COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...
COSIG CONFERENCE BROCHURE.pdf - Drexel University College ... COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...
COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006 DSM-IV BPD CRITERIA ARE ALSO GENERALLY SEEN IN CLUSTERS • IMPULSE CLUSTER – Impulsivity in two or more areas. – Repetitive self-destructive behavior DSM-IV BPD CRITERIA ARE ALSO GENERALLY SEEN IN CLUSTERS (Cont’d) • AFFECT CLUSTER – Uncontrolled anger – Unstable interpersonal relations – Labile moods – Stress-related paranoia or Dissociative symptoms DSM-IV BPD CRITERIA ARE ALSO GENERALLY SEEN IN CLUSTERS (Cont’d) • IDENTITY CLUSTER – Identity diffusion – Feelings or emptiness and boredom – Intolerance of being alone CULTURAL FACTORS (Paris, 1996) • BPD highly sensitive to sociocultural context • Rare in traditional societies • Maybe a byproduct of rapid change/ modernization • Need to consider a late-age onset that meets DSM-IV criteria A NEW DIAGNOSIS COMPLEX POST-TRAUMATIC STRESS DISORDER • A history of subjection to totalitarian control over a prolonged period • Alterations in affect regulation • Alterations in consciousness A NEW DIAGNOSIS COMPLEX POST-TRAUMATIC STRESS DISORDER (Cont’d) • Alterations in self-perception • Alterations in perception of perpetrator • Alterations in relations with others • Alterations in system of meaning (Herman, 1992) 6
COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006 EXAMPLES OF ASSESSMENT DOMAINS • Does individual meet DSM-IV criteria for BPD? • Identify any barriers to services/treatment. • What is the individual's subjective experience? EXAMPLES OF ASSESSMENT DOMAINS (Cont’d) • Perceptions by others in personal and human services networks? • Assess etiology • Functional Assessment • Risk Assessment EXAMPLES OF ASSESSMENT DOMAINS (Cont’d) • Assessment of the nature, role and function of non-lethal behaviors such as self-mutilation • Biomedical Assessment • Assessment/Evaluation of Practitioner/Team Responses to Individuals Being Served THE IMPACT OF TRAUMA • Trauma, related to early abuse and/or neglect, is in the histories of consumers of public MH and D & A programs. • They are frequently self –harming, high users of costly services who carry multiple diagnosis- BPD, DID, PTSD and substance abuse. GENERAL POPULATION • 10% of the women and 5% of the men are likely to suffer from PTSD • 33.3% +will have symptoms lasting several months • Those most vulnerable-inadequate social support, survivors of childhood sexual abuse Public mental health consumer • 98% of 275 consumers had exposure to severely traumatic events • 43 % suffered from PTSD • Chart reviews revealed only 2% had diagnosed PTSD in their chart • Another study-34% admitted to psychiatric state hospitals had PTSD- secondary to CSA 7
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<strong>COSIG</strong> Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006<br />
EXAMPLES OF ASSESSMENT<br />
DOMAINS<br />
• Does individual meet DSM-IV criteria for<br />
BPD?<br />
• Identify any barriers to services/treatment.<br />
• What is the individual's subjective<br />
experience?<br />
EXAMPLES OF ASSESSMENT<br />
DOMAINS (Cont’d)<br />
• Perceptions by others in personal and human<br />
services networks?<br />
• Assess etiology<br />
• Functional Assessment<br />
• Risk Assessment<br />
EXAMPLES OF ASSESSMENT<br />
DOMAINS (Cont’d)<br />
• Assessment of the nature, role and function of<br />
non-lethal behaviors such as self-mutilation<br />
• Biomedical Assessment<br />
• Assessment/Evaluation of Practitioner/Team<br />
Responses to Individuals Being Served<br />
THE IMPACT OF TRAUMA<br />
• Trauma, related to early abuse and/or<br />
neglect, is in the histories of consumers of<br />
public MH and D & A programs.<br />
• They are frequently self –harming, high<br />
users of costly services who carry multiple<br />
diagnosis- BPD, DID, PTSD and<br />
substance abuse.<br />
GENERAL POPULATION<br />
• 10% of the women and 5% of the men are<br />
likely to suffer from PTSD<br />
• 33.3% +will have symptoms lasting<br />
several months<br />
• Those most vulnerable-inadequate social<br />
support, survivors of childhood sexual<br />
abuse<br />
Public mental health<br />
consumer<br />
• 98% of 275 consumers had exposure to<br />
severely traumatic events<br />
• 43 % suffered from PTSD<br />
• Chart reviews revealed only 2% had<br />
diagnosed PTSD in their chart<br />
• Another study-34% admitted to psychiatric<br />
state hospitals had PTSD- secondary to<br />
CSA<br />
7
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