Personality and Mood Disorders Q 34
A 20-year old college student has been brought to the psychiatric hospital by her parents. Her admitting diagnosis is borderline personality disorder. When talking with the parents, which information would the nurse expect to be included in the client’s history? Select all that apply.
A. Impulsiveness
B. Lability of mood
C. Ritualistic behavior
D. Psychomotor retardation
E. Self-destructive behavior
Correct Answers: Answer: A, B, & E
Borderline personality disorder (BPD) is a serious psychological condition that’s characterized by unstable moods and emotions, relationships, and behavior. It’s one of several personality disorders recognized by the American Psychiatric Association (APA). Personality disorders are psychological conditions that begin in adolescence or early adulthood, continue over many years, and, when left untreated, can cause a great deal of distress. Thankfully, the right treatments targeted for BPD can help significantly.
Option A: Impulsivity in at least two areas that are potentially self-damaging, for example, spending, substance abuse, reckless driving, sex, binge eating, etc. Note: Do not include suicidal or self-mutilating behavior covered in criterion 5. BPD is associated with a tendency to engage in risky and impulsive behaviors, such as going on shopping sprees, drinking excessive amounts of alcohol or abusing drugs, engaging in promiscuous or risky sex, or binge eating. Also, people with BPD are more prone to engage in self-harming behaviors, such as cutting or burning and attempting suicide.
Option B: Affective instability caused by a marked reactivity of mood, for example, intense episodic dysphoria, anxiety, or irritability, usually lasting a few hours and rarely more than a few days. Emotional instability is a key feature of BPD. Individuals feel like they’re on an emotional roller coaster with quick mood shifts (i.e., going from feeling OK to feeling extremely down or blue within a few minutes). Mood changes can last from minutes to days and are often intense. Anger, anxiety, and overwhelming emptiness are common as well.
Option C: Obsessive-compulsive disorder (OCD) is often a disabling condition consisting of bothersome intrusive thoughts that elicit a feeling of discomfort. To reduce the anxiety and distress associated with these thoughts, the patient may employ compulsions or rituals. These rituals may be personal and private, or they may involve others to participate; the rituals are to compensate for the ego-dystonic feelings of the obsessional thoughts and can cause a significant decline in function.
Option D: Psychomotor retardation is a long established component of depression that can have significant clinical and therapeutic implications for treatment. Manifestations of psychomotor retardation include slowed speech, decreased movement, and impaired cognitive function. It is common in patients with melancholic depression and those with psychotic features.
Option E: Borderline personality disorder (BPD) is 1 of 4 cluster-B disorders that include borderline, antisocial, narcissistic, and histrionic. Borderline personality disorder (BPD) is characterized by hypersensitivity to rejection and resulting instability of interpersonal relationships, self-image, affect, and behavior. Borderline personality disorder causes significant impairment and distress and is associated with multiple medical and psychiatric co-morbidities.