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Mental Health Personality Disorders Chap 21
Personality Disorders
144
Nursing
Undergraduate 2
10/13/2011

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Term
the totality of emotional and behavioral characteristics that are particular to a specific person and that remain somewhat stable and predictable over time
Definition
personality
Term
enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts
Definition
personality traits
Term
When do personality disorders occur
Definition
they occur when personality traits become inflexible and maladaptive and cause either significant functional impairment or subjective distress
Term
What axis are personality disorders coded on?
Definition
axis 2
Term
The behavior of boderline personality disorder is unstable and hospitilization is usually due to ___________
Definition
attempted suicide
Term
why might a person with antisocial personality disorder enter the psychiatric arena
Definition
as result of judicially ordered evaluation. and Psychiatric intervention may be an alternative to prison.
Term
what is moral insanity
Definition
A term that psychiatrists embraced in the 19th century to define personality disorder.
Term
What is the classification for the Cluster A personality disorders
Definition
Behaviors described as odd or eccentric
Term
What is the classification for Cluster B personality disorders
Definition
Behaviors described as dramatic, emotional, or erratic
Term
What is the classification of class C personality disorders
Definition
Behaviors described as anxious or fearful
Term
What are the disorders classified under Cluster A
Definition
paranoid personality disorder
schizoid personality disorder
schizotypal personality disorder
Term
what personality disorders are classified under cluster B
Definition
Antisocial personality disorder
Borderline personality disorder
Histrionic personality disorder
Narcissistic personality disorder
Term
What personality disorders are under Cluster C
Definition
Avoidant personality disorder
Dependent Personality disorder
Obsessive compulsive personality disorder
Term
This personality disorder is defined as a pervasive distrust and suspiciousness of others that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts
Definition
Paranoid personality disorder
Term
What is the occurrence of paranoid personality disorder in comparison for men and women
Definition
happens more in men
Term
this type of individual is on guard, hypervigilant, ready for real or imagined threat, appears tense and irritable, they developed a hard exterior, and become insensitive to the feelings of others, they avoid interaction with people where they may have to relinquish power, always feel that others are there to take advantage of them
Definition
Paranoid personality disorder
Term
they are extremely oversensitive and tend to misinterpret even minute cues within the environment, magnifying and distorting them into thoughts of trickery and deception. Constantly testing others. Their intimidating manner provokes exasperation and anger in almost everyone with whom they come in contact
Definition
paranoid personality disorder
Term
How do people with paranoid personality disorder maintain their self esteem?
Definition
By attributing their short commings to others. They do not accept responsibility for their own behaviors and feelings and project this responsibility on to others.
Term
How do people with paranoid personality disorder feel toward people who are successful?
Definition
they are envious and hostile. and believe that the only reason that they are not as successful is that they have been treated unfairly.
Term
What happens when paranoid personality disorders are presented with a real or imagined threat
Definition
it can release hostility and anger and is fueled by animosities from the past. The desire for reprisal and vindication is so intense that a possible loss of control can result in aggresion and violence.
Term
Describe an outburst of someone who has paranoid personality disorder
Definition
It is usually brief, the paranoid person soon regains external control, they rationalize the behavior, and reconstructs the defenses central to his or her personality pattern.
Term
what is the link with heredity and paranoid personality disorder
Definition
It is higher among relatives of clients with schizophrenia
Term
What is the Etiological Implication for paranoid personality disorder
Definition
subjected to parental antagonism and harrassment
served as scapegoat for parental aggression
learned to percieve world as harsh and unkind
Entered world with chip on shoulder and learned to attack first
Term
this personality disorder is characterized by a profound defect in the ability to form personal relationships or to respond to others in any meaningful, emotional way.
Definition
Schizoid Personality Disorder
Term
what is the lifelong pattern of someone with schizoid personality disorder
Definition
social withdrawal, and their discomfort with human interaction is apparent.
Term
Describe someone with schizoid personality disorder
Definition
appears cold, aloof, and indifferent to others. they prefer to work in isolation and are unsociable, with little need or desire for emotional ties.they are able to invest enormous affective energy in intellectual pursuits
Term
How do schizoid personality disorders appear in the presence of others
Definition
shy, anxious, or uneasy
inappropriately serious about everything and have difficulty acting in a lightheaded manner. Behavior and conversation exhibit little or no spontaneity. typically unable to experience pleasure and affect is bland and constricted
Term
Etiological implications for schizoid personality disorder
childhood?
