Personality Disorders

More than 20 years ago Habib Davanloo coined the term unlocking of the unconscious to describe how the psychodynamic concept of the human unconscious can become accessible using the technique of Intensive Short-Term Dynamic Psychotherapy (ISTDP). According to Davanloo, the possibility that unconscious material will be revealed is greatly increased when therapeutic efforts promote dominance of the unconscious therapeutic alliance over unconscious resistance. When these ingredients are present there is a psychic shift that allows unacceptable painful feelings to come to the surface. Toward adding further empirical support for the concept, in this article we compare outcomes between patients who experienced one or more major unlocking of the unconscious (N = 57) to those who did not experience major unlocking (N = 32) during ISTDP treatment. Significant and widespread differences were seen between these two groups, those with major unlocking had greater symptom reduction, interpersonal...

Gresham, F. M. & Elliott, S. N. (2016). Inventário de Habilidades Sociais, Problemas de Comportamento e Competência Acadêmica para Crianças: SSRS Manual de aplicação, Apuração e Interpretação [Del Prette, Z. A. P., Freitas, L. C., Bandeira, M. & Del Prette, A.  Autores da adaptação e padronização brasileira]. São Paulo: Pearson.

Ver detalhes aqui: http://www.casadopsicologo.com.br/ssrs-inventario-de-habilidades-sociais-problemas-de-comportamento-e-competencia-academica-para-criancas-kit-completo.html#.Vq4xseanfqh

The Shedler-Westen Assessment Procedure (SWAP) is a personality assessment instrument designed for use by expert clinical assessors. Critics have raised questions about its psychometrics, most notably its validity across observers and situations, the impact of its fixed score distribution on research findings, and its test-retest reliability. We review empirical data addressing its validity, emphasizing the multitrait-multimethod approach to evaluating test validity. To evaluate the hypothesis that the fixed, asymmetric score distribution artifactually inflates correlations between SWAP profiles, we conducted Monte Carlo simulations and also presented empirical data from a large patient sample. We observed a mean correlation of zero between simulated SWAP profiles, indicating that the score distribution does not impact the correlation coefficients. Empirical correlations between SWAP profiles of actual patients were small and similar to those obtained using Diagnostic and Statistica...

