Personality Disorders Overview
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Questions and Answers

A patient with a personality disorder exhibits extreme feelings of dependency. Which nursing diagnosis is most appropriate?

  • Social isolation related to suspicious views of others.
  • Anxiety related to unconscious conflicts.
  • Disturbed personal identity related to social withdrawal.
  • Powerlessness related to extreme feelings of dependency. (correct)

    • What is the primary nursing intervention when dealing with a patient who has a personality disorder?

  • Showing acceptance of the person at all times by separating the person from behaviors. (correct)
  • Encouraging complete emotional dependence on the nursing staff.
  • Implementing strict disciplinary measures for behavioral infractions.
  • Avoiding any personal interaction to maintain professional boundaries.

    • Which assessment question is most likely to reveal precipitating factors for a patient's admission?

  • What are your long-term life goals and aspirations?
  • What are your earliest childhood memories?
  • Can you describe the circumstances that led to your admission? (correct)
  • How would you rate your overall life satisfaction on a scale of 1 to 10?

    • A patient with borderline personality disorder is undergoing drug therapy. Why might antidepressants be prescribed?

    <p>To alleviate co-occurring symptoms of depression. (B)</p> Signup and view all the answers

    When assessing a patient with suspected personality disorder during the nursing process, which action is most important?

    <p>Obtaining a collateral history to corroborate information and provide a broader perspective. (D)</p> Signup and view all the answers

    A patient with a personality disorder is exhibiting impulsive behavior. Which intervention should the nurse prioritize?

    <p>Identifying triggers for the behavior. (B)</p> Signup and view all the answers

    Which expected outcome is the most realistic and beneficial for a patient diagnosed with a personality disorder?

    <p>Increased interaction with others. (B)</p> Signup and view all the answers

    Which of the following medications is most likely to be used to manage episodic behavioral dyscontrol and aggression in patients with personality disorders?

    <p>Carbamazepine or lithium (A)</p> Signup and view all the answers

    During an assessment, a nurse notes scars and cuts on a patient's arm. What is the most appropriate nursing intervention?

    <p>Asking the patient about suicidal thoughts. (A)</p> Signup and view all the answers

    What is the rationale for using low-dose antipsychotics in the treatment of personality disorders?

    <p>To manage ideas of reference, impulsivity, and intensely angry affect. (D)</p> Signup and view all the answers

    Which factor differentiates schizoid personality disorder from schizotypal personality disorder most distinctly?

    <p>The presence of odd beliefs or magical thinking. (D)</p> Signup and view all the answers

    A patient displays a pervasive pattern of disregard for the rights of others, impulsivity, and a lack of remorse. These characteristics are most indicative of which personality disorder?

    <p>Antisocial personality disorder. (A)</p> Signup and view all the answers

    How does the presentation of narcissistic personality disorder differ from histrionic personality disorder in terms of seeking attention?

    <p>Individuals with narcissistic personality disorder seek attention to validate their sense of grandiosity, while those with histrionic personality disorder seek attention for validation and excitement. (D)</p> Signup and view all the answers

    Which statement accurately reflects the role of genetic factors in the etiology of personality disorders?

    <p>Genetic predispositions may interact with environmental factors to increase the risk of developing a personality disorder. (A)</p> Signup and view all the answers

    In what way does borderline personality disorder uniquely impact interpersonal relationships compared to other personality disorders?

    <p>It results in unstable and intense relationships characterized by alternating idealization and devaluation. (A)</p> Signup and view all the answers

    An individual with anankastic personality disorder is likely to exhibit which behavior in a professional setting?

    <p>Becoming easily frustrated when projects are not completed to their exacting standards. (A)</p> Signup and view all the answers

    How might disrupted psychic development during childhood contribute to the manifestation of a personality disorder in adulthood?

    <p>By impairing the individual's ability to regulate emotions and form stable self-identity. (B)</p> Signup and view all the answers

    Which of the following best describes the maladaptive handling of interpersonal situations seen in individuals with personality disorders?