Definition
early interactional patterns that the person found to be cold and unsatisfying.
Childhoods characterized as bleak, cold, and notably lacking empathy and nurturing.May become schizoid adult if carrying gene for introverted and shy
Term
This type of personality disorder was once described as being "latent schizophrenics"
Definition
Schizotypal Personality disorder
Term
How is a schizotypal personality disorder different from schizophrenia
Definition
Their behavior is odd and eccentric but does not decompensate to the level of schizophrenia
Term
this personality disorder shows characteristics of being aloof and isolated. They behave in a bland and apathetic manner. Magical thinking, depersonlization, superstitiousness, belief in clairvoyance, telepathy, or "sixth sense". belief that others can feel my feelings
Definition
schizotypal personality disorder
Term
what is the speech pattern like for someone who is schizotypal personality disorder
Definition
sometimes bizarre, people with this disorder often can not orient their thoughts logically and become lost in personal irrelevancies adn in tangential asides that seem vague, digressive, adn not pertinent to the topic at hand.
Term
What happens with someone who is schizotypal when they have stress
Definition
they may decompensate and demonstrate psychotic symptoms, such as delusional thoughts, hallucinations, or bizarre behaviors, but they are usually brief duration
Term
When is schizotypal personality disorder more common
Definition
among the first degree biological relatives of people with schizophrenia.
Term
What were the early family dynamics of someone with schizotypal personality disorder
Definition
may have been characterized as indifference, impassivity, or formality, leading to a pattern of discomfort with personal affection and closeness. Early on affective deficits made them unattractive and unrewarding social companions. they were likely shunned, overlooked, rejected, and humiliated by others, resulting in feelings of low self esteem and marked distrust for others
Term
this type of personality disorder shows a pattern of socially irresponsible, exploitative, an guiltless behavior that reflects a disregard for the rights of others. they exploit and manipulate others for personal gain and have a general disregard for the law. Cant hold a job or keep a relationship
Definition
Antisocial Personality Disorder
Term
this type of personality disorder is characterized by a pattern of intense and chaotic relationships, with affective instability and fluctuating attitudes toward other people.they are impulsive. Are directly and indirectly self destructive, and lack a clear sense of identity.
Definition
Term
What is the most common form of personality disorder
Definition
Borderline Personality Disorder
Term
This type of personality disorder is self-dramatizing, attention seeking, overly gregarious, and seductive. They use manipulative and exhibitionist behaviors in their demands to be the center of attention.
Definition
Histrionic Personality Disorder
Term
People with this type of personality disorder often demonstrate, in mild form, what society admires; well liked, succesful, popular, extroverted, attractive, sociable
Definition
Histrionic Personality Disorder
Term
What is going on underneath the accepted facade of Histrionic Personality Disorder
Definition
driven quality, all consuming need for approval and a desperate striving to be conspicuous and to evoke affection or attract attention at all costs. Failure to evoke the attention they seek often results in feelings of dejection and anxiety
Term
How does people with Histrionic Personality Disorder appear
Definition
distractible and flighty by nature. Difficulty paying attention to detail. They portray themselves as carefree and sophisticated on one hand and as inhibited and naive on the other. they tend to be highly suggestible, impressionable, and easily influenced by others. They are strongly dependent.
Term
What are relationships like for someone who has Histrionic personality disorder
Definition
fleeting and superficial
Term
What are the etiological implications for Histrionic Personality Disorder
Definition
trait of impulsivity may be associated with decreased serotonergic activity
Heredity may play factor
child may have learned that positive reinforcement was contingent on the ability to perform parentally approved and admired behaviors. Parental acceptance and approval was inconsistent.
Term
This personality disorder has an exagerated sense of self worth. they lack empathy and are hypersenstive to the evaluation of others. They believe that they have a right to receive special consideration and that their desire is sufficient justification for possessing whatever they seek.
