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41 Cards in this Set
- Front
- Back
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Personality Def
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complex patterns of characteristics largely outside of the person
-perceiving, thinking, feeling, coping, behaving about others, self and environment -emerge from biopsychosocial framework |
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Personality D/O
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pattern of deviant inner experience and behavior
-pervasive, inflexible, stable -leads to distress or impairment -permeates entire beings -stable in dysfunction -onset at early adulthood |
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Cluster A Personality D/O
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odd-eccentric
-paranoid -schizoid -schizotypal |
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Cluster B Personaltiy D/O
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dramatic and emotional (impulsive)
-antisocial -borderline -histrionic -narcissistic |
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Cluster C Personality D/O
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anxious-fearful
-avoidant -dependent -obsessive-complusive |
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Personality D/O diagnostic criteria
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-abnormal, inflexible, long duration, traced back to adolescence/adulthood
-broad range of personal and social situations -deviate markely from cultural norm (maladaptive, instability, impaired self identity, impulsivity and destructive) -usually diagnosed in clinical settings -maladaptive cognitive schema (how they interprete events) |
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Paranoid Personality D/O
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Cluster A
-mistrustful, avoid relationships, arrogent -more common in men -etiology unknown, maybe genetic |
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Paranoid Personality D/O nursing diagnosis
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disturbed thought process
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Paranoid Personality D/O nursing intervention
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-dev nurse-patient relationship
-help id problem areas -changing thought patterns takes time -realistic thinking -world is safe |
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Schizoid Personality D/O
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Cluster A
-impassive, unengaged (emotionally detacted) -introvert, reclusive, solitary -confused communication -no social relationships -limited introspection, self-awareness, interpersonal experiences |
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Schizoid personality d/o nursing diagnosis
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impaired social interactions and chronic low self-esteem
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schizoid personality d/o goal
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to enhance experience of pleasure, prevent social isolation, increase emotional responsiveness
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schizoid personality d/o intervnetion
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-provide social skill training
-encourage social interaction -long term therapy |
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schizotypical personality d/o
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cluster A
-eccentric -social and interpersonal deficits -void of close friends -odd beliefs -ideas of reference (things are about them) -unrealistic thinking -when psychotic, symptoms mimc schizoprenia |
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schizotypical personality d/o nursing diagnosis
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social isolation, ineffective coping, low self-esteem, impaired social interactions
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schizotypical personality d/o nursing managment
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-same as schizoprenia
-increase self-worth -provide social skills training -reinforce socially appropriate dress and behavior -focus on enhancing cognitive skills |
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Borderline Personality D/O
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Cluster B
-pervasive pattern of instability of interpersonal relationships, self image, affect, impulsivity -plus 5 of the following: --frantic efforts to avoid real or imagined abandonment--unstable relationships of idealization and devaluation--identity disturbance--impulsivity that are self damaging (many have eating d/o)--suicidal behavior/self mutilating--chronic feelings of emptiness--inappropriate anger--transcient stress related paranoid ideations and severe dissociative symptoms (push back feelings so they don't feel abandoned) (fun, smart, engaging people, use others as objects to get needs met) |
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Borderline Personality D/O interventions
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-crisis intervention
-remove dangerous items -check for pill hoarding -no harm contract -provide with transitional object to ensure coming back -ensure relationships with more then one staff memeber (may idealize) (try to avoid abandonment with suicide) -avoid them from splitting the unit (give them one person to go to) -behavioral contract -confront breaking of contract, manipulation, self sabotage and splitting -unconditional positive regard -maintain boundaries -encourage verbalization of feelings -support independence -assist patient in ID/validate their separateness |
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Borderline Personality D/O epidemiology
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-most diagnosed
-mostly women -mid 20's -coexist with Axis I diagnosis |
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Borderline Personality D/O etiology
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-instability, transcient psychotic episodes, impulsive, aggressive, suicidal
-maladaptive cognitive processes (neg view about world and self, future- everything is about rejection or abandonment) -biosocial- emotional dysregulation, vulnerabiltiy, invalidating environment |
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borderline personality d/o Mahler's theory
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-Theory of object relations, seperation from mother
1. autistic phase (0-1 month), child sleeps 2. symbiotic phase (1-5 months), psychi fusion, child views self as extension of self 3. differentiation phase (5-10 months), child becomes aware of seperateness from mother 4. Practicing phase (10-16 months), increased independence 5. Rapproachement Phase (16-24 months), mother realizes separateness, child wants to regain closeness but not symbiosis only for "emotional refueling" ***where BPD blooms, mother feels rejected so is negative towards child 6. On the way to object constancy phase (24-36 months), child goes thru individualization process and learns to relate to objects in constant manner |
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What stage of Mahler's theory does BPD happen and why?
