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56 Cards in this Set
- Front
- Back
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personality traits are expressed in what 3 major ways? |
the way people: think about themselves, think about others, & behave |
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Traits become inflexible Dysfunctional patterns of relating and behaving Chronic Axis II disorder Problems in fxning in significant areas of life |
personality disorder |
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diagnostic criteria for a personality disorder |
disturbances in 2 or more of the following: Cognition (self, others, events) Affective (emotional response) Interpersonal fxning Impulse control |
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Ppl with personality disorders might not find their behavior distressing to themselves. So why might they become distressed by it? |
because of others' reactions or behaviors toward them |
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What are the 3 "cluters" of personality disorders? |
Cluster A: odd, eccentric |
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characteristics of cluster _____ disorders: Aloofness (not emotionally connected) angry anxiety suspicious social anxiety eccentric (weird) behaviors |
A |
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what are the 3 cluster A personality disorders? |
Paranoid personality disorder Schizoid personality disorder Schizotypal personality disorder |
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suspicious and mistrust others' motives and actions interprets the actions of others as personal threat angry and threatening when they perceive they're attacked by others |
paranoid personality disorder |
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distant, aloof, cold, detached don't want interpersonal or social relationships choose solitary activities appear indifferent to praise, criticism |
schizoid personality disorder |
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-problems in thinking, perceiving and communicating -ideas of reference, magical thinking ---"if i close the drapes, the sun will never shine again" -few friends -high social anxiety -suspicious -odd, eccentric appearance; don't fit in; slight detachment from reality |
schizotypal personality disorder |
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therapeutic approach to Cluster A disorders |
Build trust Professional demeanor, honest, nonintrusive Clear, simple instructions Individual vs. group therapy: start with individual |
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characteristics of cluster ______ disorders: Poor tolerance for frustration Manipulative Impulsive Controlling Over-involvement vs. detachment Dramatic, emotional, erratic behaviors |
cluster B |
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what are the Cluster B personality disorders? |
Antisocial Personality Disorder Borderline Personality Disorder Narcissistic Personality Disorder Histrionic Personality Disorder |
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-Disregard for the rights and feelings of others -Lack of guilt; denies responsibility -Repeat violations of the law -Common: lying, cheating, stealing -Deny or rationalize their behavior -View problems as being within another -May appear charming and intellectual |
Antisocial Personality Disorder |
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characteristics of the incidence of antisocial PD |
-More common in males -Often linked to childhood abuse -Unstable parent-child relationship; delinquency -Genetic predisposition -Weak response to stress in autonomic nervous system, insensitive to emotional connotations of language |
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Treatment approach for antisocial PD |
-Inpatient milieu therapy -Set firm limits and have consistent approach -Help to see consequences of their actions on others -Avoid being manipulated -Evaluate progress by actions and not words -Groups with pts who have the same dx |
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Characterized by problems with the following: Impulse control, relationships, identity, self-image, thinking, mood (anxiety, dysphoria), chronic feelings of emptiness. Commonly cut themselves; more common in females |
Borderline Personality Disorder (PD) |
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Characteristics of incidence of borderline PD |
-More in females -R/t hx childhood abuse (55-80%) -Other interrelated factors: genetics, env factors, childhood experience, hyperresponsiveness to stress, neuro and biochem dysfxn |
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Criteria for dx of Borderline PD |
-Manipulation -Dependence -Fear of abandonment -Suicidal or self-mutilation ("cutters") -r/o PTSD -Splitting: "You're the only one..." -Only black or white; there's no gray -Emotional instability, impulsive |
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Treatment approaches for person with Borderline PD |
-Use empathy -Clarify relationship; set very firm limits -Cognitive-Behavioral Therapy -Inpatient: rotate staff, maintain consistent approach -Matter-of-fact approach -Education and emotional regulation -Rx to treat sx: mood, anxiety, psychosis |
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People with Borderline PD are known to "screw something up" when things are actually going well for them. This is known as ________________. |
self-sabotage |
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Characterized by the following: -Grandiose, sense of entitlement -seeks praise and admiration -arrogant, expects special treatment -seems indifferent to criticism -over-values of self -fragile ego -lacks empathy |
Narcissistic PD |
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therapeutic approach for pt with narcissistic PD |
-Group psychotherapy, but not allowed to talk about self extensively -Supportive confrontation -Consistent limits -Realistic short-term goals -Help ID and appropriately express feelings |
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Characterized by the following: -Extrovert, colorful, seductive, flirtatious -Flamboyant -Dramatizes events -Has temper tantrums |
Histrionic PD |
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therapeutic approach for pts with histrionic PD |
Positive reinforcement for unselfish and other-centered behaviors Facilitate problem solving Help clarify and appropriately express true feelings |
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Characteristics of cluster _____ disorders: Anxious, fearful behaviors Isolation & withdrawal Preoccupation with work Inability to engage in leisure |
Cluster C |
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What are the 3 cluster C disorders? |
Dependent PD Avoidant PD Obsessive-Compulsive PD |
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Characterized by the following: Pervasive and excessive need to be taken care of Submissive, clinging behaviors Fear of separation Seeking and accepting direction from others, "helplessness" Sense of inferiority and self-doubt |
Dependent PD |
