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59 Cards in this Set
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The _________ defines personality traits as enduring _____ of perceiving, relating to, and thinking about the ______ and ____ that are exhibited in a wide range of social and personal contexts. Personality ____ are reflected in how individuals ___ with feelings and impulses. Personality disorders occur when these traits become _______ and _____ and cause either significant functional _______ or subjective distress. Personality disorders are also known as ________ disorders.
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The DSM-IV-TR defines personality traits as enduring PATTERNS of perceiving, relating to, and thinking about the ENVIRONMENT and ONESELF that are exhibited in a wide range of social and personal contexts. Personality TRAITS are reflected in how individuals COPE with feelings and impulses. Personality disorders occur when these traits become INFLEXIBLE and MALADAPTIVE and cause either significant functional IMPAIRMENT or subjective distress. Personality disorders are also known as CHARACTERLOGICAL disorders
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True or False: Virtually all individuals exhibit some behaviors associated with the various personality disorders from time to time. It is only when significant functional impairment occurs in response to these personality characteristics that the individual is thought to have a personality disorder.
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true
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Many theorists have attempted to provide information about personality development. Most suggest that it occurs in an ___, stepwise fashion. Personality is the totality of _____ and ____ characteristics that are particular to a specific person and that remain somewhat ____ and ____ over time.
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Many theorists have attempted to provide information about personality development. Most suggest that it occurs in an ORDERLY, stepwise fashion. Personality is the totality of EMOTIONAL AND BEHAVIORAL characteristics that are particular to a specific person and that remain somewhat STABLE and PREDICTABLE over time.
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The behavior of clients with borderline personality disorder is very stable/unstable and hospitalization is often required due to what?
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The behavior of clients with borderline personality disorder is very unstable and hospitalization is often required due to attempts at self-injury.
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Clients with ______ personality disorder may be hospitalized as a result of judicially ordered evaluation.
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Clients with ANTISOCIAL personality disorder may be hospitalized as a result of judicially ordered evaluation.
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When looking at personality disorders, so much has to do with how people ____ with one another and their ______. What is the difference between ego-syntonic and ego-dystonic?
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When looking at personality disorders, so much has to do with how people INTERACT with one another and their RELATIONSHIPS.
Ego-syntonic: individual sees nothing wrong with his behavior, no empathy or remorse, lots of blaming, see themselves and their behavior as natural, normal, and comfortable. Ego-dystonic: care about our actions, it's painful & uncomfortable to hurt someone else (not a personality disorder). |
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Personality disorders are a disorder of the ___ and differs from the "norm." It is a character problem not a _____ problem by itself-- someone is not hospitalized just because of the personality disorder by itself.
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Personality disorders are a disorder of the SELF and differs from the "norm." It is a character problem not a CLINICAL problem by itself-- someone is not hospitalized just because of the personality disorder by itself.
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How are Cluster A behaviors described? What 3 personality disorders fall into this cluster?
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Odd & Eccentric
Paranoid Personality Disorder Schizoid Personality Disorder Schizotypal Personality Disorder |
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How are Cluster B behaviors described? What 4 personality disorders fall into this cluster?
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Dramatic, emotional, or erratic
Borderline personality disorder Antisocial personality disorder Histrionic personality disorder Narcissistic personality disorder |
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How are Cluster C behaviors described? What 3 personality disorders fall into this cluster?
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anxious or fearful
Avoidant personality disorder Dependent personality disorder Obsessive-compulsive personality disorder |
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Personality disorders rarely/frequently overlap. They may coexist with Axis __ and they develop before or during ____.
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Personality disorders frequently overlap. They may coexist with Axis I and they develop before or during adolescence.
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Common characteristics of personality disorders include inflexible and maladaptive responses to ____, unsuccessful work and love ____, and intense _____ conflict. These people are like wet boogers! They continuously "get under the skin" of others. For people with personality disorders, they see themselves as "ever the ___" and almost always seem to be in a state of ____. They do not respond well to stress and tend to act out in whichever way their personality disorder is characterized.
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Common characteristics of personality disorders include inflexible and maladaptive responses to STRESS, unsuccessful work and love RELATIONSHIPS, and intense INTERPERSONAL conflict. These people are like wet boogers! They continuously "get under the skin" of others. For people with personality disorders, they see themselves as "ever the VICTIM" and almost always seem to be in a state of CRISIS. They do not respond well to stress and tend to act out in whichever way their personality disorder is characterized.
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Cluster A disorders might coexist with ____ or other axis __ disorders. These groups are odd and eccentric.
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Cluster A disorders might coexist with schizophrenia or other axis I disorders. These groups are odd and eccentric.
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People with Cluster B (antisocial, borderline, histrionic, narcissistic) disorders are very e____ and d___, and exemplify poor ____ ____ at its ultimate. They tend to coexist with which type of axis I disorders?
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People with Cluster B (antisocial, borderline, histrionic, narcissistic) disorders are very erratic and dramatic, and exemplify poor impulse control at its ultimate. They tend to coexist with mood & affective axis I disorders. They often have labile, up and down moods.
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Cluster C disorders (avoidant, dependent, and O-C) are often very ___ and ___ful, very open/closed up individuals. They often coexist with axis I ___ disorders.
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Cluster C disorders (avoidant, dependent, and O-C) are often very anxious and fearful, very closed up individuals. They often coexist with axis I anxiety disorders.
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Describe some of the traits of paranoid personality disorder.
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characteristic feature: long-standing suspiciousness & mistrust of people in general
Don't trust anyone cold & aloof Hold grudges Secretive Always on guard Tense & irritable constantly on the defense afraid that others are out to get them or take advantage tend to misinterpret the environment & distort minute cues as trickery & deception constantly testing others' honesty hypervigilant- always ready for any real or imagined threat avoid interactions with others (could relinquish sense of power) develop a "hard exterior" and become immune/insensitive to the feelings of others The high level of paranoia can cause this person to justify his own thoughts & behaviors as normal and think it's ok to seek revenge--- they may act out on their perceived threats and become violent and aggressive. These outbursts are usually brief, and the paranoid person soon regains the external control, rationalizes the behavior, and reconstructs the defenses central to his or her personality pattern. |
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People with paranoid personality disorder often/seldom seek assistance or require hospitalization. If a peer insists that the person seek treatment, he can often pull himself together enough so that the behavior does not appear maladaptive. Which gender is the disorder more common in? Explain the possible etiology.
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People with paranoid personality disorder seldom seek assistance or require hospitalization. If a peer insists that the person seek treatment, he can often pull himself together enough so that the behavior does not appear maladaptive. This disorder is more common in males. There may be a hereditary component and there is a higher incidence in relatives of people with schizophrenia. All of the traits of this disorder stem back to childhood, the person perceived a lack of trust and love (even if there was nurturing) and learned to see the world as harsh and unkind. They anticipate humiliation and betrayal by others and learn to attack first. They were likely harassed and antagonized as a child and served as scapegoats for displaced parental aggression and gradually relinquished all hope for affection and approval.