Definition
narcissistic personality disorder
Term
this person lacks humility, overly self centered, exploits others to fulfill their own desires. They dont see their behavior as inappropriate. View themselves as superior and entitled to special rights.
Definition
Narcissistic Personality Disorder
Term
What is the mood like for the narcissist
Definition
usually optimistic, relaxed, cheerful, and carefree but mood can change because fragile self esteem. If critized by others; rage, shame, humiliation, or dejection.
Term
What might a narcissist do if they do not meet self expectations or are ciritized
Definition
may turn inward adn fantasize rationalizations that convince them of their continued stature and perfection.
Term
What are the relationships of a narcissist like
Definition
exploitation of others for self-gratification results in impaired interpersonal relationships. Usually choose a mate that provides them with praise and positve feedback and who dont require much in return
Term
What was the childhood like for narcissist
Definition
child had fears, failures, or dependency needs that were responded to with criticism, disdain, or neglect.
Term
Because the nacissist as a child had their fears, failures, adn dependency needs met with criticism, disdain, or neglect what happened.
Definition
thy grew up with contempt for these behaviors in themselves and others and are unable to view others as sources for comfort and support.
Term
This personality disorder protects an image of invulnerability and self-sufficiency that conceals their true sense of emptiness and contributes to their inability to feel deeply
Definition
Narcissistic Personality Disorder
Term
What is interesting about the parents of narcissist
Definition
they were probably narcissist themselves and placed unrealistic expectations on the child. The child modeled the parents behavior.
Term
Personality disorder where the person is extremely sensitive to rejection and because of this may lead a very socially withdrawn life. they are not asocial and may actually desire companionship
Definition
Avoidant Personality Disorder
Term
What is the clinical picture of someone with avoidant personality disorder
Definition
They are awkward and uncomfortable in social sistuations. Others may see them as timid, withdrawn, or cold or strange.
Term
What is the speech like of someone with avoidant Personality disorder
Definition
slow and constrained with frequent hesitations,fragmentary thought sequences, and occasional confused and irrelevant digressions. lonely express feeling of being unwanted.
Term
What are the etiological implications for avoidant personality distorder
Definition
poss heridity, primary psychosocial is parental rejection and censure, often raised in families where they are belittled, abandoned, and critized, learn to be suspicious and view world as hostile and dangerous
Term
disorder that is characterized by "a pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation"
Definition
dependent personality disorder
Term
what are the characteristics of dependent personality disorder
Definition
notable lack of self worth apparent in posture, voice, and mannerisms. Passive to the desires of others. Overly generous and thoughtful and underplay own attractiveness and acheivements. Suffer these feelings in silence
Term
What are relationships like for dependent personality disorders
Definition
passive in relationships, others make important decisions for them. should relationship end they feel helpless because unable to care for self.rebound relationship. avoid positions of responsibility and feel anxious when pushed into them. Will do anything for acceptance even something demeaning.
Term
What is etiological implication for Dependant Personality disorder
Definition
infant may be genetically predisposed. Fostered in infancy when stimulation and nurturance are experienced exclusively from one source.
Term
How do the parents play a role in dependant personality disorder
Definition
parents who make new experiences unneccesarily easy for teh child and refuse to allow himor her to learn by experience encourage their child to give up efforts at achieving autonomy
Term
People with this personality disorder are serious, formal, and have difficulty expressing emotions. Over disciplined, perfectionist, preoccupied with rules.Inflexible about the way in which something should be done. and devotion to productivity over pleasure. fear of mistakes makes decisions problem.
Definition
Obsessive Compulsive Personality Disorder
Term
This personality disorder is maticulous and works diligently and patiently at tasks that require accuracy and discipline.organization and efficacy. rigid and unbending of rules.
Definition
Obsessive Compulsive Personality Disorder
Term
What is the social behavior of the Obsessive Compulsive like
Definition
polite and formal. rank conscious. igratiating with authority figures. autocratic and condemnatory with subordinates
Term
On appearance person seems very calm and controlled but underneath the exterior lies great deal of ambivalence, conflict, and hostility
Definition
Obsessive Compulsive Personality Disorder
Term
what were the parents like for the OCD personality disorder
Definition
overcontrolling, expect them to live up to imposed standard of conduct and condemn them if they do not. Praise for good behavior done way less than punishment for bad.Positive acheivement is expected, taken for granted, only occaisionaly acknowledged by parents.
