Qwivy | Qwivy.com | www.qwivy.com

NUR 2488 Mental Health Nursing

Final Exam Study Guide

Module 7

Common traits of borderline personality disorder

• Emotional lability, impulsivity, splitting, dichotomous thinking, idolizing others,

devaluation when disappointed, self-mutilation (cutting).

 Qwivy | Qwivy.com | www.qwivy.com

Nursing Interventions for Bipolar Personality Disorder

• Encourage the client to examine behavior.

• Help the client realize you’re available without reinforcing dependence.

• Rotate staff members to avoid client dependence on a particular individual.

• Recognize if the client is playing one staff member against another (splitting).

• With the client, explore feelings of abandonment (clinging and distancing).

• Assist the client to work towards “object constancy” without promoting

dependency.

Criteria for Antisocial Personality Disorder

• A pervasive pattern of disregard for and violation of the rights of others.

• Failure to conform to social norms with respect to lawful behavior.

• Deceitfulness.

• Impulsivity.

• Irritability and aggressiveness.

• Reckless disregard for the safety of self and others.

• Consistent irresponsibility.

• Lack of remorse.

 Qwivy | Qwivy.com | www.qwivy.com

Nursing Interventions for Antisocial Personality Disorder

• Make aware of the behaviors that are acceptable and those that are not. Explain

the consequences of violation of limits.

• Do not try to coax or convince the client to do the right thing. Do not use the

words “you should”, instead “you are expected to”.

• Provide positive feedback for acceptable behaviors in a matter-of-fact manner.

• Provide milieu that’s appropriate environment (specific rules, group therapy with

peer feedback).

• Discuss past behaviors with outcomes.

• Maintain attitude “It’s not you, but your behavior that’s unacceptable.”

• Use least restrictive method to control abusive to others behavior.

• Recognize manipulative behavior and set clear limits.

 Qwivy | Qwivy.com | www.qwivy.com

Treatment Modalities for Personal Disorders

• Interpersonal Psychotherapy

• Psychoanalytical Psychotherapy

• Milieu/Group Therapy

• Cognitive/Behavioral Therapy

• Dialectical Behavioral Therapy

Interpersonal Psychotherapy (IPT) – May require long-term therapy to understand and

modify maladaptive behaviors.

Psychoanalytical Psychotherapy – Focuses on unconscious motivation/need for seeking

total satisfaction from others.

Milieu/Group Therapy – Appropriate for others who respond more adaptively to

support and feedback from peers.

Cognitive-Behavioral Therapy (CBT) – This therapy helps the client recognize and

correct internal mental schemata.

 Qwivy | Qwivy.com | www.qwivy.com

Dialectal Behavior Therapy – This therapy was developed by Marsha Linehan as

treatment for the chronic, self-injurious behavior of clients with a borderline personality

disorder.

It is the most effective.

Pharmacologic’s for Personality Disorders

• NONE. Drugs have no effect and the direct treatment of the disorders themselves.

Medication treat symptomatic relief.

• Borderline Personality Disorder:

• Antipsychotics – treat paranoia, illusions, ideas of reference, anxiety, hostility

• SSRIs – treat impulsivity and self-destructive acts

• SSRI & SGAs – treat mood instability, impulsivity

• Antisocial Personality Disorder:

• Lithium & Propranolol – treat episodes of violence

 Qwivy | Qwivy.com | www.qwivy.com

Paranoid Personality Disorder

• Distrust of others

• Constantly on guard

• Hypervigilant – ready to react to any threat (real or imagined) insensitive to the

feeling of others

• Tense and irritable

• Feels others are trying to take advantage of them

• Attribute their shortcomings to others

• Don’t take responsibility for their own behavior

• Envious and hostile to others who are successful

• Can become aggressive and violent (with outbursts)

o *Cluster A (odd or eccentric traits):

o Characterized by distrust and suspiciousness toward others based on

unfounded beliefs that others want to harm, exploit, or deceive the person

 Qwivy | Qwivy.com | www.qwivy.com

Schizoid Personality Disorder

• Inability to form personal relationships

• Inability to respond to others in an emotional manner

• Prefer to work in isolation

• Display discomfort in human interaction

• Cold and aloof

• Inappropriately serious about everything

• No spontaneity

• Bland affect

o *Cluster A (odd or eccentric traits):

o Characterized by emotional detachment, disinterest in close relationships,

and indifference to praise or criticism; often uncooperative

 Qwivy | Qwivy.com | www.qwivy.com