Questions and Answers
Most available data on personality disorder treatment focuses on cluster A disorders.
False
The management of personality disorders in the UK emphasizes psychosocial interventions over medication.
True
The outcome measures for borderline personality disorder typically include readmissions to hospital and self-harm.
True
The treatment of personality disorders has shown significant changes in core features like identity and social functioning.
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Comorbidity is an unusual condition among patients with personality disorders.
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Studies conducted on antisocial personality disorder often focus on long-term aggression reduction.
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Patients with cluster A personality disorders are frequently engaged in seeking treatment.
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Research on personality disorders is abundant and well-established.
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Establishing a diagnosis is not important in the management of personality disorders.
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The general aims of management include helping individuals manage their lives in a way that conflicts more with their character.
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Supportive therapy is typically provided by junior staff members for those with personality disorders.
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Considerable time should be allowed to achieve the goals set in the management of personality disorders.
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Group treatment can help to decrease dependency and enhance social learning.
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Regular attendance at outpatient clinics is always beneficial, as it prevents the development of unrealistic expectations.
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A trusting and confiding relationship is considered a central aspect of effective treatment for personality disorders.
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Patients with personality disorders generally react positively to changes in their treatment staff.
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Borderline personality disorder has a clear and uncontested definition.
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Dialectical behaviour therapy (DBT) was developed to help individuals with emotional and cognitive regulation.
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Mentalization therapy focuses on individuals acting on their thoughts without reflection.
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DBT does not include any group sessions as part of its therapy structure.
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The residential therapeutic communities for personality disorders post-World War II were mainly aimed at borderline personality disorder.
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Patients with borderline personality disorder can significantly influence their treatment options.
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Most treatment programs for antisocial personality disorder are delivered by forensic psychologists.
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Marsha Linehan developed DBT after experiencing a lack of effective self-treatment options.
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There is substantial evidence supporting the effectiveness of residential therapeutic communities for treating personality disorders.
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Cognitive behaviour therapy is not mentioned as a component of DBT.
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Patients with paranoid personality disorder engage well with treatment because they are open and trusting.
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Patients with schizoid personality disorder often remain in therapy long enough to see significant progress.
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Medication is generally helpful for treating patients with schizoid personality disorder.
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Cognitive behavior therapy is being tested as a possible approach for addressing paranoid personality traits.
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Patients with obsessive-compulsive personality disorder respond well to psychotherapy.
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Therapists should focus on helping patients with schizoid personality disorder become aware of their problems to aid treatment.
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The overall plan for treating personality disorders should encourage patients to have more contact with situations that provoke difficulties.
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Medication is considered the first choice in the treatment of personality disorders.
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Antidepressants are primarily used for treating the personality disorder itself.
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Psychodynamic psychotherapy may be beneficial when the patient is sufficiently stable and motivated.
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A community team can effectively coordinate the contributions of various team members in treating personality disorders.
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Setbacks in treatment should always be viewed negatively without any constructive value.
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Antipsychotics are commonly used to treat the primary symptoms of personality disorders.
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The establishment of specialist teams for treating personality disorder in the UK came after the 2003 Department of Health paper.
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Progress in treatment is typically achieved through rapid, large steps toward satisfactory adjustment.
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Patients with personality disorders should take a passive role in planning their care.
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Personality disorders are expected to show little change over time.
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Over 50% of patients with personality disorders in the DSM-III era maintained the criteria over time.
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Forty-eight percent of patients showed a reduction in personality disorder traits between the ages of 15 and 22.
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Borderline personality disorder is widely recognized as a single, stable entity.
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Eighty-eight percent of patients with borderline personality disorder achieved 'remission' over a ten-year period according to the McLean Hospital follow-up study.
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Antisocial personality disorder does not show significant improvement as individuals age.
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The study conducted by Stone et al. found a higher rate of suicide in patients with borderline personality disorder.
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Criminality is not considered a characteristic of antisocial personality disorder in the DSM-5.
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Robins and Regier reported that there was a high rate of remission for antisocial personality disorder in the early decades of life.