Term
personality disorder as a pervasive pattern of negativistic attitudes adn passive resistance to demands for adequate performance in social and occupational situations that begin by early adulthood and occurs in a variety of contexts.
Definition
passive aggressive personality disorder
Term
This person feels cheated and unapprecaited. They believe life has been unkind to them and they express envy and resent for others easy life.
Definition
Passive aggressive personality disorder
Term
When they feel someone has wronged them they may go to great lengths to seek retribution, or get even but always in a subtle and passive manor and never by discussing feelings with the individual.
Definition
passive aggressive personality disorder.
Term
As a tactic of interpersonal behavior they will commonly switch among the roles of the martyr, the affronted ,the aggrieved, the misunderstood, the contrite, the guilt ridden, the sickly, and the overworked. So they can vent anger and resentment subtlely gaining attention and reassurance they crave
Definition
passive aggressive personality disorder
Term
what is the etiology for passive aggressive personality disorder
Definition
may recieve kindness and support or hostility in the family. Parental responses are inconsistent and unpredictable these children internalize conflicting attitudes toward themselves and others.Dont know if they love or hate the person they depend on
Term
historically there were clients that did not classically conform to the standard categorie of neuroses or psychoses. So what was designated to them as a class
Definition
Borderline
Term
what is the MO for the borderline
Definition
They always seem to be in a state of crisis
Term
What is the affect and the behavior of the borderline
Definition
The affect is one of extreme intensity and the behavior reflects frequent changeability. Changes can occur within days, hours, or minutes.
Term
What is the tone of the borderine
Definition
Often these individuals exhibit a single, dominant affective tone, such as depression, which may give way periodically to anxious agitation or inappropriate outbursts of anger
Term
what are the implications as why depression is common in the borderline personality disorders
Definition
depression occurs in response to feelings of abandonment by the mother in early childhood.Underlying depression is a sense of rage that is sporadically turned inward on the self and externally on the environment. Usually not aware of true source of these feelings until well into long term therapy
Term
What was childhood history like for borderline personality disorders when they were children
Definition
reared in families with chaotic environments. "Risk factors include family environments characterized by trauma, neglect, and/or separation, exposure to sexual or physical abuse
Term
Who came up with the "theory of Object relations"
Definition
Mahler
Term
What are the 6 Phases of Object Relations
Definition
1- (Birth to 1Month) Autistic Phase
2- (1 month to 5 months) Symbiotic Phase
3- (5 months to 10 months) Differentiation Phase
4 (10 - 16 months)Practicing Phase
5 (16-24 months) Rapprochement Phase
6 (24 to 36 months)On the Way to Object Constancy Phase
Term
During this period of Object Relations the baby spends most of his or her time in half waking, half sleeping state. The main fulfillment of needs for survival and comfort
Definition
Phase 1 (Birth to 1 month)
Term
At this phase of Object Relations there is a type of psychic fusion of mother and child. The child views the self as an extension of the parenting figure, although there is a developing awareness of external sources of need fulfillment
Definition
Phase 2 (1 month to 5 months)
Term
During this phase of Object Relations the child is beginning to recognize that there is a separateness between the self and the parenting figure
Definition
Phase 3 (5 to 10) months Differentiation Phase
Term
This phase of Object Relations is characterized by increased locomotor functioning and the ability to explore the environment independently. A sense of separateness of the self is increased
Definition
Phase 4 (10-16) months Practicing Phase
Term
This phase of object Relations there is awareness of separateness of the self becomes acute. This is frightening to the child who wants to regain some lost closeness but not return to symbiosis. The child wants the mother there as needed for "emotional refueling" adn to maintain feelings of security
Definition
Phase 5 (16-24 Months)Rapprochment Phase
Term
In this phase of Object Relations the child completes the individuation process and learns to relate to objects in an effective, constant manner. A sense of separateness is established, and the child is able to internalize a sustained image of the loved object or person when out of sight. Separation anxiety is resolved
Definition
Phase 6 (24-36 months) on the way to Object Constancy Phase
Term
What Object Relations phase does the Boderline Personality Disorder become fixed on
Definition
The Rapprochement phase of development. This occurs when the child shows increasing separation and autonomy. Mother will reward clingy dependent behavior and punishes independent behavior (by withdrawing emotional support)
Term
What should the nurse be on the look out for with Borderline
Definition
Splitting- recognize when client is playing one staff member against another. It is the primary defense mechanism of these individuals. There impressions are either all good or all bad.
