Posted: March 28th, 2023

CONTROVERSY ASSOCIATED WITH PERSONALITY AND PARAPHILIC DISORDERS ESSAY

CONTROVERSY ASSOCIATED WITH PERSONALITY AND PARAPHILIC DISORDERS Essay Assignment.

Between 10% and 20% of the population experience personality disorders. They are difficult to treat as individuals with personality disorders are less likely to seek help than individuals with other mental health disorders. Treatment can be challenging as they do not see their symptoms as painful to themselves or others.

Paraphilic disorders are far more common in men than in women, and generally quite chronic, lasting at least two years. Treatment of these disorders usually involves both psychotherapeutic and pharmacologic treatments.

In this Assignment, you will explore personality and paraphilic disorders in greater detail. You will research potentially controversial elements of the diagnosis and/or treatment and explain ethical and legal considerations when working with these disorders.

TO PREPARE
Review this week’s Learning Resources and consider the insights they provide on assessing, diagnosing, and treating personality and paraphilic disorders.
Select a specific personality or paraphilic disorder from the DSM-5-TR to use for this Assignment.
Use the Walden Library to investigate your chosen disorder further, including controversial aspects of the disorder, maintaining the therapeutic relationship, and ethical and legal considerations.
RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

THE ASSIGNMENT
In 2–3 pages:

Explain the controversy that surrounds your selected disorder.
Explain your professional beliefs about this disorder, supporting your rationale with at least three scholarly references from the literature.
Explain strategies for maintaining the therapeutic relationship with a patient that may present with this disorder.
Finally, explain ethical and legal considerations related to this disorder that you need to bring to your practice and why they are important.
REQUIRED READINGS
National Institute for Health and Care Excellence: NICE Guidelines. (2010 – Essay Writing Service: Write My Essay by Top-Notch Writer). Antisocial personality disorder: Prevention and managementLinks to an external site..
https://www.nice.org.uk/guidance/cg77
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015 – Research Paper Writing Help Service). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. (For review as needed)
Chapter 22, “Personality Disorders”
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015 – Research Paper Writing Help Service). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
Chapter 67, “Disorders of Personality”
Chapter 68, “Developmental Risk for Psychopathy”
Chapter 69, “Gender Dysphoria and Paraphilic Sexual Disorders” (pp. 988–993 only)
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
Chapter 14, “Personality Disorders”
REQUIRED MEDIA
Buchanan, N. T. (2020, April 13). Lecture 14 part 3: Paraphilic disordersLinks to an external site. [Video]. YouTube.
MDedge. (2020, January 22). Personality disorders with Dr. Frank YeomansLinks to an external site. [Video]. YouTube.

Controversy Associated with Personality and Paraphilic Disorders

Controversy of Borderline Personality Disorder

The controversy of borderline personality disorder is related to the diagnosis, classification, assessment, and treatment. This controversy has been ongoing for many years, with some arguing that the diagnosis is too broad or too narrow. One of the critical issues is the stigma related to the diagnosis of the condition (Trull et al., 2018). This stigma can lead to negative consequences for individuals with borderline personality disorder, such as social isolation and decreased access to treatment. It is not clear if the diagnostic method is an evidence-based practice or it should be changed. Further research is needed to determine the most effective diagnostic approach for borderline personality disorder. The stigma affects how practitioners tolerate the emotions and thoughts of individuals with the condition. This can lead to a lack of empathy and understanding from practitioners, which can exacerbate the condition. The diagnostic process may lead to a negative view of patients with borderline personality disorder (Trull et al., 2018). For example, practitioners may view patients with borderline personality disorder as “difficult” or “manipulative.” For instance, practitioners may overlook strengths or minimize the symptoms. This can lead to inadequate treatment and a lack of support for individuals with borderline personality disorder. In some cases, the patients can be thought to be lazy and unable to participate in daily activities. This stereotype can be damaging and stigmatizing for individuals with borderline personality disorder. Practitioners indicate that therapeutic nihilism is a major concern in addressing borderline personality disorder (Trull et al., 2018). Therapeutic nihilism refers to the idea that some conditions are untreatable, which can lead to a lack of hope and motivation for both practitioners and patients. The diagnosis is controversial since some practitioners believe it should not be diagnosed. This controversy highlights the need for further research and discussion about the diagnosis and treatment of borderline personality disorder. Another controversy related to borderline personality disorder is how to differentiate the disease from other mental illnesses. This can be a challenging task, as borderline personality disorder often co-occurs with other mental health conditions.

Professional Beliefs about the Disorder

My professional belief is that borderline personality disorder is another mental health condition that can affect any person. I believe that it is essential to approach each individual with borderline personality disorder with empathy and understanding. Borderline personality disorder can affect individuals and their ability to participate in daily activities and ability to manage and cultivate healthy relationships (Porter et al., 2020). This can lead to significant distress and impairment in daily life. The condition can affect the ability to manage emotions and control behavior. I believe that practitioners should focus on helping individuals with borderline personality disorder develop healthy coping mechanisms and strategies for managing their emotions. I believe practitioners should not express stigma during diagnosis, assessment, and treatment. Instead, practitioners should strive to create a safe and non-judgmental environment for individuals with borderline personality disorder. Mental health nurses should understand the negative effects of the condition and seek to restore the positive behavior. This requires a comprehensive and compassionate approach to care.

