Personality Disorders

Personality Disorders

Introduction

Personality disorders are mental health conditions characterized by thinking patterns that exhibit unhealthy and fixed thinking, abnormal behavior, and daily personal functioning. Generally, people with personality disorders usually show common difficulties in the way they perceive people and issues. Therefore, a person with such problems indicates hardships concerning relationship with people and participation in social works and activities. Mostly, the condition exhibits during the early age of a person, especially at young adulthood. At that age, many victims show difficulties in relationships and social activities in schools and other learning institutions. Early intervention with a doctor may curb the procession of the condition from bad to worse. Failure to treatment may lead to an adverse effect on productive relationships and personal life. To some may also lead to suicidal acts.

According to the studies, there are three primary classifications of personality disorder. Under the main rankings, there are other sub-categories. The classification of the sub-categories depends on the similarities in the functioning and behavior of the victims. However, a person that shows a particular type of personality disorder may also exhibit behaviors of another and at least one personality disorder. However, it is unusual for persons with a specific personality disorder to manifest all the symptoms that specify that disorder (American Psychiatric Publishing, 2013). That indicates there are no proper diagnosis criteria for personality disorders. Therefore, not all personality disorders have specific boundaries that define them. Another condition may co-occur with another primary condition; a condition referred to as comorbidity.

Controversy over Understanding, Diagnosis, and Treatment of Personality Disorders

Borderline Personality Disorder

A borderline personality disorder is a common mental problem associated with its definite manifestation of behaviors such as the tendency to commit suicide, negative functioning because of depression and stress (Leichsenring et al., 2011). As a result, the disorder may cause a lot of cost to society and high treatment rates.

Epidemiology

According to the recent studies by Leichsenring et al., the portion diagnosed with borderline personality disorder ranged approximately 0.5% to 5.9% of the whole United States population. However, the number indicated was from non-clinical samples. That means prominent use of generic medication, or there is an unknown population with the condition. The study shows that a higher number depends on generic medicines as compared to the one that seeks psychiatric treatments in the United States (Leichsenring at al., 2011). Furthermore, an average of 20% psychiatric inpatients and 10% psychiatric outpatients (Leichsenring at al., 2011; Bateman at al., 20) poses a challenge to the proper treatment to such a portion of the patients.

Controversy over the Diagnosis and Treatment

Diagnosis

Among the criteria that define the existence or manifestation of borderline personality disorder, a person must exhibit at least five out of nine symptoms for proper diagnosis (Leichsenring at al., 2011). However, the author states the most prominent evident sign that indicates possession of borderline personality disorder include suicidal tendencies, self-injury, and ineffective relationships. However, despite being the most recent study (Leichsenring at al., 2011), there is still no clear indication that one criterion requires more priority than others to determine the existence of the condition. Therefore, more research is necessary to segregate and distinguish behavioral aspects for a definitive conclusion. That will bring better treatment methods and diagnosis.

 Treatment

The treatment methods at hand for borderline personality disorder include psychosocial therapy and pharmacotherapy. However, there have been several modifications to the psychosocial treatment method over the forty years of study about the condition (Bateman et al., 2015). There have been several random treatment attempts by the use of the psychological method, specific to each condition manifested by the victims. For instance, dialectical behavioral therapy for personal behavior, integrative therapies for social-community treatments, schema-focused therapy for cognitive functioning, among others. However, mental health professionals face difficulties for effective remedy by the method. First, the health professionals cannot handle the significant number by use of such treatment method, since it comprises almost 20% of the admitted patients.

Furthermore, the treatment method has shown success on one side. Improvement on the symptomatic side while there is a significant failure in the social relationship treatment (Bateman et al., 2015). Again, it is a challenge for the victims to commit to the treatment method. The treatment method also requires more training and education for effective treatment.

Pharmacotherapy is another contradicting treatment method. The American Psychiatric Association suggests that pharmacotherapy is essential for the symptomatic part in borderline personality disorder treatment. The treatment involves the use of monoamine oxidase inhibitors or the use of serotonin reuptake inhibitors (Bateman et al., 2015). The chemicals contain or inhibit aggression and stabilize the moods. However, the reviews and researches from several experts indicate there are no specific treatment methods for the condition. For instance, ‘UK’s NICE guidelines’ (Bateman et al., 2015) states drug treatment is not fit for the disorder and does not require administration for more than one week. Another evidence by ‘Cochrane review’ (Bateman et al., 2015) suggests that there is no effective treatment upon the use of selective serotonin reuptake inhibitors (SSRIs). Also, the review supports that mood stabilizers would also depress the impulsive aggressive symptoms and that antipsychotic drugs can be useful to cognitive-perceptual symptoms to a person suffering borderline personality disorder. Furthermore, ‘Australia’s National Health and Medical Research Council’ gave a review and supported that pharmacotherapy is overly not an effective method for the treatment of borderline personality disorder (Bateman et al., 2015).

