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Handbook of Diagnosis and Treatment of DSM-5 Personality Disorders: Assessment, Case Conceptualization, and Treatment PDF

317 Pages·2016·11.74 MB·English
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HANDBOOK OF DIAGNOSIS AND TREATMENT OF DSM-5 PERSONALITY DISORDERS Since the publication of the acclaimed second edition of the Handbook of Diagnosis and Treatment of DSM-IV-TR Personality Disorders, much has changed in how the personality disorders are understood and treated. However, like its previous editions, this new edition is a hands-on manual of the most current and effective, evidence-based assessment and treatment interventions for these challenging disorders. The beginning chapters describe several cutting-edge trends in the diagnosis, case conceptualization, and treatment of them. Then, specific chapters focus on evidence-based diagnosis and treatment interventions for each of the ten DSM-5 personality disorders. Emphasized are the most recent developments from Cognitive Behavior Therapies, Dialectical Behavior Therapy, Cognitive Behavior Analysis System of Psychotherapy, Pattern-Focused Psychotherapy, Mindfulness, Schema Therapy, Transference Focused Psychotherapy, and Mentalization-Based Treatment. As in previous editions, extensive case material is used to illustrate key points of diagnosis and treatment. Len Sperry, MD, PhD, is a professor of mental health counseling and director of clinical training at Florida Atlantic University, and clinical professor of psychiatry at the Medical College of Wisconsin. For more than three decades he has treated and taught courses and workshops on the personality disorders. Among his 1000+ professional publications are several articles, book chapters, and books on these disorders, including the recently published Cognitive Behavior Therapy of DSM-5 Personality Disorders. “Len Sperry has been a leader in the treatment of personality disorders for over twenty-five years. This third edition of his Handbook provides treatment strategies informed by recent research and updates from DSM-5. Sperry is the top contem- porary clinical scholar of personality disorders with his integration of empirical science, human development, and a synthetic understanding of different treatment approaches. If you are going to purchase one book on personality disorders, get this one.”—Steven J. Sandage, PhD, LP, Professor of Psychological & Brain Sciences, Boston University “As a much needed antidote to the one-size fits all of current cognitive therapy, be it for Axis I or Axis II, Dr. Sperry has presented a much needed series of evidence- based and tailored interventions that effectively treat the gamut of personality disorders that are so prevalent today.”—Nicholas A. Cummings, PhD, ScD, Former President, American Psychological Association “The Handbook of Diagnosis and Treatment of DSM-5 Personality Disorders: Assessment, Case Conceptualization, and Treatment, Third Edition is a must read for any practicing mental health clinician working with personality disordered clients. It is remarkably practical, user friendly, updated, and helpful to assist both professionals and trainees alike stay up-to-date on the thoughtful evidence based strategies for understanding and treating personality disorders. This is one of those books that should be on the shelf of all mental health professionals. Dr. Sperry, as usual, has offered the profession a terrific update to his now classic text.” —Thomas G. Plante, PhD, ABPP, Professor of Psychology, Santa Clara University “Len Sperry’s third edition of the Handbook of Diagnosis and Treatment of DSM- 5 Personality Disorders offers both the experienced clinician and student a concise overview and description of the range of personality disorders, as well as presenting the essential elements of comprehensive diagnosis and treatment. Sperry understands the world of the clinician, distilling the theoretical and pragmatic advances in clinical science that offer hope for identifying, conceptualizing and more importantly influencing the course of change for these ubiquitous and challenging disorders.”—Jeffrey J. Magnavita, PhD, ABPP, independent practice and Lecturer in Psychiatry, Yale University “Sperry’s third edition of this benchmark handbook makes it the instant standard on the assessment and treatment of personality disorders. Evidence-based yet delightfully reader-friendly, Sperry’s guide blends a scientist’s mastery of the evidence with a healer’s empathy for the pain and disruption that stalk the lives of the personality impaired. Jam-packed with case examples and practitioner- oriented recommendations, this is a must-read for the competent clinician.”— W. Brad Johnson, PhD, Professor of Psychology, U.S. Naval Academy & Johns Hopkins University “To provide effective short-term and enduring treatment, it is necessary to diag- nose and treat the personality of the client. Len Sperry MD, PhD, provides the insight and guidelines to make this once considered impossible task, likely. The book is chocked full of practical suggestions and tools that aid the diagnosis, conceptuali zation, and treatment of personality disorders following the DSM-5 guidelines. The third edition of the Handbook of Diagnosis and Treatment of DSM-5 Personality Disorders belongs on every clinician’s bookshelf. If you read only one professional book this year, this is the one!”—Jon Carlson, PsyD, EdD, ABPP, Distinguished Professor of Adlerian Psychology, Adler University, Chicago “Unlike many writers who help the reader understand personality disorders, Sperry helps the reader understand personality disorders and, more importantly, how to help those who struggle with them. With the changes in the DSM-5 related to the understanding and treatment of personality disorders, Sperry’s work is cutting edge and a must-read for all clinicians.”—Craig S. Cashwell, PhD, Professor of Counseling, University of North Carolina at Greensboro “The third edition of Dr. Sperry’s Handbook demonstrates the strengths of the previous edition: it is clearly written, comprehensive, up-to-date, and jargon- free. Its biopsychosocial approach to the personality disorders is realistically optimistic, while adhering to evidence-based treatments. Finally, Dr. Sperry is clearly dedicated to ‘listening with the third ear,’ which is essential in working with personality-disordered patients.”