Cognitive Therapy for Clients with Personality Disorders and Comorbid Axis I Psychopathology: David P. Bernstein

2013 ◽  
pp. 158-177
Keyword(s):  
Personality Disorders ◽  
Cognitive Therapy ◽  
Axis I

Cognitive Therapy for Comorbid Depression

2014 ◽  
Author(s):  
Mark A. Whisman ◽  
Daniel BE
Keyword(s):  
Substance Use ◽  
Anxiety Disorders ◽  
Personality Disorders ◽  
Cognitive Therapy ◽  
Substance Use Disorders ◽  
Clinical Guidelines ◽  
Clinical Samples ◽  
Comorbid Depression ◽  
Axis Ii ◽  
Axis I

Depression often co-occurs with other Axis I and Axis II psychiatric disorders. This chapter presents a model for how cognitive therapy (CT) of depression can be adapted in conceptualizing and treating the complex set of issues and problems that often accompany comorbid depression. It begins with a discussion of the prevalence of comorbidity in community and clinical samples, then review the research on comorbidity and outcome to CT for depression, followed by a model for adapting or modifying CT for patients who present with depression and a comorbid Axis I or Axis II disorder. The chapter concludes with specific clinical guidelines for treating depression that co-occurs with anxiety disorders, substance use disorders, and personality disorders.

Cognitive Therapy for Personality Disorders

2012 ◽  
pp. 726-750
Author(s):  
Robert L. Leahy ◽  
Lata K. McGinn
Keyword(s):  
Personality Disorders ◽  
Cognitive Therapy ◽  
Dialectical Behavior Therapy ◽  
Negative Impact ◽  
Cognitive Model ◽  
Theoretical Models ◽  
Axis I Disorders ◽  
Treatment Research ◽  
Axis I ◽  
Schema Model

Personality disorders are prevalent and common among patients presenting for treatment. Research suggests that personality disorders are associated with significant impairment and can exert a negative impact on psychological and pharmacological treatments for Axis I disorders. Despite this, treatment development and research for personality disorders has lagged behind those of Axis I disorders. The present chapter describes two major cognitive models of personality disorder—the cognitive model advanced by Beck, Freeman, and colleagues and the schema model advanced by Young and colleagues (a brief review of the dialectical behavior therapy model is also provided). The chapter presents research on both theoretical models and outlines similarities and differences between the two theoretical formulations. A description of the therapeutic relationship in cognitive therapy is also provided. The components of treatment are presented followed by a case example for purposes of illustration. Finally, the chapter summarizes the extant research on the treatment of personality disorders. Although the data are encouraging, suggesting that personality disorders are responsive to treatment, further controlled trials are still needed.

Test-Retest Reliability of a Self-Report Questionnaire for DSM-IV and ICD-10 Personality Disorders

2000 ◽  
Vol 16 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Hans Ottosson ◽  
Martin Grann ◽  
Gunnar Kullgren
Keyword(s):  
Personality Disorder ◽  
Anxiety Disorders ◽  
Personality Disorders ◽  
Clinical Sample ◽  
Self Report ◽  
Anxiety State ◽  
Short Term ◽  
Retest Reliability ◽  
Axis I ◽  
Test Retest Reliability

Summary: Short-term stability or test-retest reliability of self-reported personality traits is likely to be biased if the respondent is affected by a depressive or anxiety state. However, in some studies, DSM-oriented self-reported instruments have proved to be reasonably stable in the short term, regardless of co-occurring depressive or anxiety disorders. In the present study, we examined the short-term test-retest reliability of a new self-report questionnaire for personality disorder diagnosis (DIP-Q) on a clinical sample of 30 individuals, having either a depressive, an anxiety, or no axis-I disorder. Test-retest scorings from subjects with depressive disorders were mostly unstable, with a significant change in fulfilled criteria between entry and retest for three out of ten personality disorders: borderline, avoidant and obsessive-compulsive personality disorder. Scorings from subjects with anxiety disorders were unstable only for cluster C and dependent personality disorder items. In the absence of co-morbid depressive or anxiety disorders, mean dimensional scores of DIP-Q showed no significant differences between entry and retest. Overall, the effect from state on trait scorings was moderate, and it is concluded that test-retest reliability for DIP-Q is acceptable.

An evaluation of DSM-5 Section III Personality Disorder Criterion A (Impairment) in accounting for psychopathology

2018 ◽  
Author(s):  
Chelsea Sleep ◽  
Donald Lynam ◽  
Thomas A. Widiger ◽  
Michael L Crowe ◽  
Josh Miller
Keyword(s):  
Personality Disorders ◽  
Discriminant Validity ◽  
Factor Model ◽  
Incremental Validity ◽  
Self Report ◽  
Statistical Prediction ◽  
Dsm 5 ◽  
Criterion A ◽  
Personality Dysfunction ◽  
Axis I

