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Mental Health 2

Personality Disorders

An enduring pattern of inner experience and behavior that deviates from the expectation of the individual's culture. It is pervasive and inflexible, has an onset in adolexcence or early adulthood, is stable over time, and leads to distress or impairment. personality disorder
An enduring pattern of behavior considered to be both conscious and unconscious and reflects a means to adapting to a particular environment and its cultural, ethnic, and community standards. personality
Inflexible and maladaptive response to stress, disability in working/loving, ability to evoke intepersonal conflict, and a capacity to 'get under the skin' of others are all characteristics of personality disorders
Persons with PD's seek help for ____ rather than ____. physical complaints, mental health
Novelty seeking; reward dependence; neuroticism vs. emotional stability; introversion vs. extroversion; conscientious vs. undependable; antagonism vs. agreeable; closed vs. open to experiences. Inherited personality traits
What are common defense mechanisms used by persons with personality disorders? Repression, suppression, regression, undoing, reaction formtion, rationalization, and splitting.
Characterized by distrust and suspiciousness toward others, based on the belief that others want to exploit, harm, or deceive the person. paranoid personality disorder
Persons with this personality disorder demonstrate jealousy, controlling behaviors, and an unwillingness to forgive. paranoid
Persons with this personality disorder have the primary feature of emotional detachment. They do not seek out or enjoy close relationships. schizoid
_____ can be a precursor to schizophrenia or delusional disorder. schizoid PD
Persons with this personality disorder have the central characteristics of odd beliefs leadin gto interpersonal difficulties. They have an eccentric appearance and show evicence of magical thinking. schizotypal PD
The patient with ______ may seek psychiatric help because of the intense anxiety felt in social relationships. Schizotypal PD
What are the characteristics for a person with paranoid PD? Projects blame, suspicious, hostile/violent, cognitive/perceptual distortions.
What are the characteristics for a person with schizoid PD? Reclusive, uncooperative.
What are the characteristics for a person with schizotypal PD? Ideas of reference, cognitive/perceptual distortions, socially inept, and anxious
What medications are use in therapy for the schizotypal patient? low dose antipaychotics
What medication are used in therapy for the paranoid patient? Low dose antipsychotics if cognitive and perceptual problems are chronic; antidepressant or anxiolytics as needed.
What medication are use in therapy for the schizoid patient? Antipsychotics, antidepressants, and anxiolytics as needed.
What are the characteristics for a person with antisocial PD? Disregard for the rights of others.
What are the characteristics for a person with borderline PD? Pervasive pattern of unstable interpersonal relationships; master manipulators.
What are the characteristics for a person with narcissistic PD? Arrogant, no empathy
What are the characteristics for a person with histrionic PD? excessive emotionality, theatrical
What medications are used in therapy for the borderline patient? SSRI's for anger and depression; Carbamezapine (Tegretol) anticonvulsant for lack of control and self harm; low dose antipsychotics; and if necessary, pharmacologic agents for aggression.
What medication are used in therapy for the antisocial patient? pharmacologic agents for aggression such as lithium, anticonvulsants, and SSRI's.
What medications are used in therapy for the narcissistic patient? There are no specific medications.
What medications are used in therapy for the histrionic patient? antidepressants as needed
What are the characteristics for a person with dependent PD? submissive and clingy
What are the characteristics for a person with obsessive-compulsive PD? preoccupied with perfectionism
What are the characteristics for a person with avoidant PD? socially withdrawn
What medications are used in therapy for the dependent patient? None, only supportive therapy, group therapy or cognitive behavioral therapy.
What medications are used in therapy for the obsessive-compulsive patient? Clomipramine (Anafranil) TCA, and SSRI's for obssessional thinking and depression.
What medications are used in therapy for the avoidant patient? MAOI's and anxiolytics
Building trust, teaching basic living skills, decreasing anxiety, improving interpersonal relationship skills, teaching relaxation techniques, and cognitive restructuring are _____ _____ for patients with PD's. treatment goals
When assessing a patient with a PD it is important to obtain a full medical history
What kind of history is it necessary to obtain when assessing a patient with a PD? Medical history, behavior history, medication/drug abuse history, legal problems, and abuse history.
What is the number one priority in assessing the person with a PD? suicidal/homocidal thoughts
What assessment guidelines are there for assessing the patient with a PD? Assess for suicide, other psychiatric/medical disorder, background, recent important loss, and change of personality.
The more intense the complaints from the borderline or antisocial patients, the greater the fear of potential harm or loss
Patients with PD's require a sense of control over what is happening to them. Giving them realistic choices may enhance compliance with treatment
What are some methods of building a therapeutic nurse client relationship? Set limits, offer support, teach healthy strategies for coping, deal with confrontations with a firm and constructive demeanor, offer praise when appropriate, and review principles with the patient.
A structured, long term approach that provides significant teaching for clients. along with a support system for therapists. dialectical behavior therapy
A priority nursing intervention undertaken by the nurse dealing with clients with PD's is setting limits
The tendency to develop a PD may have biological determinants
A nurse caring for a client who has been diagnosed with a personality disorder should expect that the client will exhibit what characteristics? inflexible and maladaptive responses to stress
______ ________ may be associated with the neurotransmitter systems and overuse of primitive defense mechanisms. antisocial personalities
The primary goal of milieu therapy for clients with personality disorders is affect management in a group context
Characteristic behaviors the nurse will assess in the narcissistic client are grandiose, exploitive, and rage-filled behavior
Clients with borderline disorder can decompensate into psychotic states under stress. _________ is needed at these times. hospitalization
Characteristics the nurse will assess in the client with antisocial personality disorder are deceitfulness, impulsiveness, and lack of empathy
Splitting is a process in which the client sees things as divided into "all good" or "all bad."
A nurse is assigned to work with a client with borderline personality disorder. The nurse will need to consider strategies for dealing with the client's mood shifts, impulsivity, and splitting
The priority nursing intervention for a client with borderline personality disorder is to assess for suicidal and self-mutilating behaviors
A danger of working with a client who idealizes the nurse is becoming overinvolved and being protective and indulgent