Aim: We explored therapists' and clients' experiences of alliance rupture events for the first 15 sessions of each of eight cases; therapists were each paired with one client who had a personality disorder. Method: All sessions were videotaped and rated with the Rupture Resolution Rating System. Approximately 1 week after a rupture, clients and therapists were individually interviewed about the causes of the rupture, how the rupture evolved, the impact of the rupture on the therapeutic process, and experiences during the event. The interviews were analyzed by five judges using consensual qualitative research (CQR; Hill, 2011). Results: Typically, rupture events involved a repetition of a previous rupture event, the rupture emerged when the client was not prepared to respond to the therapist's intervention, both therapists and clients felt confused and ambivalent, and confrontation events activated intense and negative feelings. We discuss the implications for practice, training, and research.But: nous avons exploré les expériences d’événements de rupture de l'alliance de thérapeutes et de patients au cours des 15 premières séances de huit cas; chaque thérapeute était couplé avec un client ayant un trouble de personnalité. Méthode: toutes les séances ont été enregistrées en vidéo et codées avec le system de cotation des ruptures résolution. Environ une semaine après une rupture, client et thérapeute étaient interviewés individuellement à propos des causes de la rupture, comment la rupture a évolué, l'impact de la rupture sur le processus thérapeutique, ainsi que l'expérience durant l’événement. Les entretiens ont été analysés par cinq juges utilisant la recherche qualitative consensuelle (CQR; Hill, 2011). Résultats : typiquement, les événements de rupture impliquaient la répétition d'un événement de rupture précédent ; la rupture émergeait quand le client n’était pas préparé à répondre à l'intervention du thérapeute; clients et thérapeutes se sentaient tous les deux confus et ambivalents, et les événements de confrontation activaient des sentiments négatifs intenses. Nous discutons des implications pour la pratique, la formation et la recherche.Objectivo: Exploramos as experiências de rupturas na aliança terapêutica de terapeutas e clientes nas primeiras 15 sessões de 8 casos psicoterapêuticos. Os terapeutas foram emparelhados com um cliente com perturbação de personalidade.Método: Todas as sessões foram filmadas e gravadas e cotadas com o Sistemas de Codificaçao de Resolução de Rupturas (Rupture Resolution Rating System). Aproximadamente 1 semana depois da ruptura, clientes e terapeutas foram individualmente entrevistados sobre as causas da ruptura, sobre a evolução da ruptura, sobre o impacto da ruptura no processos terapêutico e sobre experiências durante o evento. As entrevistas foram analisadas por cinco juízes usando investigação qualitativa consensual (consensual qualitative research - CQR; Hill, 2011).Resultados: Tipicamente, os eventos de ruptura envolveram a repetição de um evento de ruptura anterior, a ruptura emergia quando o cliente não estava preparado para responder à intervenção do terapeuta, tanto o terapeuta como cliente se sentiram confusos e ambivalentes, e os eventos de confronto activaram sentimentos negativos e intensos. Os autores discutem as implicações para a prática, treino e investigação.Objetivo: Se exploraron las vivencias subjetivas tanto de terapeutas como de clientes en relación a eventos de ruptura de la alianza durante las primeras 15 sesiones de cada uno de 8 casos estudiados. Se tomaron pares con terapeuta/cliente en los cuales estos últimos tenían trastornos de personalidad.Método: todas las sesiones fueron video-filmadas y evaluadas con el Sistema de Puntuación de Resolución de Ruptura. Aproximadamente una semana después de la ruptura de la alianza, clientes y terapeutas fueron entrevistados en forma individual a fin de explorar las causas de la ruptura, cómo fue evolucionando el proceso que culminó en la ruptura, el impacto de la misma en el proceso terapéutico y cómo fue vivido subjetivamente el momento mismo de la ruptura. Las entrevistas fueron analizadas por cinco jueces usando los criterios de la Investigación Cualitativa Consensuada (CQR; Hill, 2011).Resultados: Típicamente, la ruptura resultó ser una repetición de situaciones previas de ruptura y surgía cuando el paciente no estaba preparado para responder a la intervención del terapeuta, cuando tanto terapeutas como clientes estaban confusos y ambivalentes, y cuando ciertas situaciones de confrontación activaban sentimientos intensos y negativos. Se discuten las implicaciones para la práctica clínica, la formación y la investigación.

Studies of birth cohorts show evidence of greater risk of violence among patients with schizophrenia compared to the general population. However, the contribution of schizophrenia to violence is heavily debated and remains unclear. This debate has spurred research whose focus can be associated with one of the following areas: psychotic symptoms, personality disorders (in particular psychopathy), mentalizing abilities, substance abuse and demographic factors. The aim of the current review is to evaluate the predictive role of these risk factors in the occurrence of violence among patients with schizophrenia. We identified two different trajectories for violent behavior in schizophrenia: one pertains to patients with no prior history of violence or criminal behavior and for whom positive symptoms appear to explain violent behavior, and another where personality pathology, including psychopathy, predict violence, regardless of other symptomatology associated with schizophrenia. Furthermore, emergent data suggest that specific mentalizing profiles can be associated with the occurrence of violence in schizophrenia, an issue that warrants further consideration in future research.► Positive symptoms predict violence in patients without premorbid antisocial conduct. ► Psychopathy predicts violence in schizophrenia above and beyond psychotic symptoms. ► Violence in schizophrenia can be associated with specific mentalizing profiles. ► Detection and treatment of first-episode psychosis is essential to abating violence.

