and off medications

Front 36

Nursing Intervention for Denial

Back 36

Assessprotective factor and how harmful, focus on when person seems to be dealingwith reality

Front 37

Rationalization

Back 37

plausible”reasons for questionable behavior to justify or deal with disappointment; helpsavoid social disapproval and deal with self-esteem issues. People userationalization to maintain their personal integrity. e.g. a nurse who fails toreturn to a patient’s bedside with a promised item and believes it doesn’tmatter because the patient won’t remember due to poor memory.

Front 38

NI for Rationalization

Back 38

Respectthe rationalizations, but help see more effect ways of dealing with situations.How have they coped in the past. “They have real strength and can call uponthis in the current circumstances.”

Front 39

Projection

Back 39

attributingone’s own unacceptable feelings and thoughts to others. It can hinder problemsolving. e.g. a person who is critical of others thinks people are critical ofthem.

Front 40

Introjection

Back 40

acceptinganother’s values and opinions as one’s own if they contradict the values onepreviously held. May lose some self-awareness.

Front 41

Undoing

Back 41

Attemptto counteract the effects of an earlier behavior or thought that isinappropriate or hurtful in the hope that it will balance out. Trying to makethings better and involves guilt feelings. Hadn’t returned multiple phone callsand when finally did also sent a belated birthday gift. Help clients reworksituations that cause this anxiety provoking response.

Front 42

Identification

Back 42

thewish to be like another and to assume the characteristics of that person’spersonality; unconsciously. It can behealthy when used in terms of admiring someone and growing, but when used andbecoming too dependent on someone for all advice and support it becomes aproblem. Inhibits growth. Need to clarify expectations and responsibility ofpatient.

Front 43

Suppression

Back 43

intentionalact to keep thoughts, feelings, wishes, or actions that cause anxiety out ofconscious awareness. “I can’t deal with that right now.” Need to support andhelp the person look at the situation.

Front 44

Respression

Back 44

unconsciousexclusion of distressing emotions, thoughts, or experiences from awareness.Protects from a distressing experience. Anxiety about the circumstances of arape, but can’t remember the event. Should not force the memory.

Front 45

Regression

Back 45

fallingback to an earlier developmental stage and into less mature behavior in orderto cope with a stressful situation. Regression after an illness is common wherethe person becomes more dependent and less able to function socially andoccupationally. Acknowledge what preceded the regression and support thegrowth.

Front 46

Reaction Formation

Back 46

keepingan undesirable impulse out of awareness by emphasizing its opposite. We developconscious attitudes and behavior patterns that are just the opposite of thosefeelings. Hostility may be concealed behind a facade of love and kindness.Someone who crusades against alcohol or pornography may have a wish to enjoythese things. Remember these clients aren’t lying or pretending; they areunconsciously protecting themselves against recognizing threatening feelings.

Front 47

Sublimation

Back 47

channelingunacceptable feelings and behaviors into acceptable ones; being angry withsomeone so takes it out in a football game.

Front 48

Intellectualization

Back 48

processof separating the emotion aroused by an event from ideas or opinions about theevent because the emotion itself is too painful to acknowledge.Intellectualization helps to blunt the emotional impact of the problems. It maybe difficult to perceive, because such clients often seem to know a great dealabout their condition. i.e. talk about their disease process, but not apply itto their individual situation. “I’drather have a broken hip than a broken neck.” Used to discuss disease processrather than discuss feelings…

Front 49

Symptoms of Panic Disorder

Back 49

•Palpitations •Sweating •Trembling •SOB, smothering•Chokingfeeling •Chestpain •Nausea •Dizzy,light headed•Chillsor heat •Numbness and Tingling•Feelingof unreality •Fearof dying

Front 50

How long does a Panic Disorder last?

Back 50

minutes or hours (rarely hours)

Front 51

What is Agoraphobia?

Back 51

a fear of being in a place or situation from which escape might be difficult or in which help might not be available in the event that panic symptoms should occur

Front 52

What is Generalized Anxiety Disorder?

Back 52

Persistent, unrealistic, excessive anxiety and worry

occurs more days than not for at least 6 months

Depression common

Front 53

What is a Social Anxiety Disorder (Social Phobia)?

Back 53

Excessive fear of situations in which a person might do something embarrassing or be judged by others

Front 54

What is a Specific Phobia?

Back 54

Fear of specific object or situation that could cause harm and the reaction is excessive, unreasonable, and inappropriate

Common: heights, mice, spiders, insects

Front 55

What is the treatment of choice for Specific Phobias?

Back 55

Exposure therapy

Front 56

What is Obsessive Compulsive Disorder?

Back 56

Anxietydisorder because anxiety symptoms develop when a person tries to resist anobsession or compulsion