Personality Disorder Scenario Discussion

Introduction

Personality Disorders are a group of disorders that are characterized by the individual having “rigid and unhealthy patterns of thinking’(mayo clinic, n.d.). These pt. tend to have trouble dealing with every day stressors.(Sadock, Sadock, & Ruiz, 2014). About 10 to 20% of the world’s population have this disorder.(Sadock et al., 2014)

This paper will describe a scenario in a 32 y/o pt. named Rhonda who has a personality disorder.(Laureate Education, n.d.)

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Case Scenario

Rhonda is a 32 y/o Hispanic female who presents to the office for mental health care. She states multiple life stressors, such as a recent break up with her boyfriend, whom she describes at the start of their relationship was nice to her but the relationship later soured. She states “I hate his guts!” (Laureate Education, n.d., para. 1). Rhonda describes having very few friends and feels like everyone has abandoned her.

She has been in jail many times for firearm offenses, and possession of controlled substances. fighting and also stealing. She also describes an incident where a friend offered to loan her money, backed out and Rhonda stole the money anyway.

Rhonda also describes being at “ the end of her rope”(Laureate Education, n.d.)

Decision 1

Based on the information provided I chose the diagnoses of Antisocial Personality Disorder. I selected this decision because people with APD due to the fact that Rhonda has been incarcerated , lacks respect for the rights of others , and she is also dramatic , erratic and emotional.(Sadock et al., 2014) This is also congruent with the DSM V criteria for APD . ( fighting, stealing, emotional and little respect for the rights of others)(DSM 5, 2017). I hoped to achieve and early accurate diagnoses, and treatment plan for Rhonda. Early diagnoses and psychotherapy will provide the pt. the best chance at living a normal life.(Sadock et al., 2014)

There was little difference in what I expected to happen and what did happen. My diagnoses fit with the DSM V criteria.

Decision 2

APD can be very challenging to diagnose, as the s/s mimic other personality disorders.(Sadock et al., 2014) Psychotherapy testing is actually considered one of the best diagnostic aids in APD. (Nelson-Gray, 2009). Also, there are limited treatment options, so with this in mind psychological testing would be in order.(Sadock et al., 2014)

So, I chose psychological testing for Rhonda. The difference between what I expected to happen and what did happen were that the testing did lean towards APD , and that Rhonda tolerated the amount of time that it took to administer the test. The other surprise that Rhonda was open to getting better and even though she wasn’t happy about she was willing to go on with treatment.

Decision 3

Psychological testing is to be used to zero in on the actual disorder that the pt. has to return to some semblance of normal functioning.(Nelson-Gray, 2009) Also, there are no FDA approved medications for the treatment of APD. (mayo clinic, n.d.). So, I chose the option of group CBT. Group CBT therapy has shown the greatest amount of success in managing the negative s/s of APD, while providing some coping skills. Dialectical behavior therapy(Sadock et al., 2014)

Ethical Considerations

About 10-20% of people suffer with APD, with this in mind it is also found that it carries a large risk of suicide. The ethical consideration would be to the provider to always assess for suicidal ideations and be ready to act in the best interest of the pt.(Sadock et al., 2014). To this end , communication with the families of friends of the pt. is vital for collateral information that the pt. may or may not share. This is done ultimately to keep the pt. safe.

References

Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition. (2017). http://dx.doi.org/Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition https://doi-org.ezp.waldenulibrary.org/10.1176/appi.books.9780890425596 Full Access

Laureate Education. (n.d.). www.waldenu.edu

mayo clinic. (n.d.). www.mayoclinic.com

Nelson-Gray, R. O. (2009). Assessment and treatment of personality disorders : A behavioral perspective . Retrieved from http://dx.doi.org/10.1037/h0100662

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s Synopsis of Psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.