Histrionic Personality Disorder
Narcissistic Personality Disorder
Avoidant Personality Disorder
Dependant Personality Disorder
Obsessive Compulsive Personality Disorder
100
  • How would others describe someone with HPD?
  • Attention seeking
  • Emotional
  • Lively
  • Dramatic
  • Enthusiastic
  • Choice of clothing attracts attention
  • Open
  • “Life of the party”
  • Dramatic speech
  • Strong opinions: frequently expressed but often changing
100
  • What fantasies preoccupy the mind of someone with NPD?
  • Unlimited success, power, beauty, ideal love/relationship
100
  • What is the person with APD avoiding?
  • Social situations
  • Occupational activities where there may be interpersonal conflict
100

What is the desperate need of someone with DPD?

  • To keep others close
100
  • What do those with OCPD struggle with?
  • Delegating tasks
  • Working with those who may do things differently than them
  • Completion of tasks
  • Adapting to change
  • Accepting new ideas
  • Discarding useless objects
200
  • What is the ultimate treatment goal for someone with HPD?
  • Change the tendency to fulfill all their needs by focusing on others to the exclusion of themselves
200
  • Describe the empathetic abilities of someone with NPD
  • While it had been previously stated that narcissists lack empathy, it is now theorized that empathy is present but dysregulated. Narcissists may display empathy when it suits them but will often lack it when they are the source of grief
200
  • What is important to note regarding the therapeutic relationship with someone with APD
  • It is necessary for these patients
  • Will take time to develop
  • Must trust that the nurse will not be critical or demeaning
200
  • Describe the functional impact of DPD
  • There is a fear of adult responsibilities
  • Patient may not have decision-making skills related to finances, shopping, cooking, and cleaning
200
  • How does someone with OCPD conduct their life?
  • Organization
  • Rules
  • Detail-oriented
  • Schedules
  • Lists
  • Highly structured and organized
300
  • What other psychiatric conditions can commonly co-occur with HPD?
  • BPD, DPD, ASPD
  • Anxiety disorders
  • Substance use
  • Mood disorders
300
  • What must a nurse keep in mind regarding the care/assessment of someone with NPD? 
  • Listen carefully to understand the person’s perceptions
  • Client may not be ready to self-disclose
  • Assess self-agency as is may provide differentiation between real competence and grandiose ones
  • Patient may expect special considerations or services
  • Consider your own reaction to the client as it will give you an idea of how others react to them
300
  • What interventions can the nurse work on with someone with APD?
  • Identify positive responses from others
  • Explore previous achievements
  • Explore reasons for self-criticism
  • Assess for activities that increase self-esteem and multiply those activities
  • Social skills training
300
  • What is important to note about the nursing care of someone with DPD?
  • Patient will readily engage in nurse-client relationship
  • Will look on you to make all the decisions
  • Resist the urge to tell them what to do
  • Recognize dependent patterns
  • Motivate them to change
  • Teach adult skills
  • Assertiveness training
300
  • How can someone with OCPD be supported with medication and a nurse-client relationship?
  • Short term antidepressants or anxiolytics
  • Nurse should accept the patient’s need for order and rigidity (allows patient to feel more confident about making changes)
  • Examine beliefs behind dysfunctional behaviours
400
  • How do those with HPD relate to others?

Persistent need and approval

Moody and helpless when others are disinterested in them

Hypersensitive to moods/thoughts of those they’re trying to please

Difficulty achieving genuine intimacy

Need for attention alienates others 

Depressed without attention from others

Often dissatisfied with spouses/friends as insufficiently supportive


400
  • Describe the contradictory nature of a narcissists self-esteem (bonus: explain why this is so)
  • Narcissists have a grandiose sense of self-worth and often believe they are special and deserving of admiration, however their internal self-esteem is quite vulnerable and they can often experience feelings of shame and are very sensitive and reactive to criticism.  

  • The reasoning behind this is that the grandiose sense of self is considered a “mask” and is used as a coping mechanism to deal with chronically low self-esteem. When this alternative “perfect” identity is challenged, the narcissist reacts intensely to protect said identity and avoid facing the reality of their self-esteem
400
  • Why is someone with APD avoiding social situations? What can occur as a maladaptive coping mechanism for these feelings?
  • Feelings of inadequacy
  • Intense fear of social rejection
  • Fear of criticism

  • APD person will often retreat into fantasy
400
  • How do you differentiate someone with DPD from someone with histrionic personality disorder?
  • Those with DPD will often describe themselves as dependent whereas those with HPD will argue against needing others
400
  • Describe the level of insight of someone with OCPD
  • They’re aware that their quality of life could be improved but they find the necessary changes very anxiety provoking to implement
500
  • What must the nurse address in treatment of HPD?
  • Explore positive personality characteristics
  • Develop independent decision making skills
  • Reinforce personal strengths
  • Convey confidence in patient’s ability to handle situations
  • Autonomy
  • Assertiveness training
500
  • Inheritance is believed to be a cause of NPD, explain why this is so. (excluding biological genetic factors)

Narcissistic abuse from parents can either greatly conflate or injure a child’s self-esteem. The resulting coping mechanisms that fall into place (learned or otherwise) are often consistent with NPD

Psychological trauma can often result from narcissistic parenting. As the NPD parent sees their needs above the child’s, neglect and humiliating/fearful experiences can occur

500
  • Why can social avoidance be more harmful for someone with APD vs someone with schizoid personality disorder?
  • Those with APD have a strong desire for affiliation and social acceptance vs those with SZPD tend to be uninterested and unfulfilled by social relationships
500
  • What characteristics of someone with DPD makes them susceptible to abuse/manipulation?
  • Submissive
  • Adapt their behavior to please those around them
  • Compliant
  • Conciliatory
  • Placating
  • Rarely disagree with others
  • Easily persuaded
  • Gullible
  • Conflict avoidant
  • Struggle with decision-making
500
  • What is the difference between OCPD and OCD?
  • Someone with OCD will have obsessions and compulsions that decrease as anxiety is decreased.
  • Someone with OCPD doesn’t necessarily have obsessions/compulsions but more struggles with overall inflexibility, perfectionism, and a need for control
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