©BRIGHTSTARS EXAM SOLUTIONS
11/16/2024 10:16 AM
NSG 2271, Psychosocial Nursing, Chapter 22,
Personality and Impulse Control Disorders.
Exam Questions With Correct Answers
Anti-Social Personality Disorder (ASPD) (Cluster B) - answer✔is characterized by a pervasive
pattern of disregard for and violation of the rights of others (occurring since age 15).
psychopath or sociopath - answer✔a person with a tendency toward antisocial and criminal
behavior with little regard for others; often used to describe persons with ASPD
Clinical & Diagnostic Criteria for ASPD - answer✔Individuals display arrogant, self-centered,
privileged and entitled behavior. They are self-serving and exploit and seek power over others.
They can be interpersonally engaging and charming which is often mistaken for a genuine sense
of concern for others. They lack empathy; are unable to express human compassion; and tend
to be insensitive, callous and contemptuous of others. Deceit and manipulation for personal
profit or pleasure are central features. They are behaviorally impulsive and interpersonally
irresponsible. Many people with this disorder repeatedly perform acts that are grounds for
arrest. They act hastily and spontaneously, are temperamentally aggressive and shortsighted,
and fail to plan ahead or consider alternatives. They fail to adapt to ethical and social standard
of the community and lack a sense of personal obligation to fulfill social and financial
responsibilities. They lack remorse.
Twelve month prevalence rates of ASPD are estimated between ___ and ___ %. - answer✔0.2
to 3.3 %
Risk Factors for ASPD - answer✔A) Males with alcohol use disorder and those released from
substance abuse clinics, prisons, or other forensic settings
B) Those with adverse socio-economic or socio-cultural factors
1|Page
, ©BRIGHTSTARS EXAM SOLUTIONS
11/16/2024 10:16 AM
(to be diagnosed the individual must be at least 18 and have exhibited one or more childhood
behavioral characteristics of conduct disorder before age 15 such as aggression to people or
animals, destruction of property, deceitfulness or theft, or serious violation of rules)
Comorbidity of ASPD - answer✔It is associated with several other psychiatric disorders,
including mood, anxiety, and other personality disorders. Strongly associated with alcohol and
drug use, but is not warranted if the behavior occurs only in the context of substance abuse.
Etiology of ASPD - answer✔Biologic Theories - studies show changes associated with
personality disorders or characteristics, but there is no evidence that these changes caused the
disorder. Early MRI studies showed that persons with ASPD failed to activate the limbic-
prefrontal circuit during fearful situations. These findings support neural basis of fearlessness in
these individuals. Impairment in moral judgment is associated with dysfunction of the
prefrontal cortex. Emotional distance, aggression, and impulsivity are consistently associated
with neural dysfunction.
Psychosocial Theories:
a) Temperament - scientist believe temperament is neurobiologically determined and is central
to understanding personality disorders. Two behavioral dimensions of temperament are activity
spectrum with varies from intense to passive, and the adaptability spectrum which varies from
having a positive attitude about new stimuli with high flexibility to withdrawal from new stimuli
with minimal flexibility in response to change. A strong relationship is found between difficult
temperament and ASPD.
b) Attachment - unsatisfactory attachments in early relationships lead to antisocial behavior in
later life. Risk factor for developing dysfunctional attachment include parental abandonment or
neglect, loss of a parent or caregiver, physical or sexual abuse. Parents who lack secure
attachments in their own childhood may be unable to form secure attachments with their
children.
c) Family Issues - Individuals with ASPD may come from chaotic families in which alcoholism and
violence are the norm. Individuals who are victims of abuse and neglect, live in foster homes, or
had several primary caregivers are more likely to be victimized by antisocial behavior, especially
aggression.
2|Page
, ©BRIGHTSTARS EXAM SOLUTIONS
11/16/2024 10:16 AM
Treatment goals for patients with ASPD - answer✔to develop a nurturing sense of attachment
and empathy for other people and situations and to live within the norms of society
Evidenced Based Nursing Care for Patients with Antisocial Personality Disorder (ASPD) -
answer✔Mental Health Nursing Assessment - key areas of assessment are determining the
quality of relationships, impulsivity, and the extent of aggression.
Nursing Diagnosis - Common diagnosis is Risk for Other Directed Violence, Dysfunctional Family
Processes, also Ineffective Role Performance, Ineffective Individual Coping, Impaired
Communication, Impaired Social Interactions, low Self-esteem, and Risk for Violence.
Outcomes - should be short-term and relevant to a specific problem. (Evaluate outcomes in
terms of management of specific problems).
Therapeutic Relationship - goal should be to identify dysfunctional thinking patterns and
develop new problem-solving behaviors.
Interventions include:
1) Facilitating Self-Responsibility - encouraging patient to assume responsibility for personal
behavior.
2) Enhancing Self-Awareness - exploring and understanding personal thoughts, feelings,
motivations and behaviors.
3) Teaching the patient about positive health care practices, impulse control, and anger
management by engaging the individual in discussion bout the issues then direct the topic to
the major teaching points
4) Group Interventions are more effective than individual modalities. Example: problem solving
groups that focus on identifying a problem and developing solutions are helpful because
patient self-responsibility is reinforced when patients remind each other of better alternatives.
5) Milieu Interventions - it is important to provide a structured environment with rules.
6) Anger Management - because the expression of anger and aggression develops during a
lifetime, these individuals can benefit from anger management techniques.
