Abnormal Psychology Unit 5

1. Abnormal PsychologyUnit 5 Personality Disorders Mindfulness & DBT

2. Personality Disorders • Axis II diagnoses are difficult to define as many of the traits noted have similarities. • All of the personality disorders include: • “Chronic interpersonal problems • Problems with identity or sense of self • Problems are pervasive and inflexible, • Stable and of long duration • Cause significant distress and impaired functioning” (Butcher, Mineka, & Hooley, 2010, p. 341)

3. Personality Disorders also include repetitive behaviors that are maladaptive that are not learned from. • Personality Disorders have been broken down into Clusters that have similar features.

4. Clusters of Traits • Cluster A - pertains to paranoid, schizoid, and schizotypal personality disorders: • Odd/eccentric • Distrustful/suspicious • Social Attachment (Butcher, Mineka, & Hooley, 2010, p. 342)

5. Cluster B - pertains to histrionic, narcissistic, antisocial, and borderline personality disorders: • Dramatic • Emotional • Erratic (Butcher, Mineka, & Hooley, 2010, p. 342)

6. Cluster C - pertains to avoidant, dependent, and obsessive-compulsive personality disorder. • Anxiety • Fearfulness (Butcher, Mineka, & Hooley, 2010, p. 342)

7. Positive Psychology & Mindfulness Therapies • In 1998, Martin Seligman—acting president of the APA—proposed a new cognitive psychology that looked “beyond human weakness, damage, and remediation to reclaim one of its fundamental missions: the understanding and facilitation of human strength and virtue” (Kelley, 2004, p. 257). Positive psychology is based on a wellness model that studies human strength, resilience, and optimal human functioning throughout life (Kelley, 2004; Peterson, 2006).

8. Mindfulness-based cognitive approaches are a departure from traditional, cognitive-behavioral treatment. CBT includes a clear goal of changing negative behaviors and thinking patterns, whereas mindfulness practice suggests that clients observe their thoughts as impermanent and refrain from evaluating them (Chandler, 2010).

9. Mindfulness components have been adapted from Buddhist meditation practices and added to structural techniques of CBT in ACT, MBSR, DBT (Baer, 2003; Fredrickson, 2001; Gratz & Gunderson, 2006; Hayes, et al.,1999; Hayes, et al., 2004; Kabat-Zinn, 1992; Linehan & Dimeff (2001).

10. Dialectic Behavioral Therapy • Developed by Marsha M. Linehan in the early 1990s specifically to treat Borderline Personality Disorder (Baer, 2003; Linehan & Dimeff, 2001).

11. Dialectical behavior therapy is a multifaceted approach that has been used to treat individuals diagnosed with borderline personality disorder (Baer, 2003). Clients learn mindfulness practices including nonjudgmental observation of thoughts, emotions, sensations, environmental stimuli, and acceptance of personal histories and current situations while working to change behaviors and environments that support building a better life (Chandler, 2010).

12. DBT: promotes 4 areas of concern specific to BPD symptoms: • Develop core mindfulness • Improve interpersonal effectiveness • Improve emotional regulation • Increase tolerance of distress (Linehan & Dimeff, 2001).

13. Skills • Observe and describe events, thoughts a non-judgmental way. • Maintain focus on here & now. • Accept that emotions are transient and deal with the feelings evoked without attachment. • Learn self-soothing techniques. • Learn to have caring interest in others. • Learn to ask for what you want clearly and dispassionately. • Learn self-respect and self-regard (Linehan & Dimeff, 2001).

14. What other issues can be effectively treated with DBT? • Can DBT be used effectively with other PD? • What do you think of CBT moving toward inclusion of mindfulness techniques?

15. References Butcher, J. N., Mineka, S., & Hooley, J. M. (2010). Abnormal psychology. (14th Ed.) Boston, MA: Allyn & Bacon. Chandler, P. L. (2010). Resiliency in healing from childhood sexual abuse. Dissertation for Saybrook University, San Francisco, CA: ProQuest Dissertations. Fredrickson, B. L. (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56(3), 218-226. Gratz, K. L., & Gunderson, J. G. (2006). Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with Borderline Personality Disorder. Behavior Therapy, 37(1), 25-35. Harris, A. H. S., Thoresen, C. E., & Lopez, S. J. (2007). Integrating positive psychology into counseling: Why and (when appropriate) how. Journal of Counseling and Development, 85, 3-13. Hayes, S. C., Bissett, R., Korn, Z., Zettle, R. D., Rosenfarb, I., Cooper, L. & Grundt, A. (1999). The impact of acceptance versus control rationales on pain tolerance. The psychological Record, 49, 33-47.

16. Hayes, S. C., Wilson, K. G., Gifford, E. V., Bissett, R., Piasecki, M., Batten, S. V., Byrd, M., & Gregg, J. (2004). A preliminary trial of twelve-step facilitation and acceptance and commitment therapy with polysubstance-abusing methadone- maintained opiate addicts. Behavior Therapy, 35, 667-688. Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L. G., Fletcher, K. E., Lenderking, W. R. , & Santorelli, S. F. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. American Journal of Psychiatry, 149, 936-943. Kelley, T. M. (2004). Positive psychology and adolescent mental health: False promise or true breakthrough? Adolescence, 39(154), 257-278. Linehan, M. M. & Dimeff, L. (2001). Dialectical behavioral therapy in a nutshell. The California Psychologist, 34, 10-13. Peterson, C. (2006). A primer in positive psychology. New York, NY: Oxford University Press.