Personality Disorders

Personality Disorders

Discussion: Therapy for Clients With Personality Disorders
Clients with personality disorders often find it difficult to overcome their problems and function in daily life. Even when these clients are aware that they have a dysfunction with their personality and are open to counseling, treatment can be challenging for both the client and the therapist. For this Discussion, as you examine personality disorders, consider therapeutic approaches you might use with clients. Personality Disorders

Learning Objectives
Students will:
Analyze therapeutic approaches to treating clients with personality disorders
To prepare:

Review this week’s Learning Resources and reflect on the insights they provide.
Select one of the personality disorders from the DSM-5.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!

 

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By Day 3
Post a description of the personality disorder you selected. Explain a therapeutic approach (including psychotropic medications if appropriate) you might use to treat a client presenting with this disorder, including how you would share your diagnosis of this disorder to the client in order to avoid damaging the therapeutic relationship. Support your approach with evidence-based literature.

Read a selection of your colleagues’ responses.

This assignment is for NURS6640 at Walden University. It’s week 11 for the course. Personality Disorders

Borderline Personality Disorder
This essay will focus on borderline personality disorder (BPD), which is a cluster B disorder (the erratic, emotional and dramatic types) (Siever & Davis, 2014). The features of this disorder include; being impulsive, manipulative with self-destructive/self-harm behaviors. Secondly, pathological attachments that are tinged with dread of being abandoned and fear. Thirdly, they have unstable self-images that are erratic. Fourthly, they have transient psychotic-like behaviors. Lastly, they are usually overwhelmed with angry demands and entitlement feelings (Glaser, Van, Mengelers & Myin-Germeys 2018).
Therapeutic modalities for BPD.
The treatment modalities focus on stabilizing the affect, anger, impulsivity, relationships, the transient dissociative/psychotic symptoms. The following pharmacological modalities are useful, firstly, The Tricyclic Antidepressants (TCAs), the disturbances of the serotonin levels have been associated with the self-harm, suicidality and impulsive aggression in BPD (Rinne, van den Brink, Wouters & van Dyck, 2016). TCA normalizes it relieving the patient. Secondly, use of first generation (typical) antipsychotics, its use is as a result of viewing BPD as a variant of the schizophrenic disorder. it was found that people with BPD have a lot of dopamine which was associated with the symptoms and the use of this drugs alleviates the symptoms. Thirdly, the second generation (atypical) antipsychotic they have an effect on the dopamine receptors, they have the same effects as the typical antipsychotics. Lastly, the mood stabilizers and the anticonvulsants. The main drug in this category is lithium, it helps in quieting the affective instabilities (Rifkin, Quitkin, Carrillo, Blumberg & Klein, 2016). The anticonvulsants help in reducing euphoria, anxiety, suicidality and impulsivity (Nickel, Muehlbacher, Nickel, Kettler, Gil, Bachler, … & Anvar, 2016).
Communicating the diagnosis to the client.
BPD is one of the most difficult mental disorder to diagnose and the most stigmatized. To reduce the stigmatization and increase the treatment adherence the patient needs full disclosure through interactive and patient-centered communication (Glaser, Van, Mengelers & Myin-Germeys 2018). Personality Disorders
Conclusion
In summary, BDP is a cluster B personality disorder that is managed by antipsychotic drugs, mood stabilizers, anti-depressants, and anti-convulsants. Its diagnosis and communication to the client are difficult as it shows signs of both schizophrenia and bipolar disorder. Therefore, patient-centered communication is important so as to maintain therapeutic communication.

References
Glaser, J. P., Van Os, J., Mengelers, R., & Myin-Germeys, I. (2018). A momentary assessment study of the reputed emotional phenotype associated with borderline personality disorder. Psychological Medicine, 38(9), 1231-1239.
Nickel, M. K., Muehlbacher, M., Nickel, C., Kettler, C., Gil, F. P., Bachler, E., … & Anvar, J. (2016). Aripiprazole in the treatment of patients with borderline personality disorder: a double-blind, placebo-controlled study. American Journal of Psychiatry, 163(5), 833-838.
Rifkin, A., Quitkin, F., Carrillo, C., Blumberg, A. G., & Klein, D. F. (2016). Lithium carbonate in emotionally unstable character disorder. Archives of General Psychiatry, 27(4), 519-523.
Rinne, T., van den Brink, W., Wouters, L., & van Dyck, R. (2016). SSRI treatment of borderline personality disorder: a randomized, placebo-controlled clinical trial for female patients with borderline personality disorder. American Journal of Psychiatry, 159(12), 2048-2054.
Siever, L. J., & Davis, K. L. (2014). The pathophysiology of schizophrenia disorders: perspectives from the spectrum. American Journal of Psychiatry, 161(3), 398-413. Personality Disorders

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