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52 Cards in this Set
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Personality |
The totality of emotional and behavioral characteristics that are particular to a specific person and that remains somewhat stable and predictable over time personality traits may be defined as characteristics with which an individual is born or develops early in life. they influence the way they perceive and relate to the environment and remain stable over time. personality disorders occur when these traits deviate markedly from the expectations of the individuals culture, become rigid and inflexible, contribute to maladaptive patterns of behavior or impairment in functioning and lead to distress. The most common symptoms occurring and personality disorders are impairment in interpersonal relationship functions dysfunctions in cognition, affect, an impulse control. is only one significant functional impairment occurs in response to these personality characteristics that the individual is thought to have a personality disorder. |
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Personality development is influenced by biological and psychological influences hereditary, temperament, experiential learning, and social interaction. |
nurses working in psychiatric settings are likely to encounter clients with borderline and antisocial personality characteristics. borderline personality disorder is very unstable and hospitalization is operate wired as a result of attempts at self injury. The client with antisocial personality disorder it may enter the psychiatric arena as a result of judicial Ali ordered evaluation. |
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the current diagnostic system classifies the personality disorders into three clusters according to the description of personality traits |
Cluster a... Behaviors described as odd or eccentric Paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder Cluster B... Behaviors described as dramatic, emotional, or erratic antisocial personality disorder, borderline personality disorder, histrionic personality disorder, narcissistic personality disorder Cluster c... Behaviors described as anxious or fearful avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder |
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Paranoid personality disorder |
Defined as a pattern of pervasive mistrust and suspiciousness of others and misinterpretation of others motives. This pattern begins by early adulthood and remains present in a variety of contexts. they're constantly on guard, hyper-vigilant, and ready for any real or imagined threat. They appear tense and irritable. they develop a hard exterior and become immune or insensitive to the feelings of others. They have weight interactions with other people they always feel the others plan to take advantage of them. They distort thoughts and to trickery and deception. Because they trust no one they are constantly testing the honesty of others. They cause anger in others due to their intimidating behaviors. they're envious and hostile towards those who are highly successful and believe the only reason they are not a successful is because they have been treated unfairly. People who are paranoid are extremely vulnerable and constantly on the defense. any real or imagined threat can release hostility and anger fueled by things from the past. |
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Predisposing factors paranoid personality |
Hereditary link especially relatives with schizophrenia. Childhood trauma including the left. Parental antagonism and harassment. They learn to perceive the world as harsh and unkind causing mistrust. anticipating humiliation of betrayal by others they learn to defend themselves by attacking first |
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Schizoid personality disorder |
is characterized primarily by a profound defect in ability to form personal relationships. People with this condition are often seen by others as eccentric, isolated, or lonely. Lifelong pattern of social withdrawal and they're just come forth human reaction is apparent. This is often under-diagnosed unless he can help for other issues. people with this disorder appear cold, aloof, and indifferent to others. they typically have a long-standing history of engaging and primarily solitary activities are engaging more with animals than people. They prefer to work in isolation indoor unsociable with little need or desire for emotional ties. In the presence of Father's day if you're shy, anxious, or uneasy. they're inappropriately serious about everything and have difficulty acting in a light-hearted manner. Their affect is commonly bland and are unable to experience pleasure. |
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Predisposing factors |
Introversion appears to be a highly inheritable characteristic. Early interactional patterns that the person found cold and unsatisfying the childhoods of these individuals have often been characterized as blink, cold, and lacking empathy and nurturing. A child brought up with this type of parenting May develop schizophrenia personality traits of the child possesses a temperament disposition that is shy anxious and introverted. |
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Schizotypal personality disorder |
