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Christina Boyd, LSCSW, LCAC
Co-Occurring Disorders EPL
Week #4
Starting to Understand
Personality Disorders
• Welcome and Check in
• Review of Learning Activity-
Personality DOs, DBT
Welcome
• Overview of Personality Disorders
• Importance of differential diagnosis
• Dealing with ambivalence in treatment
Presentation
• Preview of next week
• Assign Learning Activity
• Questions
Summary
Agenda
Why are we
looking at
all of this??
-You tell me…
Do you think there is potential for some to get diagnosed with a personality disorder during the
course of their substance use? Why does it matter? Would treatment change for these people?
What are symptoms that sound familiar to what a person may be diagnosed with that relates to
their substance use that mimics what one might see in a person with a personality disorder?
Have you ever worked with someone who had a hard time dealing with others or had patterns
discussed in the film? What was your reaction to them? Did they do well in the program?
Learning Activity-Personality DO Crash Course
Have you worked with
someone in the course of
your career who exhibited
these types of behaviors?
What was done to assist
these individuals in the
treatment process? Was it
helpful? Unhelpful?
What could your agency do
to improve identification of
these types of behaviors and
interventions to address
them?
Learning Activity:
Didactic Behavioral Therapy (DBT)
Personality
What’s the personality type?
Please type it into the chat!
What is the personality type?
Please type it into the chat!
• Pg. 645-684
of DSM 5
Personality Disorders
Is an enduring pattern of inner
experience and behavior and deviates
markedly from the expectation of the
individual’s culture, is inflexible, has an
onset in adolescence or early
adulthood, is stable over time, and
leads to distress or impairment.-(DSM 5)
A Personality
Disorders
• Is an enduring pattern of inner experience and behavior and deviates markedly from the expectation
of the individual’s culture. This pattern is manifested in two (or more) of the following areas:
1. Cognition
2. Affectivity
3. Interpersonal Functioning
4. Impulse Control
• The enduring pattern is inflexible and pervasive across a broad range of personal and social
situations.
• The enduring pattern leads to clinically significant distress or impairment in social, occupational, or
other important areas of functioning.
• The pattern is stable and of long duration with onset at least to adolescence.
• The enduring pattern is not better explained as a manifestation or consequence of another mental
disorder.
• The enduring pattern is not attributable to the psychological affects of a substance or other medical condition.
Criteria-DSM 5
Have you
ever met
this
person?
Pattern of acute
discomfort in close
relationships, cognitive or
perceptual distortions,
and eccentric in behavior
Schizotypal Personality
Detachment from social
relationships and
restricted emotions
Schizoid Personality
Pattern of distrust and
suspiciousness of
others
Paranoid Personality
Cluster A-(DSM 5)
Pattern of
disregard for
and violation
of the right of
others
• Antisocial Personality
Cluster B-(DSM 5)
•Pattern of
instability in
interpersonal
relationships,
self image,
and affects,
and marked
impulsivity-
(DSM 5)Borderline Personality
Disorder
http://www.youtube.com/watch?v=xdPuSnP8YY8
Borderline Personality
Disorder
Pattern of
excessive
emotionality
and attention
seeking-
(DSM 5)
Histrionic Personality
Disorder
Pattern of
grandiosity,
need for
admiration
and lack of
empathy-
(DSM 5)
Narcissistic Personality
Pattern of preoccupation
with orderliness,
perfectionism, and control
Obsessive-compulsive
Pattern of submissive and
clinging behavior related to
an excessive need to be
take care of.
Dependent Personality
Pattern of social inhibition,
feelings of inadequacy, and
hypersensitivity to negative
evaluation
Avoidant Personality
Cluster C-(DSM 5)
Lacks meeting criteria for
one disorder, but may show
traits or they meet the
general, but not criteria for a
particular disorder listed.-
(DSM 5)
Other specified/unspecified
Frontal lobe legion
or head injury
Personality changes
due to medical
Other
Personality
Disorders
You don’t get
to choose to
deal with
people, but you
do choose
YOUR
response!!
Interventions
When a
client/patient
doesn’t know
for sure that
they want to
change.
What to do, what to
do??
Sustain
Talk
Change
Talk
Ambivalence
VS. Resistant
Exploring Ambivalence:
What is it?
Exploring Ambivalence
Sailing through
Sustain Talk
The
Spirit
of MI
• https://www.youtube.com/watch?v=WAL7Pz1i1jU
Daniel Pink has written many books on the concept of motivation as it applies to
people and to business.
People are people!
The science that applies really is the same!
What we have learned from Big Business
and What Big Business has learned from us.
Remember…
Change is
Hard…
for ALL of us!!
What is one thing that stands out that
you learned from this series so far?
Please type it into the chat!
Question:
Sneak Peek at
next week ….
