NCMB 317: Care of Clients with Maladaptive Behaviors

What are the three main areas of focus in the learning objectives for NCMB 317?

Cognitive, Psychomotor, and Affective.

What is the definition of personality in the context of personality disorders?

Personality refers to the complex of all attributes of an individual—behavioral, temperamental, emotional, and mental—that characterize a person as a unique human being.

What characterizes a personality disorder?

A mental disorder characterized by maladaptive, persistent, pervasive, and inflexible personality traits, leading to significant distress and impairment in functioning.

At what age is personality more completely formed according to the notes?

Age 18.

What are the typical onset periods for personality disorders?

Early childhood or adolescence.

What is meant by 'ego syntonic' in relation to personality disorders?

It refers to individuals being unaware of their maladaptive behavior.

What are some common traits associated with personality disorders?

Egocentrism, self-centeredness, lack of empathy, deceit, coercion, and dysfunctional relationships.

What are some psychiatric disorders that frequently occur alongside personality disorders?

Major Depression, Eating Disorders, Post-Traumatic Stress Disorder, Somatization, Panic Disorders, and Substance Abuse.

What are the four areas in which behavior must deviate from cultural expectations for a diagnosis of personality disorder?

Cognition, Interpersonal Functioning, Impulse Control, and Affect.

What are some negative behaviors associated with maladaptive personality traits?

Manipulation, dishonesty, anger, hostility, lack of guilt, impulsivity, and irresponsibility.

What biological factors contribute to the etiology of personality disorders?

Genetics and temperament.

What are the four temperament traits mentioned in the notes?

Harm Avoidance, Novelty Seeking, Reward Dependence.

How is temperament defined in the context of personality disorders?

Biological processes of sensation, association, and motivation that underlie the integration of skills and habits based on emotions.

What is the age range during which temperament traits are ingrained?

By 2 to 3 years of age.

What is the significance of the nursing process in the care of clients with personality disorders?

It is applied to ensure effective treatment and management of clients.

What is the importance of developing empathy in nursing care for patients with personality disorders?

It enhances the quality of care and understanding towards patients.

What should be evaluated in personal feelings and attitudes when caring for clients with personality disorders?

Responses to clients with personality disorders.

What is the role of education in managing personality disorders?

To increase knowledge and understanding among clients, families, caregivers, and community members.

What is a common characteristic of behavior in individuals with personality disorders?

Behavior often fails to conform to cultural, social, and legal norms.

What is the impact of personality disorders on relationships?

They often lead to dysfunctional relationships characterized by deceit and lack of empathy.

What is a key feature of personality disorders regarding emotional responses?

Individuals may exhibit irritable, labile moods and a lack of concern for others.

What is the expected trajectory of personality disorders as individuals age?

They tend to diminish in the 40s to 50s.

What is the significance of mental status assessments in the care of clients with personality disorders?

They help in evaluating and understanding the client's mental health status.

What are the four temperament traits?

Harm Avoidance, Novelty Seeking, Reward Dependence, Persistence.

What are the high traits associated with Harm Avoidance?

Carefree, Energetic, Outgoing, Optimistic.

What results are associated with low Harm Avoidance?

Fear of Uncertainty, Social Inhibition, Shyness with Strangers, Rapid fatigability, Pessimistic worry.

What are the high traits associated with Novelty Seeking?

Quick-tempered, Curious, Easily bored, Impulsive, Extravagant.

What results are associated with low Novelty Seeking?

Slow-tempered, Stoic, Reflective, Frugal, Reserved.

What are the high traits associated with Reward Dependence?

Tender-hearted, Sensitive, Sociable, Socially dependent.

What results are associated with low Reward Dependence?

Practical, Tough-minded, Cold, Socially insensitive, Irresolute.

What are the high traits associated with Persistence?

Hardworking, Ambitious overachievers, Views fatigue or frustrations as a personal challenge.

What results are associated with low Persistence?

Inactive, Indolent, Unstable, Erratic, Frustrated and gives up easily.

What biological factors contribute to personality disorders?

Neurochemical imbalances (Serotonin, Norepinephrine, Dopamine), hormonal factors (androgens, estrogen, testosterone).

What psychodynamic factors influence personality disorders?

