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Personality Disorder (ATI Ch. 15)
Terms in this set (38)
Personality disorder (exhibits)
impairments in self-identity or self-direction and interpersonal functioning. Demonstrates patterns of personality characteristics.
Personality disorder (behaviors)
are maladaptive behaviors and are not always perceived by the individual as dysfunctional, and some areas of personal functioning may be adequate.
Personality disorder (co-occur)
occur with other mental health diagnoses, such as depression, anxiety, eating and substance use disorder.
Personality disorder (defense)
may be used by the client who has personality disorder include repression, suppression, regression, undoing and splitting.
1 Personality disorder (splitting)
is an inability to incorporate positive and negative aspects of oneself or other into a whole image, is frequently seen in the acute mental health setting. It is also associated with borderline personality disorder. 1
2 Personality disorder (splitting)
The client tends to characterized people or things as all good or all bad at any particular moment. Ex. "you are the worst person in the world" later that day "you are the best, but the nurse from the last shift is absolutely terrible. 2
Personality disorder (risk)
Often have substance use disorders, may have a history of nonviolent and violent crimes, including sex offenses. Psychosocial influences, such as childhood abuse or trauma, and development factors with a direct link to parenting. Biological influences including genetic and biochemical factors.
Personality disorder (S&O data)
One or more of the following are common pathological personality characteristics. Inflexibility/maladaptive response to stress. Compulsiveness and lack of social restraint, inability to emotional connect in social and professional relationships, tendency to provoke interpersonal conflict and ability to merge personal boundaries with others.
10 types of personality disorders
paranoid, schizoid, schizotypal (cluster A), antisocial, borderline, histrionic, narcissitic (cluster B) and avoidant, dependent and obsessive compulsive (Cluster C)
odd or eccentric traits. Consist of paranoid, schizoid and schizotypal.
is part of cluster A and is a characterized by distrust and suspiciousness toward others based on unfounded beliefs that others want to harm, export, or deceive the person. unable to trust other rigid, fixed world view that often is conspiratorial in nature. Believes others actions are based on ulterior motives.
is part of cluster A and is characterized by emotional detachment, disinterest in close relationships, and indifference to praised or criticism, often uncooperative. Prefers solitude, uninterested in interpersonal relationships. Generally unable to perceived or express strong emotions.
is part of cluster A and is characterized by odd beliefs leading to interpersonal difficulties, an eccentric appearance, and magical thinking or perceptual distortions that are not clear delusions or hallucinations. odd mannerisms and speech patterns. cold demeanor, inappropriate response. lack of affect. distorted thoughts, intense anxiety in social situations and paranoid fears of persecution.
Dramatic, emotional or erratic traits. Consist of antisocial, borderline, histrionic and narcissistic.
is part of cluster B and is characterized by disregard for others with exploitation, repeated unlawful actions, deceit, and failure to accept personality responsibility. Impulsive, lack of remorse, failure to empathize. Easily agitated, aggressive and controlling.
is part of cluster B and is characterized by instability of affect, identity, and relationships, as well as spitting behaviors, manipulation, impulsiveness, fear of abandonment; often tries self-injury and my be suicidal. extreme risk taking, impulsive, self-injury, suicidal, intense anxiety, consistently low mood and unstable relationships due to intense mistrust.
is part of cluster B and is characterized by emotional attention-seeking behavior, in which the person needs to be the center of attention; often seductive and flirtatious. Flamboyant, highly seductive in behavior and/or appearance, sexually manipulative, demands to be center of attention and seeks excitement and activity. Group therapy not recommended due attention seeking behaviors. (no pharmacologic therapy).
is part of cluster B and is characterized by arrogance, grandiose views of self-importance, the need for consistent admiration, and a lack of empathy for others that strains most relationships; often sensitive to criticism. Grandiosity, rage, depression, anxiety, manipulative and lack of empathy
anxious or fearful traits; insecurity and inadequacy. consist of avoidant, dependent and obsessive compulsive.
is part of cluster C and is characterized by social inhibition and avoidance of all situations that require interpersonal contact, despite wanting close relationship, due to extreme fear of rejection; often very anxious in social situations. extreme discomfort socially, hypersensitivity, intense anxiety related to social contact. easily internalizes negative comments by others.
is part of cluster C and is characterized by extreme dependency in a close relationship with an urgent search to find a replacement when one relationship ends. pervasive need to be under controlled by dominant other, insecure about making decisions and chronic sense of inadequacy.
is part of cluster C and is characterized by perfectionism with a focus on orderliness and control to the extent that the individual may not be able to accomplish given task. inflexible, controlling, anxiety difficulty with empathy and perfectionist.
Personality Disorder (nursing care)
self assessment is vital for nurses caring for clients who have personality disorders and should be performed prior to care. Clients may evoke intense emotion in the nurse. Being aware of personal reactions to stress promotes effective nursing care. Therapeutic communication and intervention are promoted when client behaviors are anticipated. Repeat the self-assessment if experiencing a personal stress response to client behavior.
is part of nursing care and focuses on appropriate social interaction within a group context.
Personality Disorder (safety)
is always a primary concern because some clients who have personality disorders are at risk for self-injury or violence.
Personality Disorder (medication)
include the use of psychotropic agents to provide relief from clinical manifestations. Antidepressant, anxiolytic, antipsychotic, or mood stabilizer medication may be prescribed.
Personality Disorder (teamwork)
includes psychobiological interventions like psychotherapy, group therapy, cognitive and behavior therapy, dialectical behavior therapy (a form of CBT) and case management.
Dialectical Behavior therapy
is a form of CBT used for client who are exhibiting self-injurious behavior. It focuses on gradual behavior changes and provides acceptance and validation for these clients.
is beneficial for client who have personality disorders and are persistently and severely impaired. Involves acute care facilities and long-term outpatient facilities.
acute care facilities
case management focuses on obtaining pertinent history from current or previous providers, supporting reintegration with the family, and ensuring appropriate referrals to outpatient care.
long term outpatient facilities
case management goals include reducing hospitalization by providing resources for crisis services and enhancing the social support system.
Personality disorder (Challenges)
develop a therapeutic relationship can be challenging due to the clients distrust or hostility towards others. Feeling of being threatened or having no control may cause a client to act out toward the nurse.
Personality disorder (communication)
firm, yet supportive approach and consistent care will help build a therapeutic relationship. Offer realistic choices to enhance the clients sense of control.
Border line or antisocial (communication)
benefited by setting limits with client who are maladaptive especially these types of clients.
dependent or histrionic (communication)
benefit from assertiveness training and modeling especially these types of clients.
schizoid or schizotypal (communication)
benefit by isolating themselves. The nurse should respect this need need.
may be flirtatious, it is important for the nurse to maintain professional boundaries and communication at all times.
client with dependent behavior
a nurse needs to self-assess frequently for countertransference reactions.
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