Navigating Therapeutic Alliance Ruptures in Cognitive Therapy for Avoidant and Obsessive-Compulsive Personality Disorders and Comorbid Axis I Disorders

2011 ◽  
Vol 4 (4) ◽  
pp. 397-414 ◽  
Author(s):  
Jorden A. Cummings ◽  
Adele M. Hayes ◽  
Cory F. Newman ◽  
Aaron T. Beck
Keyword(s):  
Therapeutic Alliance ◽  
Personality Disorders ◽  
Cognitive Therapy ◽  
Obsessive Compulsive ◽  
Axis I Disorders ◽  
Alliance Ruptures ◽  
Axis I

Cognitive Therapy for Personality Disorders

2012 ◽  
pp. 726-750
Author(s):  
Robert L. Leahy ◽  
Lata K. McGinn
Keyword(s):  
Personality Disorders ◽  
Cognitive Therapy ◽  
Dialectical Behavior Therapy ◽  
Negative Impact ◽  
Cognitive Model ◽  
Theoretical Models ◽  
Axis I Disorders ◽  
Treatment Research ◽  
Axis I ◽  
Schema Model

Personality disorders are prevalent and common among patients presenting for treatment. Research suggests that personality disorders are associated with significant impairment and can exert a negative impact on psychological and pharmacological treatments for Axis I disorders. Despite this, treatment development and research for personality disorders has lagged behind those of Axis I disorders. The present chapter describes two major cognitive models of personality disorder—the cognitive model advanced by Beck, Freeman, and colleagues and the schema model advanced by Young and colleagues (a brief review of the dialectical behavior therapy model is also provided). The chapter presents research on both theoretical models and outlines similarities and differences between the two theoretical formulations. A description of the therapeutic relationship in cognitive therapy is also provided. The components of treatment are presented followed by a case example for purposes of illustration. Finally, the chapter summarizes the extant research on the treatment of personality disorders. Although the data are encouraging, suggesting that personality disorders are responsive to treatment, further controlled trials are still needed.

A personality disorders prevalence study among inpatients with mood disorders, psychoactive substance use disorders and anxiety disorders

2000 ◽  
Vol 9 (1) ◽  
pp. 36-44 ◽  
Author(s):  
Maria Grazia Marinangeli ◽  
Giancarlo Butti ◽  
Antonella Scinto ◽  
Loredana Di Cicco ◽  
Artemis Kalyvoka ◽  
...  
Keyword(s):  
Personality Disorders ◽  
Mood Disorders ◽  
Clinical Sample ◽  
Psychiatric Inpatients ◽  
Self Report ◽  
Exact Nature ◽  
Obsessive Compulsive ◽  
Axis Ii ◽  
Axis I Disorders ◽  
Axis I

SummaryObjective- The aim of this study was to asses type and prevalence of Personality Disorders (PDs) and their patterns of comorbidity with Axis I disorders in a sample of psychiatric inpatients.Setting- The sample consisted of 300 subjects admitted to a psychiatric unit on a voluntary bases for an index episode. The study was conducted over a period of 12 months, from 1.11.1997 to 31.10.1998.Main outcome measures- The Italian version of SCID-II-PQ (Structured Clinical Interview for DSM-III-R personality disorders, with Personality Questionnaire-PQ- a self report questionnaire).Results- More than half the patients had at least one personality disorder. The mean of disorders per patient was 2.83±1.93 (±SD). The most prevalent Axis II disorders were Borderline PD (30.7%), Obsessive-compulsive PD (30.7%) and Avoidant PD (25.3%). Women were significantly more likely than men to meet criteria for Dependent PD and Avoidant PD. Man showed significantly more frequently than women Antisocial PD. Significant associations (p<0.05) were found for comorbidity of Mood Disorders and Avoidant PD, and for Psicoactive Use Disorders and Antisocial PD.Conclusions- Our study confirms the high prevalence of PDs in psychiatric inpatients and showes some interesting associations between Axis I and Axis II disorders. These results can't be generalized to outpatients because our clinical sample involved mainly severely ill inpatients, but they raise questions about the exact nature of PDs and of the relationship with Axis I disorders. Further research involving outpatients and general population is needed to examine factors that could affect development and course of Personality Disorders.

Associations of Parental Personality Disorders and Axis I Disorders with Childrearing Behavior

Psychiatry ◽  
2006 ◽  
Vol 69 (4) ◽  
pp. 336-350 ◽  
Author(s):  
Jeffrey G. Johnson ◽  
Patricia Cohen ◽  
Stephanie Kasen ◽  
Miriam K. Ehrensaft ◽  
Thomas N. Crawford
Keyword(s):  
Personality Disorders ◽  
Axis I Disorders ◽  
Axis I ◽  
Parental Personality

scholarly journals The Impact of Obsessive Compulsive Personality Disorder on Cognitive Behaviour Therapy for Obsessive Compulsive Disorder

2015 ◽  
Vol 44 (4) ◽  
pp. 444-459 ◽  
Author(s):  
Olivia M. Gordon ◽  
Paul M. Salkovskis ◽  
Victoria Bream
Keyword(s):  
Initial Assessment ◽  
Obsessive Compulsive ◽  
Behavioural Treatment ◽  
Compulsive Disorder ◽  
Cognitive Behavioural Treatment ◽  
Cognitive Behavioural ◽  
Axis I Disorders ◽  
Axis I ◽  
Obsessive Compulsive Personality Disorder ◽  
The Impact