Social learning, culture, random life events, and character development through experiences with people and challenges.

What are the three major character traits?

Self-directedness, Cooperativeness, Self-transcendence.

What does self-directedness refer to?

Responsibility, reliability, resourcefulness, goal-oriented behavior, and self-confidence.

What does cooperativeness refer to?

Seeing oneself as an integral part of human society, being empathic, tolerant, and supportive.

What does self-transcendence refer to?

Considering oneself as an integral part of the universe, being spiritual, humble, and fulfilled.

What are the three clusters of personality disorders?

Cluster A (Odd/Eccentric), Cluster B (Dramatic/Emotional), Cluster C (Anxious/Fearful).

What is a characteristic of Paranoid Personality Disorder?

Persistent pattern of distrust and suspicion affecting relationships.

What are some signs and symptoms of Paranoid Personality Disorder?

Mistrust, suspicions of others, guardedness, restricted affect.

What nursing intervention is recommended for patients with Paranoid Personality Disorder?

Use a serious and straightforward approach, teach validation of ideas before action.

What is the main fear associated with Avoidant Personality Disorder?

Fear of rejection.

What is a common trait of Narcissistic Personality Disorder?

Self-centeredness.

What is a common trait of Histrionic Personality Disorder?

Attention-seeking behavior.

What is the fear associated with Dependent Personality Disorder?

Fear of being left alone.

What is a key characteristic of Schizoid Personality Disorder?

Pervasive pattern of detachment from social relationships and a restricted range of emotional expression.

What are common signs and symptoms of Schizoid Personality Disorder?

Restricted affect, aloofness, emotional coldness, uncaring demeanor, rarely experiencing enjoyment, indecisiveness, and lack of future goals.

What nursing interventions are recommended for clients with Schizoid Personality Disorder?

Improve community functioning and assist in finding a case manager.

What defines Schizotypal Personality Disorder?

Persistent pattern of social and interpersonal deficits marked by discomfort in close relationships and cognitive/perceptual distortions.

What are some signs and symptoms of Schizotypal Personality Disorder?

Magical thoughts, acute discomfort in relationships, cognitive or perceptual distortions, and eccentric behavior.

What nursing interventions are suggested for Schizotypal Personality Disorder?

Development of self-care, improvement of community functioning, and social skills training.

What is a defining feature of Antisocial Personality Disorder?

Persistent pattern of disregard for and violation of the rights of others.

What are some signs and symptoms of Antisocial Personality Disorder?

Low frustration tolerance, impulsive behavior, poor judgment, conflict with authority, lack of remorse, and manipulative behavior.

What nursing interventions can be used for clients with Antisocial Personality Disorder?

Promoting responsible behavior, limit setting, confrontation of problem behavior, and helping clients solve problems.

What is the goal of limit setting in nursing interventions for Antisocial Personality Disorder?

To state limits, identify consequences of exceeding limits, and establish expected behavior.

What are some strategies for managing impulsivity in clients with Antisocial Personality Disorder?

Effective problem-solving skills, expressing negative emotions, and taking time-outs from stressful situations.

What characterizes Borderline Personality Disorder?

Persistent pattern of unstable interpersonal relationships, self-image, affect, and marked impulsivity.

What is the primary focus of nursing interventions for clients with personality disorders?

Involve patients in treatment planning and improve their functioning in the community.

What is a common emotional state experienced by individuals with Schizoid Personality Disorder?

Emotional coldness and a lack of enjoyment.

What type of behavior is associated with Antisocial Personality Disorder?

Rule-breaking and manipulation.

What is a common intervention for improving self-care in clients with Schizotypal Personality Disorder?

Social skills training.

What is a significant challenge faced by individuals with Schizotypal Personality Disorder in relationships?

Acute discomfort in forming close relationships.

What is the importance of establishing a case manager for clients with Schizoid Personality Disorder?

To help them obtain services, health care, and manage finances.

How do nursing interventions for Antisocial Personality Disorder address emotional control?

By helping clients control emotions and solve problems.

What is the expected outcome of limit setting for clients with Antisocial Personality Disorder?

To encourage adherence to rules and treatment plans.

What is a common trait of individuals with Borderline Personality Disorder?

Marked impulsivity in behavior.

What are the signs and symptoms of Borderline Personality Disorder?