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Discuss schizoid & schizotypal personality disorders. Compare & contrast them in terms of etiology & their clinical picture. (too much vague stuff to make flashcards!)
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see lecture & p. 568-9
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In caring for people with cluster A personality disorders, use a ___ approach. Respect the client's need for _____. Be mindful of own _____ communication. Gradually encourage _____ with ___, but don't force this.Behave in a non______ manner, (don't put your hands behind your back etc). Use very nonintrusive interventions. Don't be rough- they're already paranoid & suspicious. Establishing ____ is crucial but difficult (not impossible). Their personality isn't going to change but we can teach ____ skills.
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In caring for people with cluster A personality disorders, use a GENTLE approach. Respect the client's need for DISTANCE. Be mindful of own NONVERBAL communication. Gradually encourage INTERACTION with OTHERS but don't force this. Behave in a nonTHREATENING manner, (don't put your hands behind your back etc.). Use very nonintrusive interventions. Don't be rough- they're already paranoid & suspicious. Establishing TRUST is crucial but difficult (not impossible). Their personality isn't going to change but we can teach COPING skills.
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People with antisocial personality disorder fail to conform to social ____ and have a ___ficial expression of ____. They are grand____ and ___centric-- they see themselves as smarter and better than others. They consistently violate the ____ of others. These people don't believe they do anything wrong, they lack e____. They feel that whoever they wronged deserved it (who they hurt or stole from). This disorder usually begins in childhood/adolescence/adulthood as a ____ disorder. As kids, they may have been a bully, a __away, and/or truant. As adults, these people tell many ____ and may use a____-- they lie for their own profit. They aren't called antisocial because they don't want to socialize but rather that they go against society's norms, values, morals-- more like "anti-society." They have a ___less dis____ for others and also themselves- they may overindulge in drugs and alcohol. These people are often ugly/good looking and have an innate ability to ch___ others yet they're really stabbing people in the back. These people tend to be abusive and have very dysfunctional/functional marriages and relationships. It is often difficult for these people to hold onto personal relationships.
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People with antisocial personality disorder fail to conform to social norms and have a superficial expression of emotion. They are grandiose and egocentric-- they see themselves as smarter and better than others. They consistently violate the rights of others. These people don't believe they do anything wrong, they lack empathy. They feel that whoever they wronged deserved it (who they hurt or stole from). This disorder usually begins in childhood as a conduct disorder. As kids, they may have been a bully, a runaway, and/or truant. As adults, these people tell many lies and may use aliases-- they lie for their own profit. They aren't called antisocial because they don't want to socialize but rather that they go against society's norms, values, morals-- more like "anti-society." They have a reckless disregard for others and also themselves- they may overindulge in drugs and alcohol. These people are often good looking and have an innate ability to charm others yet they're really stabbing people in the back. These people tend to be abusive and have very dysfunctional marriages and relationships. It is often difficult for these people to hold onto personal relationships.
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People with antisocial personality disorder fail to conform to social ____ and have a ___ficial expression of ____. They are grand____ and ___centric-- they see themselves as smarter and better than others. They consistently violate the ____ of others. These people don't believe they do anything wrong, they lack e____. They feel that whoever they wronged deserved it (who they hurt or stole from). This disorder usually begins in childhood/adolescence/adulthood as a ____ disorder. As kids, they may have been a bully, a __away, and/or truant. As adults, these people tell many ____ and may use a____-- they lie for their own profit. They aren't called antisocial because they don't want to socialize but rather that they go against society's norms, values, morals-- more like "anti-society." They have a ___less dis____ for others and also themselves- they may overindulge in drugs and alcohol. These people are often ugly/good looking and have an innate ability to ch___ others yet they're really stabbing people in the back. These people tend to be abusive and have very dysfunctional/functional marriages and relationships. It is often difficult for these people to hold onto personal relationships.
Book: People with antisocial personality disorder show a pattern of socially irresponsible, exploitative, and guiltless behavior that reflects a disregard for the right of others. These people exploit and manipulate others for personal gain an have a general disregard for the law. They have difficulty sustaining consistent _____ment. It is one of the oldest and best researched of the personality disorders and has been included in all editions of the DSM. Is it more common in men or women? The ICD-10 this disorder as ___ personality disorder. |
People with antisocial personality disorder fail to conform to social norms and have a superficial expression of emotion. They are grandiose and egocentric-- they see themselves as smarter and better than others. They consistently violate the rights of others. These people don't believe they do anything wrong, they lack empathy. They feel that whoever they wronged deserved it (who they hurt or stole from). This disorder usually begins in childhood as a conduct disorder. As kids, they may have been a bully, a runaway, and/or truant. As adults, these people tell many lies and may use aliases-- they lie for their own profit. They aren't called antisocial because they don't want to socialize but rather that they go against society's norms, values, morals-- more like "anti-society." They have a reckless disregard for others and also themselves- they may overindulge in drugs and alcohol. These people are often good looking and have an innate ability to charm others yet they're really stabbing people in the back. These people tend to be abusive and have very dysfunctional marriages and relationships. It is often difficult for these people to hold onto personal relationships.
Book: People with antisocial personality disorder show a pattern of socially irresponsible, exploitative, and guiltless behavior that reflects a disregard for the right of others. These people exploit and manipulate others for personal gain an have a general disregard for the law. They have difficulty sustaining consistent employment. It is one of the oldest and best researched of the personality disorders and has been included in all editions of the DSM. Is it more common in men. The ICD-10 this disorder as dissocial personality disorder. |
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People with borderline personality disorder are very predictable/unpredictable. They have i___ and un____ moods and lack a sense of ___. They often have un____ personal relationships. These people are very erratic and may be the most difficult of all psychiatric patients to deal with especially because they do "____ing"- they turn people against each other by playing both ends against the middle. People with borderline tend to be self ___-- may self ___ or be s____. They are usually admitted because they are a _____ to themselves. These people have very unpredictable or nonexistent ____ control and are very ____ and emotional- they don't think things through, they do things based on their _____ status. There's lots of alcohol or drug ___, often very promiscuous- may have lots of ____. contacts
They feel that they will be _____, so they don't get close to others- they think "they're just going to leave me too." They usually burn out relationships because they're so unstable-- have a very unstable sense of self, identity. They might try to be just like you and have a ____ identity, they tend to view the world as... They have ______ thinking- "no in between"- no grey, either all bad or all good. They may exhibit transient stress induced ______, and relationships are unstable, intense go to extremes dychotomists -- overly identify, idealize person in relationship, or the person (significant other or friend) does absolutely nothing right cant see that someone was just having a bad day, etc. Book: Borderline personality disorder is characterized by a pattern of intense and chaotic ______s, with affective instability and fluctuating a______s toward other people. These individuals are i______, are directly and indirectly self-_______, and lack a clear sense of _____. It is the least/most common personality disorder. Is it more common in men or women? The ICD-10 identifies this disorder as _____ ____ personality disorder. |
People with borderline personality disorder are very predictable/unpredictable. They have intense and unstable moods and lack a sense of identity. They often have unstable personal relationships. These people are very erratic and may be the most difficult of all psychiatric patients to deal with especially because they do "splitting"- they turn people against each other by playing both ends against the middle. People with borderline tend to be self destructive-- may self mutilate or be suicidal. They are usually admitted because they are a danger to themselves. These people have very unpredictable or nonexistent impulse control and are very labile and emotional- they don't think things through, they do things based on their emotional status. There's lots of alcohol or drug abuse, often very promiscuous- may have lots of sexual contacts
They feel that they will be abandoned, so they don't get close to others- they think "they're just going to leave me too." They usually burn out relationships because they're so unstable-- have a very unstable sense of self, identity. They might try to be just like you and have a superficial identity, they tend to view the world as black or white. They have dichotomous thinking- "no in between"- no grey, either all bad or all good. They may exhibit transient stress induced paranoia, and relationships are unstable and intense go to extremes dychotomists -- overly identify, idealize person in relationship, or the person (significant other or friend) does absolutely nothing right cant see that someone was just having a bad day, etc Book: Borderline personality disorder is characterized by a pattern of intense and chaotic relationships, with affective instability and fluctuating attitudes toward other people. These individuals are impulsive, are directly and indirectly self-destructive, and lack a clear sense of identity. It is the most common personality disorder and is more common women. The ICD-10 identifies this disorder as emotionally unstable personality disorder. |
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Histrionic personality disorder is characterized by ____ful, overly dr____, and extroverted/introverted behavior in excitable, emotional people. They have difficulty maintaining ___-lasting _______s, although they require constant affirmation of ____ and ______ from others. Is it more common in men or women?