Term
Why do Borderlines have little tolerance to be alone
Definition
Because of chronic fear of abandonment. They prefer a frantic search for companionship, no matter how unsatisfactory, to sitting with feelings of lonliness,emptiness, and boredom
Term
What are patterns of interaction for Borderlines
Definition
Clinging and Distancing, Splitting, Manipulation, Self-Destructive behaviors, Impulsivity
Term
When the borderline is clinging what are they demonstrating
Definition
exhibit helpless, dependent, or even childlike behavoirs. They overidealize a single individual that they want to spend all of their time
Term
Describe distancing behaviors with the borderline
Definition
hostility, anger, and devaluation of others, arising from a feeling of discomfort with closeness. also occur in response to separations, confrontations, or attempts to limit certain behaviors. They discredit, undermine their strengths and personal significance.
Term
What is splitting?
Definition
ego defense mechanism that arises from lack of acheivement of object constancy and is manifested by an inability to integrate and accept both positive and negative feelings. people including themselves are either all good or all bad.
Term
To prevent separation from an individual what is a tactic of manipulation that borderlines use
Definition
play one individual against another
Term
How are the relatives of borderlines in relation to moods
Definition
Relatives of borderlines have more mood disorders than control groups
Term
What is the biochemical defect possibly with borderlines
Definition
serotonergic defect in clients with borderline personality disorder. Clients demonstrate significantly decreased frontal, superior temporal, and striatal regions of the brain.
Term
What is another theory about decreased serotonin in borderlines
Definition
It could be genetic
Term
what types of symptoms do most schizophrenia clients exhibit
Definition
both positive and negative
Term
these types of schizophrenia symptoms are associated with normal brain structures on the CT scan and relatively good responses to treatment
Definition
positive symptoms
Term
Negative symptoms are difficult to treat and respond less to __________than positive symptoms are are more destructive because they render the patient inert and unmotivated
Definition
neuroleptics
Term
What are the eight categories positive and negative behavioral disturbances are categorized
Definition
content of thought, form of thought, perception, affect, sense of self, volition, impaired interpersonal functioning relationship, psychomotor behavoir
Term
What are the categories of positive symptoms
Definition
Content of thought
Form of thought
perception
sense of self
Term
what are the categories of the negative symptoms of schizophrenia
Definition
affect,
volition
Impaired interpersonal functioning and relationship to the external world
autism
Deteriorated Appearance
anergia
Wax Flexibility
Posturing
Pacing and rocking
Anhedonia
Regression
Term
What are the symptoms in Content of Thought
Definition
Delusions
Religiosity
Paranoia
Magical thinking
Term
What are the symptoms in Form of thought
Definition
Associative Looseness
neologisms
Concrete thinking
clang Associations
Word Salad
Circumstantiality
Tangentiality
Mutism
perseveration
Term
what are symptoms under perception
Definition
Hallucinations
Illusions
Term
what are symptoms under sense of self
Definition
Echolalia
Echopraxia
Identification and immitation
Depersonalization
Term
What are the symptoms under affect
Definition
Inappropriate affect
Bland or flat affect
Apathy
Term
What are the symptoms under Volition
Definition
Inability to initiate goal-directed activity
Emotional ambivalence
Term
What are the different types of delusions
Definition
Delusion of persecution
Delusion of grandeur
Delusion of reference
Delusion of control or influence
Somatic delusion
Nihilistic delusion
Term
The individual feels threatened and believes that others intend to harm or persecution toward him or her in some way
Definition
Delusion of persecution
Term
The individual has an exagerated feeling of importance, power, knowledge, or identity
Definition
Delusion of grandeur
Term
All events within the environment are referred by the psychotic person to himself or herself ex. someone trying to get message to me through magazine and I need to break the code
Definition
Delusion of reference
Term
The individual believes that certain objects or persons have control over his or her behavior
Definition
Delusions of control or influence
Term
The individual has a false ideal about the functioning of his or her body