I believe as a professional it is vital for a medical checkup at a young age to provide opportunities for early intervention. Early intervention can significantly improve outcomes for individuals with borderline personality disorder. Early treatment will eliminate the risk of adverse symptoms as patients age. This highlights the importance of early detection and intervention for borderline personality disorder. The symptoms of borderline personality disorder affect individuals as they age leading to negative behavior and inability to manage healthy relationships (Porter et al., 2020). This can lead to significant distress and impairment in daily life. Parents should observe the growth of their children to avoid adverse health outcomes when it is too late (Porter et al., 2020). For example, parents should be aware of any changes in their child’s behavior or mood. For instance, if a child has symptoms that are related to borderline personality disorder, it is crucial to take the child to a pediatrician or mental health nurse for diagnosis. Early diagnosis is vital to facilitate the normal growth of children. This requires a collaborative approach between parents, practitioners, and other healthcare professionals.

Strategies for Maintaining Therapeutic Relationship

One of the strategies of maintaining a therapeutic relationship with patients is to maintain professional boundaries with patients. This is essential for establishing trust and respect in the therapeutic relationship. It is vital to keep the boundaries to eliminate the risk of compromising relationships with patients (Chanen et al., 2020). For example, practitioners should avoid dual relationships or conflicts of interest. Despite efforts to establish rapport, maintaining professional boundaries is necessary. This requires a delicate balance between empathy and professionalism. It is important to maintain privacy during the provision of medical services. This is essential for protecting patients’ confidentiality and autonomy. A patient should be assured of professional boundaries to protect them from third parties that can undermine their confidence to share confidential information (Chanen et al., 2020). Another approach is to use active questions to engage a patient. This can help to establish a rapport and build trust in the therapeutic relationship. Using positive questions will encourage a patient to share information about their behavior. This requires a non-judgmental and empathetic approach to care.

I will strive to establish the therapeutic relationship by assuring a patient about their confidentiality. I believe that confidentiality is essential for establishing trust and respect in the therapeutic relationship. I would lay the ground rules such as assuring the patient that their information will not be shared by any third party without their consent (Temes et al., 2019). This requires a clear and transparent approach to care. Another approach is to show empathy and communicate clearly. Empathy will involve sharing and understanding the feelings of a patient without sympathizing with the patient. The communication should be clear to enhance adherence to the treatment plan (Temes et al., 2019). I will allow the patient to share feelings, emotions, and beliefs and explore their views. This requires a non-judgmental and empathetic approach to care. Expressing feelings and emotions is healthy for a patient. This can help to reduce stress and anxiety and improve overall well-being.

Ethical and Legal Considerations

Patients with borderline personality disorder have a tendency of acting before thinking. This can lead to impulsive and reckless behavior. The impulsive behavior will prompt a patient to engage in risky behavior. A practitioner should take precautions to avoid harm to a patient. Maleficence and beneficence involve the assurance that the treatment will be professional and without any harm (Haugom et al., 2019). For example, practitioners should avoid using coercive or punitive measures. In case the behavior of a patient is risky to an extent of costing their life, it is legal to report without consulting. For instance, if a patient wants to commit suicide, I would seek assistance from parents, guardians, or police to avert the risk of death. The second ethical and legal issue is fairness and justice (Haugom et al., 2019). This requires a non-discriminatory and respectful approach to care. It will be important to take care of the patient without discrimination. For instance, practitioners should not discriminate against patients with borderline personality behavior.

Involuntary hospitalization is another legal and ethical issue in practice. Patients with borderline personality disorder can express impulsive behavior that can be risky at home or the clinic. It is essential to consult a parent or guardian to seek consent before hospitalizing a patient against their wish (Haugom et al., 2019). I will strive to use other methods of making a patient cool down such as medication unlike involuntary hospitalization (Haugom et al., 2019). Another issue is the high rate of suicide among patients undergoing treatment. This highlights the need for close monitoring and support for patients with borderline personality disorder. The ethical issue should be addressed to prevent medical practices that put a patient at risk of suicide. Addressing ethical and legal issues is essential in maintaining a professional relationship with patients. This requires a comprehensive and compassionate approach to care.

References

Engel, J., Nagy, L., Dickhut, C., Veit, M., Kneer, J., & Kruger, T. H. (2024). Paraphilias and Sexual Offending in Compulsive Sexual Behavior in the Sex@ Brain-Study. Sexual Health & Compulsivity, 1-20.
References

Chanen, A. M., Nicol, K., Betts, J. K., & Thompson, K. N. (2020). Diagnosis and treatment of borderline personality disorder in young people. Current psychiatry reports, 22(5), 1-8.

Haugom, E. W., Ruud, T., & Hynnekleiv, T. (2019). Ethical challenges of seclusion in psychiatric inpatient wards: a qualitative study of the experiences of Norwegian mental health professionals. BMC Health Services Research, 19(1), 1-12.

Krueger, R. B., Kaplan, M. S., Gijs, L., Briken, P., & Aoun, E. G. (2024). Paraphilic Disorders. In Tasman’s Psychiatry (pp. 3207-3236). Cham: Springer International Publishing.

Porter, C., Palmier‐Claus, J., Branitsky, A., Mansell, W., Warwick, H., & Varese, F. (2020). Childhood adversity and borderline personality disorder: a meta‐analysis. Acta Psychiatrica Scandinavica, 141(1), 6-20.

Temes, C. M., Frankenburg, F. R., Fitzmaurice, G. M., & Zanarini, M. C. (2019). Deaths by suicide and other causes among patients with borderline personality disorder and personality-disordered comparison subjects over 24 years of prospective follow-up. The Journal of clinical psychiatry, 80(1), 0-0.

Trull, T. J., Freeman, L. K., Vebares, T. J., Choate, A. M., Helle, A. C., & Wycoff, A. M. (2018). Borderline personality disorder and substance use disorders: an updated review. Borderline personality disorder and emotion dysregulation, 5(1), 1-12.
Graham, N., Calkins, C., & Jeglic, E. (2024). Other specified paraphilic disorder: patterns of use in sexually violent predator evaluations. Sexual Abuse, 10790632241271086.

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