Agreement over content of case formulation in offender personality disorder pathway prison services

Interpersonal problems are among the most severely impairing, difficult-to-manage, and intransigent of borderline personality disorder (BPD) features and therefore require special attention in treatment. Emotion dysregulation and related mood-dependent behaviors among individuals with BPD typically occur in the context of interpersonally relevant events or stressors, signifying the central role of interpersonal and attachment-related concerns for these patients. Two prominent interpersonal themes in those with BPD are discussed: interpersonal hypersensitivity and angry or aggressive behavior. The chapter provides a brief case illustration of how these themes might emerge in psychotherapy and recommends explicit assessment of interpersonal problems and aggression to enhance risk evaluation, case formulation, treatment planning, and monitoring progress in treatment.

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Assessment of borderline personality disorder: considering a diagnostic strategy

Acta Neuropsychiatrica ◽

10.1034/j.1601-5215.2002.140201.x ◽

2002 ◽

Vol 14 (2) ◽

pp. 55-59 ◽

Cited By ~ 5

Author(s):

C. K. W. Schotte

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Biological Psychiatry ◽

Borderline Personality ◽

Therapeutic Interventions ◽

Diagnostic Strategy ◽

Case Formulation ◽

Clinical Context ◽

Idiographic Approach ◽

Dsm Iv

Background:Borderline personality disorder (BPD) represents a highly prevalent, severe and difficult-to-treat mental health problem.Objective:This paper considers methods, instruments and strategies for assessing BPD as described within the frame of the DSM-IV classification.Conclusions:Following the general diagnostic approach introduced by Van Praag in biological psychiatry, a two-tier diagnostic strategy for the descriptive diagnostic assessment of BPD is recommended. Axis one results in a DSM-IV Axis II categorical diagnosis, whereas axis two refers to a symptomatological, dimensional or functional approach, in which the psychological dysfunctions of the nosological syndrome are depicted. Moreover, in a clinical context a basic aim of the diagnostic evaluation is to obtain therapeutically valid information that leads to a constructive conceptual framework, to a case formulation in which therapeutic interventions are understood, selected and implemented. This framework should be based on a biopsychosocial theoretical model and its application in the clinical context involves feedback to the patient, in which the descriptive evaluation is integrated with etiological; and pathogenic elements using an idiographic approach. This therapeutically orientated diagnostic strategy is illustrated by the use of the ADP-IV (Assessment of DSM-IV personality disorders) questionnaire within a cognitive behavioral orientation.

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Borderline Personality Disorder

Case Studies in Clinical Psychological Science ◽

10.1093/med:psych/9780199733668.003.0012 ◽

2013 ◽

pp. 301-322 ◽

Cited By ~ 1

Author(s):

Shireen L. Rizvi ◽

Kristalyn Salters-Pedneault

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Behavior Therapy ◽

Dialectical Behavior Therapy ◽

Borderline Personality ◽

Case Formulation ◽

Patient Assessment ◽

Assessment Strategy ◽

History Of ◽

Background History

Chapter 12 covers Borderline Personality Disorder (BPD), and includes definition and history of the condition, description and background of dialectical behavior therapy (DBT) used to treatm BPD, background history of the patient, assessment strategy, case formulation and treatment approach, course of treatment, treatment transfer specific to this case, relapse prevention, avoiding common mistakes in therapy, and case conclusions.

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Developing offender manager competencies in completing case formulation

Probation Journal ◽

10.1177/0264550517744272 ◽

2017 ◽

Vol 65 (1) ◽

pp. 27-38 ◽

Cited By ~ 7

Author(s):

Kay Radcliffe ◽

Elaine McMullan ◽

Jo Ramsden

Keyword(s):

Personality Disorder ◽

Workforce Training ◽

Case Formulation ◽

Client Group ◽

Training And Supervision ◽

National Initiative ◽

Supervision Model ◽

The Impact ◽

Current Provision

The Offender Personality Disorder (OPD) pathway is a national initiative which co-commissions health and probation to work in partnership to enhance the criminal justice management of high risk offenders with personality disorder. Psychologically informed support is expected to augment the current provision for this client group alongside workforce training. The impact of training offender managers (OM) is uncertain and previous research has indicated training may be limited in its effectiveness. This paper examines the impact of a training and supervision model on the quality of formulations produced by offender managers and suggests that a model which teaches formulation through repeated consultation or the live supervision of practice leads to enhanced competencies in completing case formulations. The paper evaluates the quality of formulations produced by offender managers who have had their practice developed through repeated consultation with the OPD pathway (OPDOMs) in comparison with a generic group of offender managers. OPDOMs who have had the longest period of supervision with the project produced the highest quality formulations. The paper acknowledges a number of limitations but suggests that the model under scrutiny may usefully inform service delivery within the Offender Personality Disorder pathway.

