Posted: September 4th, 2023

CONTROVERSY ASSOCIATED WITH PERSONALITY AND PARAPHILIC DISORDERS

CONTROVERSY ASSOCIATED WITH PERSONALITY AND PARAPHILIC DISORDERS

Between 10% and 20% of the population experience personality disorders. They are difficult to treat as individuals with personality disorders are less likely to seek help than individuals with other mental health disorders. Treatment can be challenging as they do not see their symptoms as painful to themselves or others.

Paraphilic disorders are far more common in men than in women, and generally quite chronic, lasting at least two years. Treatment of these disorders usually involves both psychotherapeutic and pharmacologic treatments.

In this Assignment, you will explore personality and paraphilic disorders in greater detail. You will research potentially controversial elements of the diagnosis and/or treatment and explain ethical and legal considerations when working with these disorders.

TO PREPARE
Review this week’s Learning Resources and consider the insights they provide on assessing, diagnosing, and treating personality and paraphilic disorders.
Select a specific personality or paraphilic disorder from the DSM-5-TR to use for this Assignment.
Use the Walden Library to investigate your chosen disorder further, including controversial aspects of the disorder, maintaining the therapeutic relationship, and ethical and legal considerations.
RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

THE ASSIGNMENT
In 2–3 pages:

Explain the controversy that surrounds your selected disorder.
Explain your professional beliefs about this disorder, supporting your rationale with at least three scholarly references from the literature.
Explain strategies for maintaining the therapeutic relationship with a patient that may present with this disorder.
Finally, explain ethical and legal considerations related to this disorder that you need to bring to your practice and why they are important.
REQUIRED READINGS
National Institute for Health and Care Excellence: NICE Guidelines. (2010). Antisocial personality disorder: Prevention and managementLinks to an external site..
https://www.nice.org.uk/guidance/cg77
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. (For review as needed)
Chapter 22, “Personality Disorders”
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
Chapter 67, “Disorders of Personality”
Chapter 68, “Developmental Risk for Psychopathy”
Chapter 69, “Gender Dysphoria and Paraphilic Sexual Disorders” (pp. 988–993 only)
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
Chapter 14, “Personality Disorders”
REQUIRED MEDIA
Buchanan, N. T. (2020, April 13). Lecture 14 part 3: Paraphilic disordersLinks to an external site. [Video]. YouTube.
MDedge. (2020, January 22). Personality disorders with Dr. Frank YeomansLinks to an external site. [Video]. YouTube.

Introduction:

Paraphilic disorders and personality disorders are types of mental disorders that can cause significant distress in individuals’ lives. Paraphilic disorders are characterized by intense and persistent sexual arousal to atypical stimuli, while personality disorders involve long-standing patterns of maladaptive behavior, cognition, and emotions. In this assignment, we will discuss the controversy surrounding a specific disorder, our professional beliefs about it, strategies for maintaining the therapeutic relationship, and ethical and legal considerations.

Disorder and Controversy:

The selected disorder for this assignment is borderline personality disorder (BPD). BPD is a pervasive and persistent pattern of instability in interpersonal relationships, self-image, and affect, as well as marked impulsivity. The controversy surrounding BPD is that some clinicians believe it is a severe mental illness that requires long-term treatment, while others argue that it is a normal variation of personality that can be managed with shorter-term therapies.

Professional Beliefs:

As a mental health professional, I believe that BPD is a severe mental illness that requires specialized and long-term treatment. BPD is associated with significant impairment in functioning, including high rates of suicide, self-harm, and substance abuse. It is also challenging to treat as individuals with BPD often have difficulties with emotional regulation and interpersonal relationships. While some studies suggest that BPD symptoms may improve over time, many individuals continue to struggle with BPD symptoms even after years of treatment.

Strategies for Maintaining Therapeutic Relationship:

To maintain a therapeutic relationship with a patient with BPD, it is essential to establish clear boundaries, provide empathy, and develop a collaborative treatment plan. BPD individuals often struggle with trust and fear of abandonment, so the clinician must be consistent in their approach, avoid making promises that they cannot keep, and communicate clear expectations. Empathy is also crucial when working with individuals with BPD, as they may feel invalidated or dismissed. Finally, a collaborative treatment plan that involves the patient in the decision-making process can help foster a sense of control and reduce feelings of helplessness.

Ethical and Legal Considerations:

Ethical and legal considerations that need to be brought to practice when working with BPD individuals include informed consent, confidentiality, and potential risk of harm to self or others. It is essential to ensure that the patient has a clear understanding of their diagnosis and treatment options, as well as the potential risks and benefits of treatment. Confidentiality is also crucial when working with BPD individuals, but there may be situations where disclosure of confidential information is necessary to prevent harm to self or others. Finally, clinicians must also be aware of the potential risk of harm to self or others, as individuals with BPD are at an increased risk of suicide and self-harm.

Conclusion:

BPD is a severe mental illness that requires specialized and long-term treatment. Maintaining a therapeutic relationship with BPD individuals involves establishing clear boundaries, providing empathy, and developing a collaborative treatment plan. Ethical and legal considerations that need to be brought to practice when working with BPD individuals include informed consent, confidentiality, and potential risk of harm to self or others.

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