These people are guided by ____ rather than logic. They always have to be the ___ of ____. They see themselves as "ever the ___" The hallmark of histrionic personality disorder is ________. Their moods and emotions rapidly ___. They have very deep/shallow emotions and probably have encounters in the _____ field. Their relationships tend to fall apart because it's always about them (center of attention) and they don't really offer anything to the relationship. They often consider a relationship to be more _____ than it truly is. These people tend to m_______ others and are often very seductive (wearing inappropriate or suggestive clothing). They also are very s_____-- they can be convinced of something easily and also hypnotized easily. People with histrionic personality disorder tend to be self-dramatizing, attention seeking, and overly gregarious (sociable), and seductive. They use manipulative and exhibitionistic behaviors in their demands to be the center of attention. People with this disorder often demonstrate, in mild pathological form, what our society tends to foster and admire in its members: to be well liked, successful, popular, extroverted, attractive, and sociable. However, beneath these surface characteristics is an all-consuming need for approval and a desperate desire to be conspicuous and and to evoke affection or attract attention at all costs. Failure to evoke the attention and approval they seek often results in feelings of dejection (depression or lowness of spirits) and anxiety. Individuals with this disorder are highly dist____ and flighty by nature. They have difficulty paying attention to ____. They can portray themselves as carefree and sophisticated on one hand and as inhibited and naive on the other. They tend to be strongly independent/dependent. They lack the ability to provide another with genuine a_____. Somatic complaints are not uncommon in these individuals, and fleeting episodes of _____- may occur during periods of extreme stress. |
Histrionic personality disorder is characterized by colorful, overly dramatic, and extroverted behavior in excitable, emotional people. They have difficulty maintaining long-lasting relationships, although they require constant affirmation of approval and acceptance from others. It is more common in women. These people are guided by emotions rather than logic. They always have to be the center of attention. They see themselves as "ever the victim" The hallmark of histrionic personality disorder is emotionality. Their moods and emotions rapidly change/shift. They have very shallow emotions and probably have encounters in the entertainment field. Their relationships tend to fall apart because it's always about them (center of attention) and they don't really offer anything to the relationship. They often consider a relationship to be more intimate than it truly is. These people tend to manipulate others and are often very seductive (wearing inappropriate or suggestive clothing). They also are very suggestive-- they can be convinced of something easily and also hypnotized easily. People with histrionic personality disorder tend to be self-dramatizing, attention seeking, and overly gregarious (sociable), and seductive. They use manipulative and exhibitionistic behaviors in their demands to be the center of attention. People with this disorder often demonstrate, in mild pathological form, what our society tends to foster and admire in its members: to be well liked, successful, popular, extroverted, attractive, and sociable. However, beneath these surface characteristics is an all-consuming need for approval and a desperate desire to be conspicuous and and to evoke affection or attract attention at all costs. Failure to evoke the attention and approval they seek often results in feelings of dejection (depression or lowness of spirits) and anxiety. Individuals with this disorder are highly distractible and flighty by nature. They have difficulty paying attention to detail. They can portray themselves as carefree and sophisticated on one hand and as inhibited and naive on the other. They tend to be strongly dependent. They lack the ability to provide another with genuine affection. Somatic complaints are not uncommon in these individuals, and fleeting episodes of paranoia- may occur during periods of extreme stress.
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There are many theories about the development of histrionic personality disorder. The characteristics of enhanced sensitivity and reactivity to environmental stimuli may be related to increased/decreased noradrenergic/serotonergic activity and the trait of impulsivity may be associated with increased/decreased noradrenergic/serotonergic activity. Heredity may be a factor. The root causes of histrionic personality disorder may surround an unbonded ______ relationship and an ______ paternal relationship. When a child is not the center of a parent's attention, neglect, lack of bonding, and deprivation leaves one starving for attention, approval, praise, and reassurance. The child may have learned that positive reinforcement was contingent on the ability to perform parentally approved and admired behaviors.
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There are many theories about the development of histrionic personality disorder. The characteristics of enhanced sensitivity and reactivity to environmental stimuli may be related to increased noradrenergic activity and the trait of impulsivity may be associated with decreased serotonergic activity. Heredity may be a factor. The root causes of histrionic personality disorder may surround an unbonded maternal relationship and an abusive paternal relationship. When a child is not the center of a parent's attention, neglect, lack of bonding, and deprivation leaves one starving for attention, approval, praise, and reassurance. The child may have learned that positive reinforcement was contingent on the ability to perform parentally approved and admired behaviors.
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Narcissists tend to be very successful/unsuccessful. Which personality disorder often involves this one as a subtype? They have a preoccupation with beauty, wealth, and success. They require excessive _____ not necessarily attention like the _____ personality disorder. They are often arrogant and egotistical. They think they're gifted and they often won't socialize with anyone who isn't "gifted" like them-- they want that trophy on their arm. They may be envious of others and think that others ____ them. They exploit others in their relationships and use others to meet their own goals.
