Personality disorders 1

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NUR 448 Personality Disorders

Transcript of Personality disorders 1

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NUR 448

Personality Disorders

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Definition

Extreme exaggerations of personality traits or styles.

Essential features are: chronicity pervasiveness maladaption

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Three clusters

Cluster A (Odd, eccentric) Paranoid, Schizoid, Schizotypal

Cluster B (Dramatic, erratic) Antisocial, Borderline, Histrionic, Narcissistic

Cluster C (Anxious, fearful) Avoidant, Dependent, Obsessive-compulsive

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Cluster A - Paranoid

Distrustful, suspiciousBears grudgesJealous, envious, hypersensitiveHypervigilent, ideas of referenceRestricted affect, controllingDefense mechanism—projectionOften racist

Paranoid Personality

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Cluster A - Schizoid

LonerOdd thoughts, perceptions & speechAloof, no social involvementIndifferent to praise or criticismBouts of mini psychosisCognitive impairment

Schizoid Personality

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Cluster A - Schizotypal

Odd, peculiar speechBizarre fantasies and behaviorMagical thinkingIdeas of referenceUnusual beliefs, clairvoyantFortune tellers, street people

Schizotypal Personality

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Cluster B - Antisocial

Disregard for the rights of othersInstant gratificationNo remorseLying, stealing, revengefulTruant as children, cruelty to animalsFiresetting, substance abuseRx. Restrictive settings (jail, prison)Qualitative difference to soci0pathic personality

Antisocial Personality

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Cluster B - Borderline

Theory-problems with separation-individuationBad mother-good motherUnstable and impulsive on eating, spending,

and sexualityUnstable personal relationshipsClinging, demanding, controlling

Borderline Personality

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Borderline

Difficulty being alone, mood swingsExplosive anger, self-mutilationMini-psychoses, eating disordersSplitting (pitting one person against another)Projection, suicide gesturesCutting, carving or other self abuse actions

(never the face)Rx: Small doses of antipsychotic medication

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Cluster B - Histrionic

Needs to be center of attentionSeductive, provocative behaviorShallow emotional expressionDramatic, theatricalSuggestibleFocused on physical appearanceOften show “la belle indifference”- disconcern

for personal problems

Histrionic Personality

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Cluster B- Narcissistic

Grandiose self importanceUnlimited fantasies of power, wealth, brilliance, beautyFeels special or unique-associates with people of

high statusDemands admiration, entitlement, special

treatmentAble to break laws-severe cases act as anti-social

personalitiesNarcissistic Personality

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Narcissistic

ExploitiveLacks empathyEnviousHaughty, arrogant

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Cluster C - Avoidant

Social inhibitionFear of close relationshipsAnxious, lonely, fearful of criticism or rejectionViews self as socially inept, reluctant to take risks

Avoidant Personality

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Cluster C - Dependent

Difficulty with decision makingSeeks excessive advice and reassurance Difficulty expressing disagreementFear of having to take care of selfExcessive lengths to obtain nurturanceFeels uncomfortable when alone

Dependent Personality

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Cluster C - Obsessive-compulsive

Preoccupied with details, rules, lists and orderPerfectionism that interferes with task completionOver-conscientious and inflexibleReluctant to delegateMiserly spendingRigid and stubborn

Obsessive Compulsive Personality

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Obsessive Compulsive Personality

Obsessive Compulsive Personality

Obsessive Compulsive Disorder

Obsessive Compulsive Disorder

FastidiousNeatness and

orderlinessDemanding of othersAble to lead normal

lifeBehaviors: labeling,

measuring, things are the same

HoardingCompulsive actionsSeclusiveDisabling and anxiety

producingBehaviors: checking

the door, hand washing, counting, picking at face

Some Differences Between

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Treatment

Symptom specificSome improve with time (borderline and

antisocial)Group therapy helpful for some

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Questions

Which personality disorders are more disruptive?

What is the difference between schizoid and avoidant personalities?

What are the differences among obsessive- compulsive behavior, obsessive-compulsive personality, and obsessive-compulsive disorder?

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Which axis of the DSMIV includes personality disorders?

What are the culture issues of personality disorders?

What are the gender issues of personality disorders?