We're once described as latent skitzofrenix. Behavior is odd and eccentric but does not compensate to the level of schizophrenia. This disorder is Mark's by symptoms that are closer to those of schizophrenia than those and schizoid personality. It is not as extreme as schizophrenia for example they are able to think, behave appropriately, and have appropriate appearance but it is more extreme than schizoid. There are aloof and isolated and have a bland and a pathetic manner. And magical thinking, ideas of reference, illusions, and depersonalization which is a part of their everyday world. Examples include superstitious such as belief in clairvoyance, telepathy, or sixth sense as well as beliefs that others can feel my feelings. The speech pattern and sometimes bizarre sometimes they are not able to orient their thoughts logically and become lost in personal irrelevancies and seem vague and digress from the topic at hand. under stress these individuals may deteriorate and demonstrate psychotic symptoms such as delusional thoughts, who is Nations, or bizarre behaviors, but these are usually brief in duration. they often talk or gesture to themselves as if living in their own world. their affect is bland or inappropriate such as laughing at their own problems or at a situation that most people would consider sad. |
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Continued |
Both schizophrenia and schizotypal disorder have symptoms of psychosis but the difference is the psychosis is not as extreme or as frequent or as long a schizophrenia, and they're able to be talked out of their hallucinations or delusions and are more aware that their reality is not real |
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Predisposing factors |
First-degree biological relatives of people with schizophrenia. effective blandness, peculiar behaviors, and discomfort with interpersonal relationships May provoke other children to avoid relationships with them, or worse, engage in bullying, which reinforces their withdraw from others. their new inner worlds provides them with a more significant and potentially rewarding existence than the one experienced in reality. |
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Antisocial personality disorder |
is a pattern of socially irresponsible, exploitive, and guiltless behavior that reflects a general disregard for rights of others. These individuals exploit and manipulate others for personal gain and are unconcerned with obeying the laws. They have difficulty sustaining consistent employment and developing stable relationships. This is one of the oldest and best research personality disorders. is more common in men among the lower socioeconomic classes antisocial personality and psychopathy as synonymous terms. Substance use disorder is commonly identified as a comorbid disorder. |
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Borderline personality disorder |
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-destructed, and like a clear sense of identity. More common in women. |
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Histrionic personality disorder |
Characterized by colorful, dramatic, and extroverted behavior and excitable, emotional people.. they have difficulty maintaining long-lasting relationship although they require constant affirmation of approval and acceptance from others. cuz often gives rise to seductive, flirtatious behavior and efforts to reassure themselves of their attractiveness and gain approval. people with this disorder tend to be self dramatizing, attention-seeking, overly gracious, and seductive. They use manipulative and they demand to be the center of attention. They tend to be extreme with what our society members look at in order to be a popular, successful, well-liked, extroverted, attractive, and sociable. However beneath the surface characteristics is driven quality an all-consuming need for approval in a desperate striving to be conspicuous and evoke affection or attract attention at all cost. Failure to revoke the attention and approval they seek often results in feelings of dejection and anxiety. They're highly distractible and flighty by nature. I have difficulty paying attention to detail. They paint themselves to be carefree and sophisticated on one hand and as inhibited and naive on the other. Interpersonal relationships are fleeting and superficial. somatic complaints are not uncommon in these individuals and pleading episodes of psychosis may occur during periods of extreme stress. They have speech that is excessively impressionistic and lacking detail. they consider relationships to be more intimate than they actually are. |
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Predisposing factors |
Hereditary maybe a factor some kids may be inherited whereas others are related to a combination of genetic predisposition and childhood experiences. Learning experiences may also contribute to the development of this disorder the chime I have learned that positive reinforcement was contingent on the ability to perform parentally approved and admired behaviors. It is likely that the child really received either positive or negative feedback. parental acceptance and approval came and consistently and only when the behaviors met parental expectations |
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bpd |
Borderline personality disorder is a mental health disorder that impacts the way you think and feel about yourself and others, causing problems functioning in everyday life. It includes self-image issues, difficulty managing emotions and behavior, and a pattern of unstable relationships Inappropriate or extreme emotional reactionsHighly impulsive behaviorsA history of unstable relationships |
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Narcissistic personality disorder |
Have an exaggerated sense of self-worth they lack empathy and are hypersensitive the valuation of others. they believe that they have the inalienable right to receive special consideration and that their desire is sufficient justification for possessing whatever they seek. people with this personality disorder appear to lack humility, be overly self-centered, and exploit others to fulfill their own desires. Dolphin do not see that their behavior is inappropriate. because they view themselves as Superior beings they believe they're entitled to special rights and privileges. Although often having grandiose distortions of reality, their moods are usually optimistic, relax, cheerful, and carefree. This can easily change however because of fragile self-esteem. if they do not meet self expectations, do not receive the positive feedback they expect your mother's, or draw criticism from others, they may respond with rage, shame, humiliation, or dejection. they may turn inward and fantasize rationalizations that convince them that they are perfection. The exploitation of others for self-gratification results in impaired interpersonal relationships. In selecting a mate narcissistic individual is frequently choose a person who provide them with the praise and positive feedback that they require and he will not ask much of from their partner in return. |