Book: People with narcissistic personality disorder have an exaggerated sense of ___-____. They lack ____ and are hyper____ to the evaluation of others. They believe that they have the the inalienable (not transferable to another or capable of being repudiated) right to receive special consideration and that their desire is sufficient justification for possessing whatever they seek. The concept of narcissism was viewed by early psychoanalysts as an abnormal/normal phase of psychosexual development. Is it more common in men or women? Individuals with narcissistic personality disorder appear to lack h____, being overly ___-centered and exploiting others to fulfill their own desires. They often do not perceive their behavior as being inappropriate. Because they view themselves as "superior" beings they believe they are ______ to special rights and privileges. Although often grounded in grandiose distortions of reality, their mood is usually described as what? Their mood can easily change, however, because of their strong/fragile self-esteem. If they don't meet self-expectations, don't receive positive feedback from others, or receive criticism, they may respond with rage, shame, humiliation, or dejection. They may turn inward and fantasize rationalizations that convince them of their continued stature and perfection. The exploitation of others for self-gratification results in impaired inter____ _____s. In selecting a mate, narcissists frequently choose a person who will... |
Narcissists tend to be very successful.Antisocial personality disorder often involves this one as a subtype. They have a preoccupation with beauty, wealth, and success. They require excessive admiration not necessarily attention like the histrionic personality disorder. They are often arrogant and egotistical. They think they're gifted and they often won't socialize with anyone who isn't "gifted" like them-- they want that trophy on their arm. They may be envious of others and think that others envy them. They exploit others in their relationships and use others to meet their own goals.
People with narcissistic personality disorder have an exaggerated sense of self-worth. They lack empathy and are hypersensitive to the evaluation of others. They believe that they have the the inalienable (not transferable to another or capable of being repudiated) right to receive special consideration and that their desire is sufficient justification for possessing whatever they seek. The concept of narcissism was viewed by early psychoanalysts as a normal phase of psychosexual development. Is It is more common in men. Individuals with narcissistic personality disorder appear to lack humility, being overly self-centered and exploiting others to fulfill their own desires. They often do not perceive their behavior as being inappropriate. Because they view themselves as "superior" beings they believe they are entitled to special rights and privileges. Although often grounded in grandiose distortions of reality, their mood is usually described as carefree, cheerful, relaxed, and optimistic. Their mood can easily change, however, because of their fragile self-esteem. If they don't meet self-expectations, don't receive positive feedback from others, or receive criticism, they may respond with rage, shame, humiliation, or dejection. They may turn inward and fantasize rationalizations that convince them of their continued stature and perfection. The exploitation of others for self-gratification results in impaired interpersonal relationships. In selecting a mate, narcissists frequently choose a person who will provide them with the praise and positive feedback that they require and who will not ask much from their partner in return. |
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The etiology of narcissistic personality disorder appears to stem from ____ issues. These people had their fears, failures, or dependency needs responded to with cr____, disdain, or n___. They grow up with contempt for these behaviors in themselves and are unable to view others as sources of comfort and support. They project an image of invulnerability and self-sufficiency that hides their true sense of emptiness and contribute to their inability to feel deeply. Some say that parents of individuals with narcissistic personality disorder were ____ themselves. The parents were demanding, perfectionistic, critical, and they placed unrealistic expectations on the child. Children model their parents' behavior, giving way to the adult narcissist. The child who becomes a narcissist may also have been physically or emotionally ______. Others theorize that narcissists develop because of parents that overindulge their children and give them everything they ask for with little to no effort required. From this perspective, narcissists' tendencies toward entitlement and exploitativeness reflect the overblown implicit expectations their parents instilled in them (often living their lives vicariously though their child) while their shame-proneness reflects their chronic perception of themselves as falling short of these expectations (when reality and the oftentimes cruel nature of the real world sets in outside the home).
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The etiology of narcissistic personality disorder appears to stem from childhood issues. These people had their fears, failures, or dependency needs responded to with criticism, disdain, or neglect. They grow up with contempt for these behaviors in themselves and are unable to view others as sources of comfort and support. They project an image of invulnerability and self-sufficiency that hides their true sense of emptiness and contribute to their inability to feel deeply. Some say that parents of individuals with narcissistic personality disorder were narcissists themselves. The parents were demanding, perfectionistic, critical, and they placed unrealistic expectations on the child. Children model their parents' behavior, giving way to the adult narcissist. The child who becomes a narcissist may also have been physically or emotionally abused. Others theorize that narcissists develop because of parents that overindulge their children and give them everything they ask for with little to no effort required. From this perspective, narcissists' tendencies toward entitlement and exploitativeness reflect the overblown implicit expectations their parents instilled in them (often living their lives vicariously though their child) while their shame-proneness reflects their chronic perception of themselves as falling short of these expectations (when reality and the oftentimes cruel nature of the real world sets in outside the home).
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In caring for people with Cluster B personality disorders, the nurse needs to understand and integrate the concept of _____. She needs to provide c_____ and st_____ milieu which includes setting _____. ____ is the first priority of care. The health care team needs to collaborate together in that they all need to be on the same page, especially because of the manipulating and _____ behaviors. The nurse should explore the patients fears and behaviors with the client. The nurse should try not to buy into the splitting behaviors or fall into the emotional state of the patient. Maintain a ____ stance -- don't get angry when patient gets angry etc.
Emphasize expectations and routines, these patients don't really live by __. |
In caring for people with Cluster B personality disorders, the nurse needs to understand and integrate the concept of PATIENCE! She needs to provide consistent and structured milieu which includes setting rules. Safety is the first priority of care. The health care team needs to collaborate together in that they all need to be on the same page, especially because of the manipulating and splitting behaviors. The nurse should explore the patients fears and behaviors with the client. The nurse should try not to buy into the splitting behaviors or fall into the emotional state of the patient. Maintain a neutral stance -- don't get angry when patient gets angry etc.
Emphasize expectations and routines, these patients don't really live by rules. |
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Cluster C disorders are characterized as anxious and fearful. Avoidant personality disorder is characterized by fear of ____, a view of the self as severely in______, and a reluctance to enter _______. The person is fearful or shy and has ____ inhibitions. They are hyper____ to cr____ (unlike people in cluster __) They fear dis____ or rejection so they don't go out and meet people- they avoid people. Their lack of self worth appeared in _____ as extreme ___ness. They view themselves as inferior, unappealing, and socially inept. They literally have a preoccupation with being rejected or criticized by others o they are unwilling to become involved with others. They basically need an unconditional guarantee that they are liked before they will be involved in a relationship. They have many/few close friends. They need lots re_____ and ____ is essential, especially in the beginning.
Book- People with avoidant personality disorder are extremely sensitive to rejection and because of this may lead a very socially w____ life. Does this person want to or wish he could socialize or do they just not care about interacting with others? Is it more common in one gender over the other? These people are aw___ and un_____ in social situations. From a distance, others may perceive them as timid, withdrawn, cold, or strange. Those who know them better, however, soon learn of their sensitivities, touchiness, evasiveness, and mistrustful qualities. Their ___ is slow and constrained with frequent hesitations, fragmentary thought sequences and occasional confused and irrelevant digressions (going off topic). They are often lonely and express feelings of being unwanted. They view others as critical, betraying, and humiliating. Depression, anxiety, and anger at oneself for failing to develop social relations are commonly experienced. The etiology of avoidant personality disorder may have a hereditary influence. The primary psychosocial predisposing influence to avoidant personality disorder is parental _____ and censure (dis____) These people are often raised in families in which they are belittled, abandoned, criticized, such that any natural optimism is extinguished and replaced with feelings of low self-worth and social alienation. They learn to be suspicious and view the world as hostile and dangerous, similar to paranoid personality disorder. |
Cluster C disorders are characterized as anxious and fearful. Avoidant personality disorder is characterized by fear of rejection, a view of the self as severely inadequate, and a reluctance to enter relationships. The person is fearful or shy and has social inhibitions. They are hypersensitive to criticisms (unlike people in cluster A) They fear disapproval or rejection so they don't go out and meet people- they avoid people. Their lack of self worth appeared in childhood as extreme shyness. They view themselves as inferior, unappealing, and socially inept. They literally have a preoccupation with being rejected or criticized by others o they are unwilling to become involved with others. They basically need an unconditional guarantee that they are liked before they will be involved in a relationship. They have few close friends. They need lots reassurance and trust is essential, especially in the beginning.
