Search results for ‘Subject term:"personality disorders"’ Sort:
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Changes of attachment status among women with personality disorders undergoing inpatient treatment
- Authors:
- STRAUSS Bernhard M., MESTEL Robert, KIRCHMANN Helmut A.
- Journal article citation:
- Counselling and Psychotherapy Research, 11(4), December 2011, pp.275-283.
- Publisher:
- Wiley
To date, research exploring changes of attachment styles during psychotherapy are rare. This study investigated 40 women with either borderline (BPD) or avoidant personality disorders (AVPD) using an attachment interview and questionnaires to determine therapy outcome at the beginning and after seven weeks of therapy. Findings revealed that the therapy was generally effective, and not many women classified as secure at the end of their therapy. Comparisons of pre-post-ratings suggested that clients within both subgroups received higher ratings for the avoidant prototypes at the end of therapy, indicating deactivation of attachment. Changes from ambivalent to avoidant attachment were linked with better outcome among women with BPD than AVPD. This study adds to the evidence that attachment styles do not change considerably during psychological treatment of personality disorder. For women with BPD, these changes were linked with a more favourable outcome which might reflect a more structured attachment status as a result of therapy.
Admission patterns of patients with personality disorder
- Authors:
- DASGUPTA Pritha, BARBER Joan
- Journal article citation:
- Psychiatric Bulletin, 28(9), September 2004, pp.321-323.
- Publisher:
- Royal College of Psychiatrists
The aim was to examine the prevalence and admission patterns of patients with personality disorder admitted to a Scottish general adult psychiatry service. We carried out a retrospective case-note study of patients identified from the computerised patient administration system. A subgroup of patients was identified as having a longer in-patient stay. Their admission pattern over the preceding 4 years was studied further. Sixty-two of 844 patients admitted had personality disorder. Thirty-nine had a primary diagnosis of personality disorder, 19 had an additional diagnosis of psychiatric disorder and 12 of alcohol or substance misuse. Within the subgroup admitted for longer in 2001, patterns of few/brief and numerous/often lengthy admissions were noted in earlier years. Personality disorder occurs in approximately 7% of admissions to general adult psychiatry beds. Many have additional diagnoses of psychiatric disorder, or substance or alcohol misuse further complicating their treatment.
And here's one we audited earlier
- Authors:
- GAW Caron, REDRUP Lauren
- Journal article citation:
- Health Service Journal, 10.2.11, 2011, pp.24-25.
- Publisher:
- Emap Healthcare
An audit was undertaken to improve patients' care pathway in Croydon's mental health services, with the aim of preventing unnecessary hospital admission and returning patients to the community as soon as possible. The first audit supported the development of an outpatient personality disorder service. The findings from the second audit suggested this had resulted in a reduction in unnecessary hospital stays for people with personality disorder as planned.
Towards integration: encountering differences among therapists involved with severe borderline patients
- Authors:
- IOANNOVITS Irini, KARAMANOLAKI Hara, VASLAMATZIS Gregorios
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 28(4), Winter 2007, pp.406-415.
- Publisher:
- Emerald
This article looks at an inpatient programme for patients with severe borderline personality disorder. Such patients regularly use means to escape from their internal distress, such as 'splitting' and 'projective identification' which can have a damaging effect on the cohesiveness of the staff team. The paper looks at how such processes manifest as transference and counter transference, particularly with regard to the institution, which, being placed inside a hospital, is not entirely under the control of program staff. The authors argue for the need for staff particularly to understand the psychological processes involved, rather than getting lost inside them, and the importance of a reflective space for staff to recognize, acknowledge and work on such processes in the staff team.
The experience of a hospital's psychiatric ward organised according to a therapeutic community model
- Author:
- CESARIO Vincenzo
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 28(4), Winter 2007, pp.337-334.
- Publisher:
- Emerald
The authors describe the experience of a psychiatric ward in a hospital in Italy where care has been organised according to several fundamental work principles in the therapeutic community. The author notes that in the past similar transformations of care for psychotic patients have been achieved, and describes the context in which this current work was born and its consequent peculiarities. The therapeutic community model applied in a hospital ward may offer the advantage of a treatment more complete, democratic and better accepted by both the patients and the staff; it may also avoid some negative effects of the traditional hospital model such as institutionalisation, early leaving and coercive admission. Data presented conclude it is possible to find positive indicators related to the therapeutic community model as a care instrument for treating psychiatric patients in an acute stage who may have diagnoses of psychosis and/or personality disorders.