3|Page
11/16/2024 10:16 AM
NSG 2271, Psychosocial Nursing, Chapter 22,
Personality and Impulse Control Disorders.
Exam Questions With Correct Answers
Anti-Social Personality Disorder (ASPD) (Cluster B) - answer✔is characterized by a pervasive
pattern of disregard for and violation of the rights of others (occurring since age 15).
psychopath or sociopath - answer✔a person with a tendency toward antisocial and criminal
behavior with little regard for others; often used to describe persons with ASPD
Clinical & Diagnostic Criteria for ASPD - answer✔Individuals display arrogant, self-centered,
privileged and entitled behavior. They are self-serving and exploit and seek power over others.
They can be interpersonally engaging and charming which is often mistaken for a genuine sense
of concern for others. They lack empathy; are unable to express human compassion; and tend
to be insensitive, callous and contemptuous of others. Deceit and manipulation for personal
profit or pleasure are central features. They are behaviorally impulsive and interpersonally
irresponsible. Many people with this disorder repeatedly perform acts that are grounds for
arrest. They act hastily and spontaneously, are temperamentally aggressive and shortsighted,
and fail to plan ahead or consider alternatives. They fail to adapt to ethical and social standard
of the community and lack a sense of personal obligation to fulfill social and financial
responsibilities. They lack remorse.
Twelve month prevalence rates of ASPD are estimated between ___ and ___ %. - answer✔0.2
to 3.3 %
Risk Factors for ASPD - answer✔A) Males with alcohol use disorder and those released from
substance abuse clinics, prisons, or other forensic settings
B) Those with adverse socio-economic or socio-cultural factors
1|Page
, ©BRIGHTSTARS EXAM SOLUTIONS
11/16/2024 10:16 AM
(to be diagnosed the individual must be at least 18 and have exhibited one or more childhood
behavioral characteristics of conduct disorder before age 15 such as aggression to people or
animals, destruction of property, deceitfulness or theft, or serious violation of rules)
Comorbidity of ASPD - answer✔It is associated with several other psychiatric disorders,
including mood, anxiety, and other personality disorders. Strongly associated with alcohol and
drug use, but is not warranted if the behavior occurs only in the context of substance abuse.
Etiology of ASPD - answer✔Biologic Theories - studies show changes associated with
personality disorders or characteristics, but there is no evidence that these changes caused the
disorder. Early MRI studies showed that persons with ASPD failed to activate the limbic-
prefrontal circuit during fearful situations. These findings support neural basis of fearlessness in
these individuals. Impairment in moral judgment is associated with dysfunction of the
prefrontal cortex. Emotional distance, aggression, and impulsivity are consistently associated
with neural dysfunction.
Psychosocial Theories:
a) Temperament - scientist believe temperament is neurobiologically determined and is central
to understanding personality disorders. Two behavioral dimensions of temperament are activity
spectrum with varies from intense to passive, and the adaptability spectrum which varies from
having a positive attitude about new stimuli with high flexibility to withdrawal from new stimuli
with minimal flexibility in response to change. A strong relationship is found between difficult
temperament and ASPD.
b) Attachment - unsatisfactory attachments in early relationships lead to antisocial behavior in
later life. Risk factor for developing dysfunctional attachment include parental abandonment or
neglect, loss of a parent or caregiver, physical or sexual abuse. Parents who lack secure
attachments in their own childhood may be unable to form secure attachments with their
children.
c) Family Issues - Individuals with ASPD may come from chaotic families in which alcoholism and
violence are the norm. Individuals who are victims of abuse and neglect, live in foster homes, or
had several primary caregivers are more likely to be victimized by antisocial behavior, especially
aggression.
2|Page
, ©BRIGHTSTARS EXAM SOLUTIONS
11/16/2024 10:16 AM
Treatment goals for patients with ASPD - answer✔to develop a nurturing sense of attachment
and empathy for other people and situations and to live within the norms of society
Evidenced Based Nursing Care for Patients with Antisocial Personality Disorder (ASPD) -
answer✔Mental Health Nursing Assessment - key areas of assessment are determining the
quality of relationships, impulsivity, and the extent of aggression.
Nursing Diagnosis - Common diagnosis is Risk for Other Directed Violence, Dysfunctional Family
Processes, also Ineffective Role Performance, Ineffective Individual Coping, Impaired
Communication, Impaired Social Interactions, low Self-esteem, and Risk for Violence.
Outcomes - should be short-term and relevant to a specific problem. (Evaluate outcomes in
terms of management of specific problems).
Therapeutic Relationship - goal should be to identify dysfunctional thinking patterns and
develop new problem-solving behaviors.
Interventions include:
1) Facilitating Self-Responsibility - encouraging patient to assume responsibility for personal
behavior.
2) Enhancing Self-Awareness - exploring and understanding personal thoughts, feelings,
motivations and behaviors.
3) Teaching the patient about positive health care practices, impulse control, and anger
management by engaging the individual in discussion bout the issues then direct the topic to
the major teaching points
4) Group Interventions are more effective than individual modalities. Example: problem solving
groups that focus on identifying a problem and developing solutions are helpful because
patient self-responsibility is reinforced when patients remind each other of better alternatives.
5) Milieu Interventions - it is important to provide a structured environment with rules.
6) Anger Management - because the expression of anger and aggression develops during a
lifetime, these individuals can benefit from anger management techniques.
3|Page
