Quick review of the essential points— DSM5 diagnosis criteria, assessments, treatments—of these disorders to better prepare for the National Clinical Mental Health Counseling Exam. This was informed by several exam prep programs, and can be used like flashcards or as a presentation.
2. 1. Antisocial Personality
Disorder
2. Borderline Personality
Disorder
3. Histrionic Personality
Disorder
4. Narcissistic
Personality Disorder
Cluster B disorders are
known as dramatic
3. Pervasive patterns of thinking, moods and
actions
Relative to self perception, distressing or
exciting circumstances, personal impulses
and urges, other people
Begun in youth, consistent and inflexible in
many personal and social situations and
stable over time
Causes problems
7. Diagnosis I
Disregard for and violation of the rights of others,
lack of empathy, bloated self-image, manipulative
and impulsive behavior
From age 15 and now at least 18 years old
Evidence of conduct disorder and HDAD before
age 15
8. Diagnosis II
Requires 3 or more of the following:
Failure to conform to social norms
and laws, repeatedly arrested;
Deception, repeatedly lying, or
conning others
Impulsivity or failure to plan ahead
Irritability and aggressiveness, with
repeated physical fights or assaults
Reckless disregard for
safety of self or others;
Consistent
irresponsibility,
regarding work or
financial obligations
Lack of remorse,
rationalizing having
mistreated
9. Diagnosis III
Co-occurring
1. Anxiety disorders
2. Depressive disorder
3. Impulse control disorders
4. Substance-related disorders
5. Somatization disorder
6. Attention deficit hyperactivity
disorder
7. Borderline personality disorder
8. Histrionic personality disorder
9. Narcissistic personality disorder
Contributing factors:
Childhood ADHD
Reading
problems
Low IQ
Brain injury
Rule out:
Not only during
psychotic or
manic episodes
11. S4.Treatments
1.Very challenging
Clients deny having a
problem and see no costs
of their actions
Usually brought to
treatment by authorities
May simulate remorse to
manipulate staff
Non-critical, non-
judgmental stance
Focus on practical benefits
of prosocial behavior
2.Therapy
Schema therapy
Multisystemic therapy
Individual therapy, with
a structured and active
approach
Reality Based Approach
forAnger Management,
substance use recovery,
and Social SkillsTraining
12.
13. Diagnosis I
Marked impulsivity and instability of affects,
interpersonal relationships and self image
Highly sensitive to rejection
Present by early adulthood
14. Diagnosis I
Requires at least 5 of following:
1. Frantic efforts to avoid real or
imagined abandonment
2. Unstable, intense
relationships with extreme
idealization and devaluation
3. Identity disturbance: unstable
self-image or sense of self
4. Impulsivity in at least 2 self-
damaging ways (substances,
eating, driving)
5. Recurrent suicidal or self-
mutilating threats or behavior
6. Emotional instability and
reactivity of mood
intense episodic dysphoria,
irritability, or anxiety
Lasting hours or day3445
7. Chronic emptiness
8. Inappropriate, intense anger
9.Transient, stress-related
paranoid ideation or severe
dissociative symptoms
17. 4.Treatments
Helpful for clients to
understand their
condition and direct
their care plan
Expect problems
in relation to
therapist
Long term care is
needed
Family support
important
Psychotherapy
Dialectical BehaviorTherapy is best
Mentalization-based treatment (MBT)
Transference-focused psychotherapy
Schema-focused CBT may help
STEPP group therapy
Medications for symptoms
Depakote for impulsivity
Naltrexone for self-injury
Antipsychotics for disorganized
thinking
18. S5. Monitoring
Improved social functioning
More consistency in
relations with therapist
S6.Termination
Monitor medications (may
be many)
19.
20. Diagnosis 1
Onset in early adulthood
Exaggerates interpersonal problems and blames others
Requires:
1. Discomfort if one is not the center of attention
2. Inappropriate flirtatious and provocative behavior
3. Display of shallow and labile emotions
4. Dressing in a manner to draw attention to themselves
5. Speech is overly impressionistic and shallow
6. Theatrical and excessively emotional personal presentation
7. Suggestible by others and the situation, easily follows fads
8. Overestimates the level of intimacy in a relationship
23. S4.Treatments
Very challenging since clients deny
that they have a problem and
blame others
May act suicidal or depressed
to gain attention
Non-critical, non-judgemental
stance is essential
Possible treatments:
1. CBT
2. Long term
psychotherapy
3. GroupTherapy
4. Functional Analytic
Therapy (behavioral
therapy)
26. Diagnosis I
Key:
Excessively preoccupied
with adequacy, power and
prestige
Unable to see the
destructive damage they
are causing to themselves
and to others in the process
27. Diagnosis I
Requires at least 5:
Grandiose sense of self-
importance
Preoccupied with
fantasies of success,
power, brilliance, or love
Belief that they are
exceptional and can only
be understood by others
who are important
Needs admiration
Sense of entitlement
Exploitative and
oppressive behavior
No empathy
Envious and resentful of
others or believes others
envy them
Egotistical
30. S4.Treatments
Very challenging since clients
deny symptoms
Usually seeks treatment when
illness or other crisis shatters
illusions of perfection
Will demand high status
clinician; derisive towards
lesser staff
Initial approach of support
followed by step-by-step
confrontation of the patient’s
vulnerabilities
Therapy
CBT as SchemaTherapy
Psychoanalytic for anger,
envy, self-sufficiency
Expressive, conflict-solving
psychotherapy
Residential may be needed
Medications
Depression
Anxiety