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The impact of case formulation focussed consultation on criminal justice staff and their attitudes to work with personality disorder

Mental Health Review Journal ◽

10.1108/mhrj-12-2013-0039 ◽

2014 ◽

Vol 19 (2) ◽

pp. 124-130 ◽

Cited By ~ 16

Author(s):

Jo Ramsden ◽

Mark Lowton ◽

Emma Joyes

Keyword(s):

Pilot Study ◽

Personality Disorder ◽

Probation Officers ◽

Case Formulation ◽

Small Pilot Study ◽

Consultation Process ◽

Content Type ◽

Knowledge And Attitudes ◽

Personality Disordered ◽

The Impact

Purpose – The purpose of this paper was to examine the impact of a highly structured, formulation focused consultation process on knowledge and attitudes towards personality disorder and on perceived practice with personality disordered offenders. Consultation was delivered by the Yorkshire/Humber regional Pathway Development Service (PDS). This pilot study sought to inform the development of this service and the support offered to probation Trusts across Yorkshire/Humber to implement the national Personality Disorder Offender Pathway. Design/methodology/approach – Consultation was offered to a number of offender managers working in the Yorkshire/Humber region. The impact of the consultation on their knowledge and understanding of personality disorder in general was examined as was their attitudes to working with this population and their perceived confidence and competence in delivering supervision to each individual. Findings – The findings from this small pilot study would suggest that the structured format used by the Yorkshire PDS was helpful in enhancing the probation officers’ knowledge and understanding of personality disorder as well as their perceived confidence in and attitudes towards working with individuals with a personality disorder. Originality/value – The study indicates that the structured format used by the PDS is of value and may be applied to the support offered to probation Trusts across Yorkshire/Humber as they implement the community specification of the national Personality Disorder Offender Pathway.

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Personalized Models of Psychopathology as Contextualized Dynamic Processes: An Example from Individuals with Borderline Personality Disorder

10.31234/osf.io/amdu8 ◽

2018 ◽

Author(s):

William C. Woods ◽

Cara Arizmendi ◽

Kathleen Gates ◽

Stephanie Stepp ◽

Paul A. Pilkonis ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Clinical Assessment ◽

Borderline Personality ◽

Dynamic Processes ◽

Model Estimation ◽

Case Formulation ◽

Multiple Model ◽

Behavioral Regulation ◽

The Individual

Objective: Psychopathology research has relied on discrete diagnoses, which neglects the unique manifestations of each individual’s pathology. Borderline personality disorder combines interpersonal, affective, and behavioral regulation impairments making it particularly ill-suited to a “one size fits all” diagnosis. Clinical assessment and case formulation involve understanding and developing a personalized model for each patient’s contextualized dynamic processes, and research would benefit from a similar focus on the individual. Method: We use group iterative multiple model estimation, which estimates a model for each individual and identifies general or shared features across individuals, in both a mixed-diagnosis sample (N=78) and a subsample with a single diagnosis (n=24). Results: We found that individuals vary widely in their dynamic processes in affective and interpersonal domains both within and across diagnoses. However, there was some evidence that dynamic patterns relate to transdiagnostic baseline measures. We conclude with descriptions of two person-specific models as an example of the heterogeneity of dynamic processes. Conclusions: The idiographic models presented here join a growing literature showing that the individuals differ dramatically in the total patterning of these processes, even as key processes are shared across individuals. We argue that these processes are best estimated in the context of person-specific models, and that so doing may advance our understanding of the contextualized dynamic processes that could identify maintenance mechanisms and treatment targets.

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Using Plan Analysis in Psychotherapeutic Case Formulation of Borderline Personality Disorder

Clinical Psychology & Psychotherapy ◽

10.1002/cpp.784 ◽

2011 ◽

Vol 20 (1) ◽

pp. 1-9 ◽

Cited By ~ 6

Author(s):

Laurent Berthoud ◽

Ueli Kramer ◽

Yves de Roten ◽

Jean-Nicolas Despland ◽

Franz Caspar

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Borderline Personality ◽

Case Formulation ◽

Plan Analysis

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Differentiating between pathological demand avoidance and antisocial personality disorder: a case study

Journal of Intellectual Disabilities and Offending Behaviour ◽

10.1108/jidob-07-2016-0013 ◽

2017 ◽

Vol 8 (1) ◽

pp. 13-27 ◽

Cited By ~ 2

Author(s):

Grace Trundle ◽

Leam A. Craig ◽

Ian Stringer

Keyword(s):

Personality Disorder ◽

Antisocial Personality Disorder ◽

Large Scale ◽

Single Case ◽

Antisocial Behaviour ◽

Case Formulation ◽

Antisocial Personality ◽

Content Type ◽

Offending Behaviour

Purpose The purpose of this paper is to explore the different clinical features of pathological demand avoidance (PDA) and antisocial personality disorder (ASPD) presented in the form of a single case study. The study highlights the potential of misdiagnosis and conceptual confusions to practitioners in forensic settings between the two conditions when working with offenders with personality disorders. Design/methodology/approach A case formulation using the “five Ps” method based on the personal history of an incarcerated male is presented and the clinical similarities and differences between PDA and ASPD are delineated. These differences and similarities are evaluated and applied to offender management including intervention options. Findings There are considerable similarities between ASPD and PDA making the two conditions difficult to separate. Both diagnostic criteria identify childhood behavioural problems, aggression, destructiveness, conduct disorder (CD), manipulation and non-compliance as indications of the disorder. For example, the criteria for later adult ASPD are the presence of childhood antisocial behaviour and CD. However, these behaviours may also be suggestive of the attention deficit hyperactivity disorder and non-compliance that are part of PDA. Violent behaviours and aggression can also be perceived in a similar way. Misdiagnosis of PDA as ASPD reduces the efficiency of treatment programmes. Originality/value The implications of these findings could prove useful in the successful risk management of offenders with PDA. Given the similar behavioural characteristics between PDA and ASPD, the prevalence of PDA among offenders may be higher than observed. The aim of this study is to raise awareness of potential conceptual complications and clinical confusions between the two conditions with a view to aid offender management through case formulation. A large scale study into offenders with PDA would draw attention to the prevalence of the condition as well as its association with offending behaviour.

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