    <p>A rigid and inflexible approach that causes distress or impairment in social functioning. (A)</p> Signup and view all the answers

    What is the primary difference between the impulsive and borderline types of emotionally unstable personality disorder?

    <p>The borderline type involves identity disturbance and a pattern of unstable relationships, while the impulsive type mainly involves impulsivity. (A)</p> Signup and view all the answers

    How does social reinforcement of abnormal behaviors contribute to the development or maintenance of personality disorders?

    <p>It reinforces and perpetuates maladaptive behaviors, making them more resistant to change. (D)</p> Signup and view all the answers

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    Flashcards

    Personality Disorders

    Enduring patterns of behavior and inner experience that are maladaptive and cause distress.

    Etiology

    The study of the causes of personality disorders, which are largely unknown.

    Risk Factors

    Factors like low social class and poor parenting that increase likelihood of developing personality disorders.

    Epidemiology

    The study of the occurrence of personality disorders, affecting 3-5% of adults.

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    Cluster A

    Personality disorders characterized by odd or eccentric behavior.

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    Paranoid Personality Disorder

    A Cluster A disorder featuring sensitivity, suspicion, and jealousy.

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    Cluster B

    Dramatic or emotional personality disorders often with erratic behavior.

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    Narcissistic Personality Disorder

    A condition marked by grandiosity, need for admiration, and lack of empathy.

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    Cluster C

    Fearful or anxious personality disorders with relevant behaviors.

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    Borderline Personality Disorder

    Characterized by unstable moods, impulsivity, and dysfunctional relationships.

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    Dependent Personality

    Characterized by needing reassurance, feeling inadequate, and fearing abandonment.

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    Anxiety

    A mental state of tension, apprehension, and fear of criticism.

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    Personality Assessment Tools

    Methods like PDQ, SCIPD, and SAP used to evaluate personality disorders.

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    MRI in Personality Assessment

    Used to rule out organic causes of personality changes, such as tumors.

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    Treatment for Personality Disorders

    Includes psychotherapy, drug therapies, and addressing comorbid conditions.

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    Nursing Process Assessment

    Involves direct questions about behaviors leading to admission and assessing relationships.

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    Nursing Diagnosis Anxieties

    Diagnoses may include anxiety due to unconscious conflicts.

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    Expected Outcomes in Nursing

    Goals include increased social interaction and appropriate expression of feelings.

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    Therapeutic Interventions

    Involves showing acceptance, providing safety, and requiring responsibility.

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    Complications of Personality Disorders

    Can lead to distress, relationship issues, substance abuse, and suicide risk.

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    Study Notes

    Personality Disorders

    • Defined as enduring, deeply ingrained, pervasive, and inflexible patterns of inner experience and behavior.
    • These patterns are maladaptive within the individual's culture and lead to distress or impairment of work or social functioning.

    Etiology

    • Exact causes are unknown and can vary between types.
    • Biological factors include genetics (e.g., the D4DR gene linked to novelty-seeking behavior).
    • Abnormal brain maturation during early life and an underactive autonomic nervous system.
    • Risk factors:
      • General: social reinforcement of abnormal behaviors, low social class, poor parenting, and disrupted/arrested psychic development.
      • Specific to Borderline Personality Disorder: dysfunctional families and sexual abuse.

    Epidemiology

    • Approximately 3-5% of the adult population have a personality disorder (PD).
    • Age of onset typically occurs during adolescence or early adulthood.

