Disorders

The research states that in sexual trauma in that respect is a prevalence of consequent axis II disorders, in particular boundary line Personality Disorder (BPD) as well as Post traumatic Stress Disorder (posttraumatic tune disorder) and Substance Use Disorder (SUDS) (Yen et al. , 2002). This heavy correlation coefficient between PTSD, borderline personality disorder and substance do by disorder, acquire complications in treatment (Ross, Dermatis, Levounis, and Galanter, 2003). The goal of the present paper is three-fold.First, it aims at reviewing electric current research and theoretical frameworks which argon designed to measure the degree of the kin between PTSD and BPD. It is also sought to trace how it is possible by seeing to the correlation to avoid or neutralize further psycho social problems while step-down harm in substance abuse prevention. Second, the researcher plans to analyze the implications of how failure to address these dynamics in reducing harm and tr eating co-occurring disturbances may further delay treatment and create relapse.Finally, thither is an analysis of the methodologies employed in the treatment theories presented. A particular tension is made on the Integrative Treatment come up suggested by Najavits (2002) and the dialectic behavioral Therapy developed by Lineham (1993). The researcher attempts to explain how these theories influenced the understanding of this dilemma. forwards proceeding to the first point, it is necessary to clarify the main theoretical concepts, such as BPD and PTSD.Speaking popularly, Post Traumatic Stress Disorder (PTSD) is a customary response to an abnormal event (Schiraldi, 2000, p. 3). Being categorized by the American Psychiatric Association as unrivaled of the anxiety disorders, it is typically caused by either or several of the three types of traumatic events Intentional adult male causes, Unintentional Human causes, or Acts of Nature. The presence of the stressor as part of the diagnosis differentiates PTSD from different disorders and makes it a uniquely complex phenomenon.Besides an exposure to the nerve-wracking event, American Psychiatric Association in the 4th edition of the diagnostic and Statistical Manual of Mental Disorders (1994, paraphrased in Schiraldi, 2000) lists another four PTSD criteria persistent (to a greater extent than one month) re-experiencing of the trauma (this category of symptoms is titled interfering memories in Johnson, 2004), persistent (to a greater extent than one month) avoidance of trauma-associated stimuli and suppression of general reactivity (avoidance behavior according to Johnson, 2004), persistent (more than one month) symptoms of hyperarousal (or, according to Johnson, 2004, hypervigilance), and upset of psychological and functional equilibrium. In its turn, Borderline Personality Disorder (BPD) from the bases of accompaniment theory and developmental psychopathology is defined as a exceedingly prevalent, chronic, and debilitating psychiatric problem associated with the following symptoms a pattern of topsy-turvy and self-defeating interpersonal relationships, emotional lability, poor impulse control, angry outbursts, ordinary suicidality, and self-mutilation (Levy, 2005, p. 259).Kernberg (2004), who considered the organization of the personality to be crucially determined by emotional responses as displayed under conditions of peak affect states, listed identity diffusion and the predominance of primitive defensive operations centering on splitting among the advert symptoms of this psychological dysfunction noting that they are accompanied by the presence of trustworthy reality testing (p. 99). The researcher meant that although the enduring imagined himself living in the insane and distorted reality, he differentiated between the self and other objects. It is straight that many current researchers acknowledge the correlation between PTSD and BPD, the last mentioned cosm os treated as one type of personality disorders (PDs). Bremner (1999) conceptualized BPD as fitting to the psychiatric disorders associated with traumatic stress.From this perspective, an exposure to traumatic events and consequent stress affected structural and functional aspects of the brain so that stress-related psychiatric dysfunctions were developed. The viewpoint was supported by McGlashan et al. (2000) who as relying on the results of a descriptive, prospective, longitudinal, repeated-measures direct of a clinical sample of four representative DSM-IV personality disorders called The Collaborative longitudinal Personality Disorders Study (CLPS) (N = 571) found a high rate of bloc II/II overlap. To specify, PTSD and BPD co-existed in almost a half(prenominal) of the sample. To be even more specific, Yen et al.