Book- People with avoidant personality disorder are extremely sensitive to rejection and because of this may lead a very socially withdrawn life. This person is not "asocial" in fact there may be a strong desire for companionship but avoid them because of their fear of being rejected. It is equally common among men and women. These people are awkward and uncomfortable in social situations. From a distance, others may perceive them as timid, withdrawn, cold, or strange. Those who know them better, however, soon learn of their sensitivities, touchiness, evasiveness, and mistrustful qualities. Their speech is slow and constrained with frequent hesitations, fragmentary thought sequences and occasional confused and irrelevant digressions (going off topic). They are often lonely and express feelings of being unwanted. They view others as critical, betraying, and humiliating. Depression, anxiety, and anger at oneself for failing to develop social relations are commonly experienced. The etiology of avoidant personality disorder may have a hereditary influence. The primary psychosocial predisposing influence to avoidant personality disorder is parental rejection and censure (disapproval) These people are often raised in families in which they are belittled, abandoned, criticized, such that any natural optimism is extinguished and replaced with feelings of low self-worth and social alienation. They learn to be suspicious and view the world as hostile and dangerous, similar to paranoid personality disorder. |
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People with dependent personality disorder have very aggressive/passive behavior and feel they need to be taken care of- constantly needing support from others. They are very anxious when _____ and they lack self-c_____. These people have a pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of _____. These people tend to allow others to make decisions, feel ____less when alone, and act submissively to accomodate the needs of others. They are "people pleasers" in that they tolerate mistreatment by others, always agree/disagree, and can't say "___." The fail to function adequately in situations where they must be assertive or dominant in their behavior. The disorder is common/uncommon. Is it more common in women or men? In the oldest or youngest child? These people have a fear of a_______ and probably had these types of issues growing up. They constantly do things for others so that they have some sort of "____" that they're not going to be left alone, that's how it works in their mind. They are so overly independent/dependent on others that they end up jumping from one _____ to the next, which is often non-nurturing--- lacking what they are looking for most.
Individuals with dependent personality disorder have a notable lack of self-confidence that is often apparent in their posture, voice, and mannerisms. They are typically passive and agreeable. They are overly generous and thoughtful and underplay their own attractiveness and achievements. They avoid positions of responsibility and become anxious when forced into them. They have feelings of low self-worth and are easily hurt by criticism and disapproval. They will do almost anything, even if it is unpleasant or demeaning, to earn acceptance of others. They appear to others as optimistic and pleasant, but when alone are pessimistic, discouraged, and dejected. They suffer in silence. |
People with dependent personality disorder have very passive behavior and feel they need to be taken care of- constantly needing support from others. They are very anxious when alone and they lack self-confidence. These people have a pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation. These people tend to allow others to make decisions, feel helpless when alone, and act submissively to accommodate the needs of others. They are "people pleasers" in that they tolerate mistreatment by others, always disagree, and can't say "no." The fail to function adequately in situations where they must be assertive or dominant in their behavior. The disorder is common. Is it more common in women in the youngest child. These people have a fear of abandonment and probably had these types of issues growing up. They constantly do things for others so that they have some sort of "insurance" that they're not going to be left alone, that's how it works in their mind. They are so overly dependent on others that they end up jumping from one relationship to the next, which is often non-nurturing--- lacking what they are looking for most.
Individuals with dependent personality disorder have a notable lack of self-confidence that is often apparent in their posture, voice, and mannerisms. They are typically passive and agreeable. They are overly generous and thoughtful and underplay their own attractiveness and achievements. They avoid positions of responsibility and become anxious when forced into them. They have feelings of low self-worth and are easily hurt by criticism and disapproval. They will do almost anything, even if it is unpleasant or demeaning, to earn acceptance of others. They appear to others as optimistic and pleasant, but when alone are pessimistic, discouraged, and dejected. They suffer in silence. |
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The development of dependent personality disorder is often fostered in infancy, when stimulation and nurturance are experienced exclusively from one source. A problem may arise when parents become over_____ and discourage the child from developing in_____ behaviors. Parent who make new experiences unnecessarily easy for the child or refuse to allow the child to learn from experience encourage the child to give up efforts at achieving autonomy. The child may come to fear a loss of love or attachment from the parental figure if independent behaviors are attempted.
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The development of dependent personality disorder is often fostered in infancy, when stimulation and nurturance are experienced exclusively from one source. A problem may arise when parents become overprotective and discourage the child from developing independent behaviors. Parent who make new experiences unnecessarily easy for the child or refuse to allow the child to learn from experience encourage the child to give up efforts at achieving autonomy. The child may come to fear a loss of love or attachment from the parental figure if independent behaviors are attempted.
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People with Obsessive-Compulsive Personality Disorder are very relaxed/serious and informal/formal and have difficulty expressing _____. They are overly dis_____, perfectionistic and are preoccupied with ____. They are flexible/inflexible about the way in which things must be done and have a devotion to ______ to the exclusion of personal pleasure. An intense fear of _____ or making a ___, which leads to difficulty with decision making. The disorder is relatively common/uncommon and occurs more often in men/women. Within the family, it is more common in the oldest/youngest child. These people lack spontaneity. They are meticulous and work diligently and patiently at tasks that require accuracy and discipline. They are especially concerned with matters of organization and efficiency and tend to be rigid. Social behaviors tend to be polite and formal. They have a high need for routine and may always be late because everything has to be perfect. They are preoccupied with little _____ and often have endless ____, schedules-- everything must be in ___ at all times. They aren't efficient because they are so inflexible and so preoccupied with being orderly. They are often hoarders- which becomes pathological because they no longer have control. They are reluctant to _____ to others--- won't let their children help out, everything has to be done themself to get it done right. They may hoard money for some catastrophe that could come. They tend to _____ in fear of making a mistake. Relationships are impaired because of the the "all work and no play" attitude. Not daring to expose their true feelings of defiance and anger, they withhold these feelings so strongly that the opposite feelings come forth. Common ego defense mechanisms used by these people are isolation , intellectualization, rationalization, undoing, and especially ___ ___.
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People with Obsessive-Compulsive Personality Disorder are very serious and formal and have difficulty expressing emotion. They are overly disciplined, perfectionistic and are preoccupied with rules. They are inflexible about the way in which things must be done and have a devotion to productivity to the exclusion of personal pleasure. An intense fear of error or making a mistake, which leads to difficulty with decision making. The disorder is relatively common and occurs more often in men. Within the family, it is more common in the oldest child. These people lack spontaneity. They are meticulous and work diligently and patiently at tasks that require accuracy and discipline. They are especially concerned with matters of organization and efficiency and tend to be rigid. Social behaviors tend to be polite and formal. They have a high need for routine and may always be late because everything has to be perfect. They are preoccupied with little details and often have endless lists, schedules-- everything must be in order at all times. They aren't efficient because they are so inflexible and so preoccupied with being orderly. They are often hoarders- which becomes pathological because they no longer have control. They are reluctant to delegate to others--- won't let their children help out, everything has to be done themself to get it done right. They may hoard money for some catastrophe that could come. They tend to procrastinate in fear of making a mistake. Relationships are impaired because of the the "all work and no play" attitude. Not daring to expose their true feelings of defiance and anger, they withhold these feelings so strongly that the opposite feelings come forth. Common ego defense mechanisms used by these people are isolation , intellectualization, rationalization, undoing, and especially reaction formation.
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In treating Cluster C disorders, point out a_____ behaviors. Provide _____ solving and _____ness training. Encourage expression of fears and feelings, which may help them decrease rigitity. Assist client to recognize his or her own distress related to a need for perfection or control and help the patient understand that this ideation is causing the patient stress.These people require more/less nurturing, so the nurse is more/less neutral. These patients need lots of positive/negative reinforcement. Help the patients increase their confidence and independence/dependence on others. Use ______ type groups with them such as assertiveness groups.
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In treating Cluster C disorders, point out avoidance behaviors. Provide problem solving and assertiveness training. Encourage expression of fears and feelings, which may help them decrease rigitity. Assist client to recognize his or her own distress related to a need for perfection or control and help the patient understand that this ideation is causing the patient stress.These people require more nurturing, so the nurse is less neutral. These patients need lots of positive reinforcement. Help the patients increase their confidence and independence. Use cognitive type groups with them such as assertiveness groups.
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Within all of the clusters of personality disorders, primitive _____ are present which are built wihtin the clients' intrinsic childhood discrepencies of personality. It is important to do a self assessment before caring for a patient in the mental health setting to determine one's own feelings, bias, value judgements, assessment of understanding of disorder, etc.so you are better able to care for the patient. Remember to always protect client rights and maintain _________. In assesssments, always look at the patient's previous history and assess their current level of ____ and ___ control. What is the MMPI?
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Within all of the clusters of personality disorders, primitive defenses are present which are built wihtin the clients' intrinsic childhood discrepencies of personality. It is important to do a self assessment before caring for a patient in the mental health setting to determine one's own feelings, bias, value judgements, assessment of understanding of disorder, etc.so you are better able to care for the patient. Remember to always protect client rights and maintain _________. In assesssments, always look at the patient's previous history and assess their current level of functinoing and impulse control. The MMPI stands for Minnesota Multiphasic Personality Inventory and asks over 400 true or false questions that asks about likes and dislikes and personality traits: I've never told lie, I like to sew, I go to church.... etc, it asks same questions in different ways, figures out if they are an "outstanding citien" if they have a personality disorder, if they are depressed, suicidal, mania levels.... Sometimes used by police officers, psychiatrists.
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People with borderline personality disorder are designated as "borderline" because of the tendency of these clients to fall on the border between _____ and ____. They are often ____ive, ____ive, and always seeem to be in a state of ____. Their ____ is one of extreme intensity. Behavior reflects frequent/infrequent changeability. Self-_____ behaviors are present. People with borderline personality disorder often have ____ disorders. These people are usually girls/boys. They have flat emotions/are very emotional. They are very predictable/unpredictable.
These people are quick to tears, which is often ____ seeking behavior -- crocodile tears- huge tears that just come right out Ask yourself: What's really behing the tears? Are they just trying to elicit a response? Self mutilation in these people or in others is often a cry for help. Bleeding or physical pain can also release their _____ pain. Person who hurts themself in this way, such as cutters, have extreme issues with a_______ and t___. Often, people with borderline were _______ or physically ______. Sometimes cutting is a behavior that is kind of a "copycat" kind of phase for teenagers during their identity crisis. (Yes,Libbie went off on a tangent here, there, everywhere-- NOT ME!!.... so this is just FYI I guess... and that's the explanation for the rest of this mess of a section!!) |
People with borderline personality disorder are designated as "borderline" because of the tendency of these clients to fall on the border between neuroses and psychoses. They are often manipulative, impulsive (which can be a real problem!), and always seem to be in a state of crisis. Their affect is one of extreme intensity. Behavior reflects frequent changeability. Self-destructive behaviors are present. People with borderline personality disorder often have eating disorders. These people are usually girls. They are very emotional. They are very unpredictable.
These people are quick to tears, which is often attention seeking behavior -- crocodile tears- huge tears that just come right out Ask yourself hat's really behing the tears? Are they just trying to elicit a response? Self mutilation in these people or in others is often a cry for help. Bleeding or physical pain can also release their emotional pain. Person who hurts themself in this way, such as cutters, have extreme issues with abandonement and trust. Often, people with borderline were sexually or physically abused. Sometimes cutting is a behavior that is kind of a "copycat" kind of phase for teenagers during their identity crisis. (Yes,Libbie went off on a tangent here, there, everywhere-- NOT ME!!.... so this is just FYI I guess... and that's the explanation for the rest of this mess of a section!!) |
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People with what personality disorder are most strikingly identified by the intensity and instability of their affect and behavior.
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Borderline Personality Disorder
(Everything is a dichotomy- going and back and forth between clinging and distancing etc) |
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Common behaviors are associated with borderline personality disorder include inability to be a_____, ___ing and distancing, splitting, manipulation, and d______. These people often have ______ment issues.
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Common behaviors are associated with borderline personality disorder include inability to be alone, and distancing, splitting, manipulation, and depression. These people often have abandonment issues.
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Some etiological implications include biological influences such as biochemically a _______ defect involving an increase/decrease and there may be a hereditary factor. An MRI may show that there is a discrepancy in size and structure of the ____ ____. This is the area of the brain responsible for...
Depression and s____ are also very common among families of people with borderline personality disorder. |
Some etiological implications include biological influences such as biochemically: a serotonergic defect involving an decrease and there may be a hereditary factor. An MRI may show that there is a discrepancy in size and structure of the ____ ____. This is the area of the brain responsible for...
