Antisocial Personality Disorder Sample

Assignment 1: Decision Tree

For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat adult and older adult clients presenting symptoms of a mental health disorder Antisocial Personality Disorder Sample.

Learning Objectives

Students will:

Evaluate clients for treatment of mental health disorders

Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

** Assigned in Week 3 and submitted in Week 4

Examine Case 1: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

Decision #1: Differential Diagnosis

Which Decision did you select?

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?

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Decision #2: Treatment Plan for Psychotherapy

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?

Decision #3: Treatment Plan for Psychopharmacology

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different Antisocial Personality Disorder Sample?

Also include how ethical considerations might impact your treatment plan and communication with clients and their family.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

Antisocial personality disorder possesses debilitating effects and some of the people who suffer from them include a patient’s family, friends, and their work and education colleagues. It is also accompanied by a complex diagnostic procedure owing to the fact that it appears alongside other mental disorder symptoms. This implies that healthcare psychiatrists and PMHNP nurses need to adopt multifarious tools so as to accurately diagnose the condition hence formulate an appropriate intervention therapy. Given that an intervention can either be psychotherapeutic or psychopharmacologic, factors such as simplicity, safety, and effectiveness will be fundamental. In the current analysis, a mentally disturbed client called Rhoda, who is diagnosed with antisocial personality disorder according to the DMS-5 criteria will be analyzed. Moreover, there are certain interventions at the disposal of the nurse and these will also be examined and the best course of decision for the patient taken.

Decision Point One

        The selected decision, based on the DMS-5 criteria, is an antisocial personality disorder. The criteria reveal that antisocial personality disorder is characterized by substantial functioning, which are highlighted by self-functioning impairments. Hence, Rhoda displays these characteristics since she lacks empathy for other people and this is accompanied by antagonistic pathological behaviors such as callousness and deceitfulness (Black & Grant, 2014). In addition, the patient refuses to conform to normative ethical norms, which has made her get incarcerated multiple times. Further, Rhonda is egocentric and she uses this to gain personal pleasure from the self-esteem therein. The DMS-5 criteria for antisocial personality disorder contain all those criteria. Therefore, Rhonda does not suffer from borderline personality disorder nor does she suffer from histrionic personality disorder as they are disqualified by the DMS-5 criteria.

The diagnosis is important as it influences the intervention decisions that a PMNHP nurse will make. Whereas antisocial personality disorder can be managed using various strategies, the election of an appropriate and accurate intervention will depend on accurately diagnosing the condition. Tools such as DMS-5 present certain criteria or characteristic symptoms of antisocial personality disorder, which a prospective patient needs to meet so as to conclusively diagnose it (Widiger, 2012). For this reason, the nurse expected to form an effective and consistent intervention that will lead to the remission of the symptoms.

The difference between the expected results and the actual results is apparent in the diagnosis that was made. According to the nurse’s expectation, the DMS-5 criteria tool was to be utilized to diagnose the condition that Rhonda had. The DMS-5 subjectively categorizes each mental disorder condition based on respective symptoms (Black & Grant, 2014). Hence, the choice of antisocial personality disorder was made because the symptoms displayed by Rhonda were consistent with the ASPD characteristics from the DMS-5 criteria. Therefore, the PMNHP nurse anticipated that the ASPD would be confirmed by the DSM-5.

Decision Point Two

        Since the above test has suspected that Rhonda might be suffering from ASPD, the next logical thing to do is to refer her to a psychologist for psychological testing. Studies reveal that complex conditions such as ASPD that might display symptoms of other mental disorders need to be carefully diagnosed. So far, the data that was subjectively obtained from the patient is biased towards antisocial personality disorder. Nevertheless, the existence of the condition will be confirmed beyond reasonable doubt by undertaking a psychological evaluation of Rhonda’s feelings, thoughts, family history, relationships, and behavior patterns (Black, 2013). According to the professional standards, the psychological test is a confirmatory test of the condition and only a psychologist can conduct it. Therefore, it would be premature to begin Haldol 5 mg oral dose or even start psychotherapy as confirmation of the condition has not occurred.

By referring Rhonda to a psychologist, the PMHNP expects to disqualify the other two mental conditions. Since antisocial personality disorder has been suggested by the DMS-4 criteria, the subsequent psychological testing is anticipated to simply confirm this diagnosis. In other words, using the family history, thoughts, feelings, and behavior patterns, the psychologist is anticipated to conclude that they are demonstrative of antisocial personality disorder Antisocial Personality Disorder Sample.

