Arthur Freeman Gwen E Rock

Among the greatest myths in the process of assessment is that clinicians will typically find patients who fall neatly into the categories set forth in the nosology of the fourth text revised edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Association, 2000). What is far more typical is that the individual being assessed has co-occurring disorders, in addition to the "main problem." These co-occurring conditions may or may not rise to the level of a diagnosable disorder, or they may simply present several confusing and confounding factors. Probably one of the best examples occurs when depression is comorbid with any of the personality disorders. It is in fact unusual for a patient to seek treatment solely for a personality disorder (PD). They more typically come to treatment with complaints of depression or anxiety. It is when the clinician begins to collect life-history data that the picture (or reality) of the Axis II disorder may emerge. Often, patients seeking treatment come to therapy in an attempt to quell or control the more noticeable and common Axis I problems. They may be unaware of the more pervasive and persistent problems that are coded on Axis II. In fact, PDs, while not "visible" upon referral, may not come to light until the individual is well into the treatment process.

Each comorbid PD has its own separate panoply of traits and characteristics. The co-occurring Axis II disorders or complications may amplify depressive or anxious symptoms. This chapter describes the problems in assessment, diagnosis, presentation, and treatment PDs that co-occur with depression.

Eliminating Stress and Anxiety From Your Life

Eliminating Stress and Anxiety From Your Life

It seems like you hear it all the time from nearly every one you know I'm SO stressed out!? Pressures abound in this world today. Those pressures cause stress and anxiety, and often we are ill-equipped to deal with those stressors that trigger anxiety and other feelings that can make us sick. Literally, sick.

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