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Predisposing factors |
Evolves from a parent-child dynamic I'll be there excessive pampering or excessive criticism. children may then grow to project an image of invulnerability and self-sufficiency that conceals their true sense of emptiness and contributes to their inability to feel deep emotion. There's an increased risk for children of narcissistic parents. narcissism may also develop from an environment in which parents attempt to live their lives vicariously through their child. they expect the child to achieve the things they did not achieve, possess that which they did not possess, and have life better and easier than they did. The child is not subjected to the requirements and restrictions that may have dominated the parents lies and thereby grows up believing he or she is above that which is required for everyone else. |
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Avoidant personality disorder |
Is extremely sensitive to rejection and fuss man lead a very socially withdrawn life. It is not that he or she is asocial in fact there may be a strong desire for companionship. extreme shyness and fear of rejection however create the need for unusually strong assurances of unconditional acceptance. individuals with this disorder or awkward and uncomfortable in social situations. From a distance others May perceive them as timid, withdrawn, or perhaps cold and strange. those who have closer relationship with them however soon learn their sensitivities, touching his, evasiveness, and mistrustful qualities. Their speech is usually slow and constrained with frequent hesitations, fragmented thought processes, and occasional confused and irrelevant. They're often Lane express feelings of being unwanted. A few others as critical, betraying, and humiliating. they desire to have close relationships but avoid connecting with others because of their fear of being rejected. Depression, anxiety, and anger at oneself for failing to develop social relations are commonly experienced. they avoid occupational activities that involve significant interpersonal contact because of fears of criticism disapproval or rejection. Is unwilling to get involved with people unless certain of being liked. shows restraint within intimate relationships because of fear of being shamed or ridiculed. Is preoccupied with being criticized or rejected in social situations. See yourself as socially inept, personally unappealing, or inferior to others. |
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Dependent personality disorder |
is characterized by lack of self-confidence and extreme reliance on others to take responsibility for them sometimes to the point of intense discomfort with being alone for even a brief period. This mode of behavior is evidence and the tendency is to allow others to make decisions, feel helpless when alone, AXA miserably, tolerate mistreatment by others, demean oneself to gain acceptance, and fail to function adequately and situations that require assertive or dominant behavior. they have a notable lack of self-confidence that is often a parent in their posture, voice, and mannerisms. They're typically passive to the desires of others. They are overly generous and thoughtful and under play their own attractiveness and achievements. they may appear to others to see the world through rose-colored glasses but when alone they may feel pessimistic, discouraged, and dejected. others are not made aware of these feelings they're suffering is done in silence. they assumed the passive and submissive role in relationships. They're willing to let others make their important decisions. should a dependent relationship end,they feel fearful and vulnerable because they lack confidence in their ability to care for themselves. they may quickly attempt to establish another relationship with someone they believe can provide them with the nurturance and guidance they need. 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 anything to gain acceptance of others |
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Predisposing factors |
the infant becomes attached to one source to the exclusion of others if it's exclusive attachment continues as child grows the dependency is nurtured. The problem may arise and Prince become overprotective and discouraged independent behaviors I'm proud of the child. Parents who make new experiences unnecessarily easy for the child and refused to allow them to learn by experience encourage their child to give up efforts at achieving autonomy. dependent behaviors may be rewarded in this environment and the child may come to fear a loss of Love or attachment from the parental figure independent behaviors are attempted. |
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Obsessive-compulsive personality disorder |
