Special Considerations

Clearly, this chapter points to the prevalence of depression among patients with PDs. It is evident the depression is very pervasive among most patients with PDs, causing difficulty in accurate diagnoses and subsequent treatment planning. The modification of standard CT provides an example of overcoming the complications of depression with comorbid conditions. Perhaps another approach is to examine depression as a separate issue, out of the mood disorder category and into the personality disorder category. Two examples of this are revisiting dysthymia as a personality disorder and DPD.

Delineating the differences, the relationship, and the substance of DPD and dysthymic disorder is very much like reading a political paper on the merits of one candidate over another. Many studies can be quoted (Ryder & Bagby, 1999; Widiger, Mangine, Corbitt, Ellis, & Thomas, 1995; Bradley, Shedler, & Westen, 2006). Representatives of each side speak eloquently of the advantages of their position. The bottom line, however, is that there is no clear-cut winner. A common theme is the significant overlap between DPD and dysthymia (Bradley et al., 2006). A second theme is that the DPD diagnostic group has ramifications for the trajectory of depressive symptoms in patients with dysthymic disorder and MDD.

It is important to note that the scope of DPD can be characterized by several features of other PDs, leading to specific variants. Millon and Davis (2000) propose and differentiate five variants of DPD. Specifically, the five variants are ill-humored depressive, voguish depressive, self-derogating depressive, morbid depressive, and restive depressive. Typically, the ill-humored depressive tends to exhibit negativistic features, whereas the voguish depressive exhibits histrionic and narcissistic features. On the other hand, the self-derogating depressive exhibits dependent features, whereas the morbid depressive exhibits masochistic features. Finally, the restive depressive experiences avoidant features. Millon and Davis's variants of DPD encompass practically all possibilities of features with which patients with PD may present. Categorizing patients specifically helps the therapist to decipher interventions and techniques that best meet their needs.

Exploring EFT

Exploring EFT

EFT stands for Emotional Freedom Technique. It works to free the user of both physical and emotional pain and relieve chronic conditions by healing the physical responses our bodies make after we've been hurt or experienced pain. While some people do not carry the effects of these experiences, others have bodies that hold onto these memories, which affect the way the body works. Because it is a free and fast technique, even if you are not one hundred percent committed to whether it works or not, it is still worth giving it a shot and seeing if there is any improvement.

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