An alternative diagnostic model of personality disorders (AMPD) was introduced in DSM-5 that diagnoses PDs based on the presence of personality impairment (Criterion A) and pathological personality traits (Criterion B). Research examining Criterion A has been limited to date, due to the lack of a specific measure to assess it; this changed, however, with the recent publication of a self-report assessment of personality dysfunction as defined by Criterion A (Levels of Personality Functioning Scale – Self-report; LPFS-SR; Morey, 2017). The aim of the current study was to test several key propositions regarding the role of Criterion A in the AMPD including the underlying factor structure of the LPFS-SR, the discriminant validity of the hypothesized factors, whether Criterion A distinguishes personality psychopathology from Axis I symptoms, the overlap between Criterion A and B, and the incremental predictive utility of Criterion A and B in the statistical prediction of traditional PD symptom counts. Neither a single factor model nor an a priori four-factor model of dysfunction fit the data well. The LPFS-SR dimensions were highly interrelated and manifested little evidence of discriminant validity. In addition, the impairment dimensions manifested robust correlations with measures of both Axis I and II constructs, challenging the notion that personality dysfunction is unique to PDs. Finally, multivariate regression analyses suggested that the traits account for substantially more unique variance in DSM-5 Section II PDs than does personality impairment. These results provide important information as to the functioning of the two main components of the DSM-5 AMPD and raise questions about whether the model may need revision moving forward.Keywords: dysfunction, impairment, personality disorders, Section III, incremental validity Public Significance: The alternative model of personality disorders included in Section III of the 5th addition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes two primary components: personality dysfunction and maladaptive traits. The current results raise questions about how a new, DSM-5 aligned measure of personality dysfunction operates with regard its factor structure, discriminant validity, ability to differentiate between personality and non-personality based forms of psychopathology, and incremental validity in the statistical prediction of traditional DSM personality disorders.

The dexamethasone suppression test and DSM-III-R diagnoses in suicide attempters

2003 ◽  
Vol 18 (7) ◽  
pp. 350-355 ◽  
Author(s):  
Åsa Westrin ◽  
Karin Frii ◽  
Lil Träskman-Bendz
Keyword(s):  
Personality Disorders ◽  
Stressful Events ◽  
Suicide Attempter ◽  
Axis Ii ◽  
Suppression Test ◽  
Axis I ◽  
Cortisol Levels ◽  
Low Cortisol ◽  
Hpa Axis Activity ◽  
Dexamethasone Suppression

AbstractPrevious research on hypothalamic-pituitary adrenal (HPA) axis-activity in suicide attempter research has shown conflicting outcomes. The design of the present study was to test the influence of personality disorders and concominant axis I diagnoses on the dexamethasone suppression diagnostic test by use of multiple regression analyses. The sample consisted of 184 patients with a recent suicide attempt and 42 healthy controls. As expected, the lowest pre- and postdexamethasone cortisol levels were found in patients with personality disorders axis II, cluster B as compared to the other patients. The results remained significant when analysed for covariance with DSM-III-R axis I diagnoses, age or sex. Whether these low cortisol levels are due to previous experience of extreme stressful events or long-lasting burden, or whether they may be a consequence of biogenetic or psychological predisposal of interest, remains to be elucidated. Axis I comorbidity needs to be further examined.

Suicide Probability Among Tramadol Addicts

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Saad Mohamed ◽  
Nesreen Mohammed Mohsen ◽  
Lobna AbuBakr Ismail ◽  
Ayat Ullah Mazloum Mahmoud
Keyword(s):  
Substance Use ◽  
Personality Disorders ◽  
Outpatient Clinic ◽  
Positive Family History ◽  
Clinical Interview ◽  
Addiction Severity Index ◽  
University Hospital ◽  
Antisocial Personality ◽  
Significant Difference ◽  
Axis I

Abstract Background The magnitude of the problem of substance use in Egypt has been growing lately. Substance use disorders have been associated with depression and suicide, as well as impulsivity and specific personality traits. Suicide is closely linked to the substances use. Therefore it is very important to confirm the factors that affect the possibility of suicide. Aim of the Work This study aimed at evaluating suicide risk and its correlation with each of personality disorders and severity of addiction in a sample of 72 tramadol addicts from outpatient clinic of Institute of psychaitry Ain Shams University hospitals. Patients and Methods This is a descriptive Cross sectional study conducted in outpatient clinic of Institute of psychaitry Ain Shams University hospital. The present study aimed at analyzing the demographic data of 72 tramadol addicts, over six months period from January 2018 to August 2019. The severity of the addiction problem among those patients was assessed using Addiction Severity Index (ASI), suicidal probability was assessed using suicide probability scale (SPS), Structured Clinical Interview for DSM-VI Axis II (SCID-II) for assessing personality disorders and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I). Results The results showed that 32 (44.44%) of the patients had a risk of suicide probability. Also there was a statistically significant difference between risk of suicidal probability and personality disorders especially antisocial personality. It was found that the need for more power for work and pleasurable effects were the most risk factors for tramadol addiction. Conclusion Suicide probability was found to be (44.44%) among the studied tramadol addicts. The risk of suicide probability among them was found to be significant in each of the following: antisocial personality disorder, longer duration of addiction, being single and positive family history of addiction. Attention should be paid to include the assessment of suicidal risk as part of routine assessment of addicts.

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