(2002) conducted a longitudinal, prospective, naturalistic, multisite and cross-sectional study to analyze the correlation of the aforementioned two Axis II disorders inside the population of 668 individuals between the ages of 18 and 45 years. Twenty-five percent of those participants (N = 167) exhibited BPD symptoms. Furthermore, BPD participants more often suffered from breedingtime PTSD than diligents with any other form of PDs (51% of those 191 individuals who account of a history of traumatic exposure). Overall, Yen et al. (2002) hypothesized that BPD symptoms trigger vulnerability for traumatic exposure which is the key characteristic of PTSD. Bolton, Mueser, and Rosenberg (2006) observed that between 25% and 56% of individuals with BPD exhibit symptoms of current PTSD as compared to approximately 10% of other patients.Upon analysis of the two studies the index one involving 275 mentally impaired yard bird and outpatient individuals with PTSD (30 patients with BPD among them) and the replication one involving 204 patients (20 people with BPD among them), the researchers stated that comorbid diagnoses of BPD and PTSD were associated wi th higher(prenominal) rates of severe anxiety and depression. Ross, Dermatis, Levounis, and Galanter (2003) cited empirical evidence of comorbid PDs being exceedingly associated with Substance Use Disorder (SUDS) in approximately 50% of the samples. They also shared a viewpoint that stress-related dysfunctions predicted worse treatment outcomes, for example, poorer psychosocial functioning, increase dose use, and lower retention rates.In a way of life of the eight-month research in a specialized inpatient dual diagnosis unit at a public hospital, the researchers observed the population of 100 patients, among which 53% displayed some miscellany of PDs. Seventy-four percent of the interviewees were targeted as having BPD, whereas twenty-five percent exhibited PTSD symptoms. Patients with comorbid disorders (dual and common chord diagnoses) were more likely to abuse substance use (33% alcohol 32% polysubstance 25% cocaine 21% cannabis and 13% heroin). Consequently, such indiv iduals had more inpatient admissions and more severe symptom profiles than the ones with a single diagnosis. The divergence between people with the single-, dual- and triple diagnoses was extremely evident in after-hospitalization treatment. Ross et al.(2003) argued that comorbidity of PDs as accompanied by SUDs should put the clinicians on alert as such individuals needed to be guided at this critical conjunction (p. 275) of a transition from the in- to out-patient environments so that they would be aware of the necessity to approve with after-care therapy. II The concluding section is dedicated to the analysis of the two innovative and effective healing(p) approaches to treating PDs as combined with SUDs first, the Dialectical Behavioural Therapy developed by Lineham (1993) and, second, the Integrative Treatment Approach suggested by Najavits (2002). The cause approach fits into the problem-solving therapeutic paradigm which is praised for the treatment allowing wide amplific ation and being clinically effective.Its core assumption is that antisocial and inadequate behavioral patterns are explained by the scarcity of patients psychological resources to cope with their problems in an alternative gratifying manner. Linehams Dialectical Behavioural Therapy differentiates from other problem-solving alternatives in its particular care to the effect of a specific diagnosis on the course of treatment and its extensive preventive measures against poor attendance. Linehan compared the outcomes of her dialectical behavioural therapy (DBT) to the ones of standard outpatient-care methods to picture that the ratio of patients who continued treatment with the assistance of a single healer increased from 42 to 83 percent. The approach utilizes a range of cognitive-behavioural therapeutic techniques as based on a dialectic philosophy.On the one hand, the patient is helped to value his/her self as a precious and integrative phenomenon by eliminating the feelings of gu ilt, self-abomination and neglect. On the other hand, a therapist assists an individual with two-fold disorders in finding stimuli for change. The core concept of the approach is the skill which is defined as cognitive, emotional, and overt behavioral (or action) response repertoires together with their integration, which is necessary for effective capital punishment (Linehan, 1993, p. 329). The scholar described the four broad modules of skills (1) mindfulness, (2) interpersonal effectiveness, (3) emotion regulation, and (4) melancholy tolerance.To proceed, the pioneer of this method listed three categories of skills training procedures (1) skills acquisition, (2) skill strengthening, and (3) skill generalization. An admission of new skills occurs at the first stage. At the further stages, a patient learns to manage the freshly acquired skills and project them onto the everyday environment. The Integrative Treatment Approach suggested by Najavits (2002) was designed specificall y for treating PTSD and substance abuse. Therefore it is especially valuable for helping patients with multiple diagnoses. This therapeutic technique is a present-focused one so far as it helps patients to free themselves from the past traumatic experiences and enables them to blueprint in acquiring safety from trauma/PTSD and substance abuse.Being as effective for single patients and groups of various backgrounds, Najavits methodology relies on the five principles. First, individuals with multiple disorders are stimulated to value safety as the main life goal in regard to relationships, thinking, behavior, and emotions. Second, they are guided into the integrated course of treatment, during which several dysfunctions are seen to at once. Third, individuals are helped in designing ideals to residual against the loss of ideals resulting in PTSD and substance abuse. Fourth, a range of exercises includes cognitive, behavioral, interpersonal, campaign management practice. Finally, t he method heavily relies on clinicians activities.