are very serious and formal and have difficulty expressing emotions. They are overly disciplined, perfectionistic, and 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 making mistakes leads to difficulty with decision-making. The disorder is relatively common and occurs more often in men than women. Is most common in the oldest children. recurrent obsessions and compulsions are absent in this personality disorder, if the patient presents with such symptoms are diagnosed with obsessive-compulsive disorder rather than obsessive-compulsive personality disorder. People with this disorder are inflexible and lack of spontaneity. They are meticulous and work diligently and patiently at tasks that require accuracy and discipline. They're especially concerned with matters of organization and efficiency intend to be rigid and unbending about rules and procedures. Social behavior tends to be polite and formal. They're very rank conscious the characteristic that is reflected in their contrasting behaviors with superiors. The compulsive person can become quite autocratic and condemn people who are under them making them appear pompous and self-righteous. They have the bureaucratic personality the so-called company man. they see themselves as conscientious, loyal, dependable, and responsible. Emotional behavior is considered immature and irresponsible. Although on the surface these individuals appear to be calm and controlled underneath there is a great feeling of conflict and hostility. |
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OC personality disorder |
Is preoccupied with details rules list order organization or schedules trust perfectionism that interferes with task completion is excessively to go to work and productivity is over conscientious and inflexible about matters of morality ethics or values isn't able to discard worn out or worthless objects even when they have no sentimental value is reluctant to delegate tasks or to work with others unless they submit to exactly to their way of thinking and doing things is stubborn |
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Predisposing factors |
People with a sister order came from an overly control environment. These parents expect their children to live up to impose standards of conduct and condemn them if they do not. praise for positive behaviors is bestowed on the child and much less frequency than punishment for undesirable behaviors. In this environment individuals become experts and learning what they must not do to avoid punishment and condemnation rather than what they can do to achieve attention and praise. They learn to heed rigid restrictions and rules. positive treatments are expected to take it for granted and only occasionally knowledge by their parents whose comments and judgments are limited to pointing out transgressions and infractions |
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Berlin personality disorder application of the nursing process |
Individuals with borderline personality disorder always seem to be in a state of crisis and have frequent mood swings their affect is one of extreme intensity and their behavior reflects frequent change ability within days hours or even minutes. there's sometimes described as thriving on chaos since they frequently generate chaos particularly in interpersonal relationships. albanese individuals exhibit a single dominant effective tone such as depression which may give way periodically too anxious agitation or inappropriate outbursts of anger.
depression..... is so common in clients with this disorder that before they're diagnosed with this clients are diagnosed with depressive disorder.
Inability to be alone....because of this chronic fear of abandonment clients with BPD have little tolerance for being alone. They prefer a frantic search for companionship no matter how unsatisfactory.
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BPD |
changing and distancing... The client with BPD, exhibits a pattern of interaction with others characterized by clinging and distancing behaviors. When clients are clinging to another individual that makes a bit helpless, dependent, or even tried like behaviors. They want to spend all their time with this person and express a frequent need to talk with and often seek constant reassurance from them. Impulsive behaviors even self-mutilation may result when they cannot be with this chosen individual. distancing behaviors are characterized by hostility, anger, and evaluation of others arising from a feeling of discomfort with closeness. distancing behaviors also occur in response to separations, confrontations, or attempts to limit certain behaviors. devaluation of others is manifested by discrediting or undermining their strengths and personal significance. |
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BPD continue |
Splitting... Is a primitive ego defense mechanism common in people with BPD. It arises from their lack I'm a treatment of object constancy It is manifested by an inability to integrate and accept both positive and negative feelings. in their view, people including themselves and life situations are either all good or all bad. For example, a nurse-patient relationship may be perceived as very intense and overvalued... no one else in the world can help me the way you do... Until that individual with BPD feels threatened in any way the cause of which could be as simple as a perception that the nurse looked at them with a different expression or was not immediately available to spend time with individual. Because it's individual also struggles with emotional regulation, suddenly the nurse is devalued, valuing a shifted to another nurse, and their image of the former nurse changes from positive caregiver to hateful and cruel persecutor. The shifting allegiances and valuing / devaluing responses can generate conflict, anger, and frustration and staff members unless this dynamic is clearly understood and managed appropriately |
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Manipulation BPD |
In their efforts to prevent the separation they so desperately fear clients with this disorder become masters of manipulation. Any behavior to help separation anxiety is considered acceptable by this person. Play one individual against another is a common ploy to prevent these fears of abandonment |
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Self-destructive behaviors BPD |