    History

    • Maladaptive behaviors manifest in various aspects:
      • Cognitions
      • Affectivity
      • Impulse control and need gratification
      • Manner of relating to others
      • Handling interpersonal situations
      • Handling stress

    Clusters

    • Personality disorders are categorized into three clusters:
      • A (Odd/Eccentric):
        • Paranoid: characterized by sensitivity, suspiciousness, self-referential thinking, grudges, and jealousy.
        • Schizoid: marked by coldness, aloofness, a lack of social norms, social withdrawal, detachment, and limited sexual interest.
        • Schizotypal: displaying odd beliefs and eccentric behaviors, appearance, interpersonal styles and thought patterns, such as believing in psychic phenomena or having magical powers.
      • B (Dramatic/Emotional):
        • Histrionic: characterized by egocentrism, shallow mood, self-dramatization, and a desire to be the center of attention.
        • Dissocial (Antisocial): lacking tolerance, blaming others, displaying a lack of guilt or concern for others, irritability, and a tendency towards violence (also known as psychopathy or sociopathy).
        • Emotionally unstable: can be impulsive (inability to plan ahead, unstable moods) or borderline (borderline personality traits, with empty/unclear self-image).
        • Narcissistic: characterized by grandiose behavior or fantasies, a lack of empathy, a need for admiration, an inability to understand others' perspectives, and hypersensitivity to criticism.
      • C (Fearful/Anxious):
        • Anankastic (Obsessive-Compulsive): marked by obsessionality, meticulous attention to detail, being pedantic, perfectionistic, and cautious.
        • Dependent: exhibiting a need for reassurance, unwillingness to take responsibility for their lives, feelings of inadequacy, and fear of abandonment.
        • Anxious: experiencing tension, apprehension, fear of criticism or rejection, and a sense of self-consciousness.

    Investigations

    • Personality Diagnostic Questionnaire (PDQ)
    • Structured Clinical Interview for Personality Disorders (SCID-PD)
    • Standardized Assessment of Personality (SAP)
    • International Personality Disorder Examination (IPDE)
    • MRI to rule out medical causes if personality changes are suspected.

    Management

    • Careful assessment, which includes gathering collateral history.
    • Treating comorbid psychiatric disorders, if any (e.g., depression).
    • Psychotherapy (e.g., dynamic therapy, CBT, individual or group therapy).
    • Medications (e.g., low-dose antipsychotics for ideas of reference, impulsivity, or intense anger; antidepressants for borderline personality disorder; mood stabilizers like carbamazepine or lithium for episodic behavioral dyscontrol or aggression).
    • Hospitalization, if necessary, under specific institutional codes, if the individual is dangerous/violent or actively considering suicide.

    Complications

    • Subjective distress.
    • Adverse effects on relationships and society.
    • Risk for substance use, including alcohol and increased suicide risk.

    Prognosis

    • Cluster B personality disorders may show maturation with time.
    • Likely to impact social or occupational functioning.

    Nursing Process

    • Assessment techniques: direct questioning about events leading to the admission, assessment of thought processes, social habits, relationships, scars/cuts, suicidal ideations, and usual coping mechanisms.
    • Observing for resistance or impulsive reactions during questioning.

    Nursing Diagnoses

    • Social isolation related to suspicious views of others.
    • Anxiety related to unconscious conflicts.
    • Disturbed personal identity related to social withdrawal.
    • Self-directed violence related to self-mutilating behaviors.
    • Powerlessness related to extreme feelings of dependency.

    Expected Outcomes

    • Increased interaction with others.
    • Relaxed posture.
    • Appropriate expression of thoughts and feelings.
    • Avoidance of self-harm and harm to others.
    • Independent decision-making about self-care.

    Interventions

    • Accept the person but separate them from their maladaptive behaviors.
    • Safe environment.
    • Responsibility for actions
    • Open expression of feelings.
    • Identifying triggers of acting out behaviors.
    • Positive feedback for behavioral changes.
    • Clear and direct communication.

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    Personality Disorders PDF

    Description

    This quiz provides an in-depth overview of personality disorders, including their definitions, etiology, and epidemiology. Explore the risk factors for specific disorders and understand the characteristics that define maladaptive behaviors. Test your knowledge on the impact of personality disorders on social and work functioning.

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