Definition
Somatic delusion
Term
The individual has a false idea that the self, a part of the self, or others, or the world is nonexistent; ex. The world no longer exists, or I have no heart
Definition
Nihiliaric Delusion
Term
is an excessive demonstration of or obsession with religious ideas and behavoirs
Definition
religiosity
Term
What might an individual with schizophrenia use religiosity for
Definition
in an attempt to provide rational meaning and structure to his or her behavior
Term
Individuals who suffer from this have extreme suspiciousness of others adn of their actions or perceived intentions
Definition
Paranoia
Term
person believes that his or her thoughts or behaviors have control over specific situations or people
Definition
Magical thinking
Term
inability to experience pleasure
Definition
Anhedonia
Term
What is the most suitable approach to individual psychotherapy for schizophrenia
Definition
reality-0riented individual therapy
Term
Why is establishing a relationship hard with a schizophrenic
Definition
because the individual is desperately lonely yet defends against closeness and trust
Term
how will a person with schizophrenia respond to attempts at closeness and trust
Definition
with suspiciousness, anxiety, aggression, or regression
Term
exagerated warmth and professions of friendship are often met with confusion and suspicion so what is successful intervention acheived by
Definition
honesty, simple directness, and a manner that respects privacy and human dignity
Term
What does group therapy for schizophrenia focus on
Definition
real-life plans, problems, and relationships
Term
What is group therapy effective in for schizophrenia
Definition
reducing social isolation, increasing sense of cohesiveness, and improving reality testing for patients with schizophenia
Term
What features of behavior therapy have led to the most positive results
Definition
clearly defining goals and how they will be measured
Attaching positive, negative, and aversive reinforcements to adaptive and maladaptive behavoir
using simple, concrete instructions adn prompts to elicit the desired behavior
Term
What has become the most widely used psychosocial intervention in the treatment of schizophrenia
Definition
social skills training
Term
What is the hallmark of schizophrenia
Definition
Social Dysfunction
Term
Without drug treatment what percent of individuals who have experienced a psychotic episode relapse within a year
Definition
72%
Term
The prognosis of schizophrenia is often reported in the paradigm of thrids explain
Definition
1/3 have lasting improvement & never have another psychotic break
1/3 achieve some improvement with intermittent relapses and residual disability
1/3 experience severe and permanent incapacity
Term
These antipsychotics are used in the treatment of bipolar mania
Definition
olanzapine, aripiprazole, chlorpromazine, quetiapine, risperidone, ziprasidone
Term
these antipsychotics are used in the treatment of an antiemetic
Definition
chlorpromazine, plerphenazine, prochlorperazine
Term
This anitpsychotic is used in the treatment of intractable hiccoughs
Definition
chlorpromazine
Term
this anitpsychotic is used to treat vocal utterances and tics in tourettes disorder
Definition
haloperidol
pimozide
Term
How do typical antipsychotics work
Definition
by blocking postsynaptic dopamine receptors in the basal ganglia, hypothalmus, limbic system, brainstem and medulla
Term
these are weaker dopamine receptor antagonists than the conventional antipsychotics but are more potent antagonists of the serotonin type 2 A receptors
Definition
Atypical Antipsychotics
Term
What is the interaction between antipsychotics and antihypertensive agents
Definition
Typical antipsychotics have additive hypotensive effects when taken with antihypertensive agents
Term
Blockage of Dopamine receptors are thought to be responsible for controlling what
Definition
Blockage of Dopamine receptors is thought to be responsible for controlling positive symptoms of schizophrenia
Term
What else does dopamine blockage result in
Definition
EPS (extrapyramidal symptoms)
and
prolactin elevation
Term
What does cholinergic blockade cause
Definition
anticholingergic side effects
dry mouth, blurred vision, constipation, urinary retention, tachycardia
Term
Blockage of alpha adrenergic receptors produces what
Definition
dizziness, orthostatic hypotension, tremors, adn reflex tachycardia
Term
What is histamine blockade associated with
Definition
weight gain and sedation
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