75% of individuals with this have at least one deliberate act of self-harm. although these acts can be fatal most commonly there manipulative gestures designed to elicit a rescue response from significant others. suicide attempts are quite common and result from feelings of abandonment following separation from a significant other. The endeavor is often attempted however with a measure of safety such as swallowing pills in an area where the person will surely be discovered by others or swallowing pills and making a phone call to report the deed to someone. Other types of destructive behaviors include cutting scratching and burning. One hypothesis why these individuals can endure increased pain is that they have a higher level of endorphins than most people another theory is that self-mutilating behavior take place when the individual is in a state of depersonalization and derealization so they do not initially feel the pain. mutilation continues until penis felt an attempt to counteract the feelings of unreality. People with BPD report to feel pain is better than to feel nothing at all pain validates their existence |
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Impulsivity BPD |
they have poor impulse control based on primary process functioning. Impulsive behaviors with BPD include substance abuse, gambling, promiscuity, reckless driving, and binging and purging. Many times these behaviors occur in response to real or perceived feelings of abandonment. |
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Predisposing factors to borderline personality disorder |
His caused with environmental factors, brain anatomy and function, genetics, clients with BPD have a high incidence of major depressive episodes and antidepressants have demonstrated benefits in some cases. signs of BPD or five times more likely to have a first degree relative with BPD and some have shown personality traits such as impulsivity, affect liability, to be heritible . Psychosocial childhood trauma has been linked to PTSD and response childhood trauma and abuse. In fact BPD has been considered a controversial diagnosis because of many a parent overlaps with PTSD. There has become a difference between the two since BPD symptoms persistent after remission of PTSD symptoms. |
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Diagnosis and outcome BPD |
Have not harm self, seeks out staff when desire for self-mutilation is strong,is able to identify true source of anger, expresses anger appropriately, relates to more then one staff member, complete activities of daily living independently, does not manipulate one staff member against the other in order to fulfill own desires. |
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Planning and implementation |
Risk for self mutilation this is when the intent of causing non-fatal injury to attain relief of tension. Risk for self-directed or other directed violence which is defined as vulnerable behaviors in which an individual demonstrates that they can be physically, emotionally, and her sexually harmful to self or others. The client goals for these two diagnosis is that the client will seek out a staff member if feelings of harming self or others emerge, the client will not harm self or others, |
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Interventions for risk for self-mutilation or risk for self-directed or other directed violence |
observe the client's behavior frequently do this the routine activities and our actions avoid appearing watchful and suspicious.... encourage the client to seek out a staff member when the urge of for self-mutilation is experience. This can help provide some relief to the client. if self-mutilation occurs care for the clients spoons and a matter-of-fact manner do not give positive reinforcements this behavior by offering sympathy or additional attention. Lack of attention to the maladaptive behavior May decrease repetition of its use.... Encourage the client to talk about feelings they were having just before the behavior occurred.... Act as a role model for the appropriate expression of anger feelings and give positive reinforcements the client one attempts to appropriately Express anger are made it is vital the client expresses angry feelings because suicide and other self-destructive behaviors can occur... remove all dangerous objects in the client's environment... Try to redirect violent behavior with physical outlets for anxiety such as a punching bag, jogging.... have sufficient stuff available to indicate a show of strength... I missed your tranquilizing medications as ordered... if the clients not calmed by talking down or by medication use of mechanical restraints may be necessary... Every strain is deemed necessary and try this efficient stuff is available to assist... because of the patients extreme fear of abandonment clients with BPD should not be left alone at stressful times as this may cause an acute rising anxiety in agitation levels. |
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Complicated grieving |
a disorder that occurs after the death of a significant other or any other loss of significance to the individual and which the experience of distress accompanying bereavement fails to follow normative expectations and manifestations and functional impairment. |
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Client goals for complicated grieving |
Within 4- 5 days the client will discuss with nurse or therapist maladaptive patterns of expressing anger... by the time of discharge from treatment the client will be able to identify the true source of angry feelings, accept ownership of these feelings, and express acceptable manner in an effort to satisfactorily progress through the grieving process. |
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Interventions for complicated grieving |