The reviews by the mental treatment professionals and experts are overly controversial and do not deliver a cohesive conclusion for the treatment of borderline personality disorder.  More research and the common consensus is crucial for proper diagnosis and treatment to assist the victims in society and reduce the negative repercussions for better social relationships and a happier life.

Antisocial Personality Disorder

Diagnosis

An antisocial personality disorder is one of the conditions known to yield controversial data. However, for preventive measures, more accurate and definitive treatment methods have been conducted to the incarcerated individuals rather that the lot in the community. More focus is on the symptomatic and behavioral outcomes rather than more concentration on the data from the current scientific researches. The reason to research the incarcerated individuals is the negative response toward the treatment while in community.

Furthermore, the victims with the condition do not seek treatment attention. Also, according to the study, an antisocial personality disorder is associated with substance abuse (Bateman et al., 2015; Skodol et al., 2011). In contrast to the other disorders like a borderline personality disorder, there are no full results for antisocial personality disorder since the scientists behind that do not consider outcomes such as re-offense rate after the treatment and release of the incarcerated victims (Bateman et al., 2015).

Treatment

Studies by earlier researchers suggest that a combination of cognitive-behavioral therapy and social training skills showed more promising results for both young and adults (Bateman et al., 2015). However, the results did not indicate any improvement in the reduction of offenses after the release. Other studies revealed that victims with antisocial personality disorder and drug abuse showed positive results for cognitive behavioral therapy. The method reduces aggressions after one year of treatment, Bateman et al., 2015).

Further studies indicate that early intervention can prevent the procession of the condition to adulthood. Young people with conduct and behavioral problems are closely associated with having an antisocial personality disorder. If they can be prevented earlier by suitable treatments, then positive results can be evident at a later age or in adulthood.

There is no good evidence for the Pharmacotherapy treatment for antisocial personality disorder. However, Bateman et al. review suggest that the ‘NICE’ do not recommend pharmacotherapy as an effective method for the treatment of the disorder. On the other hand, ‘NICE’ supports pharmacotherapy intervention to other comorbidity conditions. That indicates great contradiction upon treatment methods. The suggestions to use and restrictive usage or application of treatment method on a specific mental condition indicates controversial proposals. Since there are no boundaries or criteria that define the personality conditions, the use of either psychosocial or pharmacotherapy treatment methods on such disorders would yield more confusion unless there is a clear description of each personality disorder.

Benefits of Personality Disorders Diagnosis

It is crucial for a close diagnosis of personality disorders. First, it can lead to more clues and ideas on how to segregate one disorder from another and have more specific treatment methods. It can also lead to knowledge as to why it is difficult to treat some patients suffering some of the conditions (Leichsenring et al., 2011). An example of such can be re-offenses in antisocial personality disorder.

Currently, Personality disorders are a challenge in the whole world. The conditions can have a high cost to personal life, such as acquiring depression and stress, frustrations, among others. That can lower persons’ productivity daily and problematic social relationships. On top of that, it can result in increased suicidal incidences in the world. The (American Psychiatric Publishing, 2013) review suggests that more intervention is required to curd the personality conditions through more conclusive and comprehensive researches for effective treatment methods.

Challenges

Although there is a faster requirement for the diagnosis of personality disorders, there underlie significant challenges ahead. That is because there are no definite criteria for each condition. Treatment of comorbidity mental condition has posed to be a challenge since an individual may manifest more than one condition that can be difficult to distinguish. The current researches do not hold comprehensible basis for effective treatment method. Therefore, medical researchers require effective and consistent follow-up on the studies, diagnosis, and treatment methods on each distinguished personality disorder condition (American Psychiatric Publishing, 2013).

References

Bateman, A., Gunderson, J., & Mulder, R. (2015). Treatment of personality disorder. Personality Disorder 3, (385). Retrieved 19 March 2020, from https://pdfs.semanticscholar.org/52a8/c01ac301cafd35e55d67489eadd783e819d0.pdf.

American Psychiatric Publishing. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Leichsenring, F., Leibing, E., Kruse, J., New, A., & Leweke, F. (2011). Borderline personality disorder. Seminar, (377). Retrieved 19 March 2020, from https://www.vvpt.be/images/Publicaties/leichsenring-et-al-2011.pdf.

Skodol, A., Bender, D., Oldham, J., Morey, L., Clark, L., & Alarcon, R. et al. (2011). Personality Disorder Types Proposed for DSM-V. Journal Of Personality Disorders, 25(2), 136–169. Retrieved 19 March 2020, from https://www.researchgate.net/profile/Carl_Bell/publication/51019147_Personality_Disorder_Types_Proposed_for_DSM-5/links/549c0b600cf2b8037138a4f8.pdf.