Unstable relationships, self-image issues, affect instability, impulsivity, and self-mutilation.

What is the primary focus of nursing interventions for clients with Borderline Personality Disorder?

Promoting client's safety and helping them cope and control emotions.

Name two cognitive restructuring techniques used in nursing interventions for Borderline Personality Disorder.

Thought stopping and decatastrophizing.

What are some nursing interventions for clients with Histrionic Personality Disorder?

Factual feedback, teaching social skills, role-playing, and assertive communication.

What characterizes Histrionic Personality Disorder?

Persistent pattern of excessive emotionality and attention-seeking behavior.

What are common signs and symptoms of Narcissistic Personality Disorder?

Arrogance, haughty attitude, lack of empathy, and envy of others' success.

What nursing interventions are recommended for clients with Narcissistic Personality Disorder?

Self-awareness skills, psychoeducation, and setting limits on rude or verbally abusive behavior.

What is a key characteristic of Avoidant Personality Disorder?

Pervasive pattern of social inhibition and hypersensitivity to negative evaluation.

What nursing interventions can help clients with Avoidant Personality Disorder?

Support and reassurance, cognitive restructuring techniques, and promoting self-esteem.

What is the primary fear associated with Dependent Personality Disorder?

Fear of being alone.

What nursing interventions are effective for clients with Dependent Personality Disorder?

Fostering self-reliance, teaching problem-solving skills, and decision-making skills.

What type of behavior is associated with Cluster B personality disorders?

Dramatic, emotional, or erratic behavior.

What type of behavior is associated with Cluster C personality disorders?

Anxious and fearful behavior.

What is the goal of care for clients with Narcissistic Personality Disorder?

To gain the client's cooperation.

How can clients with Borderline Personality Disorder express their feelings safely?

Through journaling and moderating emotional responses.

What is a common intervention for decreasing impulsivity in clients with Borderline Personality Disorder?

Delaying gratification.

What is a common misconception about Narcissistic Personality Disorder in adolescence?

That it necessarily indicates a personality disorder will develop in adulthood.

What is a common intervention for teaching social skills to clients with Histrionic Personality Disorder?

Modeling social skills and establishing eye contact.

What is a notable behavior of individuals with Histrionic Personality Disorder regarding relationships?

They exaggerate the closeness of relationships.

What is a significant emotional challenge for clients with Avoidant Personality Disorder?

Feelings of inadequacy and fear of judgment from others.

What is the importance of structuring time in nursing interventions for Borderline Personality Disorder?

It helps provide stability and predictability for the client.

What is a key aspect of self-care skills for clients with Narcissistic Personality Disorder?

Maintaining a matter-of-fact manner.

What is the main characteristic of Obsessive Compulsive Personality Disorder?

A pervasive pattern of preoccupation with perfectionism and control at the expense of flexibility and efficiency.

What are some nursing interventions for Obsessive Compulsive Personality Disorder?

Encourage negotiation with others, assist in making timely decisions, and use cognitive restructuring techniques.

What factors should be considered when determining treatment strategies for personality disorders?

Type and severity of the disorder, amount of distress, and functional impairment experienced by the client.

What are the four symptom categories relevant to medications for personality disorders?

Psychotic symptoms, affective symptoms, mood dysregulation, and aggression/behavioral dysfunction.

How does low reward dependence relate to personality disorders?

It is associated with affective dysregulation, detachment, and cognitive disturbances.

What is the drug of choice for managing aggression and impulsivity in personality disorders?

Lithium, anticonvulsants, and low-dose antipsychotics.

What medication is used for emotional lability in mood dysregulation?

Lithium, Carbamazepine (Tegretol), and antipsychotics.

Which medications are typically prescribed for anxiety in personality disorders?

SSRIs, MAOIs, and benzodiazepines.

What is the purpose of psychotherapy in treating personality disorders?

To build trust, teach basic living skills, provide support, decrease distress, and improve interpersonal relationships.

What therapy is recommended for Borderline Personality Disorder?

Dialectical Behavior Therapy, which focuses on distorted thinking and poorly regulated emotions.

What is the focus of Schema Therapy in treating personality disorders?

To help individuals deal with unmet emotional needs and identify thought and behavioral patterns perpetuating their distress.