Convey an accepting attitude one that creates a non-threatening environment for the client to express feelings. Be honest and keep all promises. Identify the function that anger, frustration, and range serve for the client.... Encourage the client to discharge pent-up anger their participation in large motor activities such as brisk walks, jogging, physical exercises, volleyball, punching bag, exercise bike.... Explorer with the client the true source of anger this is painful therapy that often leads to regression as a client deals with feelings of early abandonment or abuse. It can sometimes cause the client to need to get worse before they get better. reconciliation of feelings associated with this stage is necessary for progression through the grieving process can continue.... as anger is placed onto the nurse, caution must be taken to guard against the negative effects of countertransference. these behaviors have the capacity to elicit a ray of negative feelings from the caregiver..... Explain the behaviors associated with the normal grieving process. knowledge of the acceptability of the feelings associated with normal grieving may help to relieve some of the guilt that these responses generate... Help the client understand appropriate ways to express anger... Clearly identify expected behaviors within the my Lou and set limits on behaviors that are in violation of stated expectations with clearly stated consequences. He support of your consistent infirm the client Lacks sufficient self-control to limit maladaptive behaviors so assistance is required for example you tell the patient no touching, they put their arm around a patient, you remind them of the rules, if they don't abide by it they are removed from that activity |
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Impaired social interaction |
within five days the client will discuss with the nurse or therapist behaviors that impede the development of satisfactory interpersonal relationships. by the time of discharge from ra treatment the client will interact appropriately with others and the therapy setting and both social and therapeutic activities evidencing a discontinuation of splitting and clinging and distancing behaviors. |
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Interventions for impaired social interaction |
Encourage the client to examine these behaviors and associated feelings to recognize that they are occurring. they may be unaware of splitting or clinging and distancing patterns of interaction with others. Recognition must take place before change can occur for example when a client begins to recognize that they feel less anxious when engaging and destructive behaviors of foundation is laid for exploring healthier strategies for anxiety reduction. help the client understand that you will be available without reinforcing dependent behaviors. Knowledge of your availability May provide needed security. rotate staff members who work with the client to avoid the development of dependence on particular individuals. The client must learn to relate to more than one staff member in an effort to decrease the use of splitting and diminish fears of abandonment. communication and consistency among the staff team members and adherence to the established plan of care is essential to minimize opportunities for the client to successfully manipulate or split staff members. put the client explorer feelings that relate to fears of abandonment help them understand that clinging and distancing behaviors are engineered by the spheres. Exploration of feelings with a trusted individual may help the client come to terms with unresolved issues. how the patient understands how these behaviors interfere with satisfactory relationships. help the patient work toward a cheapen of object consistency be available without promoting dependency. Give positive reinforcement for independent behaviors. The client must resolve fears of abandonment to establish satisfactory intimate relationships. |
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Evaluation |
Splitting behavior is the primary symptom of BPD they see individuals has either all good or all bad. Do not engage the client and discussions that are attempts to degrade other staff members. Suggestion that this client discuss problems directly with the staff person involved has a client been able to seek out staff when feeling the desire for self-harm, has a client avoid self-harm, and the client correlate times of desire for self-harm two times of elevation of the level of anxiety? Can the client discuss feelings with the staff? Can I clean Express anger appropriately? Can the client function independently? Can the client relate to more than one staff member? In the client verbalize the knowledge that the staff members will return and are not abandoning them when they are leaving for the day? Can the client separate from the staff and inappropriate manner? Can the client delay gratification and refrain from manipulating others in order to fulfill own desires?can a client delay gratification refrain from manipulating others are to fulfill our own desires? And the client verbalized resources within the community from whom they can seek assistance in times of extreme stress. |
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Splitting |
They don’t believe good people can be bad sometimes or can make mistakes, which can lead to becoming consumed with anger toward people who fall short of idealistic thinking. Splitting as a defense mechanism to prevent them from getting hurt do the fear of abandonment. |
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Stigmatism of BPD |
Understand the disorder in the impact of childhood trauma on the Dynamics of the client's behavior to develop approach of compassion, frequently reflect on your feelings and responsive client behavior for example self-harming behaviors by the client frequently generate feelings of anger and frustration and nurses when the behavior seems to be manipulative rather than a sign of true distress. develop a clear model of communication interventions among team members for the hospitalized client consistency interventions helped a model healthy interpersonal skills for the client May minimize successful efforts at splitting staff members. when healthcare team members develop strong communication skills with each other and provides the foundation for discussing and confronting negative attitudes toward the client promotes culture change. |
