The Perfect Storm

2016 ◽  
pp. 107-128
Author(s):  
Abigail M. Judge ◽  
Peggie Ward
Keyword(s):  
Clinical Practice ◽  
Personality Disorder ◽  
Clinical Management ◽  
Case Material ◽  
Key Points ◽  
High Conflict ◽  
Court Involved ◽  
Personality Features ◽  
Parent Personality ◽  
Perfect Storm

This chapter discusses a constellation of features associated with families where children are resisting or refusing contact with a parent—personality disorder, high conflict, and court involvement—that the authors refer to as the “perfect storm.” High rates of personality disorder and associated characteristics have been described among child custody–litigating families in the psychological assessment and clinical literatures. Such personality features cause notoriously strong reactions in therapists and professional teams, especially under the added strain of separation or divorce and ongoing litigation. Left unexamined, the effects of these dynamics can undermine treatment and result in ethical missteps in clinical practice. This chapter describes each component of the perfect storm and proposes strategies for clinical management based on current writing about court-involved therapy. Case material is used to highlight key points.

Structured clinical management: inpatient treatment and prescribing

2015 ◽  
Author(s):  
Anthony W. Bateman ◽  
Roy Krawitz
Keyword(s):  
Clinical Practice ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Hospital Admission ◽  
Clinical Management ◽  
Inpatient Treatment ◽  
Borderline Personality ◽  
Comorbid Conditions

Chapter 5 discusses inpatient treatment for borderline personality disorder (BPD), and prescribing, including iatrogenesis, indicators for hospital admission, review of medication, and hospital admission. Prescribing in clinical practice is also outlined, including a summary of pharmacotherapy in BPD, clinical cautions, prescribing guidance, crisis, maintenance prescribing, time on medication, and comorbid conditions.

Late-onset personality disorder: a condition still steeped in ignorance

2020 ◽  
Vol 26 (4) ◽  
pp. 219-220
Author(s):  
Peter Tyrer ◽  
Robert Howard
Keyword(s):  
Personality Disorder ◽  
Clinical Management ◽  
Late Onset ◽  
Late Life ◽  
Older Age ◽  
Personality Change ◽  
Organic Disease ◽  
Antisocial Personality ◽  
Personality Features ◽  
Firm Evidence

SUMMARYPersonality disorder is likely to be common in late life, but our ignorance is such that, at present, we can only speculate about its frequency and importance. The only firm evidence we have is that antisocial personality features tend to be attenuated in older age and obsessional and detached features accentuated. Differentiating personality change following organic disease from personality disorder requires more attention as it is important for good clinical management.

scholarly journals The Defeat Depression Campaign

1997 ◽  
Vol 21 (3) ◽  
pp. 148-150 ◽  
Author(s):  
Ann Macaskill ◽  
Norman Macaskill ◽  
A. Nicol
Keyword(s):  
Clinical Practice ◽  
Royal College ◽  
Questionnaire Survey ◽  
Clinical Management ◽  
The Public ◽  
Health Practitioners ◽  
The Impact

The Royal College of Psychiatrists launched a five year campaign in 1992 to better inform health practitioners and the public about depression. A questionnaire survey of Sheffield general practitoners (GPs) to assess the impact of the Defeat Depression Campaign on their knowledge and clinical management of depression was carried out in May 1994, half way through the campaign. Overall, 75% of GPs who responded indicated that the Defeat Depression Campaign had had little or no impact on their clinical practice. It would appear that at its mid-point the Defeat Depression Campaign failed to achieve its main goals in relation to educating GPs about depression and its management.

scholarly journals ISMAR-study presentation: in-hospital epidemiology and clinical management of respiratory and cardiac comorbidities in cardiac and respiratory disease units

2014 ◽  
Vol 9 ◽  
Author(s):  
Roberto Tramarin ◽  
Mario Polverino ◽  
Maurizio Volterrani ◽  
Bruna Girardi ◽  
Claudio Chimini ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Management ◽  
Real Life ◽  
Length Of Hospital Stay ◽  
Relevant Information ◽  
Hospital Epidemiology ◽  
Discharge Data ◽  
Definition Of ◽  
Current Guidelines

Background: Cardiovascular and respiratory diseases are leading causes of morbidity and their co-occurrence has important implications in mortality and other outcomes. Even the most recent guidelines do not reliably address clinical, prognostic, and therapeutic concerns due to the overlap of respiratory and cardiac diseases. Study objectives and design: In order to evaluate in the reality of clinical practice the epidemiology and the reciprocal impact of cardio-pulmonary comorbidity on the clinical management, diagnostic workup and treatment, 1,500 cardiac and 1,500 respiratory inpatients, admitted in acute and rehabilitation units, will be enrolled in a multicenter, nationwide, prospective observational study. For this purpose, each center will enroll at least 50 consecutive patients. At discharge, data analysis will be aimed at the definition of cardiac and pulmonary inpatient comorbidity prevalence, demographic characteristics, length of hospital stay, and risk factors, taking into account also procedures, pharmacological and non-pharmacological treatment, and follow up in patients with cardio-respiratory comorbidity. Conclusions: The purely observational design of the study aims to give new relevant information on the assessment and management of overlapping patients in real life clinical practice, and new insight for improvement and implementation of current guidelines on the management of individual diseases.

Self-Knowledge in Personality Disorder: Self-Referentiality as a Stepping Stone for Psychotherapeutic Understanding

2018 ◽  
Vol 32 (3) ◽  
pp. 295-310 ◽  
Author(s):  
Derek Strijbos ◽  
Gerrit Glas
Keyword(s):  
Clinical Practice ◽  
Personality Disorder ◽  
Speech Acts ◽  
The Self ◽  
Stepping Stone ◽  
The World ◽  
Philosophical Framework ◽  
Self Knowledge

This article provides a philosophical framework to help unpack varieties of self-knowledge in clinical practice. We start from a hermeneutical conception of “the self,” according to which the self is not interpreted as some fixed entity, but as embedded in and emerging from our relating to and interacting with our own conditions and activities, others, and the world. The notion of “self-referentiality” is introduced to further unpack how this self-relational activity can become manifest in one's emotions, speech acts, gestures, and actions. Self-referentiality exemplifies what emotions themselves implicitly signify about the person having them. In the remainder of the article, we distinguish among three different ways in which the self-relational activity can become manifest in therapy. Our model is intended to facilitate therapists’ understanding of their patients’ self-relational activity in therapy, when jointly attending to the self-referential meaning of what their patients feel, say, and do.

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