Anti-Social Personality Disorder
Introduction
Anti-social personality disorder is characterized by traits such as recklessness, exploitative, manipulative and having no guilt. According to Sadock et al (2014), anti-social personality disorder is manifested by symptoms such as failure to follow the set rules and law; being unable to sustain jobs and difficulties in sustaining and developing relationships. This case study involves a 32-year-old woman who manifests symptoms of a personality disorder. Therefore, this paper will make three decisions regarding the client’s diagnosis and her treatment options. Anti- Social Personality Disorder Essay Paper
Decision Point One
Anti-Social Personality Disorder
Outcome of the Decision
According to the case study, the diagnosis of the client is antisocial personality disorder. This is manifested by various symptoms such as the client the inability of the client to maintain a good relationship with her boyfriend or her friend; blaming everyone for her mistakes; irresponsibility illustrated by her inability to manage her finances; getting trouble with the law; inability to maintain employment; as well as lack of remorse (American Psychiatric Association, 2013).
Difference between the Decision Outcome and the Expected Outcome
The client’s symptoms fit the DSM-5 diagnostic criteria of anti-social personality disorder. Therefore, there is no difference between the expected outcome and the decision outcome (American Psychiatric Association, 2013).
Decision Point Two
Refer to the Psychologist for Psychological Testing
The Reason for the Decision
The decision to refer the client for psychological testing was selected in order to have the client have a comprehensive assessment. The comprehensive assessment would involve the administration of psychological tests in order to identify the client’s behavioral problems, personality problems, cognitive problems, as well as any other mental health issue (Ekselius, 2018).
The Expected Outcome with the Decision
By selecting this decision, the expectation was that the earlier diagnosis (anti-social personality disorder) would be confirmed while other mental health problems would be ruled out. In addition, it was expected that any other comorbidity the client may be having would be identified (Ekselius, 2018).
Difference between the Decision Outcome and the Expected Outcome
From the comprehensive psychological battery test, even though the client showed symptoms of various personality disorders, antisocial personality disorder had the highest score. As a result, there is no difference between the decision outcome and the anticipated outcome because psychological testing just confirmed the initial diagnosis of antisocial personality disorder. Moreover, psychological testing also indicated that the client may be having other comorbid conditions.
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Decision Point Three
Refer the client to group-based cognitive behavior therapy (group CBT)
The Reason for the Decision
The reason for referring the client to a group CBT is due to the efficacy of the therapy in the treatment of personality disorders like antisocial personality disorder. According to Naza & Ramganesh (2017), antisocial personality disorder is caused by maladaptive thinking patterns, beliefs and other contextual factors that maintain the defective behaviors. As a result, CBT uses different techniques to alter the thinking patterns and modify contextual factors through cognitive restructuring, skills training, and behavior modification. A group cognitive behavior therapy will present the client with an opportunity to interact with other group members and as a result improve her social skills (Naza & Ramganesh, 2017). This will enable her to maintain interpersonal relationships.
The Expected Decision Outcome
By selecting the decision to have the client undergo group cognitive behavior therapy, it is expected that the symptoms of the antisocial personality disorder would gradually improve. This is because CBT has been shown to be effective in changing the maladaptive thinking patterns in people with antisocial personality disorder leading to behavior modification. (Papageorgiou et al, 2018). Group CBT also equips individuals with the required social skills and thus they learn socially acceptable behaviors (Papageorgiou et al, 2018). Anti- Social Personality Disorder Essay Paper
Ethical Considerations
Informed consent, autonomy, and confidentiality aspects are some of the ethical considerations that should be taken into consideration. As a result, it would be important for the therapist to seek informed consent from the client before any treatment. This will enable the client to make an informed decision regarding any treatment decision (Trull et al, 2018). In addition, respecting the autonomy the client will enable the client to make autonomous decisions regarding her treatment. Throughout the treatment process, the therapist should always maintain the confidentiality of the client and should not reveal the information shared. Finally, it will be important for the therapist to manage boundaries with the client because people with personality disorder tend to have boundary issues such as demanding undue accessibility and availability of the therapist (Trull et al, 2018).