—Ronald W. Pies, MD, Professor of Psychiatry, Lecturer on Bioethics & Humanities, SUNY Upstate Medical University “Personality disorders are the most misunderstood and misdiagnosed of all the DSM-5/ICD 10 mental disorders. Here, in this easy-to-read handbook, Len Sperry presents the most user-friendly guide available to personality disorders coupled with a completely integrative model to case conceptualization: A book for every graduate psychopathology course in the nation.”—James Robert Bitter, EdD, Professor of Counseling and Human Services, East Tennessee State University “There’s an old myth that personality disorders are equivalent to a life sentence to psychotherapy. Len Sperry uses scientific evidence and logical analysis to systematically bust this myth. If you’re interested in working with clients with personality disorders, this book is indispensable. Not only does Sperry offer hope and optimism for positive outcomes, he also deftly summarizes many evidence- based approaches that can transform your optimism to clinical reality.”—John Sommers-Flanagan, PhD, Professor of Counselor Education at the University of Montana “Len Sperry MD, PhD, is a brilliant writer who with his psychology and psychiatry background is able to capture nuances in cognitions, and affective and interpersonal styles of individuals with personality disorders in a way that crystalizes the concept for the reader. The wonderful case examples and understanding the parental injunctions and worldview perspectives of the patient were especially helpful for me. This book is an incredible manual and reference book—I still have one of Dr Sperry’s first books on personality disorders and still reference it to this day.”—Jon A. Lehrmann, MD, Chairman and Charles E. Kubly Professor of Psychiatry and Behavioral Medicine, Medical College of Wisconsin “A tremendous resource, including the latest DSM-5 descriptions, cross-theoretical conceptualizations, and integrative treatment approaches for all of the identified personality disorders, under one cover. Sperry neatly addresses the ‘categorical vs. dimensional’ assessment dilemma by expertly contrasting each personality disorder with its corresponding sub-clinical personality ‘style.’ Sperry’s captivating clinical vignettes combine with his presentation of empirical evidence to create a most satisfying volume for the interested scientist-practitioner.”—Cory F. Newman, PhD, ABPP, Professor of Psychology, in Psychiatry, Perelman School of Medicine, University of Pennsylvania HANDBOOK OF DIAGNOSIS AND TREATMENT OF DSM-5 PERSONALITY DISORDERS Assessment, Case Conceptualization, and Treatment Third Edition Len Sperry, MD, PhD Third edition published 2016 by Routledge 711 Third Avenue, New York, NY 10017 and by Routledge 2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN Routledge is an imprint of the Taylor & Francis Group, an informa business © 2016 Taylor & Francis The right of Len Sperry to be identified as author of this work has been asserted by him in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. First edition published by Brunner/Mazel 1995 Second edition published by Routledge 2003 Library of Congress Cataloging in Publication Data Names: Sperry, Len, author. Title: Handbook of diagnosis and treatment of DSM-5 personality disorders: assessment, case conceptualization, and treatment / Len Sperry. Description: Third edition. | New York, NY : Routledge, 2016. Includes bibliographical references and index. Identifiers: LCCN 2015040215| ISBN 9780415841900 (alk. paper) | ISBN 9780415841917 (alk. paper) | ISBN 9780203763728 (alk. paper) Subjects: LCSH: Personality disorders--Handbooks, manuals, etc. Classification: LCC RC554 .S68 2016 DDC 616.85/81—dc23 LC record available at http://lccn.loc.gov/2015040215 ISBN: 978-0-415-84190-0 (hbk) ISBN: 978-0-415-84191-7 (pbk) ISBN: 978-0-203-76372-8 (ebk) Typeset in Bembo by Florence Production Ltd, Stoodleigh, Devon, UK CONTENTS Foreword ix Preface xv Acknowledgments xviii 1 Diagnosis and Treatment of Personality Disorders Today 1 2 Case Conceptualization and the Effective Treatment of Personality Disorders 36 3 Antisocial Personality Disorder 51 4 Avoidant Personality Disorder 73 5 Borderline Personality Disorder 93 6 Dependent Personality Disorder 124 7 Histrionic Personality Disorder 144 8 Narcissistic Personality Disorder 163 9 Obsessive-Compulsive Personality Disorder 185 10 Paranoid Personality Disorder 206 viii Contents 11 Schizoid Personality Disorder 226 12 Schizotypal Personality Disorder 244 References 261 Index 282 FOREWORD As a new graduate student in psychology at New York University in 1964, I took the required course in psychopathology. The instructor quoted liberally from a volume he called the “Diagnostic and Statistical Manual,” or DSM, published by the American Psychiatric Association in 1952. We immediately asked if we could purchase the thin, spiral-bound book at the bookstore, but the instructor told us that access was limited to psychiatrists, and that only they could use it to diagnose a patient. He had clearly gotten the volume under false pretenses or through some subterfuge. While we did not think that that was fair, as new graduate students we recognized the pecking order in mental health. The psychiatrist was at the top and psychologists were not ordained to read or use the holy words of the DSM. This first edition was not labeled as DSM-I, simply DSM, with no portent of what was ahead. In DSM-I, all mental disorders were divided into two major groups: “(1) those in which there is a disturbance of mental function resulting from, or precipitated by a primary impairment of the function of the brain, generally due to a diffuse impairment of brain tissue; and (2) those which are the result of a more general difficulty in adaptation of the individual, and in which any associated brain function disturbance is secondary to the psychiatric disorder” (p. 9). The DSM, as might be expected of the zeitgeist, was suffused with the contemporary per- spect ive of psychoanalysis. The descriptions were brief and still left a great deal of room for clinician interpretation and creativity. It was not until 1968, with the publication of the second edition of DSM, labeled DSM-II, that there was a sequencing of editions noted. The only place that we could get the DSM-II was at the Medical School bookstore. We gave one of our graduate cohort the money and they did a DSM-II run and got copies for all of us. We never asked what lies he had to tell to get by the eagle-eyed cashiers at the bookstore.

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