Depression and s____ are also very common among families of people with borderline personality disorder. |
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Some psychosocial influences of borderline personality disorder include childhood ____ and ____. Children are often fixed in the _______ phase which occurs between ___ and ____ months of age where the awareness of the separateness of the self becomes acute and frightening. Sometimes this happens when the mother is feeling abandoned by the child becoming _________ and may withdrawal her love and affection from the child. This often happens in ___ moms and the child develops a fear of ________. Sometimes the child feels abandoned by the mother, which may be emotionally such as in the context of the mother not doing anything about it or not believing the child who is being abused by her boyfriend, for example. The abandonment could be real or just perceived. In chaotic families, a common occurrence of up to seventy percent of people with borderline report occurrences of ____ation. The abuse could have happened early on and had been repressed, then something triggered the development of the personality disorder. Another developmental factor is when the child can developmentally fail to achieve the task of ______ or independence.
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Some psychosocial influences of borderline personality disorder include childhood abuse and trauma. Children are often fixed in the rapprochement phase which occurs between 16 to 24 months of age where the awareness of the separateness of the self becomes acute and frightening. Sometimes this happens when the mother is feeling abandoned by the child becoming independent and may withdrawal her love and affection from the child. This often happens in teen moms and the child develops a fear of abandonment. Sometimes the child feels abandoned by the mother, which may be emotionally such as in the context of the mother not doing anything about it or not believing the child who is being abused by her boyfriend, for example. The abandonment could be real or just perceived. In chaotic families, a common occurrence of up to seventy percent of people with borderline report occurrences of molestation. The abuse could have happened early on and had been repressed, then something triggered the development of the personality disorder. Another developmental factor is when the child can developmentally fail to achieve the task of autonomy or independence.
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What are some common nursing diagnoses r/t borderline personality disorder and some desirable outcomes of people with this disorder?
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Risk for self-mutilation r/t parental emotional deprivation (unresolved fears of abandonment)
Complicated grieving r/t maternal deprivation during rapprochement phase of development internalized as a loss, with fixation in anger stage of grieving process Anxiety (severe to panic) r/t unconscious conflicts based on fear of abandonment Chronic low self-esteem r/t lack of positive feedback Outcomes- The client: -has not harmed self -seeks out staff when desire for self-mutilation is strong -is able to identify true source of anger -expresses anger appropriately -verbalizes feelings -develops new & improved coping skills -relates to more than one staff member -completes ADL's independently -does not manipulate one staff member against the other to fulfill own desires |
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Nursing care of the patient with borderline personality disorder is aimed at protection of the client from ___-______. The nurse also seeks to assist the client to advance the development of personality by confronting his or her true source of internalized ___. The evaluation involves reassessment conducted to determine whether nursing actions have been successful in achieving objectives of care.
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Nursing care of the patient with borderline personality disorder is aimed at protection of the client from self-mutilation. The nurse also seeks to assist the client to advance the development of personality by confronting his or her true source of internalized anger. The evaluation involves reassessment conducted to determine whether nursing actions have been successful in achieving objectives of care.
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People with antisocial personality disorder are rarely/commonly seen in most clinical settings. What kinds of things would cause a person with this disorder to be admitted?
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rarely seen in most clinical settings
-Usually it is a way for the client to avoid legal consequences for his or her behavior -Sometimes these people are admitted by court order for psychological evaluation |
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Some common behaviors associated with antisocial personality disorder include:
-socially _________ -ex_______ -guilt___ -dis__ for the ___ of others -general dis___ for the __ -cold, callous, intimidating -inconsistent ____ or _____ performance -failure to ____ to societal ____ -cr___ and mal____ -unable to form satisfying ______ _______s |
Some common behaviors associated with antisocial personality disorder include:
-socially irresponsible -exploitative -guiltless -disregard for the rights of others -general disregard for the law -cold, callous, intimidating -inconsistent ____ or _____ performance -failure to conform to societal norms -cruel and malicious -unable to form satisfying interpersonal relationships |
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Some etiological implications for antisocial personality disorder include a ____ or _____ father, ______ deprivation, _____ temperament as a child, parental _____ during the first __ years of life, and being "_____" each time in trouble (never having to suffer the _____ of own behavior).
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Some etiological implications for antisocial personality disorder include a sociopathic or alcoholic father, maternal deprivation, aggressive temperament as a child, parental deprivation during the first 5 years of life, and being "rescued" each time in trouble (never having to suffer the consequences of own behavior).
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Antisocial personality disorder is more common in first degree biologic relatives and there are higher numbers of this disorder in children from c____ families, families involved in ___, and from parents who are n_____. Usually there is some sort of parental deprivation. People who develop this disorder have a very low tolerance for adversity and extremely high frustration in their lives. They often did things as children such as _____ and hurting ___.
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Antisocial personality disorder is more common in first degree biologic relatives and there are higher numbers of this disorder in children from chaotic families, families involved in gangs, and from parents who are narcissists. Usually there is some sort of parental deprivation. People who develop this disorder have a very low tolerance for adversity and extremely high frustration in their lives. They often did things as children such as bullying and hurting pets.
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What are some nursing diagnose related to antisocial personality disorder?
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Risk for other-directed violence r/t to rage reactions, negative role-modeling, inability to tolerate frustration
Defensive coping r/t dysfunctional family system Chronic low self-esteem r/t repeated negative feedback resulting in diminished self-worth Impaired social interaction r/t negative role modeling and low self-esteem Deficient Knowledge regarding self- care activities to achieve and maintain optimal wellness r/t lack of interest in learning and denial of need for information |
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Some desirable or anticipated outcomes in treating a person with antisocial personality disorder include:
discussing angry feelings with staff and in group session, patient has not harmed ___ or ____, can rechannel hostility into socially ______ behaviors, follows ___ and regulations of the therapy environment, can _____ which of his or her behaviors are not acceptable, and shows ____ for the rights of others by ___ing g______ of own desires when appropriate, the client does not _______ others in an attempt to increase feelings of self worth, verbalizes understanding of knowledge required to maintain basic health needs. |
Some desirable or anticipated outcomes in treating a person with antisocial personality disorder include: discussing angry feelings with staff and in group session, patient has not harmed self or others, can rechannel hostility into socially acceptable behaviors, follows rules and regulations of the therapy environment, can verbalize which of his or her behaviors are not acceptable, and shows regard for the rights of others by delaying gratification of own desires when appropriate, the client does not manipulate others in an attempt to increase feelings of self worth, verbalizes understanding of knowledge required to maintain basic health needs.
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Nursing interventions for the client with antisocial personality disorder are aimed at ensuring ___ of client and others, helping client _____ and decrease unacceptable behaviors, assist client in gaining _____ into own behavior, and helping client to learn to ___ gratification.
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Nursing interventions for the client with antisocial personality disorder are aimed at ensuring safety of client and others, helping client recognize and decrease unacceptable behaviors, assist client in gaining insight into own behavior, and helping client to learn to delay gratification.
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Review the various Treatment Modalities for Personality Disorders which include:
Interpersonal psychotherapy Psychoanalytical psychotherapy Milieu or group therapy Cognitive/behavioral therapy Dialectical behavior therapy Psychopharmacology |
Review these therapies in textbook
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_______ personality disorder has also been called ambulatory schizophrenia, pseudoneurotic schizophrenia, and emotionally unstable personality.
