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Personality and Impulse DisordersPsychiatric Nursing: Contemporary Practice

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What is the distinguishing characteristic between obsessive-compulsive disorder and obsessive compulsive anxiety disorder?
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With OCD, the person doesn't demonstrate obsessions and compulsions but rather rigidity, perfectionism and need for control.
What behaviors do patients with obsessive compulsive disorder demonstrate to maintain control?
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Careful attention to rules, trivial details procedures and lists
What is thought to contribute to the development of obsessive compulsive disorder?
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Parental overcontrol and overprotection that is restrictive and sets distinct limits on a child's behavior creating a deep sense of responsibility to others and guilt when responsibilities aren?t met.
When do patients with OCD typically seek help from mental health care professionals?
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When they have attacks of anxiety, spells of immobilization, sexual impotence or excessive fatigue.
What is the typical reaction of patients who have OCD as they are making changes to improve their quality of life?
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Extreme anxiety
Patients with _________ personality disorder benefit from long-term therapy because of the time it takes to make changes in their behaviors.
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Avoidant personality disorder
Where are people with dependent or obsessive compulsive disorder typically treated?
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In the community
___________ disorder is an impulse-control disorder characterized by aggressiveness that results in assaults or destruction of property and aggressiveness that is out of proportion to the provocation.
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Intermittent Explosive
___________ disorder is an impulse-control disorder characterized by an inability to resist the urge to steal items that the individual could easily afford.
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Kleptomania
_________ is the most common symptom identified in a compulsive shoplifter (kleptomaniac).
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Depression. Anxiety and stress appear to be related to the urge to steal to relieve tension.
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___________ disorder is an impulse-control disorder characterized by irresistible urges that aren't motivated by revenge, anger, suicidal ideation or political ideology to start fires along with arousal prior to starting fires.
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Pyromania
What neurochemical imbalances have been detected in people who engage in arson, like pyromaniacs?
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Low serotonin and norepinephrine levels
T/F People with impulse control disorders are remorseful and regret the activity they engaged in to relieve tension (like stealing, setting fires, etc.).
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TRUE
When is gambling considered pathologic?
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When it is recurrent and disrupts family or vocational pursuits.
T/F Boys with a history of starting fires benefitted from fire safety education and cognitive behavioral therapy.
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TRUE
What comorbid conditions are common in people who are pathologic gamblers?
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Depression, ADHD, Tourette's, and personality disorders (they are at risk for suicide)
What is the four phases of pathologic gambling?
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Winning, losing, desperation and hopelessness.
Caring for compulsive gamblers can be frustrating. Why is this?
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They tend to feel omnipotent in their ability to win back what was lost, are self-assured and overbearing. They must confront their self-deception and denial.
What are the first line drugs in treating pathologic gambling?
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SSRIs (they treat anxiety and impulsivity)
What is a key component to relapse prevention in patients with pathologic gambling problems?
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Identifying specific cues that trigger gambling behaviors
___________ disorder is an impulse-control disorder characterized by chronic, self-destructive hair pulling that results in noticeable hair loss along the scalp, eyebrows or eyelashes.
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Trichotillomania
  
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