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rapprochment phase, mother begins to feel threatened by increasing autonomy of her child and withdrawals her emotional clinging, dependent behaviors
-a "good child" stays immature and dependent -a "bad child" grows independent so mom withholds nurturing from child which results in deep fear of abandonment that persists into adulthood -object consistency never is achieved so people are thought as good or bad, (parts) |
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What is splitting?
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BPD, defense mechanism, objects are either good or bad.
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What meds are given for BPD?
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-antidepressants- controlling emotional dysregulation
-anticonvulsants- reduce impulsivity -antipsychotics- transcient psychotic episodes -buspirone- anxiety |
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Borderline personality d/o nursing diagnosis
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-high risk for self mutilation
-high risk for violence to self or others -anxiety -impaired social interaction -personal identity disturbance -self esteem disturbance -ineffective individual coping |
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Borderline personality
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-affective instability, extreme mood shifts, fail to recognize varied responses
-identity diffusion -unstable interpersonal relationships (no boundaries, extreme fear of abandonment, seek reassurance, dissappointed in relationships, like to feel in control) -cognitive dysfunctions (dissociation, black and white thinking, bizarre behavior, del/hall) -dysfunction behaviors (impaired problem solving, impulsivity, self-injurious behaviors -mostly young women -risk factor is sexual and physical abuse |
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BPD etiology
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-small amygdala, limbic system and frontal lobe dysfunction, decrease serotinin
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BPD psychoanalystic theory
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seperation individualization abnormality from inconsistant caregiver, intense fear and distrust, not boundaries, projective indentification-blame others for inadequate feelings
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BPD maladaptive cognitive processes
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misinterpret environmental stimul, are inflexible in response to new situations, entrenche in pattern of fear and anxiety of new people or situations
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BPD biosocial theory
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-emotional vulnerability
-self-invalidation -unrelenting crisis -inhibited grieving -active passivity -apparent competence |
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Antisocial personality d/o
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cluster b
-pattern of disregard for, violations of the rights of others and begins in childhood and continues into adulthodd -impulsive -irresponsible -failure to conform to social standards -lack empathy, but engaging and charismatic -easily irritated, often aggresive -take advantage of people, scam artists, often criminals |
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Antisocial personality d/o epidemiology
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-more men
-creater in Native Americnas less in asian Americans -co-morbid with mood, anxiety, alcohol/drug abuse, other personality d/o |
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Antisocial personality d/o etiology
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-chromosomal abnormality
-serotonin deficit -dysreg catecholamines -insecure attachments -extreme temperment -chaotic family -abuse or neglect |
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Histrionic personality d/o
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cluster B
-attention seeking, like of the party -insatiable need for attention and approval -moody and sense of helplessness when others are disinterested -sexually seductive to gain attention, uncomf in single relationships -appearance is provocative and speech dramatic -no loyalty or fidelity |
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Histrionic personality d/o epidemiology
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-no gender difference
-african americans, low income and less educated at greater risk -comorbid with borderline, dependednt, antisocial personality d/o, anxiety, sustance abuse and mood d/o |
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narcissistic personality d/o
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cluster B
-grandiose -inexhaustible need for attention -entitlement -lack empathy -fantasize about looks, success -interpersonally exploitative -envious of others, arrogent -more often in men -occurs often in childhodd -comorbid with antisocial, histrionic, paranoid personality d/o, mood, anxiety, substance abuse -really just fearful, have sense of worthlessness, highly sensitive |
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avoidant personality d/o
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cluster c
-avoid social situations -fearful of criticism, feelings of inadequacy -extremely sensitive to negative commends and disapproval -engage in unconditional relationships if only unconditional -appear timid, shy and hestitant |
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dependent personality d/o
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cluster c
-cling to others to keep them close -total submission and disregard for self -difficulty making decisions -withdraw from adult responsibilities -need excessive advice and reassurance |
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obsessive compulsive personality d/o
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cluster c
-rigidity, perfectionism, control -devoted to work -uncomfortable with unstructured/leisure time -hobbies are taken serious (not for fun) -need to control others -difficulty completing tasks and making decisions, too involved in details -mood is tense and joyless -can't think outside of the box |
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def impulse control d/o
-intermittent explosive d/o -kleptomania -pyromania -pathologic gambling -trichotillomania |
irresistible impulsivity
-intermittent explosive d/o-never know when they will go off -kleptomania- steal -pyromania-fire -pathologic gambling -trichotillomania-pulling hair out |
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what is the treatment for impulse control d/o?
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psychopharmacologic agents, psychotherapy, behavioral, social interventions
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