Basics
What is a personality disorder?
An enduring pattern of inner experience and behavior that deviates from cultural expectations, is inflexible, begins in adolescence/early adulthood, is stable over time, and causes distress or impairment.
Rigid ways of thinking and behaving that differ greatly from the norm, cause distress, hinder function.
Which personality disorder is described as a “life-long loner” with detachment from social relationships and a restricted range of expression?
Schizoid Personality Disorder
Which personality disorder is often called “psychopath” or “sociopath”?
Antisocial Personality Disorder
Which personality disorder shows excessive need to be taken care of and fear of separation?
Dependent Personality Disorder
Name two examples of self-injurious behaviors in BPD.
Cutting, burning, scratching, head banging, swallowing objects
What is a key challenge when working with patients with PD?
They often have difficult relationships with health care professionals, and stigma/negative labeling is common.
Which personality disorder involves magical thinking, odd beliefs, and unusual mannerisms?
Schizotypal Personality Disorder
Which personality disorder shows pervasive grandiosity, need for admiration, and sense of entitlement?
Narcissistic Personality Disorder
Which personality disorder involves social inhibition, low self-esteem, and hypersensitivity to criticism?
Avoidant Personality Disorder
How are interpersonal relationships affected in Borderline Personality Disorder?
They typically have a pattern of unstable and intense interpersonal relationships characterized by extremes of idealization and devaluation
Name the three behavior clusters of personality disorders (e.g. Cluster A is ___)
Cluster A (odd/eccentric), Cluster B (dramatic/emotional/erratic), Cluster C (anxious/fearful)
Which personality disorder involves pervasive distrust and suspicion of others’ motives?
Paranoid Personality Disorder
What are the hallmark symptoms of Borderline Personality Disorder (BPD)?
Instability in self-identity, relationships, and affect, with marked impulsivity
Which personality disorder is preoccupied with order, perfectionism, and control at the expense of flexibility?
Obsessive-Compulsive Personality Disorder
What is a common cognitive distortion in BPD?
Dichotomous (black-and-white/all-or-nothing) thinking
What period of life do personality disorders typically emerge?
Typically adolescence or early adulthood
Nursing interventions for schizoid PD focuses on preventing what?
Prevent social isolation through providing social skills training – enhance ability to relate in interpersonal situations , enhance experience of pleasure, prevent social isolation, increase emotional responsiveness to others
Which personality disorder is characterized by excessive emotionality, attention seeking, and provocative behavior?
Histrionic Personality Disorder
What is one nursing intervention for avoidant personality disorder?
Therapeutic relationship - no negative criticism
Identification of positive responses from others
Exploration of previous achievements
Exploration of reasons for self criticism
Social skills training
What is "affective instability" in Borderline Personality Disorder?
Marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety) usually lasting a few hours and only rarely more than a few days
Self-awareness is emphasized for clinicians working with personality disorders. Why?
Experiences with personality disorder patients can evoke aversive feelings; self-awareness helps prevent stigma and countertransference.
What type of medication may help in schizotypal personality disorder?
Atypical antipsychotics and antidepressants
What is the therapy of choice for Borderline Personality Disorder that combines cognitive and behavioral techniques?
Dialectal Behavioral Therapy (DBT)
In dependent personality disorder, what is a key therapeutic strategy?
Therapeutic relationship – resist urge to tell them what to do
Help them recognize dependent patterns
Motivate them to want to change
Teach adult skills not yet developed
Antidepressants or antianxiety agents
Encourage them to stay in therapy
Practice new skills learned in therapy
What role does medication play in Borderline Personality Disorder?
Can be used for target symptoms only