Ch 24 - Personality Disorders Study Guide

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Ch. 24 – Personality Disorder Study Guide Ch. 24 – Personality Disorders Study Guide Know the following key terms. Personality – is an individual’s characteristics pattern of relative permanent thoughts, feelings, and behaviors that define his or her quality of experiences or relationships. Personality disorders – most challenging and complex group of disorders to treat. They display significant challenges in self-identity or self-direction, and they have problems with empathy or intimacy within their relationships. Emotional dysregulation – a term that describes poorly modulated (controlled) mood characterized by mood swings. These patients have difficulty managing painful emotions in ways that are health and effective. Answer the following questions. 1. According to the American Psychiatric Association (APA, 2013) how many personality disorders are there? 10 2. What personalities are found in Cluster A? Paranoid personality disorder, Schizoid personality disorder, Schizotypal personality disorder 3. What personalities are found in Cluster B? Borderline personality disorder, Histrionic personality disorder, Narcissistic personality disorder and Antisocial personality disorder 4. What personalities are found in Cluster C? Avoidant personality disorder, Dependent personality disorder, Obsessive-compulsive personality disorder 5. How should a nurse care for a patient who falls in Cluster A Personality Disorders? Considering the degree of mistrust felt by these individuals, all prearranged promises, appointments, and schedules should be strictly adhered to. • Being too nice or friendly may be met with suspicion. Instead, clear and straightforward explanations of tests and procedures should be given before they are scheduled. • It is best to use simple language and to project a neutral but kindly affect. • When a patient exhibits threatening behaviors, it is essential to set limits. 6. What type of treatment is given to patients who have a Cluster A Personality Disorders? 1

Ch. 24 – Personality Disorder Study Guide Psychotherapy is the first line of treatment. Group therapy can be used as well 7. What medications are used in treating Cluster A Personality Disorders – Paranoid Personality? An antianxiety agent such as diazepam (Valium) may be used to reduce a patient’s anxiety and agitation. More severe agitation and delusions may be treated with an antipsychotic medication such as haloperidol (Haldol) in small doses for brief periods to manage mildly delusional thinking or severe agitation. The first-generation antipsychotic medication pimozide (Orap) may be useful in reducing paranoid ideation 8. Schizoid Personality Disorder – is a Cluster A Personality Disorder what characteristics are seen here? exhibit a lifelong pattern of social withdrawal. They are somewhat expressionless and have a restricted range of emotional expression. Others tend to view them as odd or eccentric because of their discomfort with social interaction. 9. How should a nurse care for patients with Schizoid Personality Disorder? Nurses should avoid being too “nice” or “friendly.” • Efforts to promote the patient’s socialization are also to be avoided. • Patients may be open to discussing topics such as coping and anxiety. • Conduct a thorough assessment to identify symptoms that the patient is reluctant to discuss. • Protect against ridicule from group members because of the patient’s distinctive interests or ideas. 10. What therapies might be used with a Schizoid Personality Disorder? Psychotherapy first line then group therapy 11. What medications are given to these patient’s with Schizoid Personality Disorders? As with other personality disorders, there is no medication to improve the patient’s functioning. However, depressive symptoms may be treated with antidepressants such as bupropion (Wellbutrin), which can help increase the patient’s pleasure in life. Second-generation antipsychotics, such as risperidone (Risperdal) or olanzapine (Zyprexa), are used to improve emotional expressiveness 12. What kind of symptoms might be seen in a Schizotypal Personality Disorder? People with schizotypal (skit-sə-ˈtī-pəl) personality disorder do not blend in with the crowd. Their symptoms are strikingly strange and unusual. Magical thinking, odd beliefs, strange speech patterns, and inappropriate affect are hallmarks of this disorder. 13. How should a nurse care for a patient with Schizotypal Personality Disorder? Respect the patient’s need for social isolation. • Nurses should be aware of the patient’s suspiciousness and use appropriate interventions. • Perform careful assessment as needed to uncover any other medical or psychological symptoms that may need intervention (e.g., suicidal thoughts). • Be aware that strange beliefs and activities, such as strange religious practices or peculiar thoughts, may be part of the patient’s life. 14. What kind of treatment is provided to patients with Schizotypal PD? 2

Ch. 24 – Personality Disorder Study Guide Individuals with schizotypal personality disorder usually avoid treatment because they are socially anxious and somewhat paranoid. Sometimes, however, family members may be concerned enough by the individual’s depressive or psychotic symptoms to suggest and foster treatment. 15. What defense mechanisms might be used by patients with personality disorders: As adults, people with paranoid personality disorder tend to have difficult relationships due to their jealousy, controlling behaviors, and unwillingness to forgive. Projection, whereby people attribute their own unacknowledged feelings to others, is the dominant defense mechanism. For example, they may accuse their partners of being hypercritical when they themselves are constantly finding fault. 16. What is splitting, and which personality is it exhibited? It involves an inability to view both positive and negative aspects of others as part of a whole, which results in viewing someone as either a wonderful person or a horrible person. This kind of dichotomous thinking and coping behavior is believed to be partly a result of the person’s failed experiences with adult personality integration. It is likely influenced by exposure to earlier psychological, sexual, or physical trauma. 3

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