Antisocial Personality Disorder Assignment

Antisocial Personality Disorder Assignment

Antisocial personality disorder is manifested by a pattern of socially reckless, exploitative, manipulative and guiltless behavior. Symptoms of the disorder encompass; failure to adhere to regulations and law, inability to sustain employment, manipulation other people for individual gain, deception, as well as inability to develop and sustain interpersonal relationships (Sadock et al, 2014). An antisocial personality disorder is associated with comorbid mental health and addictive disorders such as bipolar disorder, depression, substance abuse, sexual disorder, anxiety disorder, among other disorders. Individuals with antisocial personality disorder are at risk of accidents, suicide, traumatic disorders, sexually transmitted infections; therefore, this population has a high mortality rate (Back, 2015). The case study presents a 32-year-old female (Rhonda) with an antisocial personality disorder. From the case study, Rhonda is manipulative, deceitful, exploits others to her advantage and blames everyone else but her for her mistakes. She also lacks remorse as indicated by her inability to feel remorse after failing to pay back her friend’s money. Rhonda is also irresponsible in her finances and job as well and also steals and gets in trouble with the law as indicated by the 120 days incarceration. It is also evident that the client’s disorder started manifesting during her childhood as she reported that she was always in trouble as a kid (Laureate Education, 2017a).  According to the DSM-5 criteria, symptoms of antisocial personality disorder include; disregarding and violating rights of other people, the individual should be above 18 years, and the misconduct behavior presented before 15 years (American Psychiatric Association, 2013). Rhonda fits the DSM-5 diagnostic criteria for antisocial personality disorder. Antisocial Personality Disorder Assignment

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Decision Point 1

Differential Diagnosis

At this point, it is essential to establish when the client started manifesting symptoms of antisocial personality disorder. If she started manifesting these symptoms before the age of 18, then there is the likelihood that the client has antisocial personality disorder.

Expected Outcome

From the assessment of the provided information in the case study, the client manifests symptoms of antisocial personality disorder. The client is unable to maintain relationships with her friend and boyfriend. She blames everyone else for her mistakes for example where she fails to pay her friend’s dent and still puts blame on her (Laureate Education, 2017a). She is irresponsible as indicated by her financial mismanagement and her inability to maintain employment. She often gets in trouble with the law as indicated by her imprisonment for stealing, illegal possession of a gun and possession of controlled substances. In addition, she has no regard for the law and rules as indicated by the stealing behavior and cashing cheque using fake names. She also lacks remorse and is not guilty as she is never remorseful for anything she does and keeps blaming them for her mistakes. She also manifests aggressive behavior, for instance where she thrashed a lady using a baseball bat (Laureate Education, 2017a).

Difference between Expected Outcome and the Achieved Outcome

The client manifests symptoms that are consistent with symptoms of antisocial personality disorder and therefore there is no difference between the expected outcome and achieved outcome.

Decision Point Two

Refer to Psychologist for Psychological Testing

The Rationale for the Decision

The rationale for this decision is to ensure a comprehensive evaluation of the client by administering psychological tests in order to have an objective and standardized assessment of her behavior. In this regard, Rhonda will be administered with various clinical inventories and scales in order to reveal any behavioral problems, cognitive problems, personality or other psychiatric issues (Bornstein, 2015). Antisocial Personality Disorder Assignment

Expected Outcome with this Decision

With this decision, it is expected that the diagnosis of antisocial personality disorder will be confirmed. It is also expected that the administered psychological tests will reveal other comorbid conditions and other mental health issues Rhonda might be having, apart from antisocial personality disorder.

Difference between Expected Outcome and the Achieved Outcome

The result of a comprehensive psychological battery test indicated that the client Rhonda manifested traits of multiple personality disorder but scored highest in antisocial personality traits, and this highly suggested that the client’s diagnosis was antisocial personality disorder. Evidently, there is no difference between the expected outcome and the achieved outcome because as expected the psychological testing confirmed the diagnosis of antisocial personality disorder and also revealed a likelihood of other comorbid conditions as indicated by traits of multiple personality disorder.

 Decision Point Three

Refer to group-based cognitive behavior therapy

The Rationale for the Decision

The rationale for selecting group-based cognitive behavior therapy is because group CBT has been shown to be effective in addressing personality disorders such as antisocial personality disorder (Bateman et al, 2015). From the perspective of CBT, an antisocial personality disorder is maintained by maladaptive beliefs, environmental/contextual factors that support the problematic behavior and skill deficits impede adaptive responding (Naza & Ramganesh, 2017). CBT integrates various techniques to modify such factors and this includes cognitive restructuring, modifying the behavior, exposure, psycho-education, as well as skills training. Additionally, CBT for Rhonda will emphasize the significance of a supportive, collaborative and definite therapeutic relationship in order to improve her willingness to make changes (Naza & Ramganesh, 2017). A group therapy will also give Rhonda an opportunity to learn the appropriate social skills by interacting with other group members.

Expected Outcome with this Decision

With this decision, it is expected that symptoms of antisocial personality disorder for the client will improve and that she will change her maladaptive beliefs and learn social skills, and thus modify her behavior and adopt a socially acceptable behavior.

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Ethical Considerations

Ethical considerations that should be taken into account include informed consent. It is important for the health practitioner to seek informed consent from Rhonda before any care provision. Even before performing any assessment informed consent should be sought in order to enable Rhonda to make an informed decision about treatment. It is also important to respect the client’s autonomy about the treatment (Howe, 2013).  In addition, confidentiality and privacy of any information that the client reveals during the course of treatment should be respected; such information should not be revealed to a third party without the client’s consent (Warrender, 2017). Finally, treatment of individuals with personality disorders such as Rhonda requires the awareness of and effective management of boundary issues. Boundary issues include excessive phone calls during therapy, as well as irrational demands on the therapeutic relationship for accessibility and availability. Accordingly, a healthcare practitioner should be able to identify the genuine needs of the client and maintain firm boundaries in order to ensure competent and ethical treatment (Warrender, 2017).  Antisocial Personality Disorder Assignment

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. (5th Edition). Washington, DC: American Psychiatric Association.

Bateman, A. W., Gunderson, J., & Mulder, R. (2015). Treatment of personality disorder. The Lancet. 385(9969), 735-743.

Back D. (2015). The Natural History of Antisocial Personality Disorder. Can J Psychiatry. 60(7), 309–314.

Bornstein R. (2015). Personality Assessment in the Diagnostic Manuals: On Mindfulness, Multiple Methods, and Test Score Discontinuities. J Pers Assess. 97(5), 446–455.

Howe E. (2013). Five Ethical and Clinical Challenges Psychiatrists May Face When Treating Patients with Borderline Personality Disorder Who Are or May Become Suicidal. Innov Clin Neurosci. 10(1), 14–19.

Laureate Education. (2017a). A woman with personality disorder [Interactive media file]

Baltimore, MD: Author.

Nazar N & Ramganesh E. (2017). Cognitive Behavior Treatment of Personality Disorders. International Journal of Humanities and Social Science Invention. 6(11), 20-29.

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry:

       Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Warrender D. (2017). Borderline personality disorder and the ethics of risk management: The action/consequence model. Nursing Ethics. 25(7), 918-927.

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Antisocial Personality Disorder Assignment