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therapeutic approach for pts with Dependent PD |
Focus on decision-making Increase responsibility gradually Teach assertiveness skills |
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Characterized by the following: Timid, withdrawn, few friends Avoids situations, doesn't want disappointment Socially uncomfortable Fears criticism and rejection Fears rejection from others Fears intimate relationships |
Avoidant PD |
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therapeutic approach to use for someone with Avoidant PD |
-Talk about feelings before and after trying something new; gradually face fears -Support and direct in accomplishing small goals -Assertiveness, social skills, relaxation training -Lead up to small groups -Give positive feedback for successes |
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Characterized by the following: Preoccupation with orderliness, perfectionism overly strict Mental and interpersonal control Struggle w/ defiance and compliance Inflexible, rigid, "rules" Restricted affect, inability to express emotions, "cold" |
Obsessive-Compulsive PD |
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therapeutic approach for someone with OCPD |
Support in the following: Exploring feelings and new experiences Making decisions Confronting procrastination and intellectualization Teaching about irrational beliefs and balancing work/leisure Looking at how pt's behavior affects others |
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little or no sexual desire or have an aversion to sexual contact |
Sexual Desire disorders |
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cannot maintain physiological requirements for sex, i.e. lubrication-swelling response in women and erection in men |
sexual arousal disorders |
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inability to achieve orgasm (anorgasmia in women) or premature ejaculation, which can frustrate a man and his partner -cannot complete sexual response cycle |
orgasm disorders |
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genital pain (dyspareunia) before, during, or after sexual intercourse. i.e. Vaginismus (involuntary spasm of outer third of vagina in women) |
sexual pain disorders |
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sexual instincts are expressed in socially appropriate manner in the form of any of the following: pedophilia, incest, exhibitionism, fetishism, frotteurism, masochism, sadism, voyeurism |
paraphilia |
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pharmacologic tx for paraphilia |
SSRIs |
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-recurrent, intense sexual urges or fantasies involving children -person acts on or is distressed by urges -can be incest -fondling, inappropriate touching, masturbating in child's presence, & penetration of mouth, anus and/or vagina -rationalization: "I am educating," or "kids like this." |
pedophilia |
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issues a/w pedophilia |
-May use threats to silence victim -Occupation with easy access to children (i.e. school teacher, sport coach) -Psychological issues: impaired inhibition, social anxiety, poor self-confidence, hx abuse, cognitive disorders, any PD, some Axis I disorders -cyber sex issues -most victims 11-17 y/o boys |
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how to tx pedophilia |
Goal is to keep children safe Therapy: Cognitive-behavioral, antiadrogen meds (dec. sexual desire), SSRIs, empathy training, education on illness and meds, coping & social skills, relapse prevention |
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pleasure derived from exposing one's genitals to unsuspecting strangers, aka "flashing" -no other sexual activity attempted; stimulated by effect of shocking someone |
exhibitionism |
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-sexual pleasure derived from inanimate objects -common objects: shoes, bra, underpants, stockings -less common: urine-soaked or feces-soaked items -often masturbates while holding or rubbing item |
fetishism |
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-sexual pleasure derived from touching or rubbing one's genitals against a non-consenting person's thighs or butt -may attempt to fondle person's genitals or breasts -usually occurs in crowded place where escape into the crowd is possible |
frotteurism |
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-pleasure derived from humiliation, being beaten, or being made to suffer -people have died in their search for enhanced orgasms by wanting this kind of arousal. |
masochism |
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a/w masochism...sexual arousal from oxygen-depleting activities, i.e. strangulation |
hypoxyphilia |
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-pleasure derived from inflicting psychological or physical suffering on another. partners may be consenting or masochistic -spanking, whipping, pinching, beating, burning, restraining |
sadism |
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some sadists tend to be criminals in that they either ________, _______ or _______ the victim. |
rape, torture or kill |
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found in the underground of the pornography world. videos of women and children being raped, tortured and murdered for viewing pleasure of sadistic people. |
"snuff films" |
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-pleasure derived form observing unsuspecting individuals naked or undressing. aka "Peeping Tom" -might masturbate during peeping or after returning home. |
voyeurism |
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tx considerations for paraphilias |
-Usually don't see behaviors as deviant so might not seek tx -Pt may be seen due to another disorder -Paraphilia behavior may occur during only stress or can be chronic -May have large # of victims |
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common comorbid conditions in ppl with a paraphilia |
Mood disorders, anxiety and impulse disorders, substance abuse disorders, personality disorders, esp. Antisocial PD and Cluster C disorders. |
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effects of mental illness on sexuality |
-Higher rates of HIV and AIDS -Higher risk sexual activities r/t: cognition, impulse control, interpersonal relationships, env factors -Issues: substance abuse, unprotected sex, multiple partners, sex for cigarettes/drugs/food, sex w/ prostitutes -Education and testing for STDs and psych disorders needed |
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nurse-patient relationship for someone with sexual disorder |
-Establish trust, be empathetic and nonjudgmental -Assess self first -Then begin the sexual discussions -Problem-solving -Refer for more help -Refer to support groups for perpetrators and victims |
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Milieu management for people with sexual disorders |
-Groups for self-esteem, assertiveness, anger management, social and relationship skills, sex ed, stress mgmt -Self-help groups: Sex Addicts Anonymous (SAA) -Family therapy -Education and Cognitive-Behavioral Therapy |