Traumas of forming: the introduction of community meetings in the dangerous and severe personality disorder (DSPD) environment
- Authors:
- MOORE Helen, FREESTONE Mark
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 27(2), Summer 2006, pp.193-209.
- Publisher:
- Emerald
This article presents a perspective on the staff and patient experiences of the introduction of community Meetings into the Rampton Hospital DSPD Peaks Unit, a high-secure setting designed to accommodate "some of the most dangerous people in society" (Home Office, 2004); who are nevertheless a client group who have often lived through deeply traumatic experiences in childhood and young adulthood. Bi-weekly Ward Community Meetings, intended to integrate aspects of Therapeutic Community living into the highly restricted and insitutionalised life of the DSPD Unit, were introduced in 2004 by the first author. In this article the author reflects on her personal experience of introducing, implementing and defending the Meetings - as well as the strong therapeutic ethos behind them. The second author presents a sociological contextualisation of this therapeutic ideal within a 'totally' institutionalised environment, with particular attending to the maintenance of a particular power/knowledge apparatus within the Unit.
Ethnic differences among patients in high-security psychiatric hospitals in England
- Authors:
- LESSE Morvan, et al
- Journal article citation:
- British Journal of Psychiatry, 188(4), April 2006, pp.380-385.
- Publisher:
- Cambridge University Press
Black (Black Caribbean and Black African) patients are over-represented in admissions to general adult and medium-security psychiatric services in England. The aim was to describe the sociodemographic, clinical and offence characteristics of patients in high-security psychiatric hospitals (HSPHs) in England, and to compare admission rates and unmet needs by ethnic group. A total of 1255 in-patients were interviewed, and their legal status, socio-demographic characteristics and individual treatment needs were assessed. Black patients in HSPHs are over-represented by 8.2 times (range 3.2–24.4,95% CI 7.1–9.3), are more often male (P=0.037), and are more often diagnosed with a mental illness and less often diagnosed with a personality disorder or learning disability (P<0.001) than White patients. Unmet needs were significantly less common among White than among Black patients (mean values of 2.22 v. 2.62, difference=0.40,95% CI 0.06–0.73). Compared with the proportion of Black patients in the general population in their region of origin, a much higher proportion of Black patients were admitted to HSPHs, and fewer of their needs were met.
14 ways to disturb the treatment of psychopaths
- Author:
- MARTENS Willem H. J.
- Journal article citation:
- Journal of Forensic Psychology Practice, 4(3), 2004, pp.51-59.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
Unsuccessful treatment of psychopaths might be determined by factors that vary from engagements of inexperienced and indifferent therapists to limited supply of therapeutic diversity and dull, non-stimulating hospital environment. Awareness of these risk factors should be increased, and the most actual criteria of and guidelines on therapeutic affectivity should be provided to all professionals who are involved in the treatment of psychopaths. More research is needed into various risk factors and adequate prevention of treatment distortions in psychopaths. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Borderline personality disorder: treatment and management: quick reference guide
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
- Publisher:
- National Institute for Health and Clinical Excellence
- Publication year:
- 2009
- Pagination:
- 19p.
- Place of publication:
- London
Summarises the recommendations NICE has made to the NHS 'Borderline personality disorder: treatment and management' (NICE clinical guidance 78). The contents includes principles for working with people with borderline personality disorder; recognising and managing personality disorder in primary care; and assessment and management by community mental health services.
Borderline personality disorder: treatment and management: CG78
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
- Publisher:
- National Institute for Health and Clinical Excellence
- Publication year:
- 2009
- Pagination:
- 42
- Place of publication:
- London
This guideline makes recommendations for the treatment and management of borderline personality disorder in adults and young people who meet criteria for diagnosis in primary, secondary and tertiary care. The contents includes principles for working with people with borderline personality disorder; recognising and managing personality disorder in primary care; and assessment and management by community mental health services.