1002-Diagnosis of Personality Disorders A Trauma Informed Approach

Counselor Toolbox Podcast with DocSnipes

Overview of Personality Disorders

• Definition:
• Key Features:
• Inflexible and Pervasive Behavior: Present across various contexts.
• Early Onset: Behavior is stable and typically begins in adolescence or early adulthood.
• Exclusion Criteria: Must rule out other mental disorders, medical conditions, or substance use as primary causes.

Common Diagnostic Challenges

• Overlap with Other Disorders:
• Trauma Considerations: .

Specific Personality Disorders and Trauma-Informed Perspectives

• Paranoid Personality Disorder:
• Mnemonic: "SUSPECT" - Suspiciousness, unforgiving, perceives attacks, etc.
• Trauma Link: May develop from environments with distrust or betrayal.
• Schizoid Personality Disorder:
• Mnemonic: "DISTANT" - Detached, indifferent to praise/criticism, tasks done solitarily, etc.
• Trauma Link: Chronic exposure to trauma may lead to emotional numbing and detachment.
• Schizotypal Personality Disorder:
• Mnemonic: "ME PECULIAR" - Magical thinking, eccentric behavior, anxiety in social situations, etc.
• Trauma Link: Development of odd beliefs or behaviors may stem from a need to cope with a traumatic environment.
• Avoidant Personality Disorder:
• Mnemonic: "CRINGES" - Certainty of being liked, rejection preoccupies thoughts, intimacy restrained, etc.
• Trauma Link: Likely related to experiences of rejection or abandonment, leading to extreme caution in relationships.
• Dependent Personality Disorder:
• Mnemonic: "RELIANCE" - Reassurance required, expressing disagreement difficult, life responsibilities assumed by others, etc.
• Trauma Link: Often linked to enmeshed or controlling family environments, where independence was discouraged.
• Antisocial Personality Disorder:
• Mnemonic: "CORRUPT" - Conformity to law lacking, obligations ignored, reckless, etc.
• Trauma Link: May develop from a criminogenic environment or chronic trauma leading to a disregard for societal norms.
• Borderline Personality Disorder:
• Mnemonic: "AM SUICIDE" - Abandonment fears, mood instability, suicidal behaviors, etc.
• Trauma Link: Strongly associated with early abandonment or chaotic environments.
• Histrionic Personality Disorder:
• Mnemonic: "PRAISE ME" - Provocative behavior, relationships considered more intimate than they are, uncomfortable not being center of attention, etc.
• Trauma Link: May develop as a way to gain attention in emotionally neglectful environments.
• Narcissistic Personality Disorder:
• Mnemonic: "SPECIAL" - Believes they are special, preoccupied with fantasies of success, lacks empathy, etc.
• Trauma Link: Possible development as a defense mechanism in response to trauma or low self-esteem.
• Obsessive-Compulsive Personality Disorder:
• Mnemonic: "LAW FIRMS" - Loses point of activity due to detail, friendships excluded due to work, inflexible, etc.
• Trauma Link: Rigidity and control may arise from environments where safety and predictability were lacking.

Differential Diagnosis and Considerations

• Rule Out Other Disorders:
• Mood disorders with psychotic features.
• Autism spectrum disorders.
• Substance use disorders.
• Importance of Context:
• Acculturation and Intergenerational Trauma:

Treatment and Systemic Considerations

• Personality Disorder Stigma:
• Trauma-Informed Care:
• Treatment Barriers:

Chapters:

00:00:00 - Differential Diagnosis of Personality Disorders from a Trauma-Informed Perspective

00:06:56 - Characteristics of Paranoid Personality Disorder

00:13:38 - Trauma's effect on mood and libido

00:20:22 - Unusual Perceptions and Magical Thinking

00:27:13 - Characteristics of Dependent Personality Disorder

00:33:59 - Borderline Personality Characteristics

00:40:54 - Differential Diagnosis and Co-occurring Disorders

00:47:27 - Differential Diagnosis of Personality Disorders

00:54:12 - Differentiating Personality Disorders from Other Conditions

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