Background: It is often suggested that, in general, co-morbid personality disorders are likely to interfere with CBT based treatment of Axis I disorders, given that personality disorders are regarded as dispositional and are therefore considered less amenable to change than axis I psychiatric disorders. Aims: The present study aimed to investigate the impact of co-occurring obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) on cognitive-behavioural treatment for OCD. Method: 92 individuals with a diagnosis of OCD participated in this study. Data were drawn from measures taken at initial assessment and following cognitive-behavioural treatment at a specialist treatment centre for anxiety disorders. Results: At assessment, participants with OCD and OCPD had greater overall OCD symptom severity, as well as doubting, ordering and hoarding symptoms relative to those without OCPD; however, participants with co-morbid OCD and OCPD demonstrated greater treatment gains in terms of OCD severity, checking and ordering than those without OCPD. Individuals with OCD and OCPD had higher levels of checking, ordering and overall OCD severity at initial assessment; however, at post-treatment they had similar scores to those without OCPD. Conclusion: The implications of these findings are discussed in the light of research on axis I and II co-morbidity and the impact of axis II disorders on treatment for axis I disorders.

Psychiatric (axis I) and personality (axis II) disorders in patients with burning mouth syndrome or atypical facial pain

2011 ◽  
Vol 2 (4) ◽  
pp. 155-160 ◽  
Author(s):  
Tero Taiminen ◽  
Laura Kuusalo ◽  
Laura Lehtinen ◽  
Heli Forssell ◽  
Nora Hagelberg ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Personality Disorders ◽  
Psychiatric Disorders ◽  
Orofacial Pain ◽  
Burning Mouth Syndrome ◽  
Atypical Facial Pain ◽  
Obsessive Compulsive ◽  
Axis I ◽  
Chronic Pain Conditions ◽  
Chronic Course

AbstractBackground and aimsBurning mouth syndrome (BMS) and atypical facial pain (AFP) are often persistent idiopathic pain conditions that mainly affect middle-aged and elderly women. They have both been associated with various psychiatric disorders. This study examined current and lifetime prevalence of psychiatric axis I (symptom-based) and II (personality) disorders in patients with chronic idiopathic orofacial pain, and investigated the temporal relationship of psychiatric disorders and the onset of orofacial pain.MethodForty patients with BMS and 23 patients with AFP were recruited from Turku university hospital clinics. Mean age of the patients was 62.3 years (range 35–84) and 90% were female. BMS and AFP diagnoses were based on thorough clinical evaluation, and all patients had undergone clinical neurophysiological investigations including blink reflex and thermal quantitative tests. Current and lifetime DSM-IV diagnoses of axis I and II disorders were made on clinical basis with the aid of SCID-I and II-interviews. The detected prevalence rates and their 95% confidence intervals based on binomial distribution were compared to three previous large population-based studies.ResultsOf the 63 patients, 26 (41.3%) had had an axis I disorder that preceded the onset of orofacial pain, and 33 (52.4%) had had a lifetime axis I disorder. Rate of current axis I disorders was 36.5%, indicating that only about 16% of lifetime disorders had remitted, and they tended to run chronic course. The most common lifetime axis I disorders were major depression (30.2%), social phobia (15.9%), specific phobia (11.1%), and panic disorder (7.9%). Twelve patients (19.0%) had at least one cluster C personality disorder already before the emergence of orofacial pain. Patients with cluster C personality disorders are characterized as fearful and neurotic. None of the patients had cluster A (characterized as odd and eccentric) or B (characterized as dramatic, emotional or erratic) personality disorders. The most common personality disorders were obsessive–compulsive personality (14.3%), dependent personality (4.8%), and avoidant personality (3.2%). The majority of the patients (54%) had also one or more chronic pain conditions other than orofacial pain. In almost all patients (94%) they were already present at the onset of orofacial pain.ConclusionsOur results suggest that major depression, persistent social phobia, and neurotic, fearful, and obsessive–compulsive personality characteristics are common in patients with chronic idiopathic orofacial pain. Most psychiatric disorders precede the onset of orofacial pain and they tend to run a chronic course.ImplicationsWe propose that the high psychiatric morbidity, and comorbidity to other chronic pain conditions, in chronic idiopathic orofacial pain can be best understood in terms of shared vulnerability to both chronic pain and specific psychiatric disorders, most likely mediated by dysfunctional brain dopamine activity.

Cognitive Therapy for Comorbid Depression

2014 ◽  
Author(s):  
Mark A. Whisman ◽  
Daniel BE
Keyword(s):  
Substance Use ◽  
Anxiety Disorders ◽  
Personality Disorders ◽  
Cognitive Therapy ◽  
Substance Use Disorders ◽  
Clinical Guidelines ◽  
Clinical Samples ◽  
Comorbid Depression ◽  
Axis Ii ◽  
Axis I

Depression often co-occurs with other Axis I and Axis II psychiatric disorders. This chapter presents a model for how cognitive therapy (CT) of depression can be adapted in conceptualizing and treating the complex set of issues and problems that often accompany comorbid depression. It begins with a discussion of the prevalence of comorbidity in community and clinical samples, then review the research on comorbidity and outcome to CT for depression, followed by a model for adapting or modifying CT for patients who present with depression and a comorbid Axis I or Axis II disorder. The chapter concludes with specific clinical guidelines for treating depression that co-occurs with anxiety disorders, substance use disorders, and personality disorders.

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