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Personality DX
| Question | Answer |
|---|---|
| What is the Diagnostic and Statistical Manual of Mental Disorder or DSM? | Is a categorical classification produced by the American Psychiatric Association. |
| Personality disorders are categorized under what Axis? | Axis II |
| When does a PD occur? | When personality traits become rigid and inflexible and cause either significant impairments or subjective distress. |
| Those who struggle with a PD have a difficulty dealing with whom? | They have a great difficulty dealing with other people. |
| What is the criteria that a PD disorder must fulfill? | Recognized by adolescence or earlier and continue throughout life. |
| What is the difference between a PD and an Axis I dx like schizophrenia? | PD is hard to medicate, and it is difficult to treat. Axis I dx are easier to medicate. |
| Why don't people with PDs seek treatment? | They do not understand their bx and the consequences of their bx. |
| Are PDs caused by nurture or nature? | Never 50/50. One is bigger thatn the other. Nurture plays the bigger part. |
| All PDs share certain characteristics; what are they? | poor impulse control, mood characteristics, impaired self-perception |
| What are some of the bx seen in people with PD? | staff splitting, manipulation, they dehumanize others and treated them as objects |
| When is manipulation pathological? | When it is the primary method of used to get needs met. |
| What are some manipulation techniques used by a person with a PD? | sexual, physical, mental, financial |
| What are some interventions for manipulative bx? | identify behavior, examine the technique used,be assertive, create a strong boundary, don't accept any gifts (like praise) |
| What are the clusters that PDs are grouped into? | 3 clusters: A, B, C. |
| What PDs fall under cluster A | paranoid, schizoid, schizotypal |
| What are the characteristics of paranoid PD? | oversensitive, misinterpret cues in environment, envious, hostile, they don't trust anybody, testing the honesty of others |
| The predisposing factors for paranoid PD are | possible genetic link (nature), parental upbringing (nurture) |
| Tx for a paranoid PD | psychotherapy; the goal is to modify the maladaptive bx. |
| What are the characteristics of schizoid | cold people, aloof, they tend to work in isolation, unsociable, shy (no affect, monotone, no energy, uneasy (not a lot of eye contact) |
| Predisposing factors for a schizoid | might have been raised in family where there wasn't enough nurturing. Not a lot of relating to people; were isolated. |
| Tx for schizoid | psychotherapy |
| Characteristics for schizotypal | aloof, speech pattern bizarre, under stress may become psychotic (hear voices, see things), often have inappropriate affect, isolated, telepathy *lost of touch with reality |
| Tx for schizotypal | medication, interpersonal psychotherapy |
| Predisposing factors for schizotypal | Nurture plays a big part |
| What PDs fall under Cluster B? | Histrionic, borderline, narcissistic, antisocial |
| Cluster B PDs are described as | dramatic and emotional; each is dramatic in its own way |
| Characteristics of Histrionic PD | overly concerned with appearance, early bored, highly seductive, poor social relations with people, centre of attention, very lively, semantic (lots of physical complaints). |
| What are the predisposing factors for histrionic PD? | serotonin levels |
| What is the TX for histrionic PD? | psychotherapy with goal of finding the unconscious bx. |
| Characteristics for borderline PD | pattern of intense chaotic relationships, easily bored, easily angered, classic staff splitter, self destructive bx, fear of being alone, fear of abandonment |
| BPD predisposing factors | sexual abuse |
| TX | Costly, therapy is long, lots of periods of progress then reverse. |
| A nursing intervention for BPD | Dialectical Behavior Therapy or DBT |
| What type of PD is DBT psychotherapy used to treat? | was the first psychotherapy shown to be effective in treating BPD. |
| According to DBT, what is the core problem in BPD? | emotional dysregulation |
| Emotional dysregulation in BPD is mainly due to what? | biological risk factors and emotionally unstable childhood environments. |
| What is the focus of DBT? | to help the client develop and maintain skills that will decrease emotional dysregulation. |
| Most BPD patients are what? | They are females and have been sexually molested. |
| What are the characteristics of Narcissistic PD? | preoccupied with fantasies, need for admiration, lack empathy for others, they overestimate their abilities, sudden mood changes, fragile self-esteem. |
| Narcissistic PD predisposing factors | raised by narcissistic parents (nurturing); person stunted in the ID (me, me, me) |
| TX for Narcissistic PD | interpersonal therapy (1:1) to develop good self-esteem; teaching how to relate to people |
| Antisocial PD characteristics | cold, view others as objects, poor work hx, impulsive, intimidation, manipulation |
| TX for antisocial PD | Group therapy; never 1:1 |
| antisocial predisposing factors | have been dx with conduct disorder as a youth |
| Psychopaths make up what percent of the general population? | 1-2% |
| Psychopaths make up what percent of the prison population? | 10% |
| Possible biological psychopath explanations revolve around what part of the brain? | The amygdala which is linked with fear. |
| Psychopaths also know as | sociopaths |
| The frontal cortex plays what function? | Plays a part in voluntary decision making. |
| According to Robert Hare, many white collar criminals are what? | psychopaths. |
| White collar individuals flourish in business because they have what psychopath characteristics? | manipulation, intimidation, competitive nature. |
| The TX for psychopaths | Some experts believe there is no treatment for them |
| which medications have been successful in decreasing impulsivity and self-destructive acts in borderline paties? | SSRI's (prozac) and MAOI's |
| Millie or group therapy has been found to be useful with which type of PD? | antisocial PD |
| Cluster A PDs are described as | odd or eccentric; have difficulty in relating to others, isolate themselves and are unable to socialize comfortably. |
| Cluster C PDs are described as | anxious or fearful |
| Diagnostic criteria for antisocial PD | disregard for and violation of rights of others, at least 18 years old, evidence of conduct disorder with onset before 15, occurrence of antisocial bx is not exclusively during the course of schizophrenia or a manic episode. |
| Nsg. Dx for rage, negative role moleing, Hx of violence | risk for other directed violence |
| Nursing actions for dx of other directed violence | unconditional acceptance, low environmental stimuli, observe bx, safe environment, explore cause for anger, encourage appropriate expression of anger, (if needed show strength, give meds (lorazepam), and restraint). |
| Nsg Dx for disregard for norms, laws, no guilt, not able to delay gratification | Defensive coping |
| Nursing actions for defensive coping | explain acceptable bx, consequences, explain expectations of client, + feedback & rewards for good bx, provide Millieu, promote insight development, maintain attitude of acceptance. |
| outcomes for risk for other directed violence | not harmed self or others, discuss angry feelings with staff, engages in physical exercises |
| Outcomes for Dx defensive coping | demonstrates acceptable bx, able to delay gratification, not manipulate others |
| Nsg. Dx for unresolved fears of abandonmetn | risk for self-mutilation |
| intervention for risk for self mutilation | observe clients bx, secure contract, care for wounds, encourage verbalization of feelings, safe environment, act as role model |
| outcome for risk for self mutilation | has not harmed self, seeks staff when desire for mutilation occurs |
| Nsg. Dx for depresed mood, and acting out bx | complicated grieving |
| intervention for complicated grieving | trusting relationship, appropriated expression of anger, explore source of anger, teach states of grief, set limits, give + feedback. |
| Outcome for complicated grieving | expresses anger, understands stages of grief |
| Nsg Dx for clinging,distancing bx, and staff splitting | Nsg. Dx impaired social interaction |
| Intervention for impaired social interaction | examine bx, encourage independence and give + reinforcement, explore fears, rotate staff |
| outcome for impaired social interaction | relates to more than one staff, completes ADLs, no manipulating of staff or splitting. |
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juanaortiz76
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