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Antisocial personality disorder |
Individuals with antisocial personality disorder are seldom seen in most clinical settings and when they are it is commonly way to avoid legal consequences. However these individuals are encountered in prisons jails and rehabilitation services. It is synonymous with psychopathy. antisocial personality disorder as a distinct entity and is identified as characterized by behaviors that are reactive to perceived threats, control, and negative affect. They're prone to violence. A pervasive pattern of disregard for the violation of the rights of others occurring since age 15 for example, failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest, deceitfulness as indicated by repeated lying use of aliases or conning others for personal profit or pleasure, impulsivity or failure to plan ahead, irritability and aggressiveness, reckless disregard for safety of self or others, consistent and responsibilities as indicated by repeated failure to sustain consistent work behavior or honor financial obligations, lack of remorse... individuals at least 18 years... There's evidence of conduct disorder with onzet before age 15. |
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Clinical picture of antisocial personality disorder |
it is a pattern of socially, irresponsible, exploitive, and guiltless behavior that reflects a general disregard for the rights of others. individuals with antisocial personality disorder explained to manipulate others for personal gain and are unconcerned with obeying the law. They have difficulty sustaining consistent employment and developing relationships. They appear cold and callous off and intimidating others with their belligerent manner. They tend to be argumentative and at times cruel and malicious they lack warmth and compassion and are often suspicious of these qualities in others. they have a very low tolerance for frustration, act impulsively, and are unable to delay gratification. they are restless and easily bored off and taking chances and seeking thrills as if they were immune to danger. The pattern of impulsivity may be manifested in failure to plan ahead causing sudden job, residence, relationship changes. When things go their way individuals with this disorder act cheerful even gracious and charming. But because of their low tolerance for frustration this pleasant exterior can change very quickly. They're easily provoked to attack and dominate they believe that good guys finish last. and they show contempt for the week and underprivileged. They exploit others to fulfill their own desires showing no trace of shame or guilt for their behavior. individuals with this disorder see themselves as victims, using projection, devaluing, and denial as primary ego defense mechanisms. They do not accept responsibility for the consequences of their behavior. Physical attacks or other attacks of aggression or not uncommon. Satisfying interpersonal relationships are not possible because they have learned to trust only themselves. They believe it's every man for himself. The most distinctive characteristics is the tendency to ignore conventional authority and rules they act as though established social norms and guidelines for self-discipline and cooperative behavior do not apply to them. |
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Family Dynamics and causes of antisocial personality disorder |
Antisocial personality disorder frequently arises from a catacomb environment. parental deprivation during the first five years of life appears to be a critical predisposing factor in the development of this disorder. studies have shown that antisocial personality disorder in adulthood is highly associated with physical abuse and neglect, teasing, and locked up parental bonding and childhood. severe physical abuse is particularly correlated to violent offending, triggering the development of a pattern of reactive aggression as persistent over one lifetime. although a diagnosis of antisocial personality disorder is only made in the client's at least 18 years old these behavioral patterns are often seen earlier in childhood and adolescence. Increased risk if they have ADHD and conduct disorder as a child |
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Outcome criteria |
Discusses angry feelings with staff and in a group session. has not himself or others, can reach in the hostility into socially acceptable behaviors, follows rules and regulations of the therapy environment, can verbalize which of their behaviors are not acceptable, shows regard for the rights of others by delaying gratification of own desires when appropriate, does not manipulate others and attempt to increase feelings of self-worth, verbalizes understanding of knowledge required to maintain basic health needs. |
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Planning and implementation antisocial personality |
Risk for other directed violence.... which is defined as vulnerable to behaviors in which an individual demonstrates that they can be physically, emotionally, and or sexually harmful to others client goals... Within three days the client will discuss angry feelings and situations that precipitate hostility... The client will not from others... |
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Interventions antisocial personality disorder |
Pconvey an accepting attitude toward the client feelings of rejection are undoubtedly familiar to them. Work on development of trust. Be honest and keep all of your promises and ensure them that it's not them but the behavior that is unacceptable. An attitude of acceptance promotes feelings of self-worth. maintain a low-level stimuli in the client's environment a stimulating environment may increase agitation and promote aggressive behavior observe the client's behavior frequently through routine activities and attractions avoid appearing watchful and suspicious help the client identify the true object of their hostility... You seem to be upset with... Because of weak ego development the client may miss use the defense mechanism of displacement. encourage the client to gradually verbalize hostile feelings for blue ization of feelings in a non-threatening environment may help the client come to terms with unresolved issues Explorer with a client alternative ways to handle frustration such as exercise for example |
