193 -8 Common Errors in the Diagnosis of Personality Disorders – Addiction Counselor Training Series
Summary: <p>8 Errors in Effective Differential Diagnosis of Personality Disorders<br> Instructor: Dr. Dawn-Elise Snipes, PhD<br> Executive Director: AllCEUs.com, Counselor Education and Training<br> Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery</p> <p>Objectives<br> ~ Review the criteria for<br> ~ Paranoid<br> ~ Schizoid<br> ~ Schizotypal<br> ~ Antisocial<br> ~ Borderline<br> ~ Histrionic<br> ~ Narcissistic<br> ~ Avoidant<br> ~ Dependent<br> ~ Obsessive Compulsive<br> ~ Identify 8 common errors in diagnosis</p> <p>Overview of Personality Disorder Diagnosis<br> ~ Enduring pattern of inner experience and behavior that deviates markedly from cultural expectations in 2 or more areas<br> ~ Cognition<br> ~ Affectivity (range, intensity, lability, appropriateness)<br> ~ Interpersonal functioning<br> ~ Impulse control<br> ~ Behavior is inflexible and pervasive<br> ~ Behavior is stable and can be traced back to adolescence or early adulthood<br> ~ Not better explained as a manifestation of consequence of another mental disorder or attributable to medical conditions or substances: (Mania, Addiction, Autism Spectrum, FASD)<br> ~ Dx of a PD in someone under 18 requires a duration of at least 1 year<br> ~ Adopted as well as biological children have similar chances of developing a PD indicating the influence of environment<br> Issue 1: Acculturation<br> ~ Do not confuse with problems with acculturation<br> ~ Take into account individual’s cultural background (ethnicity, country, urban/rural, high/low SES, religion)<br> ~ Common intergenerational heritage<br> ~ Shared values, beliefs, customs, behaviors, traditions, institutions, arts, folklore, and lifestyle.<br> ~ Similar relationship and socialization patterns.<br> ~ A common pattern or style of communication or language.<br> ~ Geographic location of residence (e.g., country; community; urban, suburban, or rural location).<br> ~ Patterns of dress and diet</p> <p>Issue 1: Acculturation cont…<br> ~ Cultural Issues<br> ~ Minority groups, immigrants, individuals from different ethnic backgrounds and those with physical handicaps may display suspiciousness, guarded or defensive behaviors resulting from perceived neglect or indifference by the majority society<br> ~ Some ethnic groups also display culturally related behaviors which should not be confused with<br> ~ Paranoia<br> ~ Avoidance<br> ~ Dependence</p> <p>Issue 2: Stereotyped Gender Roles<br> ~ Do not misdiagnose based on stereotypical gender roles<br> ~ Females: Borderline, histrionic, dependent<br> ~ Males: Antisocial, narcissistic<br> ~ Personality traits are only personality disorders when inflexible, maladaptive, persistent and cause functional impairment or subjective distress<br> Issue 3: Differentiate from Mood Disorders with Psychotic Features<br> ~ Paranoid, schizoid and schizotypal must not have occurred exclusively within<br> ~ Schizophrenia<br> ~ Bipolar<br> ~ Depressive disorders with psychotic features<br> Issue 4:Personality Changes from PTSD</p> <p>~ Personality changes as the result of PTSD<br> ~ Lack of interest in social relationships<br> ~ Solitariness<br> ~ Affect flattening/emotional numbing<br> ~ Irritability<br> ~ Lack of trust/paranoia<br> ~ Avoidance of reminders of the event</p> <p>Issue 5: Addictions<br> ~ Differential diagnosis with addictive disorders (~47%)<br> ~ More time spent getting, using, recovering from the substance than intended<br> ~ Irritability, grudging during withdrawal<br> ~ Paranoia or irritability while under the influence<br> ~ Histrionic behaviors to manipulate getting the substance<br> ~ Inability to stop or cut down<br> ~ Dependence on dealers<br> ~ Failure to meet important role obligations<br> ~ Reduction in hobbies and important activities<br> ~ Continued use despite 2 or more problems<br> ~ Sensitive to perceived attacks on character<br></p>