We all know one. Those armoured cockroach narcissists that can survive anything. It is said that cockroaches are some of the most adaptable creatures on earth. They are in-vulnerable survivors. But at what, and who’s cost? The costs and burdens of being ‘used up’ by narcissists, in their entitled need for never ending supply, are carried by the common or garden everyday creatures called Human Beings. It’s the humanness in us that makes us vulnerable. We feel, we have compassion, we can empathise and we have a natural instinct to support and protect others. We see this mechanism of care operational throughout the animal kingdom. Gabor Mate says it is a disservice to call someone a rat as rats are very empathic creatures and will support their kin. Paradoxically the narcissist will “rat out” their fellow man and expose them to undeserved punishment. All with the aim of their own embellishment and fuelling of omnipotence.

Since 2001 the armed services have discharged over 22,500 service members due to personality
disorders. Veterans discharged due to a personality disorder are usually not provided service
connected disability (SC) benefits because the military categorizes personality disorders as a
preexisting condition. However, PTSD and personality disorders seem to share a number of
symptoms and risk factors that may make distinguishing between them difficult. A definitive
method for diagnosing PTSD and personality disorder is being researched in order to insure that
veterans receive the correct diagnosis and that VA benefits are not being taken advantage of.
This literature review seeks to summarize the issues associated with misdiagnosis of PTSD and
personality disorders in combat veterans and to review the existing research regarding possible
relationships between PTSD and personality disorders.

SummaryThis review summarizes the recent literature about personality disorders among substance abusers. First, it will be shown that personality disorders are highly prevalent co-morbid conditions among addicted individuals. Second, it is argued that this co-morbidity is likely to be accounted for by multiple complex etiological relationships. Finally, the clinical relevance of routine assessment of (maladaptive) personality traits in individuals admitting for substance abuse treatment will be discussed.

Clinicians and legal practitioners have often assumed, uncritically, that sensational interests are predictive of sadistic personality disorder (SADPD). This association has never been empirically tested in a non-pathological sample. Using a sample of adults (N = 219) from two countries, a four-factor SADPD structure was identified. A latent variable model was used to test the hypothesis that Sensational Interests Questionnaire (SIQ) scores would be associated with SADPD scores, after the separation of general and specific variance. The general association was not significant, but a direct pathway from SIQ Criminal Identity to SADPD Antisocial was required, to improve model fit. SADPD was predicted largely by normal personality traits. Sensational interests are therefore not a simple signifier of deviance or sadism, in clinical and legal contexts. However, Criminal Identity may emerge as a risk factor for certain forms of antisocial behaviour, and should be investigated further.

The aim of the present study was to analyze the results of a cognitive-behavioral group therapy applied in an outpatient unit to treat drug addiction. The sample consisted of 130 males with an alcohol dependence disorder. Around 56% of the sample completed treatment – they were given therapeutic discharge. From those, 75.3% never resumed treatment, increasing to 77.7% when patients completed the check-up period after discharge. Follow-up from therapeutic discharge
varies from 2 to 18 years; 58% of patients with personality disorders completed treatment with therapeutic discharge. Cognitive-behavioral treatment, whose essential components are detailed in the present study, is effective for the group treatment of patients with alcohol dependence and a comorbid personality disorder.

Louis Charland’s claim that DSM Cluster B personality disorders are moral rather than clinical kinds has recently triggered a lively debate. In order to deliver a reliable report of the latter, both (1) Charland’s arguments concerning the impossibility of identifying and treating personality disorders without applying a morally laden conceptual framework and (2) some critical responses they provoked are discussed. Then, in turn, the conceptual history of the notion of personality disorder is traced, including not only well-recognized contributions from (3) medical psychiatry, psychoanalysis, and DSM nosology, but also (4) an important, but often neglected, tradition of virtue and moral character. Finally, (5) the idea of a normatively neutral concept of personality disorder is scrutinized in the context of its logical dependence on the fact-value distinction. The latter dichotomy’s recent criticism, in particular, is employed to support Charland’s argument and to suggest that the normative character of personality disorders may go much deeper than this or that DSM formulation.