Antisocial Personality Disorders Essay
Antisocial Personality Disorders Essay
Rhonda is a 32-year-old Hispanic female who presents to your office for her initial appointment. When you ask what brought her to your office, she states: “I’m at the end of my rope, I don’t know what else to do.” She then bursts into tears. Rhonda explains that she has very few friends left, and everyone seems to have “abandoned” her. Rhonda explains that she goes out of her way to help other people, and to be nice to them, but this does not seem to help Antisocial Personality Disorders Essay.
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Rhonda then stands up and begins to pace around your office at times using wild hand gestures to explain the circumstances that led up to her making the appointment with you. She describes the recent breakup with her boyfriend as traumatic and explains “when we first met, he was the best guy in the world. He treated me really well. But he just became a complete monster! Even though he broke off the relationship with me, I was glad to see it end. I hate his guts!”
Rhonda explains that her current financial situation is also precarious. She states that she recently purchased an automobile, and is not certain how she is going to pay for it. She states that she had a car that was repossessed last year at that time, and that she borrowed some money from a friend to help pay for the car; the friend later turned around and accused her of theft. “It was my friend’s fault. She told me she would loan me the money and then backed out. I only took the money because she said she would loan it to me … people just can’t go back on their word like that when other people are counting on them.”
Rhonda reports that she was “always in trouble” as a kid. She states that people were always picking on her, to which she adds: “the other kids my age were just stupid. They didn’t know how to have fun.” She says “I have always been impulsive, but it’s fun. Sometimes people can be such prudes … you only go around life once, so you have to make the best of it.”
Rhonda is currently single. She has no children. Educationally, she had completed two semesters toward her bachelor of arts degree in fine arts. Rhonda currently works as a waitress at a local restaurant. She has held this job for about 2 weeks. Prior to this, Rhonda worked as a housekeeper for a local hotel chain. She states that she was fired from this job because her coworkers were jealous of her and “planted” evidence of her stealing from hotel patrons. She was also arrested for cashing checks under an alias, for which she spent 120 days in jail.
Rhonda has a history of multiple incarcerations for offences ranging from larceny to possession of controlled substances to possession of an illegal firearm. She was also arrested several times for fighting and on at least one occasion, used a baseball bat to beat up a girl who she thought was trying to “set her up” with the police.
MENTAL STATUS EXAM
Rhonda is alert and oriented × 4 spheres. Her speech is clear, coherent, goal directed, and spontaneous. She reports her mood as “terrible!” Affect is labile and seems to change rapidly with the subject being discussed. Her eye contact is normal, but at times, she appears to stare at you. Rhonda is oriented to person, place, and time. She denies visual/auditory hallucinations, no overt paranoia or delusional thought processes noted. Rhonda denies any suicidal or homicidal ideation.
Personality disorder refers to an enduring pattern where an individual faces an inner experience and exhibits behavior that acts to deviate from the expected normal culture of an individual. This behavior is pervasive, and the individual tends to be inflexible. This condition is common at the onset of adolescence or the onset of early childhood and gains stability as the child in question grows up. When grown, the individuals with such conditions tend to exhibit distress and impairment (Kline, 2013)Antisocial Personality Disorders Essay.
There are various types of personality disorders that are classified into three categories. These include cluster A, cluster B, and cluster C individuals. The cluster A individuals are characterized by eccentric or odd features, cluster b individuals being known for their dramatic and emotional behaviors. The cluster C individuals, on the other hand, are marked by fear and anxiety. This task purposes to present a discussion on a patient with a personality disorder. The task will explore the trees decisions that relate to the various differential diagnoses, psychopharmacology, and psychotherapy based on the clinical manifestations exhibited by the woman (Kline, 2013).
Decision Pont One
The clinical manifestation of the patient evident in the case study is indicative of a mix of personality disorders. Most significant of the personality disorders are the antisocial personality disorder (APD) and borderline personality disorder (BPD). The patient has expressed fear and anxiety over abandonment, a trait that is highly associated with BPD. The patient in this case study also talks about her break-up with her boyfriend, the fact that touches on interpersonal relationship engagement with a man she idolizes and to whom she has interest. She appears to devalue the man she previously admired, a fact that depicts her as a BPD casualty as presented in the diagnostic criteria outlined by the American Psychology Association (2013).
My informed diagnosis for the patient in this case study is a clear case of ASPD. This is premised on the fact that the patient displays clinical manifestations of the ASPD condition than BPD. One of the factors that motivated my arrival at this conclusion is the fact that the patient lacked remorse. She stole from friends and was unapologetic, going ahead to accuse a fellow friend of the same. She does not comply with the universal norms and defies every law as being evidenced in her numerous arrests (Hatchett, 2015). The client, in this case, lacks every merit of right deeds, fails to uphold any standards of financial obligation and is an exact case of deceit. Moreover, the client is very irresponsible and does not show any capacity to keep her jobs, as evidenced by frequent firings and her ceaseless pursuit of new jobs. Based on these presentations, the factors are only evident with persons suffering from ASPD and for which this client is no exception.
Decision Point Two
Being that the client displays symptoms that are synonymous with the two subsets of personality disorder, it would be prudent to carry out psychological testing. This will enable the professional to decipher what lies between the two diagnoses or even justify the fact that the patient indeed suffered from the two subsets of personality disorders, that is, the antisocial and borderline personality disorders. Notably, such a condition is a possible occurrence and should never be ruled out (Hatchett, 2015).
It is intimated that there is scarce evidence on the possibility of medication being effective in the core symptoms of the ASPD. According to Khalifa et al. (2010), pharmaceutical interventions are considered to be adjunctive medications to target the symptoms of ASPD such as aggression and depression among other symptoms. They add that the pharmaceutical interventions are not and should not be deemed to be monotherapy (Kline, 2013). Haldol which is the antipsychotic drug can be used to reduce the severity of aggression but can’t treat the main features of the disorder like lack of remorse exhibited by the client in this case study. The medication can also bring about serious side effects that in other circumstances, can lead to non-compliance. It should be noted that psychotherapy can prove to be very beneficial. Be that as it may, psychodynamic is never recommended for such patients as it may first and foremost, call for the patient to address the state of emotions (Hatchett, 2015) Antisocial Personality Disorders Essay.
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Decision Point Three
The decision three recommends that the patient be admitted to group-based cognitive therapy. The dialectical behavioral therapy would not be as useful to the patient if she has a confirmed ASPD. It is only effective for those with BPD. The most effective approach would be the cognitive behavioral therapy (CBT). It is effective in the sense that it will make it possible for the client to explore and address the distorted beliefs on themselves, on others and the environment and the people around them (Hatchett, 2015). The approach will also enhance the interpersonal and social functioning of the individuals in question, such as this client.
Ethical and Legal Considerations
Due to various clinical manifestations of the ASPD, some professionals and clinicians have developed cold feet towards helping those with the condition. It is useful to note that professionals should be privy to the new treatment options for the condition and should at the same time disregard any myths that relate to the treatment of patients with ASPD. It should be remembered that such patient requires autonomy and confidentiality to the core until the clients are fit and ready to come out of the closet, treatment (Hatchett, 2015).
Hatchett, G. (2015). Treatment guidelines for clients with antisocial personality disorder. Journal of Mental Health Counseling, 37(1), 15-27.
Khalifa, N., Duggan, C., Stoffers, J., Huband, N., Völlm, B. A., Ferriter, M., & Lieb, K. (2010). Pharmacological interventions for antisocial personality disorder. status and date: New, published in, (8).
Kline, P. (2013). Handbook of psychological testing. Routledge Antisocial Personality Disorders Essay.