Professional Documents
Culture Documents
Key Term:
o Antisocial Personality Disorder: characterized by a pervasive pattern of disregard for and
violation of the rights and with the central characteristics of deceit and manipulation
o Avoidant Personality Disorder: characterized by a pervasive pattern of social discomfort and
reticence, low self-esteem, and hypersensitivity
o Borderline Personality Disorder: pervasive and enduring pattern of unstable interpersonal
relationships, self-image, and affect; marked impulsivity; frequent self-mutilation behavior
o Character: consist of concepts about the self and the external world
o Cognitive Restructuring: therapy that focuses on changing the way one thinks about or interprets
ones self, relationships, and/or environment
o Confrontation: technique designed to highlight the intercongurence between a persons
verbalizations and actual behavior; used to manage manipulative or deceptive behavior
o Decatastrophizing: a technique that involves learning to assess situations realistically rather than
always assuming a catastrophe will happen
o Dependent Personality Disorder: characterized by a pervasive and excessive need to be taken
care of, which leads to submissive and clinging behavior and fears of separation
o Depressive Behavior: characterized by a pervasive pattern of depressive cognitions and
behaviors in various contexts
o Dysphoric: mood that involves unhappiness, restlessness, and malaise
o Histrionic Personality Disorder: characterized by a pervasive pattern of excessive emotionality
and attention seeking
o Limit Setting: an effective technique that involves three steps: stating the behavioral limit
(describing the unacceptable behavior), identifying the consequences if the limit is exceeded, and
identifying the expected or desired behavior
o Narcissistic Personality Disorder: characterized by a pervasive pattern of grandiosity (in fantasy
or behavior), need for admiration and lack of empathy
o Nonsuicidal Self-Injury: intentional physical damage to the body such as cutting or burning;
results from self-harm urges or thoughts; injury is not an attempt at suicide
o No-Self-Harm-Contract: a client promises to not engage in self-harm and to report to the nurse
when he or she is losing control
o Obsessive- Compulsive Personality Disorder: characterized by a pervasive pattern of
preoccupation with perfectionism, mental and interpersonal control, and orderliness at the
expense of flexibility, openness, and efficiency
o Paranoid Personality Disorder: characterized by pervasive mistrust and suspiciousness of others
o Passive-Aggressive Behavior: characterized by a negative attitude and pervasive pattern of
passive resistance to demands for adequate social and occupational performance
o Personality: an ingrained, enduring pattern of behaving and relating to self, others, and the
environment; includes perceptions, attitudes, and emotions
o Personality Disorders: diagnosed when personality traits become inflexible and maladaptive and
significantly interfere with how a person functions in society or cause the person emotional
distress
o Positive Self-Talk: a cognitive-behavioral technique in which the client changes thinking about
the self from negative to positive
o Schizoid Personality Disorder: characterized by a pervasive pattern of detachment from social
relationships and a restricted range of emotional expression in interpersonal settings
o Schizotypal Personality Disorder: characterized by a pervasive pattern of social and interpersonal
deficits marked by acute discomfort with and reduced capacity for close relationships as well as
by cognitive or perceptual distortions and behavioral eccentricities
UNIT 4: NURSING PRACTICE FOR PSYCHIATRIC DISORDERS
CHAPTER 18: PERSONALITY DISORDERS
o Temperament: refers to the biologic process of sensation, association and motivation that
underline the integration of skills and habits based on emotion
o Thought Stopping: a cognitive-behavioral technique to alter the process of negative or self-
critical thought processes
o Time-Out: retreat to a neutral place to give the opportunity to regain self-control
Objectives:
o Describe personality disorders in terms of the clients difficulty in perceiving, relating to, and
thinking about self, others, and the environment
Behaviors and characteristics are consistent across a broad range of situations and do not
change easily
Many factors influence personality: some stem from biologic and genetic make-up,
whereas others are acquired as a person develops and interacts with the environment and
other people
Behavior often fails to conform to cultural, social, or legal norms, and they are motivated
by personal gratification
Relationships with others are dysfunctional and often characterized by deceit, coercion,
or intimidation by the individual with a personality disorder
Not capable of mutual, intimate relationship, and lack the capacity for empathy, remorse,
or concern for others
Maladaptive or dysfunctional personality traits exhibited by individuals with personality
disorder may include:
Negative behaviors towards others, such as manipulative, dishonest, deceitful, or
lying
Anger and/or hostility
Irritable, labile moods
Lack of guilt or remorse, emotionally cold and uncaring
Impulsivity, poor judgement
Irresponsible, not accountable for own actions
Risk-taking, thrill seeking behaviors
Mistrust
Exhibitionism
Entitlement
Dependency
Eccentric perceptions
Not diagnosed until adulthood, at age 18, when personality is more completely formed
No specific medication alters personality and therapy designed to help clients make
changes is often long-term with very slow progress
Hybrid Model For Personality Disorders Box 18.1 pg 338
Diagnoses are organized according to clusters around a predominate type of behavioral
pattern:
Clients with antisocial personality disorder may enter a psychiatric setting as part of a
court ordered evaluation or an alternative to jail, where as those with borderline
personality disorder are oft hospitalized because their emotional instability may lead to
self-inflicted injuries; two of the most common nurses will encounter in a psychiatric
setting
Other clusters of behavior related to maladaptive personality traits include the following:
Depressive Behavior:
o Occurs more often with people with relatives who have major depressive
disorders
UNIT 4: NURSING PRACTICE FOR PSYCHIATRIC DISORDERS
CHAPTER 18: PERSONALITY DISORDERS
o Often seek treatment for their distress
Passive-Aggressive Behavior:
o May appear cooperative, even ingrating, or sullen and withdrawn,
depending on the circumstances
o Mood may fluctuate rapidly and erratically, and they may be easily upset
or offended
Usually not consciously aware of own personality
Personality Disorders:
Schizotypal Personality Disorder
Borderline Personality Disorder
Antisocial Personality Disorder
Narcissistic Personality Disorder
Obsessive-Compulsive Personality Disorder
Avoidant Personality Disorder
Related Disorders:
Paranoid Personality Disorder
Schizoid Personality Disorder
Histrionic Personality Disorder
Dependent Personality Disorder
o Discuss factors through to influence the development of personality disorders
DSM-5 DIAGNOSTIC CRITERIA: Borderline Personality Disorder 301.83 (F60.3) pg
339
Onset and Clinical Course:
Relatively common 10-20% of general population
Higher for people in lower socioeconomic groups and unstable or disadvantaged
population
15% of all psychiatric inpatients have a primary dx of a personality disorder
40-45% of people with primary dx of major mental illness also with coexisting
personality disorder that significantly complicates tx
30-50% in outpatient setting
Higher death rate, especially as a result of suicide; higher rates of suicide
attempts, accidents, and emergency department visits, and increased rates of
separation, divorce, and involvement in legal proceedings regarding child custody
Correlated highly with criminal behavior, alcoholism, and drug abuse
Description of being treatment resistant
Lack of perception by person that behavior is a problem
Etiology:
Biologic Theories
o Personality develops through the interaction of heredity dispositions and
environmental influences
o Genetic differences account for about 50% of variances in temperament
traits
o 4 temperament traits: each affects a persons automatic responses to
certain situations; response patterns are ingrained by 2-3 years of age
Harm Avoidance:
High: fear of uncertainty, social inhibition, shyness with
strangers, rapid fatigability, pessimistic worry in