Comorbid Case Study
The case study of Bill highlights and conceptualizes Antisocial Personality Disorder (ASPD) with comorbid narcissistic and borderline personality disorder (NPD and BPD). ASPD is a complex mental condition where an individual has ingrained behavioral patterns to disregard people’s rights or have callous unconcern for others’ feelings. The case of Bill takes a developmental perspective to describe, diagnose, and illustrate a treatment framework for comorbidity.
Bill is a 30-year-old man with past criminal records, and he is recommended for mandatory treatment by his parole office. He is referred to the narrating therapist for assessment to determine his motivation for treatment after inconsistencies and lack of adherence to therapeutical interventions. In his evaluation, the therapist identifies several characteristics and patterns indicative of ASPD diagnosis. Bill’s ASPD symptoms as prescribed in DSM-5 include violation of people’s rights in stealing and hurting others, all before the age of 18, as evidenced in medical reports.
Bill’s case is a comorbid condition as he is diagnosed with both NPD and BPD. Several instances in the assessment were indicative of NPD, where he presents himself as grandiose, suggests his unmatched abilities, and even lies on attending a prestigious university. Bill similarly meets DSM-5 criteria of BPD. His life is characterized by unstable relationships with family and intimate partners. Bill’s moral codes also shift according to his self-interest.
The case study is, additionally, informative in presenting the difficulties associated with treating ASPD patients. Bill has a dismissive attitude, rationalizes his doings, and adopts the kettle logic to externalize blame. He’s unforthcoming in giving information posed a barrier to treatment and jeopardized the credibility of his statements. The article, nobly, presents some essential techniques used by the therapist when conversing with ASPD clients. The therapist is direct and explicitly clear in his responses, and also very keen to detect inconsistencies in Bill’s stories.
References