There are no noticeable differences between the expected results and the actual results. The referral given to Rhonda to the psychologist is standard for any suspected case of antisocial personality disorder as may have been revealed by the first test. The decision made by the nurse hinged on the hope that the psychologist would support the revelation of the DMS-5 test that has already been undertaken. To do this, a psychologist will adopt varied psychological testing instruments so as to either confirm or reject the diagnosis made by the nurse (Widiger, 2012). According to the standard procedure for the diagnosis of mental disorders such as ASPD, seeking a psychological test is paramount as the formulation of an intervention will depend on the accuracy of the diagnosis.

Decision Point Three

Considering that the nurse has already confirmed that Rhonda has antisocial personality disorder from the two diagnostic procedures, an intervention needs to be chosen from the available options. Herein, the selected decision is to refer the patient to group-based cognitive behavior therapy. According to studies, groups based CBT is an effective approach to the treatment of conditions such as ASPD. By making a patient mingle with people of a similar condition, they get insight into the manner in which their cogitations and feelings influence their behavior in addition to allowing them to confront their fundamental beliefs. According to Hatchet (2015), this approach should be preferred over other therapies because it is simple to administer, effective and does not have risks associated with it. At this stage, the application of psychopharmacological intervention such as beginning Lacuda is not recommended as the FDA has not approved it. Another therapy that could be considered is the dialectical behavior therapy yet it cannot be adopted as questions linger about its simplicity. Moreover, Hatchet (2015) posits that the effectiveness of the dialectical therapy has been doubted by researchers as they claim that it selectively reduces self-harm tendencies in patients with antisocial personality disorder. Therefore, adopting the group based therapy is the only decision that the nurse can take.

The purpose of adopting any intervention is to combat the symptoms of a condition by initiating abeyance. Thus, the group based CBT is expected to reduce the presentation of the symptoms of the condition. After two weeks, Rhonda is expected to become remorseful, respectful and restrained. Further, she is expected to have empathy and also become more truthful when discussing issues (Holas et al., 2016). In other words, the group based CBT is expected to enhance her functional outcomes four weeks into the therapy.

The administration of group-based cognitive behavior therapy is expected to lead to remission of the symptoms of ASPD. Cognitive behavior therapy has been demonstrated to be useful in the treatment of the symptoms of ASPD, which will lead to the above-mentioned expectation. However, there are symptoms of other conditions that the therapy may not manage, which might impact the expected results of the intervention. Hence, the difference between expected result and the actual result is the existence of these symptoms.

Ethical Consideration

While recommending the cognitive behavior therapy, the nurse needs to be cognizant of certain ethical considerations and confer with the patient. Normally, such groups are always diverse in nature and form people from different races, different sexes, and perhaps different social classes. Therefore, the nurse needs to inform the client of all these factors and ask her if she is comfortable in such a setting (In Scott, 2015). In other words, the nurse needs to seek informed consent from the patient.

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Conclusion

Antisocial Personality Disorder is thus an important condition that needs to be addressed expeditiously and accurately. However, necessary interventions such as CBT should be preceded with accurate diagnosis using DMS-5 criteria and clarification testing from psychologists. Even as a nurse formulates the therapy, they need to realize that it could only work with the informed consent of the patient; hence they have an obligation to seek it Antisocial Personality Disorder Sample.

References

Black, D. W. (2013). Bad boys, bad men: Confronting antisocial personality disorder (sociopathy). Oxford: Oxford University Press.

Black, D. W., Grant, J. E., & American Psychiatric Association,. (2014). DSM-5 guidebook: The essential companion to the Diagnostic and statistical manual of mental disorders, fifth edition. Washington, DC : American Psychiatric Publishing.

Hatchett, G. T. (2015). Treatment Guidelines for Clients with Antisocial Personality Disorder. Journal Of Mental Health Counseling, 37(1), 15-27.

Holas, P., Suszek, H., Szaniawska, M., & Kokoszka, A. (2016). Group Cognitive-Behavioral Therapy for Anxiety Disorders With Personality Disorders in Day Clinic Setting. Perspectives In Psychiatric Care, 52(3), 186-193.

In Scott, C. L. (2015). DSM-5 and the law: Changes and challenges. New York, NY : Oxford University Press

Widiger, T. A. (2012). The Oxford handbook of personality disorders. Oxford: Oxford University Press. Antisocial Personality Disorder Sample

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