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Borderline
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People with borderline personality disorder often exhibit a single, dominant affective tone, such as depression, which may give way periodically to anxious agitation or inappropriate outbursts of anger. Because ______ is so common in these clients, many of them were originally diagnosed with this. It occurs in response to feelings of ____ by the mother in early childhood. Underlying the _____ is a sense of rage that is sporadically turned inward on the ___ and externally on the _____. Seldom is the individual aware of the true source of these feeling until well into long-term ____. Because of this chronic fear of ____, clients with borderline have little tolerance for being ___. They prefer a frantic search for companionship, no matter how unsatisfactory, to sitting with feelings of loneliness, emptiness, and boredom.
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People with borderline personality disorder often exhibit a single, dominant affective tone, such as depression, which may give way periodically to anxious agitation or inappropriate outbursts of anger. Because depression is so common in these clients, many of them were originally diagnosed with this. It occurs in response to feelings of abandonment by the mother in early childhood. Underlying the depression is a sense of rage that is sporadically turned inward on the self and externally on the environment. Seldom is the individual aware of the true source of these feeling until well into long-term therapy. Because of this chronic fear of abandonment, clients with borderline have little tolerance for being alone. They prefer a frantic search for companionship, no matter how unsatisfactory, to sitting with feelings of loneliness, emptiness, and boredom.
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The client with borderline commonly exhibits a pattern of interaction with others that is characterized by clinging and distancing behaviors. When clients are clinging to another individual, they may exhibit help__, dependent or even __like behaviors. They over____ a single individual with whom they want to spend all their time, with whom they express a frequent need to talk, or whom they seek constant reassurance. Acting out behaviors, even self-_____, may result when they cannot be with this chosen individual. Distancing behaviors also occur in response to separations, confrontations, or attempt to limit certain behaviors. Devaluation of others is manifested by dis____ or under___ their strengths and personal significance.
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The client with borderline commonly exhibits a pattern of interaction with others that is characterized by clinging and distancing behaviors. When clients are clinging to another individual, they may exhibit helpless, dependent or even childlike behaviors. They overidealize a single individual with whom they want to spend all their time, with whom they express a frequent need to talk, or whom they seek constant reassurance. Acting out behaviors, even self-mutilation, may result when they cannot be with this chosen individual. Distancing behaviors also occur in response to separations, confrontations, or attempt to limit certain behaviors. Devaluation of others is manifested by discrediting or undermining their strengths and personal significance.
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Borderline personality disorder involves a pervasive pattern of instability of interpersonal relationships, self-image, and affects and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by ____ or more of the following diagnostic criteria (DSM-IV-TR)
1. Frantic efforts to avoid ___ or ______ abandonment. 2. A pattern of ____ and ____ interpersonal ______ characterized by alternating between extremes of ____ and _____ 3. _____ disturbance: markedly and persistently unstable self-image or sense of ___ 4. ______ in at least __ areas that are potentially damaging (e.g.) spending, sex, substance abuse, reckless driving, binge eating) 5. Recurrent ____ behavior, gestures, threats, or self-_____ behavior. 6. _____ instability due to marked reactivity of ___ (e.g. intense episodic dysphoria, irritability, or anxiety usually lasting a few ___ and only rarely more than a few ___.) 7. acute/chronic feelings of ___ness 8. Inappropriate, intense ____ or difficulty controlling ___ (e.g. frequent displays of temper, constant anger, recurrent physical fights) 9. Trans___, ___-elated ____ ideation or severe dis____ symptoms |
Borderline personality disorder involves a pervasive pattern of instability of interpersonal relationships, self-image, and affects and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five or more of the following diagnostic criteria (DSM-IV-TR)
1. Frantic efforts to avoid real or imagined abandonment. 2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation 3. Identiy disturbance: markedly and persistently unstable self-image or sense of self 4. Impulsivity in at least 2 areas that are potentially damaging (e.g.) spending, sex, substance abuse, reckless driving, binge eating) 5. Recurrent suicidal behavior, gestures, threats, or self-mutilation behavior. 6. Affective instability due to marked reactivity of mood (e.g. intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days.) 7. chronic feelings of emptiness 8. Inappropriate, intense anger or difficulty controlling anger (e.g. frequent displays of temper, constant anger, recurrent physical fights) 9. Transient stress-related paranoid ideation or severe dissociative symptoms |
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Splitting is a _____ ego ___ mechanism that is common in borderline. It arises from their lack of achievement of ____ _____ and is manifested by an inability to integrate and accept both ____ and ____ feelings. In their view- things, people, or life situations are either all good or all bad.
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Splitting is a primitive ego defense mechanism that is common in borderline. It arises from their lack of achievement of object constancy and is manifested by an inability to integrate and accept both positive and negative feelings. In their view- things, people, or life situations are either all good or all bad.
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In their efforts to prevent separation they so desperately fear, people with borderline become masters of _____. Playing one individual against another is a common ploy to allay these fears of abandonment.
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manipulation
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Various theories describe why individuals perform self-mutilating behaviors. One suggests they may have higher levels of ____ in their bodies which increases their pain threshold. Another relates to the individual's personal identity disturbance, proposing that the behaviors take place when the individual is in a state of depersonalization and derealization, he or she does not initially feel the pain. The mutilation continues until pain is felt in an attempt to counteract feelings of unreality. Some clients with borderline have reported that "to feel pain is better than to feel nothing." The pain validates their existence.
Suicide attempts are common in people with borderline and again result from feelings of abandonment. Self-mutilation and suicide are seen as manipulative gestures designed to elicit a ___ response from significant others. Usually a person with borderline that commits suicide does so in such a way that they will be saved, like swallowing pills when they know they will be found quickly or calling someone right after cutting themself. There is usually a "___" measure in the plan. |
Various theories describe why individuals perform self-mutilating behaviors. One suggests they may have higher levels of endorphins in their bodies which increases their pain threshold. Another relates to the individual's personal identity disturbance, proposing that the behaviors take place when the individual is in a state of depersonalization and derealization, he or she does not initially feel the pain. The mutilation continues until pain is felt in an attempt to counteract feelings of unreality. Some clients with borderline have reported that "to feel pain is better than to feel nothing." The pain validates their existence.
Suicide attempts are common in people with borderline and again result from feelings of abandonment. Self-mutilation and suicide are seen as manipulative gestures designed to elicit a rescue response from significant others. Usually a person with borderline that commits suicide does so in such a way that they will be saved, like swallowing pills when they know they will be found quickly or calling someone right after cutting themself. There is usually a "safety" measure in the plan. |
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True or False" Patients with borderline have more relatives with mood disorders than do control groups, and persons with borderline often have mood disorders as well.
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true
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What are some risk factors for the development of borderline personality disorder?
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family environment characterized by trauma, neglect, or separation
exposure to sexual and physical abuse serious parental psychopathology such as substance abuse and antisocial personality disorder In some instances, this disorder has been linked to PTSD in response to childhood trauma and abuse. |
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Review page 576 developmental factors esp. rapprochement phase
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Review care plans ch 21 and treatment modalities page 590-91
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