PERSONALITY DISORDERS 1
Diagnosesand Treatment of Personality Disorders
Diagnosesand Treatment of Personality Disorders
The knowledge about the classification of personality disorders hasevolved over time. Throughout history, there have been differentclassification systems used to describe and diagnose personalitydisorders at a particular point in time. Some of the alternative andtraditional methods of diagnosing and describing personalitydisorders included the categorical, dimensional, as well asprototypical approaches (Barlow & Durand, 2012).
In this approach, Kraepelin suggested that a psychological disorderhas one set of causative factors, which do not lap over otherdisorders (Barlow et al., 2012). For a person to be diagnosed with aparticular disorder, he or she must present one defining criterion,which each in that category should meet. In this method, a person hasa disorder or not.
In this method, personality disorders are classified on a scaleranging from very healthy to very unhealthy (Barlow et al., 2012).Every person has a personality therefore, classifying personalitieson a continuum forms the most accurate diagnoses.
According to Barlow et al., (2013), a prototypical approach is analternative method of classifying and organizing personalitydisorders to both dimensional and categorical approaches. In thisapproach, a personality disorder is diagnosed through variouspossible features for an individual to fall into a specific category.
Currently, there are two diagnostic systems for personality disordersincluding the DSM and the ICD. The DSM-5 classifies the tenpersonality disorders in clusters of three namely cluster Acharacterized by eccentric or odd behavior, cluster B characterizedby dramatic or erratic behavior, as well as cluster C characterizedby anxious or fearful behavior. The paranoid personality disorderfalls under cluster A, and a patient with this disorder exhibitssymptoms of distrust and suspicion of other people. The antisocialpersonality disorder falls under cluster B, and its symptoms includeinvasion and violation of rights of other individuals. The avoidantpersonality disorder fall under cluster C and a person with thisdisorder present symptoms like inadequate feelings, high sensitivityto criticisms, and social suppression (Kring, Davison, & Johnson,2016).
Mary’s presentation best fits the personality cluster B, and hercondition can be best described by the borderline personalitydisorder. Mary finds it difficult to keep friends, she is emotionallyunstable, which is characterized by rage, irritability, severe moodswings, suicidal thoughts, and strange experiences such as vibrationsfrom her peers, impulsive behavior such as self-harm and engaging inirresponsible behaviors like drug abuse and prostitution. The mostcentral aspect of Mary’s behavior over time that led to thisdiagnoses is her inability to maintain stable relationships. Mary haddifficulties relating with her high school peers, co-workers, andeven her therapist.
Mary presentssymptoms of distrust and suspicion to other people, and this “symptompicture” might lead to erroneous diagnosis of thinking that she issuffering from a paranoid personality disorder. Borderlinepersonality disorder can be best treated by Dialectical behaviortherapy (DBT) (Kring et al., 2016). The therapist assists the patientin realizing that the condition he or she has is due to emotionalvulnerability or due to emotional dismissal in early developmentalstages. The therapist brings positive change to the client by helpingthe client come to the realization that his or her emotions are real,acceptable, and valid. Moreover, through dialectics, the client ismade to understand the importance of being open to other people`sopinions and ideas that might be in conflict with those of his or herown (Kring et al., 2016).
Legaland Ethical Issues
A person with borderline personality disorder is likely to engage invarious criminal offenses such as intimate partner violence, serialmurder, reckless driving, intoxication, drug abuse, and homicide. Atthis point, such people are arrested and face criminal charges.Mental health courts and forensic hospitals treat borderlinepersonality disorder offenders as clients who can become law abidingcitizens. A multidisciplinary team approach comprised of justicesystem representatives, social support systems, and mental healthproviders, is used in mental health courts (Daff & Thomas, 2014).The judge supervises and oversees the patient’s treatment and themental health providers conduct screening and therapy to theoffenders.
If Mary happened to have committed a crime, she would be admissiblefor trial because the criminal justice system argues that apersonality disorder is not equivalent to a mental illness. Becauseof her current mental state, Mary is competent to stand trial. Daffet al., observed that several issues are taken into considerationbefore a decision for trial is made including the accused competencyfor trial, the sanity of the accused at the time of the criminal act,the influence of the mental illness leading to diminished capacity,and the accused execution competence. Also, for experts who seek totestify about a particular mental health issue, there are severalguidelines that determine the reliability of the testimony such astestability of the proposed theory, the reliability and validity ofthe testing procedure, and so forth (Daff et al., 2014).The symptompattern that would justify Mary’s need for civil commitment is heraddiction to drugs and premature termination of various therapies.
Barlow, D. H., &Durand, M. (2012). Abnormal Psychology: An Integrative Approach.Boston: Cengage Learning.
Daff, E., &Thomas, S. (2014). Bipolar disorder and criminal offending: a datalinkage study. Social Psychiatry Epidemiology, 49(12),1985-1991.
Kring, A. M.,Davison, G. C., Johnson, S. L., & Neale, J. M. (2016). AbnormalPsychology Twelfth Edition Wiley International Edition PremiumCustom Edition. New Jersey, NJ: John Wiley & Sons.