Conclusion
The diagnosis of the client is antisocial personality disorder as indicated by symptoms such as failure to follow the set rules and law; being unable to sustain jobs and difficulties in sustaining and developing relationships. The second decision is to refer the client for psychological testing to ensure she undergoes a comprehensive assessment. The third decision is to refer the client for group CBT. CBT will facilitate behavior modification and improve the client’s social skills. Lastly, ethical considerations likely to impact the client’s treatment include the issue of informed consent, autonomy, privacy/confidentiality, and boundary management.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. (5th Edition). Washington, DC: American Psychiatric Association.
Ekselius L. (2018). Personality disorder: a disease in disguise. Ups J Med Sci. 123(4), 194–204.
Nazar N & Ramganesh E. (2017). Cognitive Behavior Treatment of Personality Disorders. International Journal of Humanities and Social Science Invention. 6(11), 20-29.
Papageorgiou C, Carlie K, Sue T, Howard W, Justin H & Wells A. (2018). Group Cognitive-Behavior Therapy or Group Metacognitive Therapy for Obsessive-Compulsive Disorder? Benchmarking and Comparative Effectiveness in a Routine Clinical Service. Front Psychol. 1(9), 2551.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry:
Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
Trull T, Freeman L, Tayler V, Choate A, Helle A & Wycoff A. (2018). Borderline personality disorder and substance use disorders: an updated review. Borderline Personal Disord Emot Dysregul. 5(15). Anti- Social Personality Disorder Essay Paper
Woman with personality Disorder
Rhonda is a 32 -year old Hispanic female who presents to the office for initial appointment. When asked the reason for her visit, she states she is at the end of her rope and don’t know what else to do. She then becomes tearful, commenting that everyone she knows has abandoned her although she has gone out of her way to help other people.
Rhonda stands and paces around the room using hand gestures to explain the circumstances that caused her to make the appointment. She talks about her recent break-up with her boyfriend, saying that it was traumatic for her, commenting, “When we first met, he was the best guy in the world, and he treated me really well. However, then he became a monster. Even though he broke off the relationship, I am glad it ended. I hate his guts.”
Rhonda goes on to talk about her financial situation and how precarious it is, commenting that she recently purchased an automobile and does not how she is going to pay for it. She states that she had a car repossessed last year and how she borrowed money from a friend to help pay for the car. She then states that the friend turned around and accused her of theft, commenting, “It was my friend’s fault. She told me she would loan me the money and then changed her mind. I took the money because she promised to loan it to me and people just can’t go back on their work when other people are counting on them.”
Rhonda reports being in trouble as a kid, adding that other people were always picking on her. She then refers to the kids as being stupid and not knowing how to have fun. She admits to impulsive behaviors and believes her impulsivity is fun commenting, “Some people are such prudes. You only go around life once, so you have to make the best of it.” psychological battery.
Mental Status
Rhonda is alert and oriented x 4 spheres, speech clear, coherent and spontaneous. She reports that her mood is terrible. She is labile and seems to change topics being discussed quickly. Her eye contact is good, but at times she stares intensely at PMHNP. She denies A/V hallucinations, no overt paranoia or delusional thoughts noted. She denies suicidal/homicidal ideations.
Decision Point One
BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PSYCHIATRIC/MENTAL HEALTH NURSE PRACTITIONER (PMHNP) GIVE TO RHONDA?
In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis.
Anti-social Personality Disorder
Decision Point Two
Refer Rhonda for psychological Testing. Explain why.
Client returns to clinic in four weeks. The psychologist’s report indicates that a comprehensive psychological battery was performed for the purposes of diagnostic clarification. The end result suggested that Rhonda has traits of multiple personality disorders, but scores highest in antisocial personality traits, suggesting antisocial personality disorder. When Rhonda returns to the office, you review the psychologist’s report with her. Rhonda seems upset, but also states “well, that’s why I am here, to get better … what do I need to do?” Refer for group-based cognitive therapy. Explain why Anti- Social Personality Disorder Essay Paper