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Personality and Impulse DisordersPsychiatric Nursing: Contemporary Practice

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Why do health professionals miss underlying psychiatric disorders?
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They are tending to other aspects of patient care
__________ personality disorder is characterized by a person having problems regulating their moods, developing a sense of self, maintaining interpersonal relationships, reality based cognitive processes and avoiding impulsive or destructive behavior.
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Borderline Personality Disorder
What are the long term problems for a patient with borderline personality disorder?
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Feelings of intense anger, profound abandonment concerns
________, characterized by erratic emotional responses to situations and intense sensitivity to criticism or perceived slights, is a core characteristic of borderline personality disorder.
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Affective instability
________ occurs when a person lacks aspects of personal identity or when it is poorly developed. In patients with borderline personality disorder, it is often disturbed.
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Identity diffusion
What are the four factors of identity that are commonly disturbed in patients with borderline personality disorder?
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Role absorption (narrowly defined self in a single role), painful incoherence (internal disharmony), inconsistency and lack of commitment.
What does identity diffusion look like in a patient with borderline personality disorder?
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They appear to have no sense of their own identity or direction, they are distressed by it, experience chronic feelings of emptiness and boredom.
____________ thinking is a characteristic of people with borderline personality disorder. It is characterized by extreme interpretations of events that would normally be viewed as including both positive and negative aspects.
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Dichotomous
__________ is a common cognitive dysfunction seen in patients with borderline personality disorder. It is characterized by thinking, feeling or behaving outside a person's awareness.
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Dissociation
In patients with borderline personality disorder, there is a strong correlation between dissociation and ________.
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Self injurious behaviors
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People with borderline personality disorder demonstrate several dysfunctional behaviors. What behavior is seen when they are engaged in problem solving?
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Soliciting help from others in a helpless, hopeless manner and rarely taking the suggestions.
When are self-injurious behaviors like parasuicide, compulsive, episodic or periodic harm more likely to occur in a patient with borderline personality disorder?
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When the individual is depressed, has a highly unstable interpersonal relationship and is paranoid, hypervigilant and resentful.
What is considered the strongest risk factor for developing borderline personality disorder?
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Sexual abuse
What are considered risk factors for borderline personality disorder?
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Sexual abuse, physical abuse, parental loss and separation
What biologic differences have been found in patients with borderline personality disorder?
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CNS dysfunction, a smaller amygdala, limbic system and frontal lobe dysfunctions, decreased serotonin, increased alpha2 adrenergic receptor sites, and excessive dopaminergic activity.
What three borderline personality disorder characteristics are associated with biologic abnormalities?
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Affective instability, transient psychotic episodes and impulsive/aggressive/suicidal behavior
What are the two psychoanalytic concepts that focus on behaviors of borderline personality disorder?
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Separation-individuation and projective identification
___________ is the term for the time in which a child develops a sense of self, a permanent sense of significant others, and integration of both good and bad components of self. In patients with borderline personality disorder, this process isn't successful.
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Separation-individuation
What do theorists suggest is the reason for poor separation-individuation of patients with borderline personality disorder?
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Inconsistent or insensitive behaviors by a primary caregiver which causes a child to experience intense fear and anger when separating from others.
_________ is a defense mechanism used by people with borderline personality disorder to protect their self-image. It is characterized by unconsciously blaming others for what happens to them by attributing their own feelings to others.
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Projective identification
What is Lineham's theory regarding borderline personality disorder?
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The combination of a person's innate emotional vulnerability, emotional dysregulation (lack of control), and an environment that invalidates their emotions leads to borderline personality disorder.
  
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