exam 3 psych

antisocial personality disorder risk factors

-genetically linked (twin studies indicate a predisposition to this disorder) -an alteration in serotonin transmission -childhood mistreatment -cultural bias have also been implicated

Borderline Personality Disorder (BPD) Nursing Dx

-risk for self mutilation -chronic low self-esteem -impaired socialization -impaired coping

antisocial personality disorder nursing dx

-risk for violence -impaired coping

DSM-5 criteria for conduct disorder

-the client often initiates fights -other's basic rights are violated -three of 15 criteria must be present -one criterion must be present in the past 6 months -the behavior has caused the child to be suspended from school -in adolescent onset, there are no symptoms before 10 years of age

therapy for antisocial personality disorder

-behavioral therapy -CBT -DBT -MBT -group therapy

Borderline personality disorder risk factors

-genetic component (first-degree biological relatives with the same disorder) -Serotonergic dysfunction may accompany the borderline trait of impulsivity. -disruption of the normal separation-individuation between the child and the mother.

antisocial personality disorder interventions

Assess current life stressors B. Assess for criminal history C. Assess for suicidal, violent, and/or homicidal thoughts D. Assess anxiety, aggression, and anger levels E. Assess motivation for maintaining control F. Assess for substance use (past and present)

antisocial personality disorder assessment

Assess current life stressors B. Assess for criminal history C. Assess for suicidal, violent, and/or homicidal thoughts D. Assess anxiety, aggression, and anger levels E. Assess motivation for maintaining control F. Assess for substance use (past and present)

therapy for borderline personality disorder

CBT, DBT and schema-focused therapy.

antisocial personality disorder signs and symptoms

History of violence • Violates rights of others • Anger and aggression • Impulsivity • Substance use • Illegal and reckless behaviors • Unstable relationships • Lacks empathy, callous, unemotional

Borderline Personality Disorder (BPD) interventions

Set realistic goals, using clear action words. B. Assess for manipulative behaviors (e.g., flattery, seductiveness, guilt instilling). C. Provide clear and consistent boundaries and limits. D. Use clear and straightforward communication. E. When behavioral problems emerge, calmly review the therapeutic goals and boundaries of treatment. F. Avoid rejecting or rescuing. G. Assess for suicidal ideation and non-suicidal self-injury, especially during times of stress.

which initial statement would the nurse say to a client with BPD who is badgering clients in the day room? a. you must leave people alone; this behavior is unacceptable b. there will be consequences if you do not stop annoying people c. tell me how you feel when you are exerting control over other people d. i'm surprised that you're acting this way; you seemed to have improved lately

a

which personality traits are exhibited in a client who has a diagnosis of BPD? select all that apply a. engaging b. indecisive c. withdrawn d. mainpulative e. perfectionistic

a, d

Cluster B personality disorders

antisocial, borderline, histrionic, narcissistic -dramatic, overly emotional or unpredictable thinking or behavior

Cluster C personality disorder

avoidant, dependent, obsessive-compulsive -anxious, fearful thinking or behavior

which response would the nurse expect from a client diagnosed with antisocial personality disorder? a. i need a lot of help with my troubles b. society makes people follow rules that don't apply to me c. this might help me straighten out my life d. i dont't like to be around other people for long periods of time

b

which strategies would the nurse implement for a client with conduct disorder to increase the client's ability to meet personal needs without manipulating others? a. discuss how others can precipitate anxiety b. provide physical outlets for aggressive feelings c. establish a contract regarding manipulative behavior d. develop activities that provide opportunities for success e. encourage the client to verbalize negative feelings to others

b, c, d

ego-systonic

behaviors, values, and feelings that are in harmony with or acceptable to the needs and goals of the ego, or consistent with one's ideal self-image.

which goal is applicable to adolescents with conduct disorder? a. increased impulse control and ability to focus b. identification of two positive personal attribute c. demonstration of respect for the rights of others d. age-appropriate play activites with at least one peer

c

which parameter would the nurse consider before confronting a client diagnosed with borderline personality disorder who has been consistently attempting to take advantage of other clients? a. the last time the med was given b. the depth of their working relationship c. the clients ability to be empathic toward others d. the degree of self-awareness exhibited by the client

c

the nurse discovers the client with antisocial personality disorder and visitors are smoking marijuana in the hall. Which response would the nurse make when the client responds, "i'm celebrating. I went to trial today and just got put on probation"? a. you were lucky you just got probation, so don't get right back into trouble b. i understand your relief about the trial, but smoking pot is against the rules c. it's important that you and your friends join the other visitors in the dayroom d. if you can't follow the rules against drug use on the unit, your visiting privileges will be canceled

d

which action would be difficult for a client who has BPD to complete during the orientation phase of a therapeutic relationship? a. controlling anxiety b. terminating the session on time c. accepting the psychiatric diagnosis d. setting mutual goals for the relationship

d

which intervention will the nurse use for a client diagnosed with BPD to develop healthier coping mechanisms? a. provide a stress-free environment b. encourage healthy relationships with peers c. allow the client to take responsibility for decisions d. set realistic limits on maladaptive behavior

d

which overall outcome would the school nurse formulate for a 6-year-old with ADHD? a. developing language skills b. avoiding regressive behavior c. attending regular classes in school d. enhancing self-image as a worth person

d.

which long-term outcome would the nurse use for a child who has conduct disorder? a. avoids verbally aggressive behavior for 4 months b. verbalizes 10 alternative methods to address anger c. is sent to the principal's office 5 times in 5 weeks d. has no physically aggressive episodes for 3 months

d. has no physically aggressive episodes for 3 months

Antisocial Personality Disorder (ASPD)

disorder in which a person uses other people without worrying about their rights or feelings and often behaves in an impulsive or reckless manner without regard for the consequences of that behavior. lack of empathy pre-cursor in childhood (conduct disorder) cluster B

meds for antisocial personality disorder

no medications specifically approved by the fda -mood-stabilizing medications such as lithium or valproic acid -SSRIs -Benzodiazepines used with caution -Methylphenidate (Ritalin) may help if there is a comorbidity of attention-deficit/hyperactivity disorder.

Cluster A personality disorders (weird)

paranoid, schizoid, schizotypal -odd eccentric thinking and behavior

Borderline Personality Disorder (BPD).

patterns of marked instability in -emotional regulation (dysregulation) -impulsivity, identity -unstable mood -unstable interpersonal relationships -Emotional lability is exhibited in moving from one emotional extreme to another, usually in response to a pathological fear of separation and intense sensitivity rejection.

antisocial personality disorder desired outcomes

refrain from violence

ego-dystonic

the opposite, referring to thoughts and behaviors (dreams, compulsions, desires, etc.) that are conflicting or dissonant with the needs and goals of the ego, or further, in conflict with a person's ideal self-image.

medication for borderline personality disorder

· there are no medications specifically approved by the FDA for treating borderline personality disorder. This means that prescribers use medications off-label until evidence-based pharmacotherapies are proven to be safe and effective. · SSRIs · Anticonvulsants · Lithium · 2nd gen. antipsychotics