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The validity of measures assessing personality disorders has been widely accepted without question.
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Evidence-based treatments for borderline personality disorder typically rely on unstructured approaches to address problems.
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Patients undergoing evidence-based treatment for borderline personality disorder are discouraged from exercising a sense of agency.
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Therapists provide minimal assistance in connecting feelings to events and actions in evidence-based treatments for borderline personality disorder.
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Active, responsive, and validating interactions from therapists are not a characteristic of evidence-based treatments.
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Discussing personal reactions to cases is a common practice among therapists in evidence-based treatments for borderline personality disorder.
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Study Notes
Overview of Personality Disorder Treatment
- Limited research primarily focuses on cluster B disorders: borderline and antisocial personality disorders.
- Engagement in treatment is challenging due to core features such as functional disability and disturbed relationships.
- Comorbidity is common, complicating treatment outcomes.
Treatment Management
- UK national guidelines emphasize psychosocial interventions; medication is reserved for crisis management.
- Cluster A and C disorders typically do not seek treatment directly for personality issues, complicating overall management.
Assessment
- Accurate diagnosis is essential, focusing on patient strengths and weaknesses.
- Treatment should aim to enhance favorable traits and modify unfavorable ones.
General Aims of Management
- The goal is to help patients navigate life in alignment with their personality.
- Building a trusting therapeutic relationship is crucial, while avoiding excessive dependency.
- Group treatment can foster social learning and reduce dependency on individual therapists.
Supportive Therapy
- Psychological support is vital, allowing patients to feel validated over time.
- Care must be taken to avoid a paternalistic approach, making supportive psychotherapy best suited for experienced staff.
- Involvement of multiple professionals necessitates careful coordination to prevent inconsistencies.
Treatment Planning
- Focus on minimizing exposure to triggering situations and maximizing personal development opportunities.
- Patients should actively participate in their care planning with clear explanations for treatment decisions.
Treatment Options
Psychotherapy
- Psychodynamic and cognitive psychotherapy may be utilized if the patient shows motivation and stability.
Medication
- Medication serves a minimal role; antidepressants address associated mood disorders, not personality disorders directly.
- Antipsychotics may reduce aggressive behavior but are not a primary treatment.
Organization of Services
- Comprehensive care can be managed by a single practitioner or through a coordinated community team approach.
- Specialist teams for personality disorder treatment have emerged post-2003 in the UK, often utilizing therapeutic community principles.
Progress and Outcomes
- Progress typically occurs in small increments, with setbacks offering opportunities for constructive reflection.
- Studies reveal that personality disorders, particularly borderline, can show marked improvement over time.
Borderline Personality Disorder
- Management requires negotiation, as patients have significant influence over treatment choices.
- Access to advanced treatment modalities like mentalization or dialectical behavior therapy (DBT) can vary among patients.
Dialectical Behavior Therapy (DBT)
- DBT combines individual therapy, group sessions, and a focus on developing emotional and cognitive regulation skills through mindfulness.
- Originally developed to mitigate self-harm, suicidal ideation, and substance abuse.
Mentalization
- Evolved targeted therapy focuses on enhancing self-awareness regarding thoughts and feelings, typically engaged through combined group and individual work.
Antisocial Personality Disorder
- Treatment primarily occurs within forensic settings and is often rooted in cognitive behavior therapy, focusing on schema modification.
Course of Personality Disorders
- Evidence suggests that personality disorders may not be as stable as previously thought: over 50% may no longer meet diagnostic criteria over time.
- Studies indicate significant reductions in personality disorder traits, particularly in later adolescence and adulthood.
Characteristics of Treatment for Borderline Personality Disorder
- Structured, manual-directed approaches encourage patient control and agency within the therapeutic process.
- Therapists facilitate connections between feelings, events, and actions to foster self-awareness and understanding.
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Description
Explore the challenges and strategies in treating personality disorders, especially focusing on cluster B disorders like borderline and antisocial personality disorders. Discover the issues surrounding patient engagement in treatment and research, as well as the limited data available. This quiz assesses your understanding of current treatment approaches and research limitations.
