Comprehensive exams for Mental Health Q 79
A male client is admitted to a psychiatric facility by court order for evaluation for antisocial personality disorder. This client has a long history of initiating fights and abusing animals and recently was arrested for setting a neighbor’s dog on fire. When evaluating this client for the potential for violence, nurse Perry should assess for which behavioral clues?
A. A rigid posture, restlessness, and glaring
B. Depression and physical withdrawal
C. Silence and noncompliance
D. Hypervigilance and talk of past violent acts
Correct Answer: A. A rigid posture, restlessness, and glaring
Behavioral clues that suggest the potential for violence include a rigid posture, restlessness, glaring, a change in usual behavior, clenched hands, overtly aggressive actions, physical withdrawal, noncompliance, overreaction, hostile threats, recent alcohol ingestion or drug use, talk of past violent acts, inability to express feelings, repetitive demands and complaints, argumentativeness, profanity, disorientation, inability to focus attention, hallucinations or delusions, paranoid ideas or suspicions, and somatic complaints.
Option B: Before performing a comprehensive psychiatric assessment of the patient, a careful history and physical examination is necessary. “The DSM-5 diagnostic criteria for Antisocial Personality Disorder. A pervasive pattern of disregard for and violation of the rights of others, since age 15 years, as indicated by three (or more) of the following: failure to conform to social norms concerning lawful behaviors, such as performing acts that are grounds for arrest; deceitfulness, repeated lying, use of aliases, or conning others for pleasure or personal profit; Impulsivity or failure to plan; Irritability and aggressiveness, often with physical fights or assaults; reckless disregard for the safety of self or others; consistent irresponsibility, failure to sustain consistent work behavior, or honor monetary obligations; lack of remorse, being indifferent to or rationalizing having hurt, mistreated, or stolen from another person.
Option C: Of those children with conduct disorder, 25% of girls and 40% of boys will meet the diagnostic criteria for antisocial personality disorder. Boys exhibit symptoms earlier than girls, who often only elicit these symptoms in puberty. Children who do not develop conduct disorder and progress to the age of 15 without antisocial behaviors will not develop ASPD.
Option D: Antisocial personality disorder, although a chronic condition with a lifelong presentation, has had moderations shown with advancing ages, with the mean remitted age of 35 years old. Those with less baseline symptomatology showed better-remitted rates. Studies in the past revealed remission rates of 12 to 27% and 27 to 31% rates of improvement, but not remitted. Crime rates and severity reflect this relation as well, with peak crime statistics in late teens and higher severity of crimes at younger ages.