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Defensive coping antisocial personality disorder...which is repeated projection of falsely positive self evaluation based on a self-protective pattern that defends against underlined perceived threats to positive self-regard |
within 24 hours after admission the client will verbalize understanding of treatment setting rules and regulations of the consequences for violation... The client will verbalize personal responsibility for difficulties experienced an interpersonal relationships... by the time of discharge from treatment the client will be able to cope more adaptively by delaying gratification of own desires and following rules and regulations of treatment setting... The client will demonstrate ability to interact with others without becoming defensive, rationalizing behaviors, expressing grandiose ideas |
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Interventions defensive coping |
from the onset the client should be made aware of which behaviors are acceptable and which are not and explain consequences of violation of the limits. The consequence must involve something of value to the client. Ideal goal would be for the client eventually internalize societal norms beginning with a step-by-step either or approach... For example either you do this or this will occur. Explanations must be concise concrete and clear with little or no capacity for misinterpretation. don't ever use the statement you should or shouldn't... Instead use the words you will be expected to because you do not want to attempt to coax or convince the client to do the right thing Provide positive feedback rewards acceptable behaviors an attempt to assist the client to delay gratification increase the length of time requirement for acceptable behavior in order to achieve the reward. For example two hours of acceptable behaviors may be exchanged for a phone call, 4 hours of acceptable behavior for 2 hours of television, one day of acceptable behavior for a recreational therapy bowling activity, five days of acceptable behavior for a weekend pass. |
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Interventions continued antisocial personality disorder |
A meliu unit provides the appropriate environment for the client with antisocial personality the Democratic approach, with specific rules and regulations, community meetings, and group therapy session, I mean like the type of societal situation in which the client must learn to live. feedback from peers is often more effective and confrontation from an authority figure. Help the client gain insight into their own behavior often these individuals deny that their behavior is inappropriate for example of rationalizing may be reflected in statement such as... The owner of the store has much money he'll never miss the little bit I take. He has everything, and I have nothing. It's not fair I deserve to have some of what he has... The client must come to understand that certain behaviors will not be tolerated within society and its severe consequences are imposed on those individuals who refused to comply. The client must want to change behavior before they can be helped talk about past behaviors with a client discuss which are acceptable by societal norms and which are not. help the client identify ways in which they have exploited others and the benefits vs consequences of previous behavior. |
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Evaluation antisocial personality disorder |
does the client recognize my anger is getting out of control, can the clients take out staff instead of expressing anger and an inappropriate manner, can the clients he got stabbed instead of expressing anger in an inappropriate manner, can the client use other sources for rechanneling anger, has harm to others been avoided, can the client follow the rules and regulations of the therapeutic group with little or no reminding, can the client verbalized which behaviors are appropriate but you're not, does the client expressed a desire to change, can the client delay gratification of own desires in deference to those of others when appropriate, does the client refrain from manipulating others to fulfill our own desires, does the climb fulfill activities of daily living willingly and independently, |
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Dialectical behavior therapy used for borderline personality disorder |
group skills training... And these groups clients are taught skills relevant to the problems experienced by people with BPD such as core mindfulness skills, interpersonal effectiveness skills, emotion regulation skills, and distress tolerance skills. Two. individual psychotherapy... Weekly sessions address dysfunctional behavioral patterns, personal motivation, and skill strengthening Three. telephone contract... The therapist is available to the client by telephone cording to limit set by the therapist but usually for 24 hours a day. Telephone contact is to give the patient help and support and applying the skills that they are learning to their real-life situation between sessions and to help them find ways of avoiding self-injury. Four. therapist consultation team meeting... Therapist meet regularly to review their work with their clients. These meetings are focused specifically and providing support for each other, keeping the therapist motivated, and providing effective treatment to their clients. Dialectical behavior therapy has been well studied, and the evidence supports the benefits of this treatment for clients with BPD. |