Integration
of Mental
Health into
SUD
Treatment
Research at least 1 Behavioral Health App that might be
helpful to share with people that are accessing
treatment at your agency
-
Investigate your discipline’s stance on addressing co-occurring disorders as
well as your state’s regulations or statute about scope of practice.
Learning Activity-Week #4
Questions
https://ncadd.org/get-help/addiction-
medicine/482-dsm-5-coming-may-2013
American Psychiatric Association. (2013).
Diagnostic and Statistical Manual of Mental
Disorders (5th ed.). Washington, DC.
Co-Occurring disorders program: integrating
combined therapies 2008, Hazelden
References:

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Region 8 Co-Occurring Disorders (Wk 4)

  • 1. Christina Boyd, LSCSW, LCAC Co-Occurring Disorders EPL
  • 2. Week #4 Starting to Understand Personality Disorders
  • 3. • Welcome and Check in • Review of Learning Activity- Personality DOs, DBT Welcome • Overview of Personality Disorders • Importance of differential diagnosis • Dealing with ambivalence in treatment Presentation • Preview of next week • Assign Learning Activity • Questions Summary Agenda
  • 4. Why are we looking at all of this?? -You tell me…
  • 5. Do you think there is potential for some to get diagnosed with a personality disorder during the course of their substance use? Why does it matter? Would treatment change for these people? What are symptoms that sound familiar to what a person may be diagnosed with that relates to their substance use that mimics what one might see in a person with a personality disorder? Have you ever worked with someone who had a hard time dealing with others or had patterns discussed in the film? What was your reaction to them? Did they do well in the program? Learning Activity-Personality DO Crash Course
  • 6. Have you worked with someone in the course of your career who exhibited these types of behaviors? What was done to assist these individuals in the treatment process? Was it helpful? Unhelpful? What could your agency do to improve identification of these types of behaviors and interventions to address them? Learning Activity: Didactic Behavioral Therapy (DBT)
  • 8. What’s the personality type? Please type it into the chat!
  • 9. What is the personality type? Please type it into the chat!
  • 10. • Pg. 645-684 of DSM 5 Personality Disorders
  • 11. Is an enduring pattern of inner experience and behavior and deviates markedly from the expectation of the individual’s culture, is inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.-(DSM 5) A Personality Disorders
  • 12. • Is an enduring pattern of inner experience and behavior and deviates markedly from the expectation of the individual’s culture. This pattern is manifested in two (or more) of the following areas: 1. Cognition 2. Affectivity 3. Interpersonal Functioning 4. Impulse Control • The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. • The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning. • The pattern is stable and of long duration with onset at least to adolescence. • The enduring pattern is not better explained as a manifestation or consequence of another mental disorder. • The enduring pattern is not attributable to the psychological affects of a substance or other medical condition. Criteria-DSM 5
  • 14. Pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentric in behavior Schizotypal Personality Detachment from social relationships and restricted emotions Schizoid Personality Pattern of distrust and suspiciousness of others Paranoid Personality Cluster A-(DSM 5)
  • 15. Pattern of disregard for and violation of the right of others • Antisocial Personality Cluster B-(DSM 5)
  • 16. •Pattern of instability in interpersonal relationships, self image, and affects, and marked impulsivity- (DSM 5)Borderline Personality Disorder
  • 19. Pattern of grandiosity, need for admiration and lack of empathy- (DSM 5) Narcissistic Personality
  • 20. Pattern of preoccupation with orderliness, perfectionism, and control Obsessive-compulsive Pattern of submissive and clinging behavior related to an excessive need to be take care of. Dependent Personality Pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation Avoidant Personality Cluster C-(DSM 5)
  • 21. Lacks meeting criteria for one disorder, but may show traits or they meet the general, but not criteria for a particular disorder listed.- (DSM 5) Other specified/unspecified Frontal lobe legion or head injury Personality changes due to medical Other Personality Disorders
  • 22. You don’t get to choose to deal with people, but you do choose YOUR response!! Interventions
  • 23. When a client/patient doesn’t know for sure that they want to change. What to do, what to do??
  • 26. • https://www.youtube.com/watch?v=WAL7Pz1i1jU Daniel Pink has written many books on the concept of motivation as it applies to people and to business. People are people! The science that applies really is the same! What we have learned from Big Business and What Big Business has learned from us.
  • 28. What is one thing that stands out that you learned from this series so far? Please type it into the chat! Question:
  • 29. Sneak Peek at next week …. Integration of Mental Health into SUD Treatment
  • 30. Research at least 1 Behavioral Health App that might be helpful to share with people that are accessing treatment at your agency - Investigate your discipline’s stance on addressing co-occurring disorders as well as your state’s regulations or statute about scope of practice. Learning Activity-Week #4
  • 32. https://ncadd.org/get-help/addiction- medicine/482-dsm-5-coming-may-2013 American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC. Co-Occurring